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1.
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.

2.
Article in Chinese | WPRIM | ID: wpr-908510

ABSTRACT

With the development of laparoscopic techniques, the requirement of fine dissection in surgeons is also growing. Laparoscopic technique has the advantages in the choice of anatomical level and nerve vascular protection for surgery. 4K laparoscopy provides more clear field of vision and more detailed anatomic prerequisites. Combined with surgical examples, the authors share experiences in protection of plant nerve during 4K laparoscopic radical resection of colorectal cancer.

3.
Article in Chinese | WPRIM | ID: wpr-908502

ABSTRACT

With the development of laparoscopic technology, surgeon's requirements for precise anatomy are gradually increasing. Laparoscopic system has great advantages in the selection of anatomical level, the protection of nerve and blood vessel in surgery. 4K laparoscopic system can provide high-definition vision of operative field, which is conducive to precise anatomical operation. The authors share the practical team cooperation experience of laparoscope left hemi-colectomy for colon cancer in order to provide references for surgical colleagues.

4.
Article in Chinese | WPRIM | ID: wpr-798908

ABSTRACT

Objective@#To investigate the incidence of postoperative pancreatic fistula (POPF) and its risk factors after radical gastrectomy.@*Methods@#The prospective study was conducted. The clinicopathological data of 2 089 patients who underwent radical gastrectomy in 22 medical centers between December 2017 and November 2018 were collected, including 380 in the Zhongshan Hospital of Fudan University, 351 in the Renji Hospital of Shanghai Jiaotong University School of Medicine, 130 in the Ruijin Hospital of Shanghai Jiaotong University School of Medicine, 139 in the Peking University Cancer Hospital, 128 in the Fujian Provincial Cancer Hospital, 114 in the First Hospital Affiliated to Army Medical University, 104 in the First Affiliated Hospital of Nanchang University, 104 in the Affiliated Hospital of Qinghai University, 103 in the Weifang People′s Hospital, 102 in the Fujian Medical University Union Hospital, 99 in the First Affiliated Hospital of Air Force Medical University, 97 in the Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine, 60 in the Hangzhou First People′s Hospital Affiliated to Zhejiang University School of Medicine, 48 in the Fudan University Shanghai Cancer Center, 29 in the First Affiliated Hospital of Xi′an Jiaotong University, 26 in the Lishui Municipal Central Hospital, 26 in the Guangdong Provincial People′s Hospital, 23 in the Jiangsu Province Hospital, 13 in the First Affiliated Hospital of Sun Yat-Sen University, 7 in the Second Hospital of Jilin University, 4 in the First Affiliated Hospital of Xinjiang Medical University, 2 in the Beijing Chao-Yang Hospital of Capital Medical University. Observation indicators: (1) the incidence of POPF after radical gastrectomy; (2) treatment of grade B POPF after radical gastrectomy; (3) analysis of clinicopathological data; (4) analysis of surgical data; (5) risk factors for grade B POPF after radical gastrectomy. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using ANOVA. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Univariate analysis was conducted using the t test or chi-square test based on data excluding missing data of clinico-pathological and surgical data. Multivariate analysis was conducted using the Logistic regression model based on factors with P<0.20 in univariate analysis.