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1.
Chinese Journal of School Health ; (12): 713-718, 2021.
Article in Chinese | WPRIM | ID: wpr-877136

ABSTRACT

Objective@#To investigate the smartphone addiction among college students during the Coronavirus Disease 2019 (COVID-19) pandemic and its association with daily behaviors and mental health,and to provide reference for heath education and psychological counseling for college students.@*Methods@#An observational study using online quyestionnaire was conducted among 10 357 college students of two provincial medical schools in Guangdong and Shanxi Province from February 24th to March 4th in 2020. Participants were investigated on demographic information, smartphone addiction, daily routine, physical activity, weight status, anxiety, and other health information. Logistic regression with inverse probability treatment weighting (IPTW) based on propensity score was used to analyze the association between smartphone addiction with daily behavior and mental health.@*Results@#The prevalence of smartphone addiction was 59.42%. The prevalence of phone addiction was higher in postgraduates, senior undergraduates, students with non-medical major, students living in GuangDong and those without regular exercise habit before vacation(χ 2=47.91,17.78,42.75,138.58,P<0.05). With IPTW, there were significant associations between smartphone addiction and late bedtimes (OR=1.82, 95%CI=1.66-1.98) and wake-up times (OR=1.55, 95%CI=1.44-1.68), more sedentary behaviors (OR=1.21, 95%CI=1.12-1.31), less moderate to vigorous physical activity (OR=1.33, 95%CI=1.22-1.44), anxiety (OR=2.98, 95%CI=2.52-3.40), weight gain(OR=1.27,95%CI=1.17-1.37) and other detrimental daily behavior and feelings.@*Conclusion@#High prevalence of smartphone addiction has been observed during the COVID-19 pandemic, with impaired daily behavior and mental health.

2.
Article in Chinese | WPRIM | ID: wpr-884528

ABSTRACT

Objective:To analyze the radiotherapy-related factors affecting the survival of non-small cell lung cancer (NSCLC) patients complicated with malignant pleural effusion (MPE)(MPE-NSCLC).Methods:From 2007 to 2019, 256 patients pathologically diagnosed with MPE-NSCLC received primary treatment. Among them, 117 cases were enrolled in this study. All patients were divided into two groups according to the radiation dose (<63 Gy and≥63 Gy). Propensity score matching (PSM) was performed to further adjust the confounding factors (Calipers value=0.1). The impact of radiotherapy-related factors on the overall survival (OS) was analyzed by Kaplan—Meier method, log-rank test and Cox’s regression model. Results:Primary tumor radiotherapy significantly prolonged the OS ( P<0.001). The radiation dose escalation (36.0-44.1 Gy, 45.0-62.1 Gy, 63.0-71.1 Gy) of primary tumor significantly prolonged the OS ( P<0.001). The corresponding median OS were 5, 13 and 18 months, respectively. Before the PSM, univariate analysis suggested that radiation dose ≥63 Gy, gross tumor volume (GTV)<157.7 cm 3 and stations of metastatic lymph node (S-mlN)≤5 were significantly associated with better OS (all P<0.05) and T 4N 3 was significantly associated with worse OS ( P=0.018). After the PSM, univariate analysis indicated that radiation dose ≥63 Gy was significantly associated with better OS ( P=0.013) and S-mlN ≤5 had a tendency to prolong the OS ( P=0.098). Prior to the PSM, multivariate analysis showed that radiation dose ≥63 Gy was an independent favorable factor of OS ( HR=0.566, 95% CI 0.368-0.871, P=0.010) and GTV<157.7 cm 3 had a tendency to prolong the OS ( HR=0.679, 95% CI 0.450-1.024, P=0.065). After the PSM, multivariate analysis revealed that radiation dose ≥63 Gy was still an independent favorable factor of OS ( HR=0.547, 95% CI 0.333~0.899, P=0.017). No ≥grade 4 radiation toxicity occurred. The incidence rates of grade 3 radiation esophagitis and pneumonitis were 9.4% and 5.1%, respectively. Conclusion:For MPE-NSCLC, radiotherapy dose of primary tumor may play a key role in improving OS on the basis of controllable MPE.

