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1.
Article in Chinese | WPRIM | ID: wpr-882606

ABSTRACT

The medical insurance is provided by the Unified Health System (SUS) covering most of Brazilians and alsocombined with private insurance, and every Brazilan could get access to basic health services. The major diseaseas leading to death in Brazil are ischemic heart disease, stroke and lower respiratory infection. The incidence of AD, chronic kidney disease and diabetes are increasing in recent years. Traditional Chinese Medicine (TCM), which was represented by acupuncture, was introduced to Brazil in the early 19th. At present, acupuncture has been widely accepted and used, which was included in SUS. A number of universities have acupuncture courses. However, the specialities and advantages of TCM needs to be strengthened, the local practioners lack the understanding of TCM theory, the appropriate use of herbal medicine, and there lacks TCM education standards, all these limit the development of TCM. Thus, in order to promote the development and dissemination of TCM in Brazil, it is suggested to give full play of the characteristics of TCM in preventing disease, increase the research and development input of herbal medicine, standardize the education stystem of TCM, etc.

2.
Asian Journal of Andrology ; (6): 273-280, 2021.
Article in English | WPRIM | ID: wpr-879763

ABSTRACT

Postprostatectomy erectile dysfunction (pPED) remains a current problem despite improvements in surgical techniques. Vacuum therapy is clinically confirmed as a type of pPED rehabilitation. However, its underlying mechanisms are incompletely understood. Recently, autophagy and apoptosis were extensively studied in erectile dysfunction resulting from diabetes, senescence, and androgen deprivation but not in the context of pPED and vacuum therapy. Therefore, this study was designed to investigate the roles of autophagy and apoptosis in pPED and vacuum therapy. Twenty-four adult male Sprague-Dawley rats were randomly divided into three groups: the control group, bilateral cavernous nerve crush (BCNC) group, and BCNC + vacuum group. After 4 weeks of treatment, intracavernosal pressure was used to evaluate erectile function. Real-time quantitative polymerase chain reaction, western blot, and immunohistochemistry were used to measure the molecular expression. TdT-mediated dUTP nick-end labeling staining was used to assess apoptosis. Transmission electron microscopy was used to observe autophagosomes. After treatment, compared with those of the BCNC group, erectile function and cavernosal hypoxia had statistically significantly improved (P < 0.05). Apoptosis and the relative protein expression of B-cell lymphoma-2-associated X and cleaved Caspase3 were decreased (P < 0.05). Autophagy-related molecules such as phosphorylated unc-51-like autophagy-activating kinase 1 (Ser757) and p62 were decreased. Beclin1, microtubule-associated protein 1 light chain 3 A/B, and autophagosomes were increased (P < 0.05). Besides, the phosphatidylinositol 3-kinase/AKT/mammalian target of rapamycin signaling pathway, as a negative regulator of autophagy to some degree, was inhibited. This study revealed that vacuum therapy ameliorated pPED in BCNC rats by inhibiting apoptosis and activating autophagy.

3.
Asian Journal of Andrology ; (6): 215-221, 2021.
Article in English | WPRIM | ID: wpr-879712

ABSTRACT

Penile length shortening and erectile dysfunction are common complications after radical prostatectomy. Various methods have been used to maintain erectile function, but less attention has been paid to preserving penis length. N-acetylcysteine (NAC) has the effect of antioxidation and antifibrotic, which may be beneficial to improve those postoperative complications. This study investigated the effect of NAC on maintaining the penile length and the erectile function after bilateral cavernous nerve crush (BCNC) and its underlying mechanism. Twenty-four male rats were randomly divided into three groups: control group, BCNC group, and BCNC + NAC group. NAC or equal volume of saline was daily administrated by intragastric gavage for 4 weeks. The initial and end penile lengths were measured. Intracavernosal pressure/mean arterial pressure (ICP/MAP) ratio was calculated to assess erectile function. Hematoxylin-eosin staining, Masson's trichrome staining, immunohistochemistry, and Western blot were performed to explore cellular and molecular changes of the penis. Compared to the BCNC group, the penile length, ICP/MAP ratio and smooth muscle/collagen ratio in the BCNC + NAC group were improved significantly (all P < 0.05), and the expressions of endothelial nitric oxide synthase, α-smooth muscle actin, glutathione, and glutathione peroxidase 1 were significantly increased after NAC treated (all P < 0.05), along with the decreased expressions of hypoxia-inducible factor-1α, transforming growth factor-β1, collagen I, collagen III, collagen IV, malonaldehyde, and lysine oxidase (all P < 0.05). This study demonstrated that NAC could maintain penile length and partly improve erectile function. Possible mechanism is directly and/or indirectly related to antihypoxic and antifibrosis.

