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Objective To study the sexual behavioral characters of HIV-positive men who have sex with men(MSM) with different age group and different sexual orientation. Mehtods A total of 321 newly-diagnosed HIV-positive MSM were selected by convenience sampling from January 2016 to February 2019 in Wuhan Jingyingtan Hospital. All the interviews were performed by doctors one by one and face by face. Spss 23.0 software was used to analyse the difference of sexual behavioral characters in different age groups and sexual orientations. Results Among 321 MSM patients , 44.24% were ≤35 years, 33.02% were 36-59 years, 22.74% were ≥60 years. Homosexuality accounted for 44.86%, bisexuality 20.25%, heterosexuality were 24.30%, and other sexual orientation accounted for 10.59%. Internet was the main way for ≤35 years old group to look for fixed partners, while friends, colleagues and classmates were the main way for 36-59 years old group and ≥60 years old group. There was significant difference in the ways of looking for partners among different age groups(χ2=136.50,P=0.00). The main way for ≤35 years old and 36-59 years old group to find temporary partners was internet, and the main way for ≥60 years old group to find temporary partners was from friends, colleagues and classmates, there was a significant difference in different age groups in the way to find temporary partners(χ2=69.66,P=0.00). The age of first male sexual activity was the lowest in homosexual MSM cases, followed by bisexual MSM cases, and the highest in heterosexual MSM cases. The age of first male sexual activity was significantly different in different homosexual orientation MSM cases (F=32.52,P=0.00). Conclusion When taking intervention measures, the sexual behavior difference in different age groups and different sexual orientations should be considered.
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Objective: To reassess the predictors for response at 6 months in patients with severe or very severe aplastic anemia (SAA/VSAA) who failed to respond to immunosuppressive therapy (IST) at 3 months. Methods: We retrospectively analyzed the clinical data of 173 patients with SAA/VSAA from 2017 to 2018 who received IST and were classified as nonresponders at 3 months. Univariate and multivariate logistic regression analysis were used to evaluate factors that could predict the response at 6 months. Results: Univariate analysis showed that the 3-month hemoglobin (HGB) level (P=0.017) , platelet (PLT) level (P=0.005) , absolute reticulocyte count (ARC) (P<0.001) , trough cyclosporine concentration (CsA-C0) (P=0.042) , soluble transferrin receptor (sTfR) level (P=0.003) , improved value of reticulocyte count (ARC(△)) (P<0.001) , and improved value of soluble transferrin receptor (sTfR(△)) level (P<0.001) were related to the 6-month response. The results of the multivariate analysis showed that the PLT level (P=0.020) and ARC(△) (P<0.001) were independent prognostic factors for response at 6 months. If the ARC(△) was less than 6.9×10(9)/L, the 6-month hematological response rate was low, regardless of the patient's PLT count. Survival analysis showed that both the 3-year overall survival (OS) [ (80.1±3.9) % vs (97.6±2.6) %, P=0.002] and 3-year event-free survival (EFS) [ (31.4±4.5) % vs (86.5±5.3) %, P<0.001] of the nonresponders at 6 months were significantly lower than those of the response group. Conclusion: Residual hematopoietic indicators at 3 months after IST are prognostic parameters. The improved value of the reticulocyte count could reflect whether the bone marrow hematopoiesis is recovering and the degree of recovery. A second treatment could be performed sooner for patients with a very low ARC(△).