3.
Article in Chinese | WPRIM | ID: wpr-910435

ABSTRACT

Objective:To explore the establishment of radiation-induced heart damage (RIDH) SD rat models caused by irradiation of 15Gy/3f and the changes in early detection indicators, and evaluate the effect of irradiation combined with recombinant human endostatin (Endostar).Methods:75 adult male SD rats were randomly divided into the blank control group (C group), Endostar group (E group), 25Gy irradiation group (MHD 25 group), 15Gy irradiation group (MHD 15 group) and 15Gy irradiation combined with Endostar group (MHD 15+ E group), respectively. Blood sample was taken to measure the CK, CK-MB, LDH and CRP at 24h, 48h and 15d after corresponding interventions. After cardiac echocardiography at 1, 3 and 6 months, 5 rats in each group were randomly sacrificed and myocardial tissues were collected for HE and Masson staining. Two-way ANOVA was employed for statistical analysis. Results:Compared with group C, myocardial fibrosis were observed in the MHD 15 group at 6 months ( P<0.05), which occurred later than that in the MHD 25 group. Ejection fraction (EF) and fractional shortening (FS) were significantly decreased after 3 months in each irradiation group (all P<0.05), whereas the degree of decrease was similar among all groups (all P>0.05). The expression levels of myocardial enzymes and inflammatory cytokines did not significantly differ among different groups (all P>0.05). Conclusions:In the early stage, exposure to 15Gy/3f irradiation can cause cardiac function damage in SD rat hearts, such as the reduction of EF and FS, and even lead to myocardial fibrosis in the late stage, which is delayed and less severe than high-dose irradiation. Irradiation combined with Endostar has no significant effect on radiation myocardial injury in rats.

4.
Article in Chinese | WPRIM | ID: wpr-868709

ABSTRACT

Objective:To explore the changes of CD 8+ T cells in stage Ⅲ-Ⅳ non-small cell lung cancer (NSCLC) patients before and after radiochemotherapy and evaluate its clinical value in predicting survival. Methods:A total of 795 patients with stage Ⅲ-Ⅳ NSCLC who completed CD 8+ T cell testing from January 2011 to December 2017 were recruited (249 patients completed 1-3 tests within 6 months after treatment). The survival difference of patients with different levels of CD 8+ T cells and the prognostic value of the changes in the CD 8+ T cell level were analyzed. The survival analysis was performed by Kaplan- Meier method and log-rank test or univariate analysis. The multivariate survival analysis was conducted by Cox’s regression model. Results:Before treatment, the levels of CD 8+ T cells in the peripheral blood did not significantly differ among patients with different clinical factors. The survival time of stage Ⅲ NSCLC patients with CD 8+ T cell levels of<26.44% was significantly prolonged ( P=0.043). After treatment, the levels of CD 8+ T cells were significantly higher than those before treatment. The levels were similar within 1-3 months, decreased after 4-6 months but still significantly higher than those before treatment. The median survival time of patients with CD 8+ cell levels of<43.90% after treatment was 22 months, significantly longer than 16 months of those with CD 8+ cell levels of ≥43.90%( P=0.032). Stratified analysis demonstrated no significant difference in the survival time at 1 month and 2-3 months after treatment ( P>0.05), whereas the survival time significantly differed at 4-6 months ( P=0.001). The multivariate survival analysis showed that CD 8+ cell levels of<43.90% after treatment was an independent prognostic factor ( HR=0.714, P=0.031). Conclusions:The effect of CD 8+ T cells on prognosis of patients with stage Ⅲ-Ⅳ NSCLC is limited. After treatment, CD 8+ T cell levels are increased significantly. A certain increase in the CD 8+ T cell levels can prolong the survival time. The detection of CD 8+ T cell subtypes plays a more significant role.

5.
Article in Chinese | WPRIM | ID: wpr-868687

ABSTRACT

Objective:To explore the possibility of CD 4+ T cells and CD 4+ /CD 8+ ratio in peripheral blood to predict the survival of patients with stage Ⅳ non-small cell lung cancer (NSCLC), and to establish a Nomogram prediction model. Methods:The influence of CD 4+ T cells and CD 4+ /CD 8+ ratio on the clinical factors and survival of 682 patients pathologically diagnosed with stage Ⅳ NSCLC with no history of cancer treatment was retrospectively analyzed and the Nomogram prediction model was established. Combined with the changes of immune cells levels in 110 patients after treatment, the prognostic and predictive values of CD 4+ T cells and CD 4+ /CD 8+ ratio were verified. Countable data were analyzed by t-test. The survival rate was calculated by Kaplan-Meier method, log-rank test or univariate analysis. The multivariate analysis was performed by Cox regression model. Results:Univariate analysis demonstrated that CD 4+ > 43.15% before treatment significantly prolonged the survival. By multivariate analysis of Cox regression model, CD 4+ >43.15% was an independent prognostic factor to prolong survival for stage Ⅳ NSCLC. The Nomogram model was established and verified that the predicted and actual overall survivals were highly consistent. Further analysis showed that 43.15% as the critical value of CD 4+ T cell level significantly prolonged survival when CD 4+ expressed at a high-level before treatment, after treatment, before and after treatment, or combined with CD 4+ /CD 8+ >1.65. Conclusions:The baseline level of CD 4+ T cells before treatment in peripheral blood is an independent prognostic factor for stage Ⅳ NSCLC. The CD 4+ /CD 8+ ratio before treatment has limited value in predicting the prognosis.