@*Results@#There were 2 089 patients screened for eligibility, including 1 512 males, 576 females and 1 without sex information, aged (62±11)years. The body mass index (BMI) was (23±3)kg/m2. (1) The incidence of POPF after radical gastrectomy: the total incidence rate of POPF in the 2 089 patients was 20.728%(433/2 089). The incidence rates of biochemical fistula, grade B pancreatic fistula, and grade C pancreatic fistula were 19.627%(410/2 089), 1.101%(23/2 089), 0, respectively. (2) Treatment of grade B POPF after radical gastrectomy: 2 of 23 patients with grade B POPF after radical gastrectomy had drainage tube placed for more than 21 days and received anti-infective therapy. Four of 23 patients with grade B POPF after radical gastrectomy had ascites detected by imaging examination, of which 2 received peritoneal drainage guided by ultrasound, 1 received failed puncture drainage, 1 received no puncture drainage, and they were given anti-infective therapy. Eleven of 23 patients with grade B POPF after radical gastrectomy had no ascites detected by imaging examinations, and they were given anti-infective therapy and inhibitors of pancreas secretion for clinical manifestation as fever or elevated white blood cells. Six patients with no typical clinical manifestations were given somatostatin to inhibite pancreas secretion and prolonged duration of abdominal drainage tube placement (with a median time of 7 days). All the 23 patients recovered well after treatment, without reoperation. (3) Analysis of clinicopathological data: for the 2 089 patients, BMI, cases with or without neoadjuvant therapy were (23±3)kg/m2, 1 487, 160 of patients without pancreatic fistula, (23±3)kg/m2, 386, 22 of patients with biochemical fistula, and (24±3)kg/m2, 22, 1 of patents with grade B pancreatic fistula, showing significant differences between the three groups (F=5.787, χ2=8.269, P<0.05). (4) Analysis of surgical data: for the 2 089 patients, cases with open surgery, laparoscopic assisted surgery, totally laparoscopic surgery (surgical method), cases with D1 lymph lode dissection, D2 lymph lode dissection, and other lymph lode dissection (range of lymph lode dissection), cases with no omentectomy, partial omentectomy, and total omentectomy (range of omentectomy), cases with no usage of energy facility, usage of CUSA, LigaSure, LigaSure+ CUSA as energy facility, cases with or without biological glue, the number of lymph node dissection were 737, 624, 292, 24, 1 580, 51, 418, 834, 381, 63, 1 530, 23, 16, 1 431, 201, 33±14 of patients without pancreatic fistula, 146, 189, 74, 11, 389, 9, 110, 171, 128, 35, 359, 6, 9, 378, 31, 31±14 of patients with biochemical fistula, and 14, 5, 4, 0, 20, 3, 6, 13, 4, 2, 18, 1, 2, 22, 1, 37±16 of patients with grade B pancreatic fistula, showing significant differences between the three groups (χ2=15.578, 9.397, 15.023, 28.245, 8.359, F=4.945, P<0.05). (5) Risk factors for grade B POPF after radical gastrectomy: results of univariate analysis showed that usage of energy facility was a related factor for grade B POPF after radical gastrectomy (χ2=9.914, P<0.05). Results of multivariate analysis showed that laparoscopic assisted surgery, combined evisceration, application of LigaSure + CUSA, the number of lymph lode dissection were independent factors for for grade B POPF after radical gastrectomy (odds ratio=0.168, 3.922, 9.250, 1.030, 95% confidence interval: 0.036-0.789, 1.031-14.919, 1.036-82.602, 1.001-1.059, P<0.05).@*Conclusions@#The incidence of grade B POPF after radical gastrectomy is relatively low. Laparoscopic assisted surgery, combined evisceration, application of LigaSure + CUSA, and the number of lymph lode dissection are independent risk factors for grade B POPF. Trial Registration: This study was registrated at ClinicalTrial.gov in United States with the registration number of NCT03391687.