Subject(s)
Anemia, Aplastic/drug therapy , Antilymphocyte Serum/therapeutic use , Cyclosporine/therapeutic use , Humans , Immunosuppression Therapy , Immunosuppressive Agents/therapeutic use , Prognosis , Receptors, Transferrin/therapeutic use , Retrospective Studies , Treatment OutcomeABSTRACT
Objective: To evaluate the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOAC) in patients with atrial fibrillation (AF) and hypertrophic cardiomyopathy (HCM). Methods: This study was a prospective cohort study. The data of this study were based on the Chinese Atrial Fibrillation Registry (CAFR) Study, which was a prospective, multicenter registry study. The CAFR Study enrolled inpatients and outpatients with AF from 31 hospitals. Patients with AF and HCM were selected from August 2011 to December 2018. The patients were divided into NOAC-treated group and warfarin-treated group. General clinical data, echocardiographic results and treatment options were collected and compared between the two groups. Patients were followed up every 6 months; outcome events included effective endpoint events(thromboembolism)and safety endpoint events(major bleeding). The incidence of endpoint events in both groups was calculated and compared. Cox proportional hazards regression models and Kaplan-Meier survival analysis were performed to determine the association between NOAC use and endpoint events. Results: A total of 393 patients were included (average age: (60.5±11.8) years, 252 men (64.1%)). There were 133 (34.0%) patients in the NOAC-treated group and 260 (66.0%) patients in the warfarin-treated group. Compared with the warfarin-treated group, the patients in the NOAC-treated group had a higher proportion of paroxysmal AF, catheter ablation of AF, a lower proportion of hypertension, ischemic stroke/transient ischemic attack (TIA), lower heart rate, lower usage rate of angiotensin-converting enzyme inhibitors(ACEI)/angiotensin receptor blockers(ARB), β-blockers, non-dihydropyridine calcium channel blockers(NDH-CCB)(P<0.05). There were no significant differences on the echocardiographic results, including interventricular septal thickness, left ventricular posterior wall thickness, left ventricular end-diastolic diameter, left atrial diameter, left ventricular ejection fraction(P>0.05). After a follow-up of 42 (24, 60)months, the incidence rates of thromboembolism were 1.63 and 2.10 events per 100 person-years for NOAC-and warfarin-treated group, and those of major bleeding were 0.66 and 1.03 events per 100 person-years. Kaplan-Meier survival analysis showed survival rates free from endpoint events were similar between NOAC-treated group and warfarin-treated group(thromboembolism-free survival comparison, P=0.476; major bleeding-free survival comparison, P=0.855). Cox multivariate regression analysis revealed that there was no significant difference on risk of thromboembolism(HR=1.21, 95%CI: 0.42-3.50, P=0.720) and major bleeding(HR=1.50, 95%CI: 0.27-8.41, P=0.642) between NOAC-treated and warfarin-treated group. Conclusion: Patients with AF and HCM can be safely and effectively treated with NOAC.
Subject(s)
Administration, Oral , Aged , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Anticoagulants/therapeutic use , Atrial Fibrillation/drug therapy , Cardiomyopathy, Hypertrophic/drug therapy , Humans , Male , Middle Aged , Prospective Studies , Stroke , Stroke Volume , Treatment Outcome , Ventricular Function, LeftABSTRACT
Objective:To investigate the effect of multicomponent training on nutritional status and muscle function in older adults with frailty syndrome.Methods:A total of 120 elderly patients with frailty syndrome of Elderly Diagnosis and Treatment and Physical Examination Center,Jiangsu Provincial People′s Hospital from June 2018 to December 2019 were randomly divided into observation group and control group, each contained 60 cases. The control group received routine nursing care. On the basis of these, the observation group was given multicomponent training. The nutritional status, frailty status and muscle function were compared between two groups before and after 12 weeks of intervention.Results:Before intervention, there was no significant difference in the nutritional status, degree of frailty and muscle function between the two groups ( P>0.05). After intervention, the protein, skeletal muscle and total plasma protein, serum albumin, serum prealbumin and transferrin were (7.55 ± 1.34) kg, (21.37 ± 2.41) kg, (61.97 ± 5.69) g/L, (229.05 ± 17.67)mg/L, (42.14 ± 4.83) g/L, (2 364.29 ± 296.31) mg/L in the observation group, significantly higher than those in the control group (6.92 ± 0.97) kg, (20.31 ± 2.04) kg, (57.96 ± 5.22) g/L, (210.15 ± 27.99) mg/L, (37.66 ± 5.75) g/L, (2 247.42 ± 267.39) mg/L, the differences were statistically significant ( t values were 2.19-4.47, P<0.05). After intervention, the scores of physical, psychological and total frailty were 6.03 ± 0.71, 2.46 ± 0.73, 9.63 ± 0.99 in the observation group, significantly higher than in the control group (6.45 ± 0.95) pionts, (2.71 ± 0.52) pionts, (10.34 ± 1.20) pionts, the differences were statistically significant ( t=2.67, 2.02, 3.39, P<0.05). After intervention, the side-by-side, full-tandem, 4-m walk, repeated chair stands scores and total Short Physical Performance Battery (SPPB) scores were (0.87 ± 0.28) pionts, (1.65 ± 0.29) pionts, (2.09 ± 0.47) pionts, (1.93 ± 0.49) pionts, (7.36 ± 0.75) pionts, those socres were (0.72 ± 0.31) pionts, (1.50 ± 0.31) pionts, (1.87 ± 0.61) pionts, (1.70 ± 0.62) pionts, (6.55 ± 0.89) pionts in the control group, the differences were statistically significant ( t values were 2.16-5.18, P<0.05). Conclusions:Multicomponent training can improve the nutritional status and muscle function and delay the progress of frailty in elderly in elderly patients.