6.
Article in Chinese | WPRIM | ID: wpr-868659

ABSTRACT

Objective:To investigate the primary tumor volume change and timing of radiotherapy for patients with stage Ⅳ non-small cell lung cancer with EGFR mutation during molecular targeted therapy.Methods:Simulated CT scanning measurement and analysis were performed to observe the volume changes of primary tumors before and after treatment with a time interval of 10 days in this prospective study. Positioning and volume measurement were terminated when the volume change was 5% or less between two time points before and after treatment or 90 days after treatment. Primary tumor radiation therapy was then performed, acute radiation-induced injury was recorded, and the implementation and simulation of related parameters of radiotherapy plans were compared.Results:Twenty-nine of 30 cases were included in the analysis (1 case dropped off). After EGFR-TKIs treatment, the volume of all primary tumors was decreased, but the shrinking rate was inconsistent with the speed. Until the last simulated CT scanning, the maximum and minimum shrinking rates were 90% and 28%, respectively. There was no case of termination within 30 days of treatment, and the average tumor volume was significantly decreased within 40 days and the average tumor volume significantly differed every 10 days ( P<0.001). After 40 days, the volume shrinking rate of primary tumors ≤5% gradually appeared, and one patient presented with a volume shrinking rate of >5% on 90 days. During this time, the average volume shrinking rate slowed down and became stable, ranging from 49.15% to 54.77%. Moreover, the average volume continued to gradually shrink after slight increase at 70 days. There was no significant difference in the average volume every 10 days ( P>0.05). After the termination of simulated CT scanning, the dose of primary tumor was (69±7) Gy for patients receiving radiotherapy. Two patients had grade 2 acute radiation-induced pneumonitis and 3 patients had grade 3 acute radiation-induced pneumonitis. In addition, 1 patient had grade 2 radiation-induced esophagitis. According to the technology and dose parameters of radiotherapy plan, simulated radiotherapy plans before and 40 days after EGFR-TKIs treatment were designed. The timing of implementation plan was significantly better than that before EGFR-TKIs treatment (all P<0.05), whereas it was similar to that at 40 days after EGFR-TKI treatment ( P>0.05). Conclusions:The primary tumor shrinking rate is gradually slowed down over time after EGFR-TKIs treatment in patients with stage Ⅳ non-small cell lung cancer. The average tumor volume is significantly decreased within 40 days and then the shrinking rate becomes slow. The tumor shrinking rate of each case is inconsistent. Radiotherapy at 40 days after treatment is probably the optimal timing to obtain high dose and control radiation-induced injury.

7.
Article in Chinese | WPRIM | ID: wpr-868654

ABSTRACT

Objective:To retrospectively analyze the clinical efficacy and safety of three-dimensional radiotherapy for the primary tumors in patients with stage Ⅳ non-small cell lung cancer complicated with malignant pleural effusion (MPE-NSCLC).Methods:A total of 198 patients who were initially pathologically diagnosed with MPE-NSCLC from January 2007 to April 2018 were enrolled and divided into the untreated group ( n=45), drug group ( n=57) and radiotherapy group ( n=96), respectively. The short-term efficacy, overall survival (OS) and adverse events in the drug and radiotherapy groups were analyzed. The OS rate was analyzed by Kaplan-Meier method and log-rank test. Clinical prognosis was evaluated by multivariate Cox′s regression model. Results:In the radiotherapy group, the objective response rate and non-response rate was 54% and 46%, significantly better than 25% and 75% in the drug group ( P=0.007). In the radiotherapy group, the 1-, 2-, 3-, 5-year OS and median survival was 47%, 18%, 6%, 1% and 12 months, remarkably higher than 15%, 3%, 2%, 0% and 5 months in the drug group, respectively (all P<0.001). Multivariate Cox′s regression analysis showed that radiotherapy for the primary tumors was an independent prognostic factor to prolong the OS ( P<0.001). Radiotherapy at a dose of ≥63 Gy and 4-6 cycles of chemotherapy tended to prolong the OS ( P=0.063 and 0.071). The OS of patients with EGFR mutation receiving radiotherapy combined with molecular target therapy was significantly better than that of those with unknown EGFR status treated with radiotherapy and chemotherapy ( P=0.007). Addition of radiotherapy for the primary tumors did not significantly increase the incidence of adverse events ( P>0.05). Conclusion:Addition of three-dimensional radiotherapy for the primary tumors in MPE-NSCLC patients may prolong the OS and yield tolerable adverse events.