5.
Article in Chinese | WPRIM | ID: wpr-865015

ABSTRACT

Objective To investigate the incidence of postoperative pancreatic fistula (POPF) and its risk factors after radical gastrectomy.Methods The prospective study was conducted.The clinicopathological data of 2 089 patients who underwent radical gastrectomy in 22 medical centers between December 2017 and November 2018 were collected,including 380 in the Zhongshan Hospital of Fudan University,351 in the Renji Hospital of Shanghai Jiaotong University School of Medicine,130 in the Ruijin Hospital of Shanghai Jiaotong University School of Medicine,139 in the Peking University Cancer Hospital,128 in the Fujian Provincial Cancer Hospital,114 in the First Hospital Affiliated to Army Medical University,104 in the First Affiliated Hospital of Nanchang University,104 in the Affiliated Hospital of Qinghai University,103 in the Weifang People's Hospital,102 in the Fujian Medical University Union Hospital,99 in the First Affiliated Hospital of Air Force Medical University,97 in the Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine,60 in the Hangzhou First People's Hospital Affiliated to Zhejiang University School of Medicine,48 in the Fudan University Shanghai Cancer Center,29 in the First Affiliated Hospital of Xi'an Jiaotong University,26 in the Lishui Municipal Central Hospital,26 in the Guangdong Provincial People's Hospital,23 in the Jiangsu Province Hospital,13 in the First Affiliated Hospital of Sun Yat-Sen University,7 in the Second Hospital of Jilin University,4 in the First Affiliated Hospital of Xinjiang Medical University,2 in the Beijing Chao-Yang Hospital of Capital Medical University.Observation indicators:(1) the incidence of POPF after radical gastrectomy;(2) treatment of grade B POPF after radical gastrectomy;(3) analysis of clinicopathological data;(4) analysis of surgical data;(5) risk factors for grade B POPF after radical gastrectomy.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was analyzed using ANOVA.Count data were described as absolute numbers or percentages,and comparison between groups was analyzed using the chi-square test.Univariate analysis was conducted using the t test or chi-square test based on data excluding missing data of clinicopathological and surgical data.Multivariate analysis was conducted using the Logistic regression model based on factors with P<0.20 in univariate analysis.Results There were 2 089 patients screened for eligibility,including 1 512 males,576 females and 1 without sex information,aged (62± 11)years.The body mass index (BMI) was (23±3) kg/m2.(1) The incidence of POPF after radical gastrectomy:the total incidence rate of POPF in the 2 089 patients was 20.728%(433/2 089).The incidence rates of biochemical fistula,grade B pancreatic fistula,and grade C pancreatic fistula were 19.627%(410/2 089),1.101%(23/2 089),0,respectively.(2) Treatment of grade B POPF after radical gastrectomy:2 of 23 patients with grade B POPF after radical gastrectomy had drainage tube placed for more than 21 days and received anti-infective therapy.Four of 23 patients with grade B POPF after radical gastrectomy had ascites detected by imaging examination,of which 2 received peritoneal drainage guided by ultrasound,1 received failed puncture drainage,1 received no puncture drainage,and they were given anti-infective therapy.Eleven of 23 patients with grade B POPF after radical gastrectomy had no ascites detected by imaging examinations,and they were given anti-infective therapy and inhibitors of pancreas secretion for clinical manifestation as fever or elevated white blood cells.Six patients with no typical clinical manifestations were given somatostatin to inhibite pancreas secretion and prolonged duration of abdominal drainage tube placement (with a median time of 7 days).All the 23 patients recovered well after treatment,without reoperation.(3) Analysis of clinicopathological data:for the 2 089 patients,BMI,cases with or without neoadjuvant therapy were (23±3) kg/m2,1 487,160 of patients without pancreatic fistula,(23±3)kg/m2,386,22 of patients with biochemical fistula,and (24±3)kg/m2,22,1 of patents with grade B pancreatic fistula,showing significant differences between the three groups (F=5.787,x2 =8.269,P<0.05).(4) Analysis of surgical data:for the 2 089 patients,cases with open surgery,laparoscopic assisted surgery,totally laparoscopic surgery (surgical method),cases with D1 lymph lode dissection,D2 lymph lode dissection,and other lymph lode dissection (range of lymph lode dissection),cases with no omentectomy,partial omentectomy,and total omentectomy (range of omentectomy),cases with no usage of energy facility,usage of CUSA,LigaSure,LigaSure+CUSA as energy facility,cases with or without biological glue,the number of lymph node dissection were 737,624,292,24,1 580,51,418,834,381,63,1 530,23,16,1 431,201,33±14 of patients without pancreatic fistula,146,189,74,11,389,9,110,171,128,35,359,6,9,378,31,31± 14 of patients with biochemical fistula,and 14,5,4,0,20,3,6,13,4,2,18,1,2,22,1,37±16 of patients with grade B pancreatic fistula,showing significant differences between the three groups (x2=15.578,9.397,15.023,28.245,8.359,F=4.945,P< 0.05).(5) Risk factors for grade B POPF after radical gastrectomy:results of univariate analysis showed that usage of energy facility was a related factor for grade B POPF after radical gastrectomy (x2=9.914,P<0.05).Results of multivariate analysis showed that laparoscopic assisted surgery,combined evisceration,application of LigaSure + CUSA,the number of lymph lode dissection were independent factors for for grade B POPF after radical gastrectomy (odds ratio=0.168,3.922,9.250,1.030,95% confidence interval:0.036-0.789,1.031-14.919,1.036-82.602,1.001-1.059,P<0.05).Conclusions The incidence of grade B POPF after radical gastrectomy is relatively low.Laparoscopic assisted surgery,combined evisceration,application of LigaSure + CUSA,and the number of lymph lode dissection are independent risk factors for grade B POPF.Trial Registration:This study was registrated at ClinicalTrial.gov in United States with the registration number of NCT03391687.