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Multiple myeloma (MM) is a kind of hematologic malignancy occurring in plasma cells. Cytogenetic technique plays an important role in risk stratification of MM. 1q21 amplification is one of the common chromosomal abnormalities in MM. Studies have shown that 1q21 amplification is associated with poor prognosis in MM patients. At present, with the development of new drugs, cellular immunotherapy, and improvement of hematopoietic stem cell transplantation technology, the remission depth and survival time of MM significantly increased. Rapid and accurate identification of high-risk patients and individualized treatment according to the patient's condition is the key to improve the therapeutic effect of MM. This article reviews the mechanism of 1q21 amplification in MM and the efficacy of new drugs in the treatment of MM with 1q21 chromosome amplification.
Subject(s)
Chromosome Aberrations , Chromosomes , Chromosomes, Human, Pair 1/genetics , Hematopoietic Stem Cell Transplantation , Humans , Multiple Myeloma/drug therapy , PrognosisABSTRACT
Objective@#SET8 is a member of the SET domain-containing family and the only known lysine methyltransferase (KMT) that monomethylates lysine 20 of histone H4 (H4K20me1). SET8 has been implicated in many essential cellular processes, including cell cycle regulation, DNA replication, DNA damage response, and carcinogenesis. There is no conclusive evidence, however, regarding the effect of SET8 on radiotherapy. In the current study we determined the efficacy of SET8 inhibition on radiotherapy of tumors and the underlying mechanism.@*Methods@#First, we explored the radiotherapy benefit of the SET8 expression signature by analyzing clinical data. Then, we measured a series of biological endpoints, including the xenograft tumor growth in mice and apoptosis, frequency of micronuclei, and foci of 53BP1 and γ-H2AX in cells to detect the SET8 effects on radiosensitivity. RNA sequencing and subsequent experiments were exploited to verify the mechanism underlying the SET8 effects on radiotherapy.@*Results@#Low expression of SET8 predicted a better benefit to radiotherapy in lung adenocarcinoma (LUAD) and invasive breast carcinoma (BRCA) patients. Furthermore, genetic deletion of SET8 significantly enhanced radiation treatment efficacy in a murine tumor model, and A549 and MCF7 cells; SET8 overexpression decreased the radiosensitivity. SET8 inhibition induced more apoptosis, the frequency of micronuclei, and blocked the kinetics process of DNA damage repair as 53BP1 and γ-H2AX foci remained in cells. Moreover, RNF8 was positively correlated with the SET8 impact on DNA damage repair.@*Conclusion@#Our results demonstrated that SET8 inhibition enhanced radiosensitivity by suppressing DNA damage repair, thus suggesting that SET8 potentiated radiotherapy of carcinomas. As new inhibitors of SET8 are synthesized and tested in preclinical and clinical settings, combining SET8 inhibitors with radiation warrants consideration for precise radiotherapy.
Subject(s)
Animals , Apoptosis , Carcinogenesis , Carcinoma/radiotherapy , Cell Cycle , Cell Line, Tumor , DNA Damage , DNA Replication , HeLa Cells , Histone-Lysine N-Methyltransferase , Humans , Mice , RadiotherapyABSTRACT
Objective:To study the effect of social support on depression-posttraumatic stress disorder(PTSD) comorbidity among people living with human immunodeficiency virus/acquired immunodeficiency syndrome(PLWHA).Methods:Using questionnaire to one-to-one investigate the newly-diagnosed PLWHA in Wuhan Jingyintan Hospital HIV/AIDS clinic from October 2016 to February 2019. The content of the questionnaire included general demographic characteristics, HIV-related high-risk behaviors before diagnosis, social support, depression and PTSD.Patients with depression and PTSD were collected as P+ D group.Patients without depression or PTSD were collected as N group. The statistical software was SPSS 21.0. Chi-square test, t test and rank sum test were used to compare the differences between the two groups, and multivariate Logistic regression analysis was used to identify the influencing factors of depression combined with PTSD. Results:Among 320 PLWHA, 72 subjects(22.50%) had depression with PTSD(P+ D group), 161 subjects(50.31%) had neither depression nor PTSD(N group). Between the two groups, the differences of constituent ratios of gender(χ 2=9.84), routes of infection(χ 2=11.16), whether ever used drug(χ 2=30.00)were statistically significant(all P<0.05). There were statistically significant differences in the scores of social support((30.64±10.90) vs (25.51±8.55)), objective social support((7.20±3.08) vs (5.76±2.24)), subjective social support((16.70±6.87) vs (14.04±5.61)) and utility of social support((6.74±2.59) vs (5.71±2.60)( t=3.56, 3.57, 2.88, 2.81, all P<0.05). The results of Logistic analysis revealed that gender as male( β=-1.48, OR= 0.23, 95% CI=0.09-0.61) was protective factor for depression co-occuring with PTSD, while lower level of social support ( β=1.40, OR=4.05, 95% CI=1.36-12.10) was a risk factor. Conclusion:The prevalence of depression co-occuring with PTSD in PLWHA is high. The influence of gender and social support should be paid more attention to PLWHA.
