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1.
Article in Chinese | WPRIM | ID: wpr-884527

ABSTRACT

Objective:To evaluate the clinical efficacy and failure patterns of prophylactic cranial irradiation (PCI) in patients with limited-stage small cell lung cancer (LS-SCLC) on the basis of modern chemoradiotherapy and diagnostic techniques.Methods:In this retrospective study, clinical data of 201 LS-SCLC patients treated with chemotherapy (EP/CE regimens, ≥4 cycles) and intensity-modulated radiotherapy (IMRT) in Cancer Hospital of Chinese Academy of Medical Sciences from 2006 to 2014 were reviewed. All patients were primarily managed with concurrent or sequential chemoradiotherapy and achieved complete response (CR) or partial response (PR). Ninety percent of patients were revaluated for brain metastasis (BM) by MRI and 10% by CT scan. Long-term survival and failure patterns were compared between the PCI ( n=91) and non-PCI groups ( n=110). Results:The median follow-up time was 77.3 months (95% CI 73.0-81.5 months). The median overall survival (OS), 2-and 5-year OS rates were 58.5 months, 72.5% and 47.7% in the PCI group, and 34.5 months, 61.7% and 35.8% in the non-PCI group ( P=0.075). The median progression-free survival (PFS), 2-and 5-year PFS rate were 22.0 months, 48.0% and 43.4% in the PCI group, significantly higher than 13.9 months, 34.4% and 26.7% in the non-PCI group ( P=0.002). The 2- and 5-year cumulative incidence of BM were 6.6% and 12.2% in the PCI group, and 30.0% , 31.0% in the non-PCI group ( P=0.001). The median time and rate of BM as an isolated first site of relapse were 11.9 months and 4.4% in the PCI group, and 8.7 months and 25.5% in the non-PCI group ( P<0.001). Multivariate analysis showed that response after chemoradiotherapy ( P<0.001) and PCI ( P=0.033) were the independent prognostic factors for PFS. Stratified analysis demonstrated that PCI significantly improved the 5-year PFS in patients who achieved CR (72.7% vs. 48.0%, P=0.013), while it did not improve the 5-year PFS in patients who obtained PR (26.1% vs. 20.2%, P=0.213). Conclusion:In the new era of standard chemoradiotherapy and more accurate diagnostic methods for BM, PCI was associated with improved PFS and lower incidence of BM in LS-SCLC patients.

2.
Article in Chinese | WPRIM | ID: wpr-884188

ABSTRACT

Objective:To explore the epidemiological characteristics and the antibiotic resistance of Streptococcus pneumoniae isolates, and to provide the evidence for the rational use of antimicrobial agents to treat Streptococcus pneumoniae infection. Methods:The positive microbiological laboratory identification and antimicrobial susceptibility testing of Streptococcus pneumoniae from sputum of children with respiratory infections during January 2010 to December 2017 in Children′s Hospital of Soochow University were retrospectively analyzed. The positive rates of Streptococcus pneumoniae of different genders, ages, years and seasons were compared. The annual detection rates and trends of drug resistance of Streptococcus pneumoniae to penicillin, amoxicillin and cefotaxime were analyzed by Mann-Kendall trend test. The seasonal decomposition of time series was conducted to assess the association between Streptococcus pneumoniae detection rate and season. Enumeration data was compared using χ2 test. Results:Of the 88 480 sputum specimens, the total positive rate of Streptococcus pneumoniae was 10.3%(9 081/88 480). The detection rates of Streptococcus pneumoniae in children aged 0 to <0.5 years old, 0.5 to <2 years old, 2 to <3 years old, 3 to <5 years old, and 5 to <15 years old were 4.2%(1 407/33 224), 13.1%(3 191/24 390), 14.9%(2 417/16 252), 17.9%(1 474/8 246) and 9.3%(592/6 368), respectively. The difference was statistically significant ( χ2=2 421.6, P<0.01). The detection rates were 8.1%(1 321/16 306) from January to March, 10.9%(2 194/20 207) from April to June, 8.5%(2 141/25 058) from July to September, and 12.7%(3 425/26 909) from October to December. The discrepancy of positive rates in different seasons showed statistical significance ( χ2=311.5, P<0.01). During 2010 to 2017, significant decreases in antibiotic resistant rates of Streptococcus pneumoniae to penicillin, amoxicillin and cefotaxime were detected (tau=-0.93, -0.93 and -0.71, respectively, all P<0.05). Conclusions:The detection rate of Streptococcus pneumoniae in sputum of children with respiratory infections may present seasonal pattern and vary between different ages of children. The resistance to β-lactam antibiotics has declined.