6.
Article in Chinese | WPRIM | ID: wpr-828534

ABSTRACT

OBJECTIVE@#To investigate the prognosis of patients with vulnerable plaque indicated by coronary CT angiography (CCTA).@*METHODS@#Totally 1963 patients underwent CCTA from February 2nd 2015 to September 13th 2015, and 2728 coronary borderline lesions (stenosis of 50%-70%) were detected. Among them 804 patients had vulnerable plaques and 1159 patients had stable plaques. The primary endpoint was major cardiac adverse events (MACE), including cardiac death, acute myocardial infarction and target lesion revascularization.@*RESULTS@#Patients were followed up for a mean follow-up of 27.4±2.3 months. The incidence of MACE in the vulnerable plaque group was significantly higher than that in the stable plaque group (10.8%vs 2.3%, < 0.01). After adjusting for age, gender, smoking, hypertension, diabetes, hyperlipidemia, the MACE hazard ratio () in the vulnerable plaque group was 5.022 (95% :3.254-7.751, < 0.01).Subgroup analysis showed that in the vulnerable plaque group, the incidence of MACE in patients taking antiplatelet and statin ≤3 months and those taking antiplatelet and statin > 3 months was 17.0%and 5.8%, respectively (=3.149, 95% :1.987-4.992, < 0.01); but the difference did not seen in stable plaque group (=1.721, 95% :0.798-3.712, >0.05).@*CONCLUSIONS@#This study confirmed the risk of MACE in patients with vulnerable plaque detected by CCTA and the drug treatment may reduce the risk for patients with vulnerable plaque.


Subject(s)
Computed Tomography Angiography , Coronary Angiography , Coronary Artery Disease , Diagnostic Imaging , Coronary Stenosis , Diagnostic Imaging , Humans , Infant , Plaque, Atherosclerotic , Diagnostic Imaging , Pathology , Prognosis , Risk Factors
7.
Article in English | WPRIM | ID: wpr-772271