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Objective:To evaluate the detection of copy number variation (CNV) by chromosome microarray analysis (CMA) in fetuses with congenital anomalies of the kidney and urinary tract (CAKUT).Methods:A total of 1 929 fetuses who were ultrasonically found with CAKUT and underwent CMA from Guangdong Women and Children's Hospital and Health Institute were enrolled in this retrospective study from January 2016 to July 2020. These fetuses were divided into isolated CAKUT group ( n=1 567), CAKUT with soft markers group ( n=269), and CAKUT with other structural anomalies group ( n=93) for comparing the detection rate of pathogenic CNV using Chi-square test or Fisher exact test. Results:(1)The detection rate of all and pathogenic CNVs were 6.5%(125/1 929) and 4.8%(93/1 929), respectively. The total detection rate of CNV, clinically significant CNV and large chromosome structural variations in the CAKUT with other structural anomalies group were higher than those of the CAKUT with soft markers group and isolated CAKUT groups[31.2%(29/93), 11.5%(31/269) vs 4.2%(65/1 567), χ2=119.002; 18.3%(17/93), 9.0%(24/269) vs 3.6%(56/1 567), χ2=49.677; 9.7%(9/93), 2.2%(6/269) vs 0.3%(4/1 567), χ2=42.727; all P<0.001]. CAKUT with other structural anomalies group had a higher detection rate of pathogenic CNV (18.3%, 17/93) than the CAKUT with soft markers group (8.6%, 23/269) and the isolated CAKUT group [3.4%(53/1 567)] ( χ2=51.932, P<0.001). (2) The detection rate of pathogenic CNV was the highest in fetuses with enhanced renal echo (14.7%, 23/156), followed by renal enlargement (8.2%, 5/61), renal dysplasia (5.0%,13/261), polycystic renal dysplasia (5.0%, 13/261), and hydronephrosis (4.8%, 20/413). Fetuses with polycystic renal dysplasia, renal agenesis, fused kidney and hydronephrosis in the CAKUT with other structural anomalies group had a higher detection rate of pathogenic CNV than those in the isolated CAKUT group [3/9 vs 3.5%(8/230), 2/17 vs 1.3%(3/237), 1/8 vs 0.0%(0/59) and 3/18 vs 3.4%(12/344), all P<0.017]. The CAKUT with other structural anomalies group had a higher detection rate of pathogenic CNV than CAKUT with soft markers group in fetuses with enhanced renal echo [4/8 vs 12.8%(5/39), P<0.017]. (3) The top three microdeletion/microduplication syndrome were 17q12 microdeletion syndrome (36.6%, 34/93), 22q11.2 microdeletion syndrome (23.7%, 22/93), and 16p11.2 microdeletion syndrome (7.5%, 7/93) among those with pathogenic CNV. Conclusions:The risk of CNV in fetuses with isolated CAKUT, CAKUT with soft markers, and CAKUT with additional structural anomalies increased progressively. CMA might be a better choice in fetuses with hydronephrosis, enhanced renal echo, renal enlargement, renal hypoplasia, and multicystic renal dysplasia to improve the detection rate of CNV.