3.
Article in Chinese | WPRIM | ID: wpr-883155

ABSTRACT

Mycoplasma pneumoniae encephalitis is one of the extrapulmonary complications of mycoplasma pneumoniae infectiontion children.The clinical diagnosis of mycoplasma pneumoniae encephalitis is difficult, so it is necessary to make stratified diagnosis based on the diagnosis of encephalopathy and the reliability of pathogen detection evidence.In addition to considering whether antibiotics are sensitive to mycoplasma pneumoniae, the selection of antibiotics should also consider the tissue penetration of antibiotics and the safety of children′s medication.These problems may lead to the delay in diagnosis as well as treatment of mycoplasma pneumoniae encephalitis in children and affect the prognosis of children.This paper intended to introduce and summarize the diagnosis of mycoplasma pneumoniae encephalitis and the selection principles and characteristics of main antibiotics for mycoplasma pneumoniae encephalitis, hoping to be helpful to clinicians.

4.
Article in Chinese | WPRIM | ID: wpr-882620

ABSTRACT

Objective:To explore the molecular mechanism of Guchang-Zhixie pill in the treatment of ulcerative colitis based on network pharmacology. Methods:Retrieve the TCMSP database to get the effective components and target genes of each drug in Guchang-Zhixie pill, and then retrieve the OMIM database Disgenet database to get disease genes, and then intersect the drug genes and disease genes to get the core genes. Used STRING database to build gene function association network, and used DAVID database to analize go enrichment and pathway enrichment of the core genes. Results:A total of 77 active ingredients and 211 targets of Guchang-Zhixie pill were obtained by TCMSP database, 914 genes of ulcerative colitis were obtained by retrieving disease gene database, 72 core genes were obtained by intersection of drug gene and disease gene. Topology analysis showed that the core targets were IL6, IL1B, MAPK1, VEGFA, MMP9, etc; Twelve enriched biological process clusters were obtained. The biological processes with more contact targets were positive regulation of RNA polymerase Ⅱ promoter transcription and positive regulation of DNA template transcription; A total of 14 enriched pathway clusters were obtained by pathway enrichment analysis, among which TNF signaling pathway and PI3K/Akt signaling pathway were closely related to inflammation and associated with more targets. Conclusion:The target and pathway of Guchang-Zhixie pill in the treatment of ulcerative colitis are preliminarily obtained through database analysis, which has provided the reference for clarifying its mechanism.

5.
Article in Chinese | WPRIM | ID: wpr-905220

ABSTRACT

Objective:To solve the problem of leg shaking caused by the sudden change of angular acceleration at the joint of periodic motion during circular gait training of lower limb rehabilitation robot. Methods:A kind of quasi-circular gait was proposed, which divided the periodic motion into three phases: start phase, middle phase and end phase. The time was equal in the start phase and the end phase, and could be adjusted with the parameter ratio. The joint trajectories of the two phases were planned by quintic polynomial, and the middle phase was still the circular gait joint trajectory. The trajectory of the proposed quasi-circular gait was simulated. Results:The angular velocity was continuously differentiable and 0, the angular acceleration was continuous and 0, and the end-effector trajectory became flat with the increase of ratio. The results on the physical prototype of the lower limb rehabilitation robot were principally consistent with the simulation, and the machine worked smoothly. Conclusion:The proposed variable quasi-circular gait had smooth angular acceleration at the junction of periodic motions, which effectively solved the jitter problem when using circular gait for lower limb rehabilitation training and avoided secondary injury to the patients.

6.
Article in Chinese | WPRIM | ID: wpr-905134

ABSTRACT

Objective:To develop an automatic adjustment algorithm of bed height of multi-position lower limb rehabilitation robot, to meet the variety of leg lengths and training modes to avoid the collision between robot and ground. Methods:Six mathematical models of robot bed body height were established for six training modes of multi-position lower limb rehabilitation robot, which were described with leg length and bed tilt angle. The influence was analyzed that mechanical clearance and deflection as well as the jitter error of leg bracket during movement. Furthermore, a software related to these models was developed to automatically adjust the bed height for training. Volunteers were recruited to test actually. Results:The test data of bed height are consistent with the theoretical calculation of six mathematical models. Clearance and deflection did not affect the theoretical results of bed height. The end of robot's lower limb was always above the safe height during rehabilitation training. Conclusion:The automatic adjustment algorithm of bed height has been established, which can ensure that the rehabilitation robot runs at a safe height.