4.
Article in English | WPRIM | ID: wpr-878359

ABSTRACT

Objective@#This study aimed to use an air-liquid interface (ALI) exposure system to simulate the inhalation exposure of motorcycle exhaust particulates (MEPs) and then investigate the benchmark dose (BMD) of MEPs by evaluating cell relative viability (CRV) in lung epithelial BEAS-2B cells.@*Methods@#The MEPs dose was characterized by measuring the number concentration (NC), surface area concentration (SAC), and mass concentration (MC). BEAS-2B cells were exposed to MEPs at different concentrations @*Results@#Our results reveal that BMD of NC and SAC were estimated by the best-fitting Hill model, while MC was estimated by Polynomial model. The BMDL for CRV following ALI exposure to MEPs were as follows: 364.2#/cm @*Conclusion@#These results indicate that MEPs exposure


Subject(s)
Benchmarking/statistics & numerical data , Bronchi/physiology , Cell Line , Cell Survival/drug effects , Epithelial Cells/physiology , Humans , Motorcycles , Particulate Matter/adverse effects , Vehicle Emissions/analysis
5.
Chinese Journal of Radiology ; (12): 209-214, 2020.
Article in Chinese | WPRIM | ID: wpr-868271

ABSTRACT

Objective:To investigate the value of tumor hemodynamics and morphological features from conventional dynamic contrast-enhanced MRI (DCE-MRI) scan before surgery in predicting postoperative recurrence time in breast cancer patients.Methods:A retrospective analysis of 58 patients with breast cancer who had recurred after operation from November 2012 to December 2014 in Liaoning Cancer Hospital was performed. According to the recurrence time, the patients were divided into early recurrence group (≤2 years after surgery, 33 cases) and late recurrence group (>2 years after surgery, 25 cases). All patients underwent routine DCE-MRI scans before surgery, and hemodynamic features of the three-dimensional volume of the tumor and the morphological and textural features of the tumor in each phase were extracted by computer. The counts and measurement data of patients in early recurrence group and late recurrence group were compared by Fisher′s exact probability method and Mann-Whitney U test, and receiver operating characteristic (ROC) curves were drawn. The multivariate logistic regression was used to calculate the combined efficacy in predicting early recurrence and late recurrence. Kaplan-Meier method was used to analyze the survival prognosis, and Log-Rank test was used to compare the differences in survival curves between groups. Results:There was no significant difference in background parenchymal enhancement, lesion margin, lesion internal enhancement characteristics, lesion morphology, time-signal intensity curve type and the degree of whole-breast vascularity increase between early recurrence and late recurrence groups ( P>0.05).There were significant differences in the maximum concentration of contrast (Max Conc), the area under the time signal curve (AUC) and the maximum slope value of the time signal curve (Max Slope) ( P<0.05). Comparative analysis of the radiomics parameters of 8 phases DCE-MRI found that the sphericity of morphological characteristic parameters in the phase 3 was statistically different between the early recurrence and late recurrence groups ( P=0.03). Area under the ROC curve of AUC, Max Conc, Max Slope and parameter sphericity of phase 3 morphological characteristics for predicting early and late recurrence were 0.664, 0.659, 0.684 and 0.670, respectively. The area under the ROC combined with the above four parameters for prediction was 0.765, with a specificity of 63.6% and a sensitivity of 84.0%; the predictive efficacy was higher than that of univariate. Fifty-eight patients were followed up for 17 to 64 months with a median follow-up of 47 months. The disease-free survival and overall survival in the early recurrence group were significantly lower than those in the late recurrence group, and the difference was statistically significant ( P<0.05). Conclusion:It is of certain value to predict the postoperative recurrence time of breast cancer based on the tumor hemodynamic characteristics combined with morphological characteristics from preoperative non-invasive conventional DCE-MRI.

6.
Journal of Chinese Physician ; (12): 857-860,865, 2020.
Article in Chinese | WPRIM | ID: wpr-867340

ABSTRACT

Objective:To investigate the effect and value of V-type fundoplication in the treatment of hiatal hernia with gastroesophageal reflux disease.Methods:From January 2012 to November 2018, a retrospective analysis was performed on 115 cases of patients with esophageal hiatal hernia and gastroesophageal reflux disease who underwent laparoscopic fundoplication in our hospital, including 68 cases of Nissen operation and 47 cases of type V-type stomach fundoplication. The information of surgical status, postoperative recovery, postoperative gastroesophageal reflux disease questionnaire (GERD-Q) score, and postoperative complications were collected and analyzed in these 2 groups.Results:Compared with Nissen technique, the operation time of V-shaped fundus plication was shortened, but the difference was not statistically significant ( P>0.05). There was no statistical difference in terms of indicators including intraoperative blood loss, postoperative drinking time, drainage tube extraction time, postoperative hospitalization time between two types of the operation ( P>0.05); the difference between the two groups was not statistically significant in the improvement of reflux symptoms, manometry and 24-hour pH result among the postoperative patients ( P>0.05); all the patients had no recurrence occurred; the incidence of dysphagia after surgery was significantly lower in V-shaped gastric fundus compared with Nissen operation, with statistically significant difference ( P<0.05); there was no statistical difference in the incidence of bloating, diarrhea, and constipation ( P>0.05). Conclusions:Laparoscopic V-shaped fundus fold surgery, as an anti-reflux technique, has the advantages of simple operation, clear results, fewer complications and easy standardization.