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Objective:To investigate the power and prenatal diagnosis strategies of cell-free fetal DNA (cffDNA) testing for chromosomal aneuploidy screening apart from trisomy-13/18/21.Methods:This study collected the clinical data of three cases at high risk of trisomy-16 indicated by cffDNA testing in Hunan Provincial Maternal and Child Health Care Hospital from March 2019 to March 2020. Results of the conventional G-banding karyotype analysis of amniotic fluid, single nucleotide polymorphism array (SNP-array) and low-coverage massively parallel copy number variation sequencing (CNV-seq) of placenta/fetal skin samples were analyzed.Results:(1) cffDNA testing results suggested that case 1-3 were at high risk of trisomy-16 and the Z values of chromosome 16 were 20.57, 24.88 and 17.87, respectively. (2) Karyotype analysis of amniotic fluid samples did not identify any abnormalities in Case 1 and 2, while SNP-array revealed a 19.2 Mb and 23.0 Mb heterozygous deletion at 16p13.3p12.3 and 16q22.1q24.3 in Case 1, and a 16.0 Mb loss of heterozygosity at 16q22.3q24.3 in Case 2. Case 3 had a mosaicism karyotype of 47,XY,+16[3]/46,XY[97] and SNP-array analysis showed no heterozygous deletion greater than 5 Mb or copy number variation. (3) Ultrasonography indicated fetal growth restriction in Case 1 and 2 and fetal death in Case 3. All three pregnancies were terminated. CNV-seq analysis of placental tissue in the center of both fetal and maternal side revealed mosaic trisomy 16, with the copy numbers of chromosome 16 of 2.56/2.70, 2.73/2.82, 2.80/2.81, respectively. However, no copy number variation was detected in Case 1 or 2 by CNV-seq analysis of fetal skin tissues. Conclusions:cffDNA testing has a certain power in detecting trisomy-16 apart from trisomy-13/18/21. For high-risk cases of trisomy-16 indicated by cffDNA testing, SNP-array analysis combined with karyotype analysis is suggested to rule out low-level mosaicism and loss of heterozygosity.
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The aim of this paper was to investigate the preventive and therapeutic effects of Xiaoer Feike Granules(XEFK) on chronic bronchitis in rats and its mechanism. Except for 10 rats in the blank group, the remaining 50 of the 60 SD rats were used to establish a model of chronic bronchitis induced by LPS. On the 22 nd day, the model rats were randomly divided into 5 groups according to their body weight, and administrated with purified water, Keteling Capsules 0.11 g·kg~(-1), XEFK 3.2, 1.6 and 0.8 g·kg~(-1)(the dosing concentrations were 0.32, 0.16, 0.08 g·mL~(-1), respectively). These rats took the corresponding drug orally once a day, for consecutive 21 days. The rats were anesthetized 1 hour after the last administration, and the lavage bronchus and alveoli were collected. Then, after the fixation of the smear, neutrophils were counted microscopically, and the contents of glutathione peroxidase(GSH-Px), superoxide dismutase(SOD) and malondialdehyde(MDA) in the bronchoalveolar lavage fluid(BALF) were detected by colorimetric method. Flow cytometry was used to detect the content changes of T cell subsets CD4~+, CD8~+, CD4~+/CD8~(+ )in serum. Hemorheology related indexes were detected by automatic hemorheology. Enzyme-linked immunosorbent assay(ELISA) was used to detect the contents of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), IL-2, IL-6 and IL-10 in serum. The expression of TNF-α and IL-10 mRNA in lung was detected by Real-time quantitative PCR(RT-qPCR). HE staining was used to observe the pathological changes in the bronchitis tissues. Compared with the model group, XEFK high and medium dose groups could significantly reduce the contents of neutrophils and MDA in bronchial lavage fluid, and increase the activities of GSH-Px and SOD in BALF, and repair the chronic inflammatory cell infiltration and lymphoid tissue hyperplasia in the bronchial mucosal layer and submucosal layer. The high-dose group could reduce the plasma viscosity of rats, but there was no statistical difference in other hemorheological indexes. CD4~+, CD8~+, CD4~+/CD8~+, IL-2 and IL-10 contents in each dose group were significantly increased, and TNF-α, IL-1β and IL-6 contents were significantly decreased in serum. Each dose group could significantly down-regulate the expression level of TNF-α mRNA in the lung and increase the expression of IL-10 mRNA. XEFK could reduce lipid peroxidation, increase the content of peripheral blood T cell subsets, regulate the release and secretion of inflammatory factors, and repair the morphological and pathological changes of bronchial tissue. Its mechanism might be related to the improvement of inflammatory response and the enhancement of immune function.
Subject(s)
Animals , Bronchitis, Chronic/drug therapy , Drugs, Chinese Herbal/pharmacology , Glutathione Peroxidase , Lipopolysaccharides , Lung , Rats , Rats, Sprague-Dawley , Tumor Necrosis Factor-alphaABSTRACT
The cultivation of interdisciplinary talents for life science is still in the state of exploration. The 4I training mode includes four key elements, interdisciplinary course setting, integration of cross project, instruction and administration across whole research and innovational evaluation at the end. Based on the 4I training mode, systematic and targeted design and arrangement would enhance the training level of interdisciplinary talents of life science in universities.