7.
Article in Chinese | WPRIM | ID: wpr-904623

ABSTRACT

Objective To investigate the changes of mitochondrial metabolic functions of macrophages following Echinococcus multilocularis infections, so as to provide insights into the pathogenesis of alveolar echinococcosis. Methods Two groups were assigned according to different treatment methods. In the culture group, mouse leukemic monocyte macrophage RAW264.7 cells were cultured with 2 000 E. multilocularis at a ratio of 500∶1, while RAW264.7 cells in the control group were given no treatment. Then, both the culture and control groups were further divided into the 24 h and 72 h subgroups. Mitochondria were stained with MitoTracker® Deep Red FM and the mean fluorescence intensity of macrophage mitochondria was measured with the Cytation 5 Cell Imaging Multi-Mode Reader. The mitochondrial DNA copy number was quantified using the quantitative real-time PCR (qPCR) assay, and the mitochondrial energy metabolism was monitored using the Seahorse XF assay. In addition, the mitochondrial reactive oxygen species and mitochondrial membrane potential were detected using flow cytometry. Results The mean fluorescence intensities of macrophage mitochondria were significantly lower in the 24 h (15 341 ± 2 532 vs. 17 823 ± 3 429; t = 6.379, P < 0.01) and 72 h (18 102 ± 3 505 vs. 21 511 ± 5 144; t = 17.680, P < 0.01) culture subgroups than in the corresponding control subgroups, and lower mitochondrial DNA copy numbers were measured in the 72 h culture subgroup than in the 72 h control group [(3.23 × 109 ± 1.78 × 107) vs. (4.39 × 109 ± 3.70 × 107); t = 8.85, P < 0.001]. The oxygen consumption rates were significantly greater in the 24 h [(241.70 ± 73.13) pmol/min vs. (69.05 ± 52.30) pmol/min; t = 7.89, P < 0.01] and 48 h culture groups [(249.50 ± 42.06) pmol/min vs. (60.28 ± 40.66) pmol/min; t = 8.64, P < 0.01] than in the corresponding control groups, and a higher extracellular acidification rate was seen in the 48 h culture group than in the 48 h control group ([ 111.6 ± 17.49) mpH/min vs. (35.05 ± 7.57) mpH/min; t = 16.90, P < 0.01]. In addition, flow cytometry detected higher mean fluorescence intensity of mitochondrial reactive oxygen species (58 264 ± 10 087 vs. 4 307 ± 97; t = 12.930, P < 0.01) and lower mitochondrial membrane potential (9.833% ± 2.285% vs. 2.667% ± 0.208%; t = 6.645, P < 0.01) in the 72 h culture group than in the control group. Conclusions E. multilocularis infection may impair mitochondrial functions and inhibit oxidative phosphorylation of macrophages, resulting in increased macrophage glycolysis. It is speculated that the alteration of macrophage metabolic states may contribute to the mechanisms underlying the development and progression of alveolar echinococcosis.

8.
Article in Chinese | WPRIM | ID: wpr-879467

ABSTRACT

The surgical treatment of recurrent anterior shoulder dislocation is a difficult problem in the field of sports injury medicine. The main reason focus on dynamic and osseous constraints of shoulder joint could not recover well. At present, arthroscopic surgery is used at home and abroad, and could receive statisfied postoperative effect, but the choice of specific surgical methods is still controversial. According to presence and size of glenoid and humeral skull defects, different treatments should be selected in clinic. The author recommends that no articular glenoid defect or glenoid defect 40% or Bristow-Latarjet if the surgical repair fails, bone grafting is used. In addition, if (humeral avulsion of glenohumeral ligaments, HAGL) injury existed, HAGL injury repair should be used. In addition to considering the important factor of bone defects, it is necessary to combine patient's age, exercise level and surgeon's technique to comprehensively select the bestsurgical method.


Subject(s)
Arthroscopy , Humans , Joint Instability , Recurrence , Scapula , Shoulder Dislocation/surgery , Shoulder Joint
9.
Article in Chinese | WPRIM | ID: wpr-879390

ABSTRACT

Shoulder arthroscopic as a conventional method usually is applied to repair rotator cuff tears. In clinical, plenty single-row, double-row and transosseous tunnels suture technique are performed, but the ideal suture technique for rotator cuff repair is not found. Compared with single-row, double-row has better strength in biomechanics property. As the two best suture technique among the single-row, massive cuff stitch and modified Mason-Allen suture have the strongest biomechanics property. Clinical trials indicate that double-row could improve healing rates, but there are no significant difference in clinical outcome functional scores. Transosseous tunnel techniques possess a better bio-mechanic property, which could improve regional micro-environment and induce tendon-bone healing. Transosseous tunnel techniques are better for small to media size rotator cuff tears and osteoporosis patient. The author suggest that optimal rotator cuff repair technique should performed according to skill of performer and individual of patient by analysing bio-mechanic properties, clinical outcome, operative complexity and patient situation. The technique should follow simple opertaion, rapid, less trauma, stable fixation and utility to perform.


