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1.
Acta Pharmaceutica Sinica ; (12): 3268-3276, 2021.
Article in Chinese | WPRIM | ID: wpr-906841

ABSTRACT

Cryptotanshinone (CPT), an active ingredient with the inhibitory effect on brain glioma cells, is trapped with poor solubility and low tumor permeability. Therefore, it is urgent to design nano drug delivery systems characterized with deep penetration and accurate targeting. In the present study, tLyp-1 modified liposomes loaded with CPT (tLipo/CPT) was prepared by emulsion solvent evaporation method. Peptide tLyp-1 which targeting tumor angiogenesis and neuropilin receptors (NRP) was modified on surface of CPT liposomes, with the aim of active targeting brain glioma cells and further release CPT precisely. The size and polymer dispersity index (PDI) of tLipo/CPT were (162.2 ± 14.6) nm and 0.24 ± 0.03. The optimal molar ratio of tLyp-1 modified on CPT liposomes was 0.5% determined by intracellular fluorescence parameters. The morphology displayed a smooth sphericity structure as determined by transmission electron microscope. Efficiency of CPT encapsulated in tLipo/CPT was detected by high performance liquid chromatography. The encapsulation efficiency of CPT was (70.06 ± 7.22) %. Liposomes modified with tLyp-1 peptide (tLipo) were internalized more than liposomes not modified with tLyp-1 (Lipo) by GL261 cells. Fluorescence intensity of tLipo in GL261 cells increased 40% than that of Lipo. Furthermore, we proved that the intake of tLipo/CPT in GL261 cells was mediated by NRP-1 receptor. MTT analysis indicated that tLipo/CPT significantly inhibit the proliferation of GL261 cells. The half maximal inhibitory concentration (IC50) was 5.70 μmol·L-1. In vitro blood-brain barrier (BBB) model experiment indicated that tLipo/CPT could penetration across BBB. Moreover, in vivo fluorescence biodistribution study indicated tail vein injection of DiR labeled tLipo after 0.5 h, DiR fluorescence could be observed in the brain of mice. Even after 24 h, DiR fluorescence still was observed in the brain. Our research certified that tLipo/CPT can penetrate the BBB and show effect of anti-glioma by inhibiting the proliferation of GL261 cells. The animal experiment was carried out in accordance with protocol evaluated and approved by the Ethics Committee of Nanjing University of Chinese Medicine.

2.
Article in Chinese | WPRIM | ID: wpr-905969

ABSTRACT

Objective:To observe the rehabilitation effect of modified Guipitang administration combined with traditional Chinese medicine (TCM) hot pressing in patients with deficiency of Qi and blood syndrome breast cancer postoperative, and investigate its effect on immune function and tumor markers. Method:One hundred and fifty-four patients were divided into observation group (77 cases) and control group (77 cases) by random number table. Two groups were given comprehensive treatment measures after operation. Patients in control group additionally took Bazhen granules orally, 8 g/time, 2 times/day, for eight weeks. Patients in observation group additionally took Guipitang orally for syndrome differentiation, 1 dose/day for eight weeks. The chest, shoulders and upper limbs of the affected side were hot-pressed with TCM, 20 min/time, 2 times/ day, 5 days a week, the first 4 weeks. The occurrence of lymphedema, subcutaneous fluid, poor skin flap growth, sleep disturbance, shoulder joint dysfunction, etc. Were recorded in both groups. Before and after treatment, the scores of European organization for research and treatment of cancer quality of life questionnaire core-30(EORTC QLQ-30), and scores of cancer-induced fatigue and Qi and blood deficiency were graded. T lymphocyte subsets (CD3<sup>+</sup>, CD4<sup>+</sup>, CD8<sup>+</sup> levels and CD4<sup>+</sup>/CD8<sup>+</sup>), regulatory T cells (Treg), inhibitory T cells (Ts), cytotoxic T cells (Tc), human growth differentiation factor 3 (GDF3), serum carbohydrate antigen 153 (CA153), carcinoembryonic antigen (CEA) and human epidermal growth factor -2 (HER-2) levels were detected before and after treatment. Result:After treatment, the observation group incidence of lymphedema, subcutaneous effusion, poor skin flap growth, sleep disturbance and shoulder joint dysfunction was 8(10.39%), 9(11.69%), 11(14.29%), 25(32.47%) and 8 (10.39%) respectively in the observation group, all lower than 18(23.38%), 20(25.97%), 23(29.87%), 46(59.74%) and 19(24.68%) in the control group(<italic>P</italic><0.05, <italic>P</italic><0.01). The scores of overall quality of life and function scores in the observation group were higher than those in the control group (<italic>P</italic><0.01), hile symptom score was lower than that in the control group (<italic>P</italic><0.01). The scores of cancer-induced fatigue deficiency of Qi and blood syndrome in the observation group were lower than those in the control group (<italic>P</italic><0.01). The Tc, CD3<sup>+</sup>, CD4<sup>+</sup>, CD4<sup>+</sup>/CD8<sup>+</sup> levels in the observation group were higher than those of the control group (<italic>P</italic><0.01), while the Treg, Ts, CD8<sup>+</sup> levels were lower than those in the control group (<italic>P</italic><0.01). The GDF3, CA153, CEA, HER-2 levels in the observation group were lower than those in the control group (<italic>P</italic><0.01). Conclusion:On the basis of conventional comprehensive interventions of western medicine, Guipitang combined with TCM hot pressing for breast cancer patients after surgery can reduce postoperative complications, reduce fatigue, postoperative symptoms and TCM syndromes. Besides, it can enhance the immune function of the body, improve the quality of life, promote postoperative recovery, and inhibit the expression of tumor markers, thus improving the prognosis of patients.