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Objective: To explore the possibility of using artificial intelligence (AI) technology based on convolutional neural network (CNN) to assist the clinical diagnosis of laryngeal squamous cell carcinoma (LSCC) through deep learning algorithm. Methods: A deep CNN was developed and applied in narrow band imaging (NBI) endoscopy of 4 799 patients with laryngeal lesions, including 3 168 males and 1 631 females, aged from 21 to 87 years, from 2015 to 2017 in Beijing Tongren Hospital, Capital Medical University. A simple randomization method was used to select the laryngeal NBI images of 2 427 patients (1 388 benign lesions and 1 039 LSCC lesions) for the training and correction the CNN model. The remaining laryngeal NBI images of 2 372 patients (including 1 276 benign lesions and 1 096 LSCC lesions) were used as validation data set to compare performance between CNN and otolaryngologists. SPSS 21.0 software was used for Chi-square test to calculate the accuracy, sensitivity and specificity of AI and otolaryngologists. The area under the curve (AUC) of receiver operating curve (ROC) was used to evaluate the diagnostic ability of the algorithm for NBI images. Results: The accuracy, sensitivity and specificity for NBI predictions were respectively 90.91% (AUC=0.96), 90.12% and 91.53%, which were equivalent to those for otolaryngologists' predictions (accuracy, sensitivity and specificity were (91.93±3.20)%, (91.33±3.25)% and (93.02±2.59)%, t values were 0.64, 0.75 and 1.17, and P values were 0.32, 0.28 and 0.21, respectively). The diagnostic efficiency of CNN was significantly higher than that of otolaryngologists (0.01 vs. 5.50, t =9.15, P<0.001). Conclusion: AI based on deep CNN is effective for using in the laryngeal NBI image diagnosis, showing a good application prospect in the diagnosis of LSCC.
Subject(s)
Adult , Aged , Aged, 80 and over , Artificial Intelligence , Endoscopy , Female , Head and Neck Neoplasms , Humans , Male , Middle Aged , Narrow Band Imaging , Neural Networks, Computer , Sensitivity and Specificity , Squamous Cell Carcinoma of Head and Neck , Young AdultABSTRACT
Objective: To investigate the clinical characteristics, diagnosis, endoscopic surgical procedures, and therapeutic effect of blunt laryngeal trauma with arytenoid injury. Methods: We retrospectively reviewed 12 patients who suffered blunt laryngeal trauma with laryngeal mucosa avulsion and arytenoid region injury at the Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital from April 2007 to December 2018. Among the 12 patients, 10 were males, 2 were females, aged from 7 to 48 years old, with a median age of 21 years old. All patients were performed with transoral endoscopic laryngeal microsurgery under general anesthesia. Clinical characteristics, laryngoscopic signs, laryngeal CT, endoscopic surgical findings and procedures, and therapeutic effect were analyzed. The subjective and objective parameters of the voice quality of patients before and after surgery were compared using SPSS 22.0 statistical software by paired T test. Results: All patients had a history of obvious dysphonia immediately after trauma, accompanied by throat pain and hemoptysis without obvious dyspnea and dysphagia. Slight subcutaneous emphysema was found in 3 patients by physical examination. Laryngoscope revealed that 14 sides of vocal folds immobilized, arytenoid and/or ventricular region and posterior glottis mucosa were avulsed in 4 patients within 48 h of injury, and arytenoid cartilage was exposed in 4 sides. The arytenoid and ventricular regions were covered with thick pseudo-membrane or granulation, with abnormal structure in 8 patients with damage of more than 48 h. Intraoperative exploration revealed that there were 17 sides of arytenoid region (bilateral 5 cases, unilateral 7 cases) with varying degrees of injury. There was only limited laceration on three sides of the vocal folds. The lateral ventricular and vocal fold mucosae were avulsed vertically from the arytenoid region and arytenoid cartilage was exposed in 14 sides, among which 6 sides had abnormal arytenoid cartilage morphology and 8 sides had fracture displacement. Laryngeal CT showed irregular thickening of lateral glottis and/or supratroglottic structures in patients with vocal folds immobility, among which asymmetry of arytenoid cartilage structure on both sides in 3 cases and displacement in 2 cases were found. Restoration and microsuture of the fractured arytenoid, perichondrium and avulsion laryngeal mucosa under the direct laryngoscope were performed. The degree of dysphonia was significantly improved immediately after laryngeal microsurgery, the voice significantly improved in G, R, B, A, jitter, shimmer, NHR, and MPT three months after surgery(t=12.792, 12.792, 10.340, 3.276, 2.865, 3.781, 3.173, 3.090, respectively, P<0.05). Except for 1 patient with scar on vocal fold, all the other patients had normal laryngeal morphology and normal vocal fold movement. No laryngeal stenosis was found during the follow-up period. Conclusions: For patients with blunt laryngeal trauma, the injury of arytenoid region and arytenoid cartilage should be evaluated if there is obvious hoarseness, vocal fold immobility, avulsion of ventricular/vocal folds mucosa, or structural abnormality of arytenoid region under laryngoscopic examination. For highly suspected cases, microrphonosurgery under the direct laryngoscope should be performed as soon as possible, which can effectively reduce the occurrence of vocal fold movement disorders and laryngeal scar/stenosis, reconstruct the normal laryngeal structure, and restore the vocal function.