8.
Article in Chinese | WPRIM | ID: wpr-868593

ABSTRACT

Objective:The experimental animal model was established to unravel the mechanism of radiation-induced myocardial fibrosis and validate the role of recombinant human endostatin in aggravating the process of radiation-induced myocardial fibrosis via the TGF-β 1, Smad 2 and Smad 3 signaling pathways. Methods:Sixty male adult Sprague-Dawley rats were randomly divided into the following groups: radiotherapy (RT)25 Gy, recombinant human endostatin (RE) 6 mg/kg, RE 12 mg/kg, RT 25 Gy+ RE 6 mg/kg, RT 25 Gy+ RE 12 mg/kg and blank control groups. Five rats were sacrificed in each group at 1 and 3 months after interventions. The myocardial tissues were collected. The pathological changes were observed by Hematoxylin and eosin staining. The degree of fibrosis was assessed by Masson trichrome staining. The expression levels of TGF-β 1, Smad 2, Smad 3 and Collagen-I mRNA and protein were quantitatively measured by real-time PCR and Western blotting. Results:At 3 months after intervention, Masson trichrome staining revealed that the collagen deposition in the RT 25Gy and RT 25Gy+ RE (6 and 12 mg/kg) groups was more significant than that in the control group. In addition, The expression levels of TGF-β 1, Smad 2, Smad 3 and Collagen-I mRNA and protein in these groups were significantly up-regulated compared with those in the control group. Conclusions:Radiation with a total physical dose of 25 Gy can induce myocardial fibrosis in the SD rat models. TGF-β 1 and Smad 2 signaling pathways are the common signaling pathways of myocardial fibrosis induced by radiation combined with recombinant human endostatin.

9.
Article in Chinese | WPRIM | ID: wpr-865918

ABSTRACT

Cardio-oncology has developed into a new subspecialty of modern cardiology, and the clinical mentors usually need to guide students to focus on this frontier field. However, there are many deficiencies in the field of cardio-oncology training in China, and there is a lack of perfect teaching and training objectives and evaluation system. In order to adapt to the goal and orientation of talent training in cardio-oncology, the First Affiliated Hospital of Dalian Medical University adopts a multi-disciplinary teaching mode. Corresponding teaching contents and training objectives are set according to the trainees at different levels of training, and various teaching methods and assessment forms are cooperated to explore and establish the training and assessment system of cardio-oncology for doctors at different levels. The system is put into practice, and the teaching effect is outstanding which has been widely recognized by teachers and students.

10.
China Pharmacy ; (12): 217-220, 2020.
Article in Chinese | WPRIM | ID: wpr-817365

ABSTRACT

OBJECTIVE:To provide reference for safe and rational use of Sodium tanshinone ⅡA sulfonate(STS)injection in the clinic. METHODS :The information of the patients who received STS injection from Jan. 2016 to Dec. 2017 were collected from a Grade 3 hospital. According to relevant suggestions in drug package inserts ,drug utilization rationality was evaluated ,and single-factor and multi-factor analysis on the risk and influential factors for ADR/ADE were performed by group design and individual matching to examine their correlation. RESULTS :Totally 3 283 patients were included in the study. The drug use frequency were less than 1.5,and the drug utilization indexes were less than 1.0,suggesting that the hospital using STS injection was basically reasonable. Irrational use of drugs mainly included that inappropriate indications (46.48%),unreasonable solvent selection(15.84%),and excessive concentration (2.71%). Patients with renal insufficiency received STS injection ,and then the risk of ADR/ADE increased by correlation analysis (P<0.05). CONCLUSIONS :Irrational use of STS injection in clinics existed , mainly like off-label drug use ,excessive concentration ,irrational solvent selection. Drug use evaluation and monitoring should be strengthened. For patients with renal insufficiency ,it is necessary to prevent the occurrence of ADR/ADE .