7.
Chinese Critical Care Medicine ; (12): 575-580, 2020.
Article in Chinese | WPRIM | ID: wpr-866871

ABSTRACT

Objective:To explore the patient-ventilator interaction of neurally adjusted ventilatory assist (NAVA) in patients with severe neurological diseases.Methods:A prospective study was conducted. Sixteen severe neurological patients with tracheotomy admitted to neurosurgery intensive care unit (NSICU) of Yijishan Hospital of the First Affiliated Hospital of Wannan Medical College from September 2019 to February 2020 were enrolled. According to the random number table method, they were treated with pressure support ventilation (PSV) mode followed by NAVA mode or NAVA mode followed by PSV mode mechanical ventilation. Each mode was ventilated for 24 hours. The number of auto-triggering, ineffective trigger, double trigger, inspiratory trigger delay, premature cycling, late cycling, and patient-ventilator asynchronous time (inspiratory trigger delay time, premature cycling time, and late cycling time) within 1 minute were recorded every 8 hours for 3 minutes. The average number of asynchronies per minute, asynchrony index (AI), total AI, asynchrony time, arterial blood gas analysis, and coefficient variation (CV%) of respiratory mechanics parameters of each asynchrony type between the two modes were compared.Results:There were significant decrease in the number or AI of auto-triggering, ineffective trigger, inspiratory trigger delay, premature cycling, and late cycling with NAVA mode ventilation compared with PSV mode ventilation [auto-triggering times (times/min): 0.00 (0.00, 0.00) vs. 0.00 (0.00, 0.58), auto-triggering AI: 0.00 (0.00, 0.00) vs. 0.00 (0.00, 0.02), ineffective trigger times (times/min): 0.00 (0.00, 0.33) vs. 1.00 (0.33, 2.17), ineffective trigger AI: 0.00 (0.00, 0.02) vs. 0.05 (0.02, 0.09), inspiratory trigger delay times (times/min): 0.00 (0.00, 0.58) vs. 0.67 (0.33, 1.58), inspiratory trigger delay AI: 0.00 (0.00, 0.02) vs. 0.05 (0.02, 0.09), premature cycling times (times/min): 0.00 (0.00, 0.33) vs. 0.33 (0.08, 1.00), premature cycling AI: 0.00 (0.00, 0.01) vs. 0.02 (0.00, 0.05), late cycling times (times/min): 0.00 (0.00, 0.00) vs. 1.17 (0.00, 4.83), late cycling AI: 0.00 (0.00, 0.00) vs. 0.07 (0.00, 0.25), all P < 0.05]. But there was significant increase in the number or AI of double trigger with NAVA mode ventilation as compared with PSV mode ventilation [times (times/min): 1.00 (0.33, 2.00) vs. 0.00 (0.00, 0.00), AI: 0.04 (0.02, 0.11) vs. 0.00 (0.00, 0.00), both P < 0.05]. Total AI and incidence of total AI > 0.1 showed significant decrease during NAVA mode ventilation as compared with PSV mode ventilation [total AI: 0.08 (0.04, 0.14) vs. 0.22 (0.18, 0.46), incidence of total AI > 0.1: 37.50% (6/16) vs. 93.75% (15/16), both P < 0.01]. There was no significant difference in asynchronous time or arterial blood gas analysis between the two modes. There were significant increases in variances of peak airway pressure (Ppeak) and expiratory tidal volume (VTe) during NAVA mode ventilation as compared with PSV mode ventilation [Ppeak coefficient of variation (CV%): 11.25 (7.12, 15.17)% vs. 0.00 (0.00, 2.82)%, VTe CV%: (8.93±5.53)% vs. (4.71±2.61)%, both P < 0.05]. Conclusions:Compared with PSV mode, NAVA mode can reduce the occurrence of patient-ventilator asynchronous events, reduce the AI and the occurrence of serious patient-ventilator asynchronous events, so as to improve the patient-ventilator interaction. NAVA and PSV modes can achieve the same gas exchange effect. At the same time, NAVA mode has potential advantages in avoiding insufficient or excessive ventilation support, diaphragm protection and prevention of ventilator-induced lung injury.