3.
Chinese Medical Journal ; (24): 2430-2437, 2021.
Article in English | WPRIM | ID: wpr-921177

ABSTRACT

BACKGROUND@#Circulating tumor DNA (ctDNA) is a promising biomarker for non-invasive epidermal growth factor receptor mutations (EGFRm) detection in lung cancer patients, but existing methods have limitations in sensitivity and availability. In this study, we used the ΔCt value (mutant cycle threshold [Ct] value-internal control Ct value) generated during the polymerase chain reaction (PCR) assay to convert super-amplification-refractory mutation system (superARMS) from a qualitative method to a semi-quantitative method named reformed-superARMS (R-superARMS), and evaluated its performance in detecting EGFRm in plasma ctDNA in patients with advanced lung adenocarcinoma.@*METHODS@#A total of 41 pairs of tissues and plasma samples were obtained from lung adenocarcinoma patients who had known EGFRm in tumor tissue and were previously untreated. EGFRm in ctDNA was identified by using superARMS. Through making use of ΔCt value generated during the detection process of superARMS, we indirectly transform this qualitative detection method into a semi-quantitative PCR detection method, named R-superARMS. Both qualitative and quantitative analyses of the data were performed. Kaplan-Meier analysis was performed to estimate the progression-free survival (PFS) and overall survival (OS). Fisher exact test was used for categorical variables.@*RESULTS@#The concordance rate of EGFRm in tumor tissues and matched plasma samples was 68.3% (28/41). At baseline, EGFRm-positive patients were divided into two groups according to the cut-off ΔCt value of EGFRm set at 8.11. A significant difference in the median OS (mOS) between the two groups was observed (EGFRm ΔCt ≤8.11 vs. >8.11: not reached vs. 11.0 months; log-rank P = 0.024). Patients were divided into mutation clearance (MC) group and mutation incomplete clearance (MIC) group according to whether the ΔCt value of EGFRm test turned negative after 1 month of treatment. We found that there was also a significant difference in mOS (not reached vs. 10.4 months; log-rank P = 0.021) between MC group and MIC group. Although there was no significant difference in PFS between the two groups, the two curves were separated and the PFS of MC group tended to be higher than the MIC group (not reached vs. 27.5 months; log-rank P = 0.088). Furthermore, EGFRm-positive patients were divided into two groups according to the cut-off of the changes in ΔCt value of EGFRm after 1 month of treatment, which was set at 4.89. A significant difference in the mOS between the two groups was observed (change value of ΔCt >4.89 vs. ≤4.89: not reached vs. 11.0 months; log-rank P = 0.014).@*CONCLUSIONS@#Detecting EGFRm in ctDNA using R-superARMS can identify patients who are more likely sensitive to targeted therapy, reflect the molecular load of patients, and predict the therapeutic efficacy and clinical outcomes of patients.


Subject(s)
Adenocarcinoma of Lung/genetics , Circulating Tumor DNA/genetics , ErbB Receptors/genetics , Humans , Lung Neoplasms/genetics , Mutation/genetics , Protein Kinase Inhibitors
4.
Article in Chinese | WPRIM | ID: wpr-912526

ABSTRACT

Flow cytometric immunophenotyping of leukemia has been used as the main method of acute leukemia diagnosis and classification. The revised Classification of Hematopoietic and Lymphoid Tissue Tumors in 2016 improved the diagnostic method for acute leukemia assessment. In China, at present there are still difficulties in the large-scale application and the standardization of this new flow cytometric immunophenotyping of acute leukemia in daily work. A thorough analysis and solution is demanded.