11.
Acta Pharmaceutica Sinica B ; (6): 397-409, 2019.
Article in English | WPRIM | ID: wpr-774978

ABSTRACT

Hyaluronic acid (HA) is a natural ligand of tumor-targeted drug delivery systems (DDS) due to the relevant CD44 receptor overexpressed on tumor cell membranes. However, other HA receptors (HARE and LYVE-1) are also overexpressing in the reticuloendothelial system (RES). Therefore, polyethylene glycol (PEG) modification of HA-based DDS is necessary to reduce RES capture. Unfortunately, pegylation remarkably inhibits tumor cellular uptake and endosomal escapement, significantly compromising the antitumor efficacy. Herein, we developed a Dox-loaded HA-based transformable supramolecular nanoplatform (Dox/HCVBP) to overcome this dilemma. Dox/HCVBP contains a tumor extracellular acidity-sensitive detachable PEG shell achieved by a benzoic imine linkage. The and investigations further demonstrated that Dox/HCVBP could be in a "stealth" state at blood stream for a long circulation time due to the buried HA ligands and the minimized nonspecific interaction by PEG shell. However, it could transform into a "recognition" state under the tumor acidic microenvironment for efficient tumor cellular uptake due to the direct exposure of active targeting ligand HA following PEG shell detachment. Such a transformative concept provides a promising strategy to resolve the dilemma of natural ligand-based DDS with conflicting two processes of tumor cellular uptake and nonspecific biodistribution.

12.
Article in Chinese | WPRIM | ID: wpr-755093

ABSTRACT

Objective To investigate the effect of primary tumor volume on the survival in the three-dimensional radiotherapy of primary tumors of stage Ⅳ non-small cell lung cancer (NSCLC).Methods Clinical data of 428 patients in a multicenter prospective clinical study from December 2002 to January 2017 were reanalyzed,and 423 of them were subject to survival analyses.Platinum-based doublet chemotherapy was adopted.The median number of chemotherapy cycle was 4,and the critical value of planning target volume (PTV) of primary tumors was 63 Gy.The critical value of gross tumor volume (GTV) of primary tumors was 150 cm3.Results Single factor Cox regression analysis demonstrated that female,KPS score,single organ metastasis,N0-N1 staging,adenocarcinoma,radiotherapy dose ≥63 Gy,4-6 cycles of chemotherapy,recent effectiveness,post-treatment progress in taking targeted drugs and GTV< 150 cm3 were good prognostic factors for the patients with stage Ⅳ NSCLC (all P<0.05).According to the stratified analysis of different radiotherapy regimes,for the stage Ⅳ NSCLC patients with a GTV ≥ 150 cm3,the survival rate of the primary tumor radiotherapy dose ≥ 63 Gy on the basis of systemic chemotherapy was significantly better than that of the primary tumor radiotherapy dose <63 Gy (P<0.05).Conclusions Stage Ⅳ NSCLC patients with GTV ≥ 150 cm3 in 4-6 cycles of chemotherapies combined with primary tumor radiotherapy dose ≥ 63 Gy and GTV< 150 cm3 in 1-3 cycles of chemotherapies combined with primary tumor radiotherapy dose ≥63 Gy may prolong the overall survival of patients with stage Ⅳ NSCLC.