Subject(s)
Arthroscopy , Humans , Rotator Cuff/surgery , Rotator Cuff Injuries/surgery , Suture Anchors , Suture Techniques , Sutures
10.
Cancer Research and Clinic ; (6): 492-498, 2021.
Article in Chinese | WPRIM | ID: wpr-912912

ABSTRACT

Objective:To explore the data of patients with inoperable stage Ⅲ non-small cell lung cancer (NSCLC) after radiotherapy from the Surveillance, Epidemiology, and End Results (SEER) database, and to evaluate the effect of age on prognosis.Methods:The data of patients with inoperable stage Ⅲ A and Ⅲ B NSCLC according to the 7th edition of the American Joint Committee on Cancer (AJCC) staging standard who had been treated with radiotherapy from 2010 to 2016 were collected in the SEER database. A total of 17 117 cases were included in the analysis. According to the maximally selected test, the best cut-off value of age was 72 years old. According to the best cut-off value of age, patients were divided into the young group (< 72 years old, 11 008 cases) and the elderly group (≥ 72 years old, 6 109 cases). The basic clinical characteristics were compared between the two groups. Kaplan-Meier method was used to analyze the overall survival (OS) and log-rank test was performed. The multivariate Cox proportional hazards regression model was used to analyze the influencing factors for OS. The cumulative incidence function (CIF) was used to calculate the lung cancer-specific death rate and death rate from other causes in the different age groups, and the difference between the two groups was compared by Fine-Gray competing risk model, and the influencing factors of lung cancer-specific death were analyzed. Results:The proportion of squamous cell carcinoma in the elderly group was higher than that in the young group [51.1% (3 123/6 109) vs. 46.8% (5 154/11 008), P < 0.01], and the proportion of stage Ⅲ A was also higher than that in the young group [67.4% (4 120/6 109) vs. 60.1% (6 615/11 008), P < 0.01]; the proportion of patients receiving chemotherapy in the elderly group was lower than that in the young group [69.2% (4 226/6 109) vs. 88.6% (9 748/11 008), P < 0.01]. The 2-year and 5-year OS rates of the young group were 39.2% and 18.0%, and the elderly group were 32.4% and 12.5% (both P < 0.01). The multivariate Cox regression analysis showed that age, gender, race, year of diagnosis, pathological type, T stage, N stage, reason for non-operation and chemotherapy were independent influencing factors for patients' OS after radiotherapy, and among them, HR of age (≥ 72 years old vs. < 72 years old) was 1.13 (95% CI 1.09-1.18) ( P <0.01). The 2-year and 5-year cumulative incidence rate of lung cancer-specific death in the elderly group were 60.3% and 75.7%, which were higher than the corresponding values of 55.9% and 74.0% in the young group, and the difference of cumulative incidence rate of lung cancer-specific death between the two groups was statistically significant ( P < 0.01). The 2-year and 5-year cumulative incidence rate of death from other causes in the elderly group were 7.3% and 11.8%, which were higher than the corresponding values of 4.9% and 8.0% in the young group, and the difference of death from other causes between the two groups was statistically significant ( P < 0.01). The competing risk model analysis showed that age, gender, race, year of diagnosis, pathological type, T stage, N stage, and with or without chemotherapy were independent influencing factors for lung cancer-specific death in patients with inoperable stage Ⅲ NSCLC after radiotherapy, and among them, HR of age (≥ 72 years old vs. < 72 years old) was 1.07 (95% CI 1.02-1.12) ( P =0.002). Conclusions:Age is an independent prognostic factor for patients with inoperable stage Ⅲ NSCLC after radiotherapy. The prognosis of elderly patients is poor, and they have high risks of lung cancer-specific death and death from other causes.