5.
Article in Chinese | WPRIM | ID: wpr-912438

ABSTRACT

With the development and application of high-throughput sequencing and multi-omics techniques, more and more biomarkers have been excavated and used in disease diagnosis, risk stratification, treatment response evaluation and prognosis predication. Machine learning has certain advantages in mining and evaluating of tumor markers due to the capacity of dealing with complicated data and building models. This article summarized common machine learning methods, and detailed current applications of machine learning in mining of tumor markers. Additionally, our review aimed to provide the advantages and disadvantages of different machine learning methods in mining of tumor markers.

6.
Article in Chinese | WPRIM | ID: wpr-912429

ABSTRACT

In recent years, with the rapid development of molecular diagnostic technology, more and more serum molecular tumor markers have been found and been used in the tumor prevention, diagnosis, treatment, prognosis assessment and relapse monitoring. However, each laboratory techniques and molecular markers has its own advantages and limitations. How to choose the appropriate laboratory technology and tumor markers is a hot topic in clinical practice.

7.
Article in Chinese | WPRIM | ID: wpr-883336

ABSTRACT

Objective:To compare the visual quality of patients with astigmatic multifocus intraocular lens (ART IOL) and astigmatic monofocus IOL (Toric IOL) after implantation.Methods:A prospective, non-randomized, controlled study was conducted to include 72 eyes of 72 cataract patients with corneal astigmatism (1.0-2.5 D) who were scheduled to receive phacoemulsification combined with IOL implantation in Chaoju Eye Hospital of Inner Mongolia from July 2017 to October 2018.Patients were divided into ART IOL group (37 eyes) and Toric IOL group (35 eyes) according to different IOLs implanted.All patients were followed up for 1 year after surgery.The main and secondary outcome indicators were compared.The main outcome indicators included distance (5 m), intermediate (80 cm), and near (40 cm) uncorrected visual acuity and best corrected visual acuity, defocus curve, contrast sensitivity, postoperative IOL rotation and residual astigmatism, while the secondary outcome indicators included visual subjective symptoms and spectacle independence rate.The above outcome indicators were compared between the two groups.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Chaoju Eye Hospital of Inner Mongolia (No.CJYKLL202012).Written informed consent was obtained from each patient before surgery.Results:There was no statistically significant difference between the two groups in average uncorrected distance visual acuity and best corrected distance, intermediate and near visual acuity (all at P>0.05).The average intermediate and near visual acuity in the ART IOL group was significantly higher than that in the Toric IOL group, showing statistically significant differences (both at P<0.05).The defocus curve of the ART IOL group presented a double peak, which reached the peak at the far focus (0.0 D) and near focus (-2.5 D), respectively.The visual acuity range from 1.5 to-3.0 D was above 0.2 logarithm of the minimum angle of resolution (LogMAR), and the focus depth range was 4.5 D (1.5 to -3.0 D).The defocus curve of the Toric IOL group had only one crest, which was located at best corrected visual acuity (0.0 D).The visual acuity reached 0.2 LogMAR or above were from 1.0 to -1.0 D, and the focal depth range was 2.0 D (1.0 to -1.0 D).There was no statistically significant difference in contrast sensitivity at different spatial frequencies between the two groups in bright light, bright flashing light and dark light (all at P>0.05), while the contrast sensitivity of the ART IOL group at high dark flashing light frequency was lower than that of the Toric IOL group, showing statistically significant difference ( P<0.05).In the ART IOL group and the Toric IOL group, the average residual astigmatism after surgery was (-0.47±0.51)D and (-0.49±0.42)D, respectively, with no statistically significant difference ( t=0.408, P>0.05).There was no significant difference in postoperative IOL rotation between the two groups ( t=1.906, P>0.05).The total postoperative spectacle independence rate in the ART IOL group was 97.30%(36/37), which was higher than that in the Toric IOL group (17.14%, 6/35), showing statistically significant difference ( χ2=15.320, P<0.05). Conclusions:Both Toric IOL and ART IOL can better correct corneal astigmatism and improve patients' distance visual acuity, but ART IOL implantation can provide better distance, intermediate and near visual acuity, and higher spectacle independence rate.