8.
Article in Chinese | WPRIM | ID: wpr-866768

ABSTRACT

Objective:To investigate the role and mechanism of splenic myeloid-derived suppressor cells (MDSCs) in sepsis-induced adrenal injury (SAI).Methods:Thirty male C57 mice aged 6-8 weeks were randomly divided into normal control group ( n = 5), sham operation group (Sham group, n = 5), sepsis model group [cecal ligation and perforation (CLP) group, n = 10] and sepsis+splenectomy group (CLPS group, n = 10). The sepsis model of mice was reproduced by CLP method. In Sham group, only the cecum was opened and separated, then closed, without CLP. In CLPS group, the spleen was removed before CLP. In normal control group, no challenge was given. After 24 hours, the rats were sacrificed by anesthesia, and peripheral blood, spleen, bone marrow, and bilateral adrenal glands were harvested. The pathological of adrenal gland was assessed by hematoxylin-eosin (HE) staining under optical microscope. The ratio of MDSCs in peripheral blood, spleen and bone marrow was determined by flow cytometry. The expressions of MDSCs surface antigen CD11b, Gr-1 and interleukins (IL-6, IL-1β) mRNA in adrenal tissue were measured by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). Western Blot was used to detect the expressions of mammalian rapamycin target protein (mTOR) pathway related proteins including total mTOR (T-mTOR), phosphorylation of mTOR (p-mTOR) and caspase-3. Results:The adrenal cortex and medulla of the normal control group and Sham group were intact and the structure was clear under optical microscope, while in the CLP group, the adrenal gland showed edema, cortical hemorrhage and cell edema. Compared with the CLP group, the adrenal tissue injury was significantly reduced in the CLPS group. Compared with the normal control group and Sham group, MDSCs ratio in the peripheral blood was significantly increased and significantly reduced in the spleen in the CLP group, but there was no significant difference in bone marrow, the expression levels of CD11b, Gr-1, IL-6, IL-1β mRNA and caspase-3 protein were increased significantly and p-mTOR protein expression was significantly decreased in adrenal tissue, there was no significant difference in the expression of T-mTOR protein. Compared with the CLP group, in the CLPS group, the MDSCs ratio in the peripheral blood was significantly decreased (0.143±0.011 vs. 0.324±0.023, P < 0.01), the expression levels of CD11b, Gr-1, IL-6 , IL-1β mRNA and caspase-3 protein in adrenal gland were significantly decreased [CD11b mRNA (2 -ΔΔCt): 2.90±0.56 vs. 5.74±0.13, Gr-1 mRNA (2 -ΔΔCt): 2.71±0.14 vs. 4.59±0.46, IL-6 mRNA (2 -ΔΔCt): 2.44±0.64 vs. 5.17±1.04, IL-1β mRNA (2 -ΔΔCt): 3.58±0.52 vs. 4.44±0.26, caspase-3 protein (caspase-3/GAPDH): 0.05±0.01 vs. 0.13±0.02, all P < 0.01], the p-mTOR protein expression was significantly increased (p-mTOR/GAPDH: 0.61±0.11 vs. 0.27±0.04, P < 0.01). Conclusions:The spleen is the major source of MDSCs in SAI. Splenectomy can attenuate SAI by reducing mobilization of MDSCs and activating the mTOR signaling pathway.

9.
Article in Chinese | WPRIM | ID: wpr-865019

ABSTRACT

Objective To investigate the application value of parallel and cross-to-overlap anastomosis method (PCOA) in three-dimensional (3D) laparoscopic radical resection of right hemicolon cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 138 patients who underwent 3D laparoscopic radical resection of right hemicolon cancer at Henan Provincial People's Hospital between July 2016 and July 2019 were collected.There were 83 males and 55 females,aged from 30 to 76 years,with a median age of 64 years.All the 138 patients with right hemicolon tumors were diagnosed as malignant tumors by enteroscopy and pathological examination before operation.The lymph node dissection and radical resection of right hemicolon cancer were performed according to the 9th edition of Japanese General Rules for Cancer of Colon,Rectum and Anus of the Japanese Colorectal Cancer Association.Observation indicators:(1) surgical situations;(2) postoperative conditions;(3) follow-up.Follow-up was conducted by outpatient examination or telephone interview to detect survival of patients and tumor recurrence and metastasis up to September 2019.Measurement data with normal distribution were represented as Mean ± SD.Measurement data with skewed distribution were represented as M (range).Count data were represented as percentages or absolute numbers.Results (1) Surgical situations:all the 138 patients underwent 3D laparoscopic radical resection of right hemicolon cancer using PCOA to reconstruct digestive tracts,without conversion to open surgery.The operation time,time for PCOA,and volume of intraoperative blood loss was (151.0±54.0)minutes,(20.1±2.0)minutes,and (60±21) mL.(2) Postoperative situations:the time to first flatus,time to semi-liquid food intake,length of auxiliary incision,and incidence rate of postoperative complications were (2.5±0.4)days,(4.0± 1.3)days,(3.0±0.2) cm,and 3.62% (5/138),respectively.Of the 5 patients with postoperative complications,1 patient with intestinal obstruction was cured after conservative treatment including gastrointestinal decompression and nutritional support,1 patient with anastomotic leakage was cured after conservative treatment including gastrointestinal decompression,local patency drainage,infection control and nutritional support,1 patient with ascites and abdominal infection was cured after computed tomography-guided percutaneous catheter drainage,1 patient with incisional infection was cured by controlling infection,strengthening dressing changes,local irrigation and drainage,1 patient with pulmonary infection was cured after anti-infective treatment.The number of lymph nodes dissected after surgery,duration of postoperative hospital stay,and hospital expenses were 19±8,(7.2±4.1) days,and (4.8± 1.4) × 104 yuan.All the 138 patients were confirmed as colonic adenocarcinoma by postoperative pathological examination,including 27 cases of poorly differentiated adenocarcinoma,92 cases of moderately differentiated adenocarcinoma,10 cases of highly differentiated adenocarcinoma,and 9 cases of mucinous adenocarcinoma.(3) Follow-up:133 of 138 patients were followed up for 2-38 months,with a median follow-up time of 18 months.During the follow-up,2 patients died,1 of which was detected multiple liver metastases at postoperative 16 months and died at postoperative 21 months,and the other was detected multiple liver metastases at postoperative 20 months and died at postoperative 24 months.Eight patients had distant metastasis,including 5 cases of liver metastasis,1 case of lung metastasis,and 2 cases of abdominal metastasis.The 10 patients with death and tumor metastasis were confirmed as stage Ⅲ by postoperative pathological examination,and the other 123 patients were generally in good condition.Conclusion PCOA is safe and effective for 3D laparoscopic radical resection of right hemicolon cancer.