11.
Chinese Journal of Microsurgery ; (6): 369-373, 2021.
Article in Chinese | WPRIM | ID: wpr-912253

ABSTRACT

Objective:To explore the surgical procedure and clinical effect of the free Flow-through superficial peroneal artery flap for repairing the digit injury with defect of proper palmar digital artery.Methods:From June, 2015 to December, 2019, free Flow-through superficial peroneal artery flap was used to repair the digit injury and to bridge the proper digital artery in 7 digits of 7 patients. There were 2 thumbs, 3 index fingers and 2 middle fingers. The size of defects on digits ranged from 2.5 cm×3.0 cm to 5.0 cm×7.0 cm. The defects of digit proper artery were 1.0 to 3.0 cm. The size of flaps was from 3.0 cm×3.5 cm to 5.5 cm×8.0 cm. The donor areas of the flap were directly sutured or covered with skin graft. Postoperative supportive treatments were given, such as infection prevention, antispasmodic, anticoagulant, analgesia and fluid infusion. The patients were kept in bed for 1 week after surgery. Monthly follow-up review were conducted and the patients were kept with the rehabilitation exercises under medical guidance.Results:All the patients entered postoperative followed-up for 6 to 18 months, with an average of 8 months. All flaps survived without any adverse event. All wounds achieved stage-one-healing. The flaps appeared in good colour, texture, elasticity and the plumps of the digit without obvious bloating. There was no obvious swelling and atrophy of the digits. The skin temperature was normal. According to the Standard for Evaluation of Upper Limb Function by the Hand Surgery Society of Chinese Medical Association, 3 digits were excellent and 4 were good. There was no obvious scar at the donor site of shank. The donor site had a good appearance and the limb function was not affected.Conclusion:The free Flow-through superficial peroneal artery flap is an ideal material to repair the defect of digit with the defect of proper digital artery. It has the advantages of simple surgical procedure, reliable blood supply and satisfactory appearance. The defect of proper digit artery can be repaired at the same time of the surgical procedure. The blood supply, appearance and function of the digits could be well recovered and the donor site is not affected.

12.
Article in Chinese | WPRIM | ID: wpr-911727

ABSTRACT

Objective:To investigate the status quo of continuing education and training needs among general practitioners in Pudong New Area of Shanghai.Methods:An online questionnaire survey was conducted among general practitioners registered in the community health service center of Shanghai Pudong New Area in September 2019. The questionnaire included items of general information, the status quo of continuing education, the training needs and demands, and the knowledge and skills to be improved.Results:There were total 1 824 general practitioner in Pudong New Areal, 861 participated in the survey with a participant rate of 47.2%. A total of 861 valid questionnaires retrieved with a response rate of 100.0%. Among all participants, 79 (9.18%) thought that continuing education was very useful for improving or developing their professional ability, 564 (65.51%) thought it was useful, and 41 people (4.76%) thought it was almost useless. There were significant different in views on the roles of continuing education among participants with different ages, types of registration, and working years (χ2=15.544, 15.382, 21.979; P<0.05). There are 112 participants (13.01%) who spend less than 1 day in continuing education each month, and 224 (26.02%) who spent more than 3 days a month in continuing education, the times of attending continuing education was related to the taking administrative duty for general practitioners (χ2=9.551, P<0.05). When general practitioners choose continuing education programs, the first consideration was the practicability of the contents [772 (31.94%)], followed by the form of teaching [541 (22.38%)]. The three most recognized forms of continuing education courses were online learning (28.22%), training and off-line teaching (25.58%) and special lectures (24.69%) The three most required knowledge and skills to be improved through continuing education were the endocrine system, respiratory system, and blood circulation system. Conclusions:The survey shows the current status and traing needs of continuing education among general practitioners in Shanghai Pudong New Area, which indicates that it is necessary to take the job competence as the core and carry out various activities of continuing education for general practitioners in community health service centers.

13.
Article in Chinese | WPRIM | ID: wpr-911602

ABSTRACT

Objective:To explore the outcomes of standard endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) with complex neck anatomical features.Methods:Clinical data of AAA patients received standard EVAR from Jan 2004 to Dec 2018 were retrospectively collected. Based on pre-operative computed tomography angiography (CTA) data, patients were divided into complex neck group and non-complex neck group to compare the results between them.Results:There were 88 patients (66.2%) in complex neck group and 45 patients (33.8%) in non-complex group. There was no significant difference in peri-operative characters (blood loss, contrast volume used, hospital stay time, technical success rate) and follow-up results (late re-intervention, late endoleak, aneurysm enlargement, survival rate),all P>0.05.Multivariant logistic regression analysis revealed neck diameter larger than 31 mm was related with late re-intervention ( OR=24.975, P=0.02). Conclusion:Standard EVAR for AAA with complex neck characters does not cause higher perioperative complications and less favorable long term survival rate.