8.
Article in Chinese | WPRIM | ID: wpr-883270

ABSTRACT

Objective:To explore the predictive value of computed tomography (CT) texture analysis for the recurrence in children with acute pancreatitis (AP).Methods:The clinical diagnostic test was conducted. The clinical data of 56 children with primary AP who were admitted to Wuhan Fourth Hospital from January 2016 to January 2018 were collected. There were 13 males and 43 females, aged from 3.5 to 13.0 years, with a median age of 5.5 years. Based on follow-up in other hospitals, 20 children with recurrence of AP were allocated into recurrence group, and 36 children without recurrence were allocated into non-recurrence group. All the 56 children underwent abdomen plain and enhanced CT scan within 24 hours after first admission. Observation indicators: (1) comparison of clinicopathological features between two groups of children with AP. (2) comparison of CT texture parameters between two groups of children with AP. (3) diagnostic efficacy of clinical features and CT texture parameters. Follow-up using outpatient reexamination and telephone interview was conducted to detect recurrence of AP up to February 2020. The duration of follow-up required more than or equal to 24 months. The Shapiro Wilk test was used to analyze normality of measurement data. Measurement data with normal distribution were repre-sented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M (range) or M ( P25, P75), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was conducted using the Mann-Whitney U test. Clinical parameters and CT texture parameters with statistical differences were multivariate analyzed using the Logistic regression model. Receiver operating characteristic curve (ROC) analysis was used to evaluate the predictive efficacy of parameters for recurrence of AP. Results:(1) Comparison of clinicopatholo-gical features between two groups of children with AP: cases with or without complications were 14 and 6 for the recurrence group, versus 7 and 29 for the non-recurrence group, showing a significant difference between the two groups ( χ2=14.021, P<0.05). Cases with minimal, moderately severe or severe disease (severity of disease) were 2, 5, 13 for the recurrence group, versus 19, 11, 6 for the non-recurrence group, showing a significant difference between the two groups ( Z=5.414, P<0.05). (2) Comparison of CT texture parameters between two groups of children with AP: the energy value in the arterial phase on CT examination was 0.186(0.174,0.206)for the recurrence group and 0.413(0.405,0.425) for the non-recurrence group, showing a significant difference between the two groups ( Z=9.413, P<0.05). The energy value and entropy value in the venous phase on CT examination were 0.084(0.078,0.092) and 0.961(0.210,1.720) for the recurrence group, versus 0.135(0.124,0.156) and 0.372(0.210,0.535) for the non-recurrence group, showing significant differences between the two groups ( Z=4.763, 7.243, P<0.05). (3) Diagnostic efficacy of clinical parameters and CT texture parameters: results of multivariate analysis showed the complications, severity of disease, energy value in the arterial phase on CT examination were related factors for recurrence in children with AP, energy value and entropy value in the venous phase on CT examination were related factor for recurrence in children with AP ( odds ratio=0.874, 0.765, 0.837, 0.902, 0.813, 95% confidence interval as 0.802?0.985, 0.581?0.914, 0.753?0.897, 0.862?0.948, 0.765?0.873, P<0.05). Results of ROC analysis showed that that areas under curve (AUC) of complications, severity of disease in the clinical parameters were 0.734 and 0.832, the AUC of single CT texture parameter was 0.811?0.867, the AUC of clinico-pathological parameters combined with CT texture parameters was 0.882. Conclusion:CT texture analysis can early and non-invasively predict the recurrence of AP in children, and the combination of clinicopathological parameters with CT texture parameter has a better predictive efficacy.

9.
Article in English | WPRIM | ID: wpr-880999

ABSTRACT

BACKGROUND@#Acupuncture therapy has shown promise for effectively relieving preoperative anxiety. Nevertheless, previous findings from randomized controlled trials (RCTs) are inconsistent and must be examined in detail.@*OBJECTIVE@#This study systematically evaluates the efficacy and safety of acupuncture therapy for preoperative anxiety as well as the quality of evidence supporting this application.@*SEARCH STRATEGY@#The China National Knowledge Infrastructure Database, Wanfang Data Journal Database, Chinese Biomedical Literature Database, Chongqing VIP, Embase, PubMed and Cochrane Library Databases were queried from their inception to 19, February 2020, using keywords such as "acupuncture therapy," "preoperative" and "anxioty." Manual searches expanded the search breadth and included conference abstracts and other reference lists.@*INCLUSION CRITERIA@#RCTs were included in the current study if they contained a comparison between a group of anxiety patients that received acupuncture therapy and a control group that received sham acupuncture.@*DATA EXTRACTION AND ANALYSIS@#Literature was reviewed, and various articles were selected using the NoteExpress 3.2.0 software. Two researchers independently screened and extracted data and evaluated the risk of bias in the included studies. The RevMan 5.3 software was used for data aggregation and the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) assessment was used to evaluate the quality of the study outcomes.@*RESULTS@#Twelve studies were included in the review, containing a total of 916 patients. Meta-analysis showed that, compared with the control group, patients who received acupuncture therapy had reduced State-Trait Anxiety Inventory Scale (STAI-S) score (mean difference [MD] = -9.07, 95% confidence interval [CI] [-13.19 to -4.96], P < 0.0001) and Visual Analogue Scale (VAS) score (MD = -1.37, 95% CI [-2.29 to -0.45], P = 0.003). However, for the Hamilton Anxiety Scale (HAMA) score, there was no difference between the two groups (MD = -3.98, 95% CI [-12.89 to 4.92], P = 0.38). Further, the GRADE assessment demonstrated that the STAI-S was of moderate quality, the VAS of low quality and the HAMA of very low quality.@*CONCLUSION@#Acupuncture therapy may be able to decrease anxiety in preoperative patients, but the results need to be further verified due to the small sample sizes and the low quality of evidence to date.