10.
Article in Chinese | WPRIM | ID: wpr-863480

ABSTRACT

Glioma is the most common primary tumor of the central nervous system. Although clinicians select multimodal treatment, the overall prognosis of most patients is still very poor, especially glioblastoma (GB), which is related to the biological characteristics of glioma. Genomic alterations have been confirmed to be closely related to the tumorigenesis of GB. Different gene expression has a guiding therapeutic and prognostic predictive function for gliomas, so the deeper understanding of the relationship between genes and diseases behind gliomas will enable us to explore potential individualized targeted therapies for patients.

11.
Article in Chinese | WPRIM | ID: wpr-863026

ABSTRACT

MicroRNA is a group of endogenous non-coding RNAs with about 22 nucleotides, that participate in cell proliferation, differentiation, metabolism and apoptosis.Microglia are the specialized resident innate immune cells of the central nervous system, which mediate inflammation and immune response, and play an important role in the occurrence, development and rehabilitation of several nervous system diseases.Activated microglia can be polarized into two types: M1 and M2.M1 polarized microglia mainly promotes inflammation, whereas M2 cells are characterized by anti-inflammation and tissue remodeling.In recent years, studies have demonstrated that miRNAs can regulate the process of microglia polarization and affect the progress of various nervous system diseases.The biological function of miRNAs and the regulation of microglia activation and polarization are reviewed in this paper.

12.
Article in Chinese | WPRIM | ID: wpr-862658

ABSTRACT

Objective::To observe the effect of compound Kushen injection on the expressions of transforming growth factor-β1 (TGF-β1), drosophila mothers against decapentaplegic protein 3 (Smad3), glycogen synthase kinase-3β (GSK-3β) and β-catenin mice models with radiation-induced pulmonary injury (RIPI), in order to explore its possible mechanism of action. Method::On XStrahl precision radiation research platform for small animals (SARRP), a single 20 Gy bilateral lung field irradiation was performed to establish a mice model of RIPI. Thirty-two mice were randomly divided into normal control group, model group, compound Kushen injection group and dexamethasone injection group. The normal control group and the model group were given an equal volume of 0.9%sodium chloride solution and injected intraperitoneally for 4 weeks. The pathology of lung tissue tissues was observed by using hematoxylin-eosin (HE) staining. Immunohistochemical(IHC) was used to detect the expressions of E-cadheren and Vimentin proteins in mice lung tissues.Real-time polymerase chain reaction (Real-time PCR) was used to detect the mRNA expressions of TGF-β1, Smad3, GSK-3β and β-cateninin.Western blot was used to detect the protein expressions of TGF-β1, Smad3, GSK-3β and β-cateninin. Result::Compared with the normal group, the pulmonary coefficient of the model group was significantly decreased (P<0.01). Inflammatory cell infiltration, pulmonary interstitial edema, congestion, destruction of alveolar structure and partial alveolar atrophy were observed in the lung tissues of the model group. Compared with the model group, in the compound Kushen injection group, the levels of infiltration of lung inflammatory cells and pulmonary interstitial lesions in mice, the expression of Vimentin in lung tissues (P<0.01), and the expressions of TGF-β1, Smad3, GSK-3β and β-cateninin were significantly decreased (P<0.01), whereas the expression of E-cadheren was significantly increased (P<0.01). However, compared with the dexamethasone injection group, in the compound Kushen injection group, the pathological changes of lung tissues were similar, and the expression levels of E-cadheren, Vimentin, TGF-β1, Smad3, GSK-3β and β-cateninin were not significantly different. Conclusion::Compound Kushen injection can alleviate pulmonary fibrosis of lung in the treatment of RIPI, and the mechanism may be associated with inhibiting the mRNA and protein expressions of TGF-β1, Smad3, GSK-3β and β-catenin related to epithelial-mesenchymal transition(EMT), promoting the expression of E-cadheren, and inhibiting the expression of Vimentin, so as to inhibit the occurrence of EMT.

13.
Frontiers of Medicine ; (4): 776-785, 2020.
Article in English | WPRIM | ID: wpr-880963

ABSTRACT

Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread around the world. However, approaches to distinguish COVID-19 from pneumonia caused by other pathogens have not yet been reported. We retrospectively analyzed the clinical data of 97 children with probable COVID-19. A total of 13 (13.4%) patients were confirmed positive for SARS-CoV-2 infection by nucleic acid RT-PCR testing, and 41 (42.3%) patients were found to be infected with other pathogens. Notably, no pathogen was detected in 43 (44.3%) patients. Among all patients, 25 (25.8%) had familial cluster exposure history, and 52 (53.6%) had one or more coexisting conditions. Fifteen (15.5%) patients were admitted or transferred to the PICU. In the 11 confirmed COVID-19 cases, 5 (45.5%) and 7 (63.6%) were positive for IgM and IgG against SARS-CoV-2, respectively. In 22 patients with suspected COVID-19, 1 (4.5%) was positive for IgG but negative for IgM. The most frequently detected pathogen was Mycoplasma pneumonia (29, 29.9%). One patient with confirmed COVID-19 died. Our results strongly indicated that the detection of asymptomatic COVID-19 or coexisting conditions must be strengthened in pediatric patients. These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted. A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly suspected but the nucleic acid test is negative.