13.
Article in Chinese | WPRIM | ID: wpr-734315

ABSTRACT

Objective To investigate the impact of the changes of posttreatment karnofsky performance status (KPSpost) on the overall survival (OS) for patients with stage Ⅳ non-small cell lung cancer (NSCLC) underwent concurrent chemoradiation.Methods A total of 279 patients (male 198 and female 81) with histological confirmed stage Ⅳ NSCLC were enrolled in this study with a median age of 58 years old (range 22 to 80 years old).There were 166 cases of squamous carcinoma,87 cases of adenocarcinoma,and 22 cases of unclassified carcinoma,respectively.All enrolled patients received more than 2 cycles of chemotherapy and more than 36 Gy of concurrent radiotherapy.Kaplan-Meier method and Log-rank test were applied to evaluate OS.Multivariate analyses were carried out by the Cox proportionalhazard model.Chi-square test and logistic regression analysis were used to explore the related factors of KPSpost.Results There were 198 patients with improved KPSpost and 81 patients with decreased KPSpost,respectively.Univariate and multivariate analyses indicated that the improvement of KPSpost was associated with longer OS.Logistic regression analysis showed that the improvement of KPSpost was positively related with treatment of more than 4-6 cycles chemotherapy concurrent with over 63 Gy radiation to primary tumor.The improvement of KPSpost also correlated positively with disease control rate (DCR),but negatively with PLT toxicity and radiation esophagitis.Conclusions KPSpost was an independent prognostic factor of OS for patients with stage Ⅳ NSCLC underwent concurrent chemoradiation.Chemotherapy of 4-6 cycles and concurrent over 63 Gy radiotherapy dose to primary tumor,as well as DCR were positive factors for KPSpost improvement.However,stage 3-4 PLT toxicities and radiation esophagitis decreased the KPSpost.

14.
Article in Chinese | WPRIM | ID: wpr-797679

ABSTRACT

Objective@#To investigate the effect of primary tumor volume on the survival in the three-dimensional radiotherapy of primary tumors of stage Ⅳ non-small cell lung cancer (NSCLC).@*Methods@#Clinical data of 428 patients in a multicenter prospective clinical study from December 2002 to January 2017 were reanalyzed, and 423 of them were subject to survival analyses. Platinum-based doublet chemotherapy was adopted. The median number of chemotherapy cycle was 4, and the critical value of planning target volume (PTV) of primary tumors was 63 Gy. The critical value of gross tumor volume (GTV) of primary tumors was 150 cm3.@*Results@#Single factor Cox regression analysis demonstrated that female, KPS score, single organ metastasis, N0-N1 staging, adenocarcinoma, radiotherapy dose ≥63 Gy, 4-6 cycles of chemotherapy, recent effectiveness, post-treatment progress in taking targeted drugs and GTV<150 cm3 were good prognostic factors for the patients with stage Ⅳ NSCLC (all P<0.05). According to the stratified analysis of different radiotherapy regimes, for the stage Ⅳ NSCLC patients with a GTV ≥150 cm3, the survival rate of the primary tumor radiotherapy dose ≥63 Gy on the basis of systemic chemotherapy was significantly better than that of the primary tumor radiotherapy dose <63 Gy (P<0.05).@*Conclusions@#Stage Ⅳ NSCLC patients with GTV≥150 cm3 in 4-6 cycles of chemotherapies combined with primary tumor radiotherapy dose ≥63 Gy and GTV<150 cm3 in 1-3 cycles of chemotherapies combined with primary tumor radiotherapy dose ≥63 Gy may prolong the overall survival of patients with stage Ⅳ NSCLC.

15.
Article in Chinese | WPRIM | ID: wpr-862120

ABSTRACT

Objective: To investigate the clinical efficacy and prognostic factors of mechanical thrombectomy in treatment of acute posterior circulation ischemic stroke. Methods: Totally 15 patients with acute posterior circulation ischemic stroke were treated with mechanical thrombectomy. The successful recanalization rate and adverse reactions (such as intracerebral hemorrhage and infarction) within 24 hours after operation were observed. The prognosis was evaluated with modified Rankin scale (mRS) at 3 months for follow-up. The general data and the related indexes of treatment were compared between patients with good prognosis (mRS scores 0-2) and poor prognosis (mRS scores 3-6). Results: The occluded vessels were recanalized successfully in all 15 patients (15/15, 100%). Within 24 hours after operation, 1 case occured cerebral hemorrhage, 5 cases had massive cerebral infarction. After 3 months, 9 patients had good prognosis and 5 patients had poor prognosis, 1 patient died. Compared with patients with poor prognosis, patients with good prognosis had shorter time from onset to admission (t=-2.435, P=0.030), higher posterior circulation-Alberta stroke prognosis early CT score (pc-ASPECTS) at admission (t=5.925, P<0.001) and lower National Institute of Health stroke scale (NIHSS) score before operation (t=3.053, P=0.009). Conclusion: Intra-arterial mechanical thrombectomy is a safe and effective technique for treatment of acute posterior circulation ischemic stroke. Time from onset to admission, NIHSS score and pc-ASPECTS before operation are prognostic factors.