10.
Chinese Medical Journal ; (24): 1267-1275, 2021.
Article in English | WPRIM | ID: wpr-878175

ABSTRACT

Immunotherapy has opened a new era in cancer treatment. Drugs represented by immune checkpoint inhibitors have led to important breakthroughs in the treatment of various solid tumors, greatly improving the survival rate of cancer patients. Many types of immunotherapeutic drugs have become widely available; however, their efficacy is variable, and relatively few patients with advanced cancer experience life-altering durable survival, reflecting the complex and highly regulated nature of the immune system. The research field of cancer immunotherapy (CIT) still faces many challenges in pursuing the broader social goal of "curing cancer." Increasing attention has been paid to strengthening the understanding of the molecular or cellular drivers of resistance to immunotherapy, actively exploring more effective therapeutic targets, and developing combination therapy strategies. Here, we review the key challenges that have emerged in the era of CIT and the possible solutions or development directions to overcome these difficulties, providing relevant references for basic research and the development of modified clinical treatment regimens.


Subject(s)
Combined Modality Therapy , Humans , Immunologic Factors , Immunotherapy , Neoplasms/therapy
11.
Article in Chinese | WPRIM | ID: wpr-872003

ABSTRACT

Objective:To establish the clot waveform analysis (CWA) reference intervals of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fbg) and thrombin time (TT) parameters CT, |Min1|, |Min2|, |Max2| and observe the changes in patients with coagulation factors deficiency.Methods:One hundered and twenty-five cases of apparent healthy person were enrolled to establish the CWA reference intervals of four coagulation parameters and 25 cases with coagulation factors were used to study the changes of CWA patients.Results:The CWA reference intervals of PT |Min1| (dT/dt), |Min2| (d 2T/dt 2), |Max2| (d 2T/dt 2) are3.14±1.22, 0.56±0.22 and 0.50±0.18; The CWA reference intervals of APTT |Min1| (dT/dt), |Min2| (d 2T/dt 2), |Max2| (d 2T/dt 2) are 4.75±1.71, 0.78±0.29 and 0.65±0.28; The CWA reference intervals of Fbg CT(s), |Min1| (dT/dt), |Max2|(d 2T/dt 2) are 7.01±1.96, 1.22±0.51 and 0.15±0.11; The CWA reference intervals of TT |Min1| (dT/dt), |Min2| (d 2T/dt 2), |Max2| (d 2T/dt 2) are 0.95±0.32, 0.14±0.05 and 0.07±0.03.These parameters of CWA in factor Ⅴ deficient patients were significantly reduced, the activity of coagulation factor Ⅶ was 0.42, |Min2| and |Max2| were significantly lower than that of normal people. The paramenters of CWA in factor Ⅶ deficient patients were significantly reduce. Conclusion:The CWA reference intervals of four CWA parameters helps judgment of coagulation factor deficiency.

12.
Article in Chinese | WPRIM | ID: wpr-871973

ABSTRACT

Objective:A multi-center and large sample volume study was conducted on the verification and improvement of the early established criteria for intelligent routine urinalysis validation (including the microscopic review rules and manual validation rules, referred to as intelligent criteria for short), in order to improve the clinical application of this intelligent criteria.Methods:A total of 31 456 urine specimens were collected from the inpatients and outpatients in six hospitals in China, from March to September 2019. Firstly, 3105 specimens were analyzed for preliminary verification and improvement of the intelligent criteria based on the results of the microscopic examination and manual validation. Secondly, 28 351 specimens were used to verify the clinical application of the improved intelligent criteria. All samples were manually validated as reference.Results:The approval inconsistency rate of the manual validation rules in the original intelligent criteria was 8.59% (202/2 352), and the interception inconsistency rate was 8.84% (208/2 352). The false negative rate and the microscopic review rate of the microscopic review rules were similar to the previous results. Based on an in-depth analysis of big data and the discussions by senior technicians from eight hospitals, one microscopic review rules and four manual validation rules were added, meanwhile two manual validation rule was deleted. The manual validation standards were unified. Finally, the intelligent criteria was improved. Based on the improved intelligent criteria, for microscopic review rules, the false positive rate, false negative rate (misdiagnosis rate), and microscopic review rate did not change significantly, which were 14.72% (457/3 105), 4.06% (126/3 105), and 24.73% (768/3 105), respectively. The approval inconsistency rate and the interception inconsistency rate of manual validation rules were both reduced to 0; the total manual validation rate of the intelligent criteria was 50.89% (1 580/3 105), and the auto-validation rate was 49.11% (1 525/3 105). The large sample volume verification results were consistent with the preliminary verification results of the improved intelligent criteria.Conclusion:This multi-center and large sample volume study had shown that the improved intelligent criteria had better clinical performance.