Subject(s)
Age Factors , COVID-19/diagnosis , COVID-19 Testing , Child , Child, Preschool , China , Female , Hospitalization , Humans , Infant , Male , Retrospective Studies , SARS-CoV-2/isolation & purification , Symptom Assessment
14.
Article in Chinese | WPRIM | ID: wpr-798912

ABSTRACT

Objective@#To investigate the application value of parallel and cross-to-overlap anastomosis method (PCOA) in three-dimensional (3D) laparoscopic radical resection of right hemicolon cancer.@*Methods@#The retrospective cross-sectional study was conducted. The clinicopathological data of 138 patients who underwent 3D laparoscopic radical resection of right hemicolon cancer at Henan Provincial People′s Hospital between July 2016 and July 2019 were collected. There were 83 males and 55 females, aged from 30 to 76 years, with a median age of 64 years. All the 138 patients with right hemicolon tumors were diagnosed as malignant tumors by enteroscopy and pathological examination before operation. The lymph node dissection and radical resection of right hemicolon cancer were performed according to the 9th edition of Japanese General Rules for Cancer of Colon, Rectum and Anus of the Japanese Colorectal Cancer Association. Observation indicators: (1) surgical situations; (2) postoperative conditions; (3) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect survival of patients and tumor recurrence and metastasis up to September 2019. Measurement data with normal distribution were represented as Mean±SD. Measurement data with skewed distribution were represented as M (range). Count data were represented as percentages or absolute numbers.@*Results@#(1) Surgical situations: all the 138 patients underwent 3D laparoscopic radical resection of right hemicolon cancer using PCOA to reconstruct digestive tracts, without conversion to open surgery. The operation time, time for PCOA, and volume of intraoperative blood loss was (151.0±54.0)minutes, (20.1±2.0)minutes, and (60±21)mL. (2) Postoperative situations: the time to first flatus, time to semi-liquid food intake, length of auxiliary incision, and incidence rate of postoperative complications were (2.5±0.4)days, (4.0±1.3)days, (3.0±0.2)cm, and 3.62%(5/138), respectively. Of the 5 patients with postoperative complications, 1 patient with intestinal obstruction was cured after conservative treatment including gastrointestinal decompression and nutritional support, 1 patient with anastomotic leakage was cured after conservative treatment including gastrointestinal decompression, local patency drainage, infection control and nutritional support, 1 patient with ascites and abdominal infection was cured after computed tomography-guided percutaneous catheter drainage, 1 patient with incisional infection was cured by controlling infection, strengthening dressing changes, local irrigation and drainage, 1 patient with pulmonary infection was cured after anti-infective treatment.The number of lymph nodes dissected after surgery, duration of postoperative hospital stay, and hospital expenses were 19±8, (7.2±4.1)days, and (4.8±1.4)×104 yuan. All the 138 patients were confirmed as colonic adenocarcinoma by postoperative pathological examination, including 27 cases of poorly differentiated adenocarcinoma, 92 cases of moderately differentiated adenocarcinoma, 10 cases of highly differentiated adenocarcinoma, and 9 cases of mucinous adenocarcinoma. (3) Follow-up: 133 of 138 patients were followed up for 2-38 months, with a median follow-up time of 18 months. During the follow-up, 2 patients died, 1 of which was detected multiple liver metastases at postoperative 16 months and died at postoperative 21 months, and the other was detected multiple liver metastases at postoperative 20 months and died at postoperative 24 months. Eight patients had distant metastasis, including 5 cases of liver metastasis, 1 case of lung metastasis, and 2 cases of abdominal metastasis. The 10 patients with death and tumor metastasis were confirmed as stage Ⅲ by postoperative pathological examination, and the other 123 patients were generally in good condition.@*Conclusion@#PCOA is safe and effective for 3D laparoscopic radical resection of right hemicolon cancer.