Subject(s)
Adolescent , Adult , Aged , Arytenoid Cartilage/surgery , Child , Endoscopy , Female , Humans , Laryngeal Diseases , Larynx , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
Objective: To evaluate the safety and efficacy of catheter ablation in patients with new-onset atrial arrhythmia after surgical excision of left atrial myxoma. Methods: Nine patients with new onset atrial arrhythmia and a prior history of left atrial myxoma, who received surgical myxoma excision and catheter ablation between September 2014 and November 2019, were included in the present study. Baseline characteristics, procedural parameters during catheter ablation, severe perioperative adverse events, recurrence rate of arrhythmia and clinical prognosis were analyzed. Kaplan Meier survival analysis was used to define the maintenance rate of sinus rhythm after catheter ablation in this patient cohort. Results: Nine patients were included. The average age was (55.8 ± 9.1) years old (3 male), there were 3 patients (3/9) with paroxysmal atrial fibrillation (PAF) and 6 patients (6/9) with atrial flutter or atrial tachycardia (AFL or AT). Ablation was successful in all patients, there were no perioperative complications such as stroke, pericardial effusion, cardiac tamponade, vascular complications or massive hemorrhage. During a mean follow-up time of 40.0 (27.5, 55.5) months, sinus rhythm was maintained in six patients (6/9) after the initial catheter ablation. The overall sinus rhythm maintenance rate was 2/3. In addition, 1 out of the 3 AF patients (1/3) developed recurrence of AF at 3 month after ablation, and 2 out of the 6 AFL or AT patients (2/6) developed late recurrence of AF or AFL (19 months and 29 months after ablation), two out of three patients with recurrent AFs or AFL received repeated catheter ablation and one patient remained sinus rhythm post repeat ablation. Meanwhile, there was no recurrence of atrial myxoma, no death, stroke, acute myocardial infarction and other events during the entire follow-up period. Conclusions: Catheter ablation is a safe and feasible therapeutic option for patients with new-onset atrial arrhythmia after surgical excision of left atrial myxoma.
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In eukaryotic cells, the endoplasmic reticulum (ER) is the key quality control organelle for cellular protein synthesis and processing. It also serves as an important site for Ca
Subject(s)
Adipose Tissue , Diabetes Mellitus, Type 2 , Endoplasmic Reticulum Stress , Endoribonucleases , Humans , Protein Serine-Threonine Kinases , eIF-2 KinaseABSTRACT
Objective To understand the relative survival rate of cervical cancer patients in our hospital in the past 5 years, and to predict the relative survival rate in the next 5 years. The study can provide data information and scientific basis for cervical cancer prevention and treatment in Changde City. Methods According to the tumor registration database of our hospital, the 5-year relative survival rate of cervical cancer patients from 2010 to 2014 was evaluated by the cycle analysis method, and further stratified analysis was carried out according to the age of diagnosis and the township area. By establishing a generalized linear model based on the cycle analysis method, we predict the 5-year relative survival rate of patients in the future 2015-2019 period. Results From 2005 to 2019, the incidence of cervical cancer was the highest in the 45-54 age group, accounting for 40.54%. The incidence of cervical cancer was the lowest in the age group over 74, accounting for 2.72%. From 2010 to 2014, the overall 5-year relative survival rate of cervical cancer patients in our hospital was 92.73%, and the 5-year relative survival rates of patients 74 years old were 93.51%, 92.82%, 89.16%, 85.71% and 63.83%, respectively. The 5-year relative survival rates of urban and rural patients were 94.73% and 91.86%, respectively. It is predicted that the overall 5-year relative survival rate from 2015 to 2019 is 93.78%. Conclusion Compared with the previous second 5-year periods, the 5-year relative survival rate of patients in the future 2015-2019 will still show an upward trend, the age difference gradient will continue to be maintained, and the urban-rural difference will further decrease.