14.
Article in Chinese | WPRIM | ID: wpr-911591

ABSTRACT

Objective:To compare the clinical results of different endovascular thrombus reduction techniques in the treatment of acute lower extremity arterial thrombosis.Methods:The clinical data of 96 consecutive patients with acute femoral popliteal arterial thrombosis who were treated with catheter directed thrombolysis (CDT) and mechanical thrombus aspiration system (PMT) between Jan 2016 and Dec 2018 at Cangzhou People's Hospital and Peking University People's Hospital were retrospectively analyzed.Results:Ninty-six patients underwent thrombolytic surgery,including 36 with CDT thrombolysis, 28 with AngioJet aspiration alone and 32 with Rotarex aspiration alone. Angiojet thrombus aspiration reduced thrombus rate by 89.3% (25/28) and clinical success rate by 92.8% (26/28).The thrombus reduction rate of Rotarex group was 87.5% (28/32), and the clinical success rate was 96.8% (31/32). In the CDT thrombolytic group, the thrombolytic reduction rate was 61.1% (22/36), including 8 patients who underwent thrombectomy and 6 patients with PMT, with a clinical success rate of 86.1% (31/36). The rate of distal arterial embolization, puncture point and local subcutaneous hematoma and vascular rupture was 21.4%, 10.7% and 2.1%, respectively. There were no amputation cases reported during a mean 13 months follow-up.The survival rate was 97.9%. The first-stage patency rate of 67.8%, while the second-stage artery patency rate of 85.7% during the follow-up.Conclusion:Compared with CDT, PMT has higher efficiency and lower complication rate in the treatment of acute lower extremity arterial thrombosis.

15.
Article in Chinese | WPRIM | ID: wpr-911580

ABSTRACT

Objective:To evaluate the clinical significance of patent accessory hepatic vein (AHV) in treatment of Budd-Chiari syndrome (BCS) with hepatic vein occlusion.Methods:The clinical data of 21 BCS patients treated from Jan 2010 to June 2019 were retrospectively analyzed. All patients underwent AHV and IVC venography.Results:Angiography showed that the diameter of AHV was 6-13mm after the procedure, the angle between AHV and the distal end of IVC was (106.9±27.7)°, and 57.1% of the AHV were opened at the right side of IVC, 9.5% at the front, and 1.4% at the left side, respectively. The technical success rate was 100%. Thirteen patients with AHV disease underwent balloon dilatation angioplasty, and their preoperative AHV pressure dropped from (41.6±6.4) cm H 2O to (22.2±5.5) cm H 2O ( t=11.966, P<0.01). The preoperative AHV and intrahepatic IVC pressure decreased from (29.1±3.3) cm H 2O to (19.1±8.8) cm H 2O ( t=8.136, P<0.01) and from (25.5±6.1) cm H 2O to (13.8±4.0) cm H 2O ( t=5.536, P<0.01), respectively. All patients were of no symptom during follow up for 6 months and ultrasound showed that the patency rate of original lesion was 100%. Conclusion:A patent AHV helps alleviate the symptoms and blood congestion of BCS patients with hepatic vein obstruction.