16.
Article in Chinese | WPRIM | ID: wpr-745293

ABSTRACT

Objective To analyze the survival and toxicity after concurrent chemoradiotherapy in patients of different ages with stage Ⅳ non-small cell lung cancer (NSCLC).Methods Clinical data of 282 NSCLC patients in two prospective studies were retrospectively analyzed,who completed the protocol (at least 2 cycles of chemotherapy and thoracic radiation doses of ≥36 Gy).Among them,44 patients were assigned into in the young group (≤ 45 years old),161 patients in the middle-age group (46-64 years old) and 77 patients in the elderly group (≥ 65 years old).The clinical characteristics of patients among different groups were analyzed by x2 test.The overall survival (OS) was calculated by Kaplan-Meier method.Stratified analysis was performed by Log-rank test.Multi-factor prognosis analysis was conducted by Cox's proportional hazards regression model.Results The incidence of NSCLC in the male patients in the elderly group was higher than that in the middle-age and young groups.The 1-,2-,3-and 5-year OS did not significantly differ among different groups (P=0.810).The OS did not significantly differ among patients of the same gender,pathological type,T stage,N stage,metastasis status,same chemotherapy cycle,primary tumor dose and comprehensive treatment and short-term response (all P>0.05).The incidence of adverse events did not considerably differ among different groups.Multivariate analysis demonstrated that age was not an independent factor for survival (P> O.05).Conclusion Patients of different ages with stage Ⅳ NSCLC obtain similar survival benefits and adverse events after concurrent chemoradiotherapy.

17.
Pakistan Journal of Medical Sciences. 2018; 34 (2): 440-445
in English | IMEMR | ID: emr-198640

ABSTRACT

Objective: We aimed to evaluate the clinical effects of Taylor spatial frame [TSF] on tumors and tumor-like lesions complicated with pathological fractures of the lower extremities


Methods: Eighty-two patients admitted from September 2013 to January 2015 were selected. Forty-two cases were included in Group-A to receive TSF fixation and forty were included in Group-B to receive locking plate fixation. The surgical time, intraoperative blood loss, postoperative healing rate of primary incision, incidence rate of complications, hospitalization stay length, and fracture healing time as well as rate of excellent and good Enneking scores one year after surgery were compared


Results: The intraoperative blood losses of Group-A and Group-B were [150.0+/-6.5] ml and [201.9+/-7.4] ml respectively [P<0.05]. The surgical times were [77.3+/-8.9] minutes and [96.5+/-5.9] minutes respectively [P<0.05]. The postoperative rates of complications in the two groups [4.76% vs. 10.00%] were similar [P>0.05]. The primary incision healing rates of Group-A and Group-B were 97.62% and 82.50% respectively. The hospitalization stays were [15.7+/-0.9] days and [15.2+/-0.7] days respectively [P>0.05]. The fracture healing times were [30.1+/-2.1] weeks and [32.4+/-2.2] weeks respectively [P<0.05]. The rate of excellent and good Enneking scores one year after surgery was 97.61% in Group-A and 95.00% in Group-B [P>0.05]


Conclusions: Tumors and tumor-like lesions complicated with pathological fractures of the lower extremities can be effectively treated by TSF

18.
Chinese Journal of Microsurgery ; (6): 236-238, 2018.
Article in Chinese | WPRIM | ID: wpr-711659

ABSTRACT

Objective To explore the emergency strategy of microsurgical replantation to open degloving injuries in plantar soft tissue.Methods From July,2013 to July,2017,5 patients with plantar degloving injury were treated by micro-replantation,3 of which were injuried by traffic accident and 2 caused by crashed injury.After early debridement,4 cases received anastomosis of blood vessels,and 1 treated with Venous Autograft to get recovery of blood circulation.The avulsion flaps were sutured without tension.Results Four flaps survived after plantar replantation,and 1 developed a partial necrosis and secondery repaird with skin graft.The plantar repair made sensory function preserved in the maximum extent.All patients were followed-up for 0.5-2.0 years.The appearance,elasticity and feel of flaps was good.Conclusion Complete debridement,early recovery of blood supply and maximum preservation of plantar tissue function should be the key to successful replantation of open plantar degloving injuries.