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OBJECTIVE@#To analyze the clinical and genetic characteristics of a patient featuring autosomal dominant Olmsted syndrome.@*METHODS@#Clinical features of the patient was reviewed. High-throughput sequencing was carried out to detect potential genetic variants.@*RESULTS@#The proband, a 12-year-old girl, featured excessive keratinization on hands and feet, contracture of finger joints, and abnormal position and residual contraction of the fifth toes. Skin biopsy showed significant hyperkeratosis, epidermal hyperplasia, and mild interepidermal cell edema. A de novo heterozygous missense variant c.2016G>T(p.Met672Ile) was identified in the TRPV3 gene by high-throughout sequencing. The result was verified by Sanger sequencing.@*CONCLUSION@#The destructive palmoplantar keratosis in the child may be attributed to the c.2016G>T(p.Met672Ile) variant of the TRPV3 gene. Aboving finding has provided new evidence for the correlation of genetic variants with clinical phenotypes of Olmsted syndrome.
Subject(s)
Child , Female , Heterozygote , Humans , Keratoderma, Palmoplantar/genetics , Skin , Syndrome , TRPV Cation Channels/geneticsABSTRACT
Objective@#To obtain precise data on the changes in the levels of 29 cytokines in mice after high or low linear energy transfer (LET) irradiation and to develop an accurate model of radiation exposure based on the cytokine levels after irradiation.@*Methods@#Plasma samples harvested from mice at different time points after carbon-ion or X-ray irradiation were analyzed using meso-scale discovery (MSD), a high-throughput and sensitive electrochemiluminescence measurement technique. Dose estimation equations were set up using multiple linear regression analysis.@*Results@#The relative levels of IL-6 at 1 h, IL-5 and IL-6 at 24 h, and IL-5, IL-6 and IL-15 at 7 d after irradiation with two intensities increased dose-dependently. The minimum measured levels of IL-5, IL-6 and IL-15 were up to 4.0076 pg/mL, 16.4538 pg/mL and 0.4150 pg/mL, respectively. In addition, dose estimation models were established and verified.@*Conclusions@#The MSD assay can provide more accurate data regarding the changes in the levels of the cytokines IL-5, IL-6 and IL-15. These cytokines could meet the essential criteria for radiosensitive biomarkers and can be used as radiation indicators. Our prediction models can conveniently and accurately estimate the exposure dose in irradiated organism.
Subject(s)
Animals , Biological Assay , Biomarkers/blood , Carbon , Cytokines/blood , Female , Heavy Ions , Linear Energy Transfer , Linear Models , Mice , Radiation Dosage , Radiation, IonizingABSTRACT
OBJECTIVE@#To analyze the short-term prognosis of elderly patients with hip fracture after operation, and to explore the main factors affecting the recovery of daily life function.@*METHODS@#From November 2015 to November 2016, 130 elderly patients with hip fracture were analyzed, including 43 males and 87 females, aged from 60 to 95 (77.54±8.49) years. The death, fall and complications were recorded 3 months after operation. The daily life function of the patients was followed up 3 months after operation with the functional recovery of daily life scale (FRS). T-test, analysis of variance and single factor linear regression analysis were used to analyze the general clinical data. The factors with @*RESULTS@#Among 130 patients, 7 died (5.4%), 4 fell (3.1%), 103 (79.2%) had postoperative complications, and the FRS score of 123 patients was 65.92±22.79. The results showed that gender, age, fracture site, pre fracture Basel rating, frailty index, postoperative hospital stay and total number of postoperative complications had significant differences in the recovery of daily life function (@*CONCLUSION@#The short term rehabilitation level of elderly patients with hip fracture after operation is poor. Basel rating before fracture, frailty index, postoperative hospital stay and total number of postoperative complications may be related risk factors affecting the recovery of daily life function of patients after operation.
Subject(s)
Activities of Daily Living , Aged , Female , Hip Fractures/surgery , Humans , Length of Stay , Male , Postoperative Complications , Postoperative Period , Risk FactorsABSTRACT
Perineuronal nets (PNNs) is a complex network composed of highly condensed extracellular matrix molecules surrounding neurons. It plays an important role in maintaining the performance of neurons and protecting them from harmful substances. However, after spinal cord injury, PNNs forms a physical barrier that surrounds the neuron and limits neuroplasticity, impedes axonal regeneration and myelin formation, and promotes local neuroinflammatory uptake. This paper mainly describes the composition and function of PNNs of neurons and its regulatory effects on axonal regeneration, myelin formation and neuroinflammation after spinal cord injury.