ABSTRACT

Genetic studies have revealed a critical role of Distal-homeobox (Dlx) genes in bone formation, and our previous study showed that Dlx2 overexpressing in neural crest cells leads to profound abnormalities of the craniofacial tissues. The aim of this study was to investigate the role and the underlying molecular mechanisms of Dlx2 in osteogenic differentiation of mouse bone marrow stromal cells (BMSCs) and pre-osteoblast MC3T3-E1 cells. Initially, we observed upregulation of Dlx2 during the early osteogenesis in BMSCs and MC3T3-E1 cells. Moreover, Dlx2 overexpression enhanced alkaline phosphatase (ALP) activity and extracellular matrix mineralization in BMSCs and MC3T3-E1 cell line. In addition, micro-CT of implanted tissues in nude mice confirmed that Dlx2 overexpression in BMSCs promoted bone formation in vivo. Unexpectedly, Dlx2 overexpression had little impact on the expression level of the pivotal osteogenic transcription factors Runx2, Dlx5, Msx2, and Osterix, but led to upregulation of Alp and Osteocalcin (OCN), both of which play critical roles in promoting osteoblast maturation. Importantly, luciferase analysis showed that Dlx2 overexpression stimulated both OCN and Alp promoter activity. Through chromatin-immunoprecipitation assay and site-directed mutagenesis analysis, we provide molecular evidence that Dlx2 transactivates OCN and Alp expression by directly binding to the Dlx2-response cis-acting elements in the promoter of the two genes. Based on these findings, we demonstrate that Dlx2 overexpression enhances osteogenic differentiation in vitro and accelerates bone formation in vivo via direct upregulation of the OCN and Alp gene, suggesting that Dlx2 plays a crucial role in osteogenic differentiation and bone formation.


Subject(s)
Animals , Cell Differentiation , Physiology , Core Binding Factor Alpha 1 Subunit , Homeodomain Proteins , Metabolism , Mesenchymal Stem Cells , Metabolism , Mice , Mice, Nude , Osteoblasts , Metabolism , Osteocalcin , Osteogenesis , Physiology , Transcription Factors , Metabolism , Up-Regulation
8.
Article in Chinese | WPRIM | ID: wpr-806959

ABSTRACT

Objective@#To investigate the effects of Casein kinase 2-interacting protein 1 (CKIP-1) gene silencing on the proliferation of glioma cells U87-MG.@*Methods@#The recombinant lentiviral vectors targeting CKIP-1 gene or negative control were constructed and then used to infect glioma U87-MG cell line.The effects of knock-down on the mRNA or protein expression of CKIP-1 were evaluated by real-time qPCR and western blotting.Cell cycle was detected by the flow cytometry assay, and cell proliferation changes were evaluated by cell counting, MTT, and BrdU assay, respectively.Lastly, the colony formation was used to investigate the effect of CKIP-1 knock-down on the clone formation.@*Results@#Compared with the group of Ctrl, CKIP-1 siRNA was observed to significantly inhibit CKIP-1 expression at the mRNA levels (Ctrl (1.01±0.13) vs CKIP-1 siRNA (0.23±0.02), P<0.01) and protein levels in the U87-MG cells.Also, CKIP-1 suppression mediated by RNAi decreased the ratio of G0/G1 phase (Ctrl (69.64±0.79) vs CKIP-1 siRNA(62.64±0.66), P<0.01), increased that of G2/M phase (Ctrl (8.36±0.52) vs CKIP-1 siRNA(13.87±2.90), P<0.05), and significantly inhibited the cell proliferation and clone formation (Colony number: Ctrl (25±2) vs CKIP-1 siRNA(2±1), P<0.05) of transfected U87-MG cells.@*Conclusion@#Knocking down the expression of CKIP-1 significantly inhibit cell proliferation in human U87-MG glioma cells, indicating that CKIP-1 is involved in the development of gliomas and could promote the cell proliferation.