19.
Article in Chinese | WPRIM | ID: wpr-708236

ABSTRACT

Objective To evaluate the clinical efficacy and toxicity of concurrent pemetrexed-cisplatin (PP) or docetaxel-cisplatin (DP) with intensity-modulated radiation therapy (IMRT) in patients with stageⅠV lung adenocarcinoma. Methods Stage IV lung adenocarcinoma patients with unknown EGFR mutation status or wild-type admitted to Guizhou Cancer Hospital from 2011 to 2016 were randomly assigned into the PP (n=50) and DP groups (n=51).All patients received concurrent IMRT of the chest at a prescription dose of 60-70 Gy. Primary endpoint was 1-year survival rate, and secondary endpoint was acute toxicity. Results The overall response rate was 68. 0% and 72. 5% in the PP and DP groups (χ2=0. 250, P=0. 617) . The median survival time was 19. 6 months ( 95%CI 13. 9-25. 3) versus 12. 1 months ( 95%CI 10. 7-13. 5) in the PP and DP groups. The 1-, 2-and 3-year overall survival rates were 72. 0% versus 52. 9%, 28. 0% versus 17. 6%, and 16. 0% versus 13. 7%, respectively in the PP and DP groups ( P=0. 049) . In the PP and DP groups, the incidence of grade 3-4 leukopenia was declined by 48% and 63%( P=0. 098) , and the incidence of grade 3-4 neutropenia was decreased by 34% and 65%( P=0. 002) , the incidence of grade 3-4 anemia was reduced by 38% and 10%(P=0. 024), and the incidence of grade 3-4 thrombocytopenia was declined by 40% and 14%( P=0. 003) . The incidence rate of grade 2 pneumonitis ( P=0. 625) and grade 3 esophagitis ( P=0. 484) were similar in both groups. No patients experienced ≥grade 3 pneumonitis or ≥ grade 4 radiation esophagitis. Conclusions Pemetrexed-cisplatin combined with chemoradiotherapy yields higher clinical efficacy compared with docetaxel-cisplatin plus concurrent chemoradiation in the treatment of stageⅠV lung adenocarcinoma. The incidence of radiation pneumonitis and esophagitis is similar. The incidence and severity of hematological toxicity does not significantly differ between two groups.Treatment-related toxicity is tolerable in both groups. Clinical Trial Registration Chinese Clinical Trial Registry ( ChiCTR-TRC-13004184) .

20.
Article in Chinese | WPRIM | ID: wpr-694356

ABSTRACT

Objective To investigate the effect of ulinastatin on myocardial injury in rats with sepsis.Methods Thirty male SD rats were randomly (random number) divided into 3 groups:sham operation group (Sham group,n=10),sepsis group (sepsis group,n=10) and ulinastatin group (UTI group,n=10).The sepsis model of the rats was subjected to cecal ligation and puncture (CLP).Rats of UTI group were given 200 000 U/kg ulinastatin at 6 hour after modeling,and dosing was repeated every 12 h.Blood samples were collected from inferior vena cava at 6,12,24,36 h after modeling for determination of cardiac troponin-Ⅰ (cTnI) and the inflammatory factor by ELISA,then the rats were sacrificed and hearts were removed for myocardial tissue stained with hematoxylin eosin (HE) staining,the expression of Bax/Bcl-2 protein level and myocardial cell apoptosis were detected by TUNEL.The level of caspase-3 protein in myocardial tissue was detected by Western-blot.Results The level of cTnI (ng/mL) in serum in UTI group at 6,12,24 and 36 h after modeling were significantly lower compared with sepsis group(P<0.05).The protein expression levels of TNF-α and IL-6 (ng/mL) in group UTI were higher than those in Sham group,but was significantly lower than those in Sepsis group (P<0.05).HE staining showed that inflammatory cell infiltration present in myocardial cells,edema and vacuole formation were observed in sepsis group,while those were significantly attenuated in UTI group compared with sepsis group.UTI increased the level of myocardial Bcl-2 protein in the rats (P<0.05),and reduced the level of myocardial Bax protein (P<0.05).TUNEL and HE staining showed apoptosis cells in UTI group was significantly reduced compared with sepsis group [(32.2±4.8)% vs.(58.4±5.6)%,P<0.05];Western-blot method showed the level of Caspase-3 protein in UTI group was higher than that in group sham (0.32±0.048) vs.(0.12±0.03),P<0.05],but significantly lower than that of Sepsis group [(0.32±0.048) vs.(0.55±0.052),P<0.05].Conclusions Ulinastatin can reduce proinflammatory mediators release in the blood of sepsis rats,and inhibit the apoptosis of myocardial cells protecting myocardial cells through the regulation of the Caspase-3 pathway during sepsis.

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