15.
Article in Chinese | WPRIM | ID: wpr-826388

ABSTRACT

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


Subject(s)
Acute Kidney Injury , Adult , Aged , Aortic Aneurysm, Thoracic , General Surgery , Blood Transfusion , Blood Vessel Prosthesis Implantation , Female , Humans , Male , Middle Aged , Postoperative Complications , Reoperation , Retrospective Studies , Risk Factors , Smoking , Treatment Outcome , Young Adult
16.
Chinese Medical Journal ; (24): 68-72, 2020.
Article in English | WPRIM | ID: wpr-877955

ABSTRACT

BACKGROUND@#Patients with temporal lobe epilepsy (TLE) originating from different seizure onset zones had distinct electrophysiological characteristics and surgical outcomes. In this study, we aimed to investigate the relationship between the origin and prognosis of TLE, and the stereoelectroencephalography (SEEG) features.@*METHODS@#Thirty patients with TLE, who underwent surgical treatment in our functional neurosurgery department from January 2016 to December 2017, were enrolled in this study. All patients underwent anterior temporal lobectomy after an invasive pre-operative evaluation with SEEG. Depending on the epileptic focus location, patients were divided into those with medial temporal lobe seizures (MTLS) and those with lateral temporal lobe seizures (LTLS). The Engel classification was used to evaluate operation effectiveness, and the Kaplan-Meier analysis was used to detect seizure-free duration.@*RESULTS@#The mean follow-up time was 25.7 ± 4.8 months. Effectiveness was 63.3% for Engel I (n = 19), 13.3% for Engel II, 3.3% for Engel III, and 20.0% for Engel IV. According to the SEEG, 60.0% (n = 18) had MTLS, and 40.0% (n = 12) had LTLS. Compared with the MTLS group, the operation age of those with LTLS was significantly greater (26.9 ± 6.9 vs. 29.9 ± 12.5 years, t = -0.840, P = 0.009) with longer epilepsy duration (11.9 ± 6.0 vs. 17.9 ± 12.1 years, t = -1.801, P = 0.038). Patients with MTLS had a longer time interval between ictal onset to seizure (67.3 ± 59.1 s vs. 29.3 ± 24.4 s, t = 2.017, P = 0.008). The most common SEEG ictal pattern was a sharp/spike-wave rhythm in the MTLS group (55.6%) and low-voltage fast activity in the LTLS group (58.3%). Compared with the LTLS group, patients with MTLS had a more favorable prognosis (41.7% vs. 77.8%, P = 0.049). Post-operative recurrence was more likely to occur within three months after the operation for both groups, and there appeared to be a stable long-term outcome.@*CONCLUSION@#Patients with MTLS, who accounted for three-fifths of patients with TLE, showed a more favorable surgical outcome.


Subject(s)
Anterior Temporal Lobectomy , Electroencephalography , Epilepsy, Temporal Lobe/surgery , Humans , Stereotaxic Techniques , Treatment Outcome
17.
Article in Chinese | WPRIM | ID: wpr-873011

ABSTRACT

Objective:To explore the effect of modified Xiongxiesan on the proliferation of airway smooth muscle tissues and the expressions of matrix metalloproteinase-9(MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1) in cough variant asthma (CVA) model rats. Method:A total 48 male SD rats were randomly divided into the normal control group (8 rats) and model group (40 rats). CVA model of rats were established through the intraperitoneal administration with 2 mg ovalbumin (OVA) and 100 mg Al(OH)3, and then aerosol inhalation of 1% OVA 15 days later. The same volume of sterile saline was given to the normal group through the intraperitoneal injection. Then 40 rats in the modeling group were randomly divided into model group, modified Xiongxiesan group (TCM group, 6 g·kg-1·d-1), montelukast group (0.4 mg·kg-1·d-1), chemokine receptor1/2 (CXCR1/2) inhibitor group (G31P group injected subcutaneously via the neck with a dose of 0.5 mg·kg-1 every other day), and CXCR1/2 inhibitor and modified Xiongxiesan group (G31P+TCM group), with 8 rats in each group. The control group and the model group were orally given distilled water 10 mL·kg-1·d-1. Then the rats were sacrificed, and lung samples were collected. Histological changes were examined by hematoxylin-eosin(HE). Basement membrane perimeter (PBM),wall area of bronchial tube (WAt),wall area of bronchial smooth muscle (WAm) and the number of smooth muscle cells (N) were measured using image pro-plus software and standardized based on PBM. The expressions of PCNA, MMP9 and TIMP1 were detected by immunohistochemistry. Result:Compared with the control group, there were a large number of inflammatory cells infiltration and moderate hyperplasia of smooth muscle area in the model group, which however were alleviated in other groups. The expressions of PCNA and MMP-9,TIMP1 were higher in the model group,which were reduced in other groups significantly. Conclusion:Modified Xiongxiesan can reduce the thickness of airway smooth muscle tissue in the CVA model rats, which may be correlated with the inhibition of the CXCR1/2 pathway, thereby reducing the proliferative activity of smooth muscle tissue and inhibiting the expression of related matrix metalloproteinases.