16.
Chinese Journal of Anesthesiology ; (12): 1005-1009, 2021.
Article in Chinese | WPRIM | ID: wpr-911318

ABSTRACT

Objective:To evaluate the role of CXC chemokine receptor 6 (CXCR6)-mediated activation of natural killer T (NKT) cells in renal fibrosis following acute kidney injury (AKI) in mice.Methods:Eighteen male wild-type C57BL/6 mice and 18 CXCR6 knockout C57BL/6 mice, aged 8-10 weeks, weighing 20-30 g, were divided into 6 groups ( n=6 each) using a random number table method: wild-type mouse control group (group WT-CON), CXCR6 knockout mouse control group (group CXCR6 -/--CON), wild-type mouse with AKI group (group WT-AKI), CXCR6 knockout mouse with AKI group (group CXCR6 -/--AKI), wild-type mouse with AKI + NKT cell adoptive transfer group (group WT-AKI-NKT) and CXCR6 knockout mouse with AKI + NKT cell adoptive transfer group (group CXCR6 -/--AKI-NKT). Folic acid 250 mg/kg was intraperitoneally injected to establish the model of renal fibrosis in mice with AKI.NKT cellsuspension 250 μl(1×10 6 cells) was injected through the tail vein on the 4th and 9th days after folic acid injection in group WT-AKI-NKT and group CXCR6 -/--AKI-NKT, respectively.Blood samples were taken from orbital at day 14 after folic acid injection for determination of the concentrations of serum blood urea nitrogen (BUN) and creatinine (Cr). The animals were sacrificed, and renal tissues were obtained for observation of the area of renal fibrosis (by Sirius red staining) and renal injury (using H&E staining) which was scored and for determination of the proportion of CD1d Tetramer+ cells (by flow cytometry), the number of CD206 and α-smooth muscle actin (α-SMA) double positive (CD206 + -α-SMA + ) cells (by immunofluorescence) and expression of interleukin (IL)-4 and IL-13 mRNA (by real-time polymerase chain reaction). Results:Compared with group WT-CON, the BUN and Cr levels, renal injury scores, area of renal fibrosis, proportion of CD1d Tetramer + cells and CD206 + -α-SMA + cell count were significantly increased, and the expression of IL-4 and IL-13 mRNA was up-regulated in group WT-AKI and WT-AKI-NKT ( P<0.05). Compared with group WT-AKI, the BUN and Cr levels, renal injury scores, area of renal fibrosis, proportion of CD1d Tetramer + cells and CD206 + -α-SMA + cell count were significantly increased, and the expression of IL-4 and IL-13 mRNA was up-regulated in group WT-AKI-NKT ( P<0.05), and the BUN and Cr levels, renal injury scores, area of renal fibrosis, proportion of CD1d Tetramer + cells and CD206 + -α-SMA + cell count were significantly decreased, and the expression of IL-4 and IL-13 mRNA was down-regulated in group CXCR6 -/--AKI ( P<0.05). Compared with group CXCR6 -/--CON, the BUN and Cr levels, renal injury scores, area of renal fibrosis, proportion of CD1d Tetramer + cells and CD206 + -α-SMA + cell count were significantly increased in group CXCR6 -/--AKI and group CXCR6 -/--AKI-NKT ( P<0.05). Compared with group CXCR6 -/--AKI, the BUN and Cr levels, renal injury scores, area of renal fibrosis, proportion of CD1d Tetramer + cells and CD206 + -α-SMA + cell count were significantly increased, and the expression of IL-4 and IL-13 mRNA was up-regulated in group CXCR6 -/--AKI-NKT ( P<0.05). Conclusion:CXCR6-mediated activation of NKT cells is involved in renal fibrosis following AKI in mice, and the mechanism may be related to promoting Th2 cytokine-mediated M2 macrophage-myofibroblast transformation.

17.
Article in Chinese | WPRIM | ID: wpr-910594

ABSTRACT

Chronic pancreatitis (CP) is characterized by progressive pancreatic fibrosis, which can lead to irreversible pancreatic endocrine and exocrine dysfunction. Previous reported studies suggested that in patients with CP, there are varying degrees of intestinal bacteria imbalance. In addition, intestinal bacteria have been found to associate with a variety of fibrosis-related diseases. The purpose of this study is to analyze the possible mechanisms of intestinal bacteria in progression of pancreatic fibrosis in CP, by investigating regulation of intestinal barrier, regulation of immunity, and synthesis and release of metabolites, to provide further references in exploring the clinical value of intestinal bacteria in diagnosis and treatment of CP.

18.
Article in Chinese | WPRIM | ID: wpr-910013

ABSTRACT

Objective:To explore the epidemiological characteristics of inpatients with tibial pilon fracture in The Third Hospital of Hebei Medical University from 2016 to 2019.Methods:The data of all the patients who had been hospitalized for pilon fracture from January 2016 to December 2019 in The Third Hospital of Hebei Medical University were collected using the medical image computer archiving and transmission system and the medical record query system. The patients' age, gender, occupation, residence, season, cause of injury, Rüedi-Allg?wer classification, and AO classification were analyzed.Results:A total of 234 inpatients with tibial pilon fracture were collected, including 179 males and 55 females, with a ratio of male to female of 3.3∶ 1. The prevalence age ranged from 41 to 50 years in male patients (31.3%, 56/179) and from 51 to 60 years in female patients (25.5%, 14/55). In the 234 patients, farmers (101 cases, 43.2%), rural area (166 cases, 70.9%) and spring season (77 cases, 32.9%) accounted for a higher proportion. The proportions of high-altitude falling (41.0%, 96/234) and high-energy injury (61.5%, 144/234) were the highest. Of the 234 patients by the Rüedi-Allg?wer classification, 23 (9.8%) had type Ⅰ fracture, 90 (38.5%) type Ⅱ fracture, and 121 (51.7%) type Ⅲ fracture, with type Ⅲ fracture prevalent in males (58.1%, 104/179) and type Ⅱ fracture prevalent in females (16.4%, 9/55). Of the 234 patients by the AO classification, 131 (56.0%) had type 43B fracture and 103 (44.0%) type 43C fracture, with a higher proportion of type 43B fractures in women (67.3%, 37/55) than in men (52.5%, 94/179). In type 43B fractures, type 43B3 (43.5%, 57/131) and type 43B3.3 (75.4%, 43/57) were the most common; in type 43C fractures, type 43C3 (74.8%, 77/103) and type 43C3.3 (51.9%, 40/77) were the most common.Conclusions:In the recent 4 years in The Third Hospital of Hebei Medical University, pilon fractures increased year by year and occurred more frequently in spring. They were more common in farmers and in the rural areas. They prevailed in the patients aged from 41 to 50 years. The Rüedi-Allg?wer type Ⅲ fractures and the AO type 43B fractures were the most common.