13.
Article in Chinese | WPRIM | ID: wpr-905386

ABSTRACT

Functional near-infrared spectroscopy (fNIRS) is a non-invasive functional brain imaging technology, which has been used in observing activation of affected brain area and compensation of unaffected side for stroke patients, as well as the assistance of diagnosis for some other neurological diseases.

14.
Chinese Journal of Orthopaedics ; (12): 1235-1244, 2020.
Article in Chinese | WPRIM | ID: wpr-869079

ABSTRACT

Objective:To explore sagittal parameters change of upper cervical spine after anterior cervical decompression and fusion (ACDF) and analyze the influential factors by comparison between single-, double- and multi-level surgery.Methods:In this retrospective study, 126 patients (include 60 patients with radiculopathy, 41 patients with myelopathy and 25 patients with myeloradiculopathy) who underwent ACDF between December 2016 and December 2018, were followed up at least 1year ranged from14 to 38 months, with the average of 25.6±7.2 months. 20 patients were operated by single-level ACDF, 45 patients were operated by double-level ACDF and 61 patients were operated by 3- or 4-level ACDF. Standing radiographs of cervical spine and the flexion and extension cervical X-rays were obtained in all patients at 1week before, 3 months after and 1year after operation. The Japanese Orthopaedic Association (JOA) Scores, visual analogue scale (VAS) and neck disability index (NDI) were used to evaluate the clinical effectiveness. Cervical sagittal parameters were assessed with the following parameters: the platform angle of axis (C2Slope), the cobb angle and the range of motion (ROM) of C2-7, C0-1 and C1-2.Results:All the patients obtained satisfactory clinical effects. The mean operative time of single-, double- and multi-level group were 86.4±15.5 min, 117.6±15.6 min and 170.2±28.7 min, respectively. The intraoperative blood loss of 3 groups were 16.5±5.2 ml, 37.2±30.5 ml and 63.4±41.5 ml, respectively. There was statistically significant difference between the 3 groups ( P<0.05). In the single- and double-level groups, the changes of the cobb angle and ROM of upper cervical spine between 1 week before operation and 1 year after operation was no significant difference ( P>0.05). In the multi-level group, the ROM of atlantooccipital joint (C0-1) increased significantly from 11.5°±6.1° before operation to 16.1°±13.9° 3 months and 15.3°±4.8° 1 year after operation ( P<0.05). The cobb angle of upper cervical spine and C2Slpoe was decreased significantly from 21.0°±7.6°, 6.1°±6.7° before operation to 18.6°±7.7°, 4.3°±6.9° 3 months and 19.7°±7.2°, 5.6°±6.3° 1 year after operation respectively ( P<0.05). However, there was no significant difference of cobb angle ofatlantooccipital joint between 1 week before operation and 1 year after operation ( P>0.05). Conclusion:Single- and double-level surgery makes a better ability of preserving the restoration of cervical lordosis, with little impact on the upper cervical spine, meanwhile multi-level fusion shows a negative influence on the restoration and limits the range of motion, also increases risk of surgical operation and degeneration of the atlantooccipital joint, with the increased stress distribution and range of motion.