9.
Article in Chinese | WPRIM | ID: wpr-699073

ABSTRACT

Objective To investigate the influence of body configuration on the therapeutic effects of totally laparoscopic and laparoscopy-assisted radical total gastrectomies.Methods The retrospective cohort study was conducted.The clinicopathological data of 677 patients with gastric cancer who underwent laparoscopic radical total gastrectomies in the 11 clinical centers [100 patients in the First Affiliated Hospital of Army Medical University (Third Military Medical University),98 in the First Affiliated Hospital of Nanjing Medical University,94 in the First Affiliated Hospital of Nanchang University,89 in the First Affiliated Hospital of Xiamen University,81 in the Affiliated Hospital of Qinghai University,81 in the First Affiliated Hospital of Xinjiang Medical University,42 in the First Affiliated Hospital of Xi'an Jiaotong University,39 in the Traditional Chinese Medicine Hospital of Guangdong Province,26 in the First People's Hospital of Hangzhou City,17 in the Second Affiliated Hospital of Jilin University and 10 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] from January 2015 to June 2017 were collected.Among 677 patients,305 [89 patients in the First Affiliated Hospital of Army Medical University (Third Military Medical University),28 in the First Affiliated Hospital of Nanjing Medical University,14 in the First Affiliated Hospital of Nanchang University,26 in the First Affiliated Hospital of Xiamen University,75 in the Affiliated Hospital of Qinghai University,14 in the First Affiliated Hospital of Xinjiang Medical University,10 in the First Affiliated Hospital of Xi'an Jiaotong University,10 in the Traditional Chinese Medicine Hospital of Guangdong Province,19 in the First People's Hospital of Hangzhou City,13 in the Second Affiliated Hospital of Jilin University and 7 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] undergoing totally laparoscopic total gastrectomy were allocated into the totally laparoscopic group,and 372 [11 in the First Affiliated Hospital of Army Medical University (Third Military Medical University),70 in the First Affiliated Hospital of Nanjing Medical University,80 in the First Affiliated Hospital of Nanchang University,63 in the First Affiliated Hospital of Xiamen University,6 in the Affiliated Hospital of Qinghai University,67 in the First Affiliated Hospital of Xinjiang Medical University,32 in the First Affiliated Hospital of Xi'an Jiaotong University,29 in the Traditional Chinese Medicine Hospital of Guangdong Province,7 in the First People's Hospital of Hangzhou City,4 in the Second Affiliated Hospital of Jilin University and 3 in the Xijing Hospital of Air Force Medical University (Fourth Military Medical University)] undergoing laparoscopy-assisted total gastrectomy were allocated into the laparoscopy-assisted group.All patients received laparoscopic radical total gastrectomy and D2 lymphadenectomy using routine five-port method.Roux-en-Y anastomosis was applied for digestive tract reconstruction,and digestive tract reconstruction was performed under laparoscopy in the totally laparoscopic group and via upper abdominal median incision in the laparoscopy assisted group.Observation indicators:(1) surgical and postoperative situations;(2) stratified analysis:surgical and postoperative situations of obese patients [body mass index (BMI) > 25.0 kg/m2,the maximum vertical distance between the anterior abdominal skin and the back skin at the level of the xiphoid bone (X-APD) > an average value of 22.7 cm and X-APD/the maximum horizontal distance of a plane at a right angle to X-APD (X-TD) >an average value of 0.8] between groups;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative overall survival and tumor recurrence or metastasis up to July 2017.Measurement data with normal distribution were represented as x±s.Comparison between groups was analyzed by the t test.Measurement data with skewed distribution were described as M(Q),and comparison between groups was analyzed by Mann-Whithey test.Comparisons of count data were analyzed using the chi-square test.Results (1) Surgical and postoperative