19.
Article in Chinese | WPRIM | ID: wpr-908965

ABSTRACT

Objective:To investigate the extent of statistics anxiety and explore its influencing factors among university students majoring in medicine.Methods:The statistics anxiety rating scale (STARS) was first translated into Chinese and modified until the reliability and validity were acceptable. Through online questionnaire, the Chinese version of STARS was used to measure the level of statistics anxiety for students enrolling in the course of Medical Statistics during autumn term 2018 to spring term 2019 in the medical college of a university. The collected data were managed and analyzed by SPSS 25.0.Results:A total of 562 students took part in the survey, and 500 questionnaires were eligible and included in the final analysis. The measurement of Chinese version of STARS showed quite good reliability and validity, with item score of the whole scale being (2.31 ± 0.65) points. The proportions of students with mild, moderate and severe statistics anxiety were 41%, 56% and 3% respectively. Female students had higher extent of anxiety than male students, and undergraduates had higher extent of anxiety than postgraduates. The extent of anxiety of students with different majors from high to low were nursing > (dentistry, basic medicine and pharmacology) > (clinic medicine and public health) respectively. When controlling other factors, the influence of gender, student level and major on statistics anxiety was still statistically significant.Conclusion:Statistics anxiety is prevalent in medical college students. Professional teachers should pay more attention to students' psychological status, conduct targeted counseling to alleviate students' anxiety and help them to improve self-efficacy in statistics learning.

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Article in Chinese | WPRIM | ID: wpr-908466

ABSTRACT

Objective:To investigate the application value of esophagogastric anastomosis with double muscle flap plasty in total laparoscopic radical resection of proximal gastric cancer.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 5 patients undergoing radical resection of proximal gastric cancer in Cancer Hospital of China Medical University from January to December 2020 were collected. All 5 cases were male, aged from 57 to 72 years, with a median age of 65 years. All 5 patients underwent total laparoscopic radical resection of proximal gastric cancer combined with esophagogastric anastomosis with double muscle flap plasty. Observation indicators: (1) operative situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect postoperative anastomosis, esophageal reflux, nutritional status, quality of life, tumor recurrence and metastasis of patients up to February 2021. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Operative situations: all 5 patients underwent surgery successfully. The operation time, time of esophagogastric anastomosis with double muscle flap plasty, number of lymph node dissected, volume of intraoperative blood loss, length of surgical incision of 5 patients were (316±41)minutes,(109±11)minutes, 26±4, (48±12)mL, (3.4±0.4)cm, respectively. Results of intraoperative rapid frozen section pathological examination showed negative of esophageal margin. (2) Postoperative situations: the time to postoperative initial flatus, time to postoperative initial food intake, during of postoperative hospital stay, cost of treat-ment of 5 patients were (4.8±1.5)days, (5.8±1.5)days, (11.6±2.1)days and (5.5±0.4)×10 4 yuan, respectively. Results of postoperative pathological examination of 5 patients showed gastric adeno-carcinoma in all 5 patients including 4 cases with moderately and poorly differentiated adeno-carcinoma and 1 case with highly differentiated adenocarcinoma, with the TNM staging of pT1a-3N0-1 M0 stage. Of the 5 patients, 1 case underwent postoperative mild pneumonia and was cured by conservative treatment such as anti-infection and promotion of sputum evacuation. (3) Follow-up: all 5 patients were followed up for 2 to 12 months, with a median follow-up time of 6 months. Of the 5 patients, 4 cases underwent anastomotic patency and 1 case underwent mild anastomotic stenosis who was improved after endoscopic treatment. None of the 5 patients underwent reflux esophagitis. The body mass index, the score of nutritional risk screening 2002, the score of patient-generated subjective global assessment and the score of tumor patient quality of life of 5 patients were 21 kg/m 2(range, 19-27 kg/m 2), 2(range, 1-2), 2(range, 1-3) and 47(range, 42-52), respectively. None of the 5 patients underwent tumor recurrence or metastasis. Conclusion:Esophagogastric anas-tomosis with double muscle flap plasty can be used in total laparoscopic radical resection of proximal gastric cancer which will lead to satisfactory short-term efficacy.

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