15.
Chinese Journal of Trauma ; (12): 899-904, 2020.
Article in Chinese | WPRIM | ID: wpr-867802

ABSTRACT

Objective:To explore the feasibility and clinical efficacy of gelatin sponge packing in reducing bone cement leakage in percutaneous kyphoplasty (PKP).Methods:A retrospective case-control study was conducted in data of 171 patients (171 vertebrae) with monosegmental lumbar osteoporosis compressive fracture treated by PKP from January 2015 to December 2018 in Sichuan Orthopedic Hospital. There were 66 males and 105 females, with the age of (67.9±6.7)years (range, 60-87 years). There were 22 patients with T 10 fracture, 28 with T 11 fracture, 37 with T 12 fracture, 34 with L 1 fracture, 32 with L 2 fracture and 18 with L 3 fracture. A total of 80 patients were pre-filled with gelatin sponge before injection (Group A), and 91 patients were not filled with gelatin sponge before injection (Group B). The operation time, amount of bone cement, and rate of bone cement leakage were recorded. The change of anterior vertebral height, Cobb angle, visual simulation score (VAS) and Oswestry disability index (ODI) were compared before operation and at postoperative 1 day, 3 months, 6 months, 12 months. Results:All patients were followed up for 1-12 months [(12.8±0.6)months]. The operation time in Group A and B was (48.3±1.2)minutes and (42.3±1.3)minutes ( P<0.05). The amount of bone cement in Group A and B was (5.4±0.8)ml and (5.6±0.7)ml ( P>0.05). The incidence of bone cement leakage in Group A and B was 11% (9/80) and 26% (24/91) ( P<0.05). There was no significant difference between the two groups in the anterior height of injured vertebrae, change of Cobb angle, VAS and ODI before and after operation ( P>0.05). Conclusion:Gelatin sponge can reduce the rate of bone cement leakage in PKP for the treatment of thoracolumbar osteoporosis compressive fracture, and has similar effect with PKP in correcting kyphosis, alleviating pain and improving life quality.

16.
Journal of Chinese Physician ; (12): 407-411, 2020.
Article in Chinese | WPRIM | ID: wpr-867253

ABSTRACT

Objective:To explore the effect of minimally invasive percutaneous pedicle screw internal fixation on the anterior height and Cobb angle of injured vertebra in patients with single vertebra magerl type A thoracolumbar fracture.Methods:71 cases of single vertebra magerl type A thoracolumbar fracture admitted in our hospital from January 2015 to January 2017 were reviewed. Among them, 31 patients who received minimally invasive percutaneous pedicle screw internal fixation were as the observation group, and 40 patients receiving open pedicle internal fixation were as control group. All the patients were followed up for one year, and the preoperative and postoperative indexes, the height of the anterior edge of the injured vertebra and Cobb angle, as well as the score of Oswestry dysfunction were compared between the two groups.Results:The length of incision and the time of descending were shorter in the observation group than in the control group, and the amount of bleeding during operation was less than in the control group ( P<0.05); there was no significant difference in operation time between the two groups ( P>0.05). There was no significant difference in serum creatine kinase (CK) and C-reaction protein (CRP) levels between the two groups ( P>0.05); the levels of serum CK and CRP in the two groups increased significantly after operation, and those in the control group were significantly higher than those in the observation group ( P<0.01). There was no significant difference in the height of anterior edge and Cobb angle between the two groups ( P>0.05); 7 days and 1 year after operation, the height of the anterior edge of the two groups was significantly higher than that before operation ( P<0.01), and the Cobb angle was significantly lower than that before operation ( P<0.01), but there was no significant difference between the two groups ( P>0.05). There was no significant difference in Oswestry dysfunction score between the two groups ( P>0.05); the scores of Oswestry dysfunction were significantly reduced in both groups 7 days and 1 year ater operation, and the observation group was significantly lower than the control group ( P<0.01). Conclusions:Minimally invasive percutaneous pedicle screw fixation can effectively improve the anterior height and Cobb angle of the injured vertebra in patients with single vertebra magerl A thoracolumbar fracture, and the perioperative indexes, serum inflammatory factors and Oswestry dysfunction scores are better than those of open pedicle internal fixation, which is worthy of clinical application.

17.
Article in Chinese | WPRIM | ID: wpr-865632

ABSTRACT

Objective:To study the diagnosis and treatment of osteoporotic fractures in the elderly in two third Grade A hospitals in Shenyang and Dalian, and to provide scientific basis for prevention and treatment of osteoporotic fractures in Dalian and Shenyang.Methods:Patients of osteoporotic fractures over 60 years old from January 2015 to December 2015 in the Second Hospital of Dalian Medical University and the People′s Hospital of Liaoning Province were chosen, and the basic characteristics, fracture site, the number of fracture site, diagnosis treatment and secondary prevention of osteoporosis fractures of them were analyzed.Results:Among the patients of osteoporotic fractures over 60 years old in the hospitals of Shenyang and Dalian, women were more than men ( P = 0.00). The predilection sites of elderly osteoporotic fractures in two hospitals were both followed by the hip, spine, ulnar and radial distal, proximal humerus. The rates respectively were 38.26%(295/771), 34.63% (267/771), 9.34%(72/771), 5.71%(44/771). The rate of fracture-again was 10.89%(84/771). The rates of in-hospital diagnosis, in-hospital treatment and treatment of discharged medical advice among osteoporosis were 13.88%(107/771), 24.64%(190/771) and 18.81%(145/771). There were 0.65% (5/771) patients who had diagnosis of osteoporosis, basic osteoporosis treatment (vitamin D 3 and calcium) and anti-osteoporosis treatment in both in-hospital and discharged medical advice. Conclusions:The rates of in-hospital diagnosis, in-hospital osteoporosis treatment and anti-osteoporosis treatment in discharged medical advice are both very low in the two third Grade A hospitals. The secondary prevention of osteoporosis fractures in the elderly has not been taken attention, and the situation of prevention and treatment are serious.