18.
Article in Chinese | WPRIM | ID: wpr-872846

ABSTRACT

Dyslipidemia is a disease of lipid metabolism. At present, the prevalence of dyslipidemia in adults in China is as high as 40.40%. In the United States, there are more than 100 million individuals with abnormal low-density lipoprotein cholesterol (LDL-C), and the incidence rate is increasing year by year and showing a trend of becoming younger. Dyslipidemia is closely related to a variety of diseases such as fatty liver, atherosclerosis , hypertension, coronary heart disease, diabetes, and stroke. It has now developed into a global public health problem that seriously threatens human life and health. Modern medicine believes that its pathogenesis is complicated and is related to abnormal glucose and lipid metabolism, insulin resistance (IR) and other factors. Chinese medicine ascribes it to primary asthenia-secondary sthenia syndrome, which is closely related to the liver, spleen, and kidney. It is believed that excessive fat and grease can cause phlegm and cause many diseases. In terms of its treatment, western medicine mainly uses statin chemical synthesis preparations, with stable therapeutic effect, but many adverse reactions such as myalgia, myositis, rhabdomyolysis and acute renal injury are the main factors restricting its clinical application. Traditional Chinese medicine (TCM) has a long history, and multi-pathway, multi-target, multi-level regulation of dyslipidemia, few adverse reactions and low drug dependence are the principal advantages of TCM in treating dyslipidemia. At present, there are more and more researches on the prevention and treatment of dyslipidemia by TCM, but they are mainly focused on the observation of curative effect and the summary of prescription, and there are relatively few in-depth discussion and summary of the mechanism of TCM. Through comprehensively retrieving and collating the relevant domestic and foreign literatures in the past five years, we reviews from the perspective of effective ingredients, therapeutic pathways, and targets of action, and comprehensively introduces the latest research progress of TCM on the mechanism of regulating dyslipidemia, and put forward some suggestions for the possible research direction in the future, in order to provide new ideas and theoretical basis for TCM in clinical prevention and treatment of this disease.

19.
Article in Chinese | WPRIM | ID: wpr-869967

ABSTRACT

Objective:To evaluate the effects of different depths of anesthesia on CD4 + T cell function in the patients undergoing radical resection for malignant tumor. Methods:Forty-two American Society of Anesthesiologists physical status Ⅱ patients, aged 36-64 yr, weighing 49-95 kg, undergoing elective radical surgery for malignant tumor, were divided into 2 groups ( n=21 each) using a random number table method: light anesthesia group (L group) and deep anesthesia group (D group). The AAI values were maintained at 30-40 and 20-29 during operation in L group and D group, respectively.The time to eye opening, extubation time and consumption of propofol were recorded.The peripheral venous blood samples were collected immediately before induction of anesthesia (T 0), at 2 h of operation (T 1) and at 4, 24, and 72 h after operation (T 2-4) for determination of serum interferon (IFN)-γ and interleukin-4 (IL-4) concentrations (by enzyme-linked immunosorbent assay), and IFN-γ/IL-4 ratio was calculated. Results:Compared with the baseline value at T 0, the serum IFN-γ concentrations were significantly increased at T 3, 4, the serum IL-4 concentrations were decreased at T 1-4, and IFN-γ /IL-4 ratio was increased in group D ( P<0.05). Compared with group L, the serum IFN-γ concentrations were significantly increased at T 3, 4, the serum IL-4 concentrations were decreased at T 1-4, IFN-γ/IL-4 ratio was increased, the consumption of propofol was increased, and the extubation time was prolonged in group D ( P<0.05), and no significant change was found in the time to eye opening between the two groups ( P>0.05). Conclusion:Deep anesthesia can improve CD4 + T cell function in the patients undergoing radical resection for malignant tumor.

20.
Article in Chinese | WPRIM | ID: wpr-841774

ABSTRACT

Objective: To explore the selective effects of cyclamin on the proliferation and apoptosis of the liver cancer cells in vitro, and to clarify the molecular target and the underlying mechanisms. Methods: The human liver cancer HepG2 cells or normal human HL-7702 liver cells were divided into cyclamin groups (added with 0, 2 . 5, 5.0 and 10.0 jumol • L_ 1 cyclamin), cholesterol intervention group (cyclamin + 20.0 mg • L_ 1 cholesterol) and control group (0 . 5 % DMSO only). M T T assay was performed to determine the survival rates of cells in various groups. The cellular cholesterol level was measured by Filipin staining. Lactate dehydrogenase (L D H) release assay was used to determine the LDH realease levels in cells. Flow cytometry was used to detect the apoptotic rates of cells. The expressions of Fas, FADD and caspase-8 proteins were measured by Western blotting method. Results: The survival rates of HepG2 cells in 5. 0 and 10. 0 jumol • L_ 1 cyclamin groups were significantly lower than those of HL-7702 cells (P < 0 . 0 5) . The Filipin staining results showed that the cholesterol level in HepG2 cells was higher than that in HL-7702 cells (P < 0 . 0 5) . The LDH release levels in HepG2 cells in cyclamin groups were higher than those in than HL-7702 cells (P < 0 . 0 5) . Compared with 5.0 fxmol • L_ 1 cyclamin group, the LDH release level and the apoptotic rate in cholesterol intervention group were decreased (P < 0 . 0 5) . The Western blotting results showed that the expression levels of Fas, FADD and caspase-8 proteins in HepG2 cells in cyclamin groups were increased compared with control group (P < 0 . 0 5); compared with cyclamin group, the expression levels of Fas, FADD and caspase-8 proteins in cholesterol intervention group were decreased (P < 0 . 0 5) . Conclusion: Cyclamin can selectively inhibit the proliferation of liver cancer cells, and its molecular mechanisms may be related to the increased cell membrane permeabilization via targeting membrane cholesterol component and the consequent ligand-independent activation of Fas signaling pathway.

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