18.
Article in Chinese | WPRIM | ID: wpr-863858

ABSTRACT

Objective:Intensive physicians have relatively insufficient knowledge and experience in treating patients with decompensated schistosomiasis cirrhosis (DSC) admitted in intensive care unit (ICU), but are relatively familiar with patients with decompensated alcoholic cirrhosis (DAC). For this purpose, the clinical characteristics and prognosis of these patients were compared and analyzed.Methods:A retrospective analysis was performed from January 2013 to May 2019 in our hospital and Quzhou People’s hospital. The demographic data, laboratory examination, liver function, Child-Pugh classification, complications of cirrhosis, ultrasonic imaging gastroscopy manifestations were recorded and analyzed. In addition, the treatments and prognosis were also compared.Results:A total of 30 patients (12 males and 18 females) with DSC (aged 57-88) and 31 patients with DAC (aged 41-75) were collected. Compared with patients with DAC, DSC patients were more likely to have coronary heart disease, lower proportion of hyponatremia and lower need of ventilator support. Although the incidences of jaundice and hepatic encephalopathy were significantly reduced ( P<0.05), but parameters of liver function and coagulation were no significant differences in both groups ( P>0.05). B-mode ultrasound of liver in patients with DSC displayed more proportion of patchy and diffuse echo changes and liver volume reduction ( P<0.05), whereas the manifestations of gastroscope in both groups were similar. No significant difference in main treatment measures like uses of somatostatin and three-chamber and two-capsule tube was observed. After treatment, the stop time of gastrointestinal bleeding was similar between groups of DAC and DSC [1.25 (0.5-4.125) days vs. 1.75 (1-2.375) days] ( P>0.05). In addition, the length of ICU stay in DAC group was similar to DSC group [(4.96±3.58) days vs. (3.82±1.99) days], so did the 28-day mortality [14.29% (2/14) vs. 18.18% (2/11)] (both P>0.05). Conclusions:In genenal, patients with decompensated schistosomiasis cirrhosis have the similar clinical characteristics, major biochemical indicators and accessory examination results like ultrasound and gastroscopic examinations to patients with decompensated alcoholic cirrhosis. After timely treatments, both of these patients could achieve a good prognosis.

19.
Article in Chinese | WPRIM | ID: wpr-863137

ABSTRACT

Susceptibility-weighted imaging (SWI) is a high resolution, three-dimensional gradient echo T 2* sequence magnetic resonance technique. It uses the different susceptibilities between tissues to display the susceptibility image, which is extremely sensitive to paramagnetic substance such as deoxyhemoglobin and blood breakdown substances. In the acute stage of ischemic stroke, SWI can effectively evaluate the severity of the disease, guide the treatment plan, and predict the clinical outcome. This article reviews the research progress of SWI in the acute phase of ischemic stroke.

20.
Article in Chinese | WPRIM | ID: wpr-788896

ABSTRACT

Sub-threshold depression refers to a psychological sub-health state that fails to meet the diagnostic criteria for depression. Appropriate intervention can improve the state and reduce the risks of disease development. In this paper, we focus on music neurofeedback stimulation improving emotional state of sub-threshold depression college students.Twenty-four college students with sub-threshold depression participated in the experiment, 16 of whom were members of the experimental group. Decompression music based on spectrum classification was applied to 16 experimental group participants for 10 min/d music neural feedback stimulation with a period of 14 days, and no stimulation was applied to 8 control group participants. Three feature parameters of electroencephalogram (EEG) relative power, sample entropy and complexity were extracted for analysis. The results showed that the relative power of α、β and θ rhythm increased, while δ rhythm decreased after the stimulation of musical nerofeedback in the experimental group. The sample entropy and complexity were significantly increased after the stimulation, and the differences of these parameters pre and post stimulation were statistically significant ( < 0.05), while the differences of all feature parameters in the control group were not statistically significant. In the experimental group, the scores of self-rating depression scale(SDS) decreased after the stimulation of musical nerofeedback, indicating that the depression was improved. The result of this study showed that music neurofeedback stimulation can improve sub-threshold depression and may provides an effective new way for college students to self-regulation of emotion.

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