situations:all the patients in the 2 groups underwent successful operations,without perioperative death.Esophagojejunostomy methods of 305 patients in totally laparoscopic group:conventional circular stapler method were performed in 107 patients,antipuncture circular staplar method in 6 patients,OrVilTM method in 5 patients,functional end-to-end esophagojejunostomy method in 76 patients,peristalsis side-to-side esophagojejunostomy method in 106 patients and π esophagojejunostomy method in 5 patients.Three hundred and seventy-two patients in the totally laparoscopic group received conventional circular stapler method,including 361 with end-to-side esophagojejunostomy method and 11 with half end-to-end esophagojejunostomy method.Total operation time,time of esophagojejunostomy,length of assisted incision and using time of analgesics were respectively (235± 72)minutes,(33 ± 15)minutes,(5.6± 1.4) cm,(2.0 ± 1.2) days in the totally laparoscopic group and (223± 63) minutes,(29 ± 10) minutes,(8.0 ± 2.6) cm,(2.3 ± 1.6) days in the laparoscopy-assisted group,with statistically significant differences between groups (t =2.383,3.289,-15.236,-2.780,P < 0.05).The eases with postoperative overall complications,anastomosis bleeding,anastomosis stricture,anastomosis leakage were respectively 38,6,11,11 in the totally laparoscopic group and 35,7,10,13 in the laparoscopy-assisted group,with no statistically significant difference between groups (x2 =1.621,0.007,0.470,0.006,P>0.05).All the patients with postoperative complications were cured by symptomatic treatment.(2) Stratified analysis:length of assisted incision,using time of analgesics,time to postoperative anal exsufflation,time for initial fluid diet intake,time for initial semi-fluid diet intake,time of postoperative drainage-tube removal and duration of postoperative hospital stay in obese patients with BMI>25.0 kg/m2,X-APD>22.7 cm and X-APD/X-TD>0.8 were respectively (5.9±1.3)cm,(5.7±1.4)cm,(5.6±1.4)cn,(2.0±1.2) days,(2.2±1.1)days,(2.1±1.1)days,(3.4±0.9) days,(3.3±0.9)days,(3.3±0.8)days,(4.7±1.1)days,(4.1±2.0)days,(4.0±1.6)days,(6.6±1.5)days,(6.4±2.3)days,(6.3±1.9)days,(7.8±2.3)days,(7.8±2.7)days,(7.6±2.9)days,(9±4)days,(10±5)days,(10±5) days in the totally laparoscopic group and (8.7±3.1)cm,(8.9±3.0)cm,(8.8±2.8)cm,(2.4±1.3)days,(2.5±1.5)days,(2.5±1.6)days,(3.7±1.0)days,(3.8±1.1)days,(3.7±1.3)days,(5.3±1.7)days,(4.8±1.7)days,(5.0±1.9)days,(7.4±2.3)days,(7.8±2.0)days,(7.0±2.2)days,(8.7±2.4)days,(8.4±1.9)days,(8.1±1.5)days,(1 1±8)days,(11±5)days,(1 1±5)days in the laparoscopy-assisted group,with statistically significant differences between groups (t =-7.950,-2.246,-2.222,-2.500,-2.771,-2.404,-2.251,P<0.05).There were statistically significant differences in above indicators of patients with X-APD>22.7 cm between groups (t =-12.089,-2.064,-3.732,-3.220,-5.297,-2.074,-2.208,P<0.05),and in above indicators of patients with X-APD/X-TD>0.8 between groups (t =-13.451,-2.736,-3.354,-4.961,-3.280,-2.137,-2.127,P<0.05).(3) Follow-up and survival situations:of 677 patients,645 were followed up for 1-31 months,with a median time of 12 months,including 283 in the totally laparoscopic group and 362 in the laparoscopy-assisted group.During the follow-up,cases with overall survival,tumor recurrence and tumor metastasis were respectively 255,18 and 21 in the totally laparoscopic group and 327,25 and 20 in the laparoscopy-assisted group (11 and 10 patients in the totally laparoscopic and laparoscopy-assisted groups with simutaneous tumor recurrence and metastasis),showing no statistically significant difference between groups (x2 =0.009,0.076,0.959,P > 0.05).Conclusions Totally laparoscopic and laparoscopy-assisted radical total gastrectomies are safe and feasible in obese patients,with the equivalent time of esophagojejunostomy.Totally laparoscopic radical total gastrectomy is of benefit to short-term recovery of patients.

10.
Article in Chinese | WPRIM | ID: wpr-706346

ABSTRACT

Objective To investigate the value of stretched-exponential model of DWI in differential diagnosis of benign and malignant breast lesions.Methods Totally 58 patients with 63 breast lesions (33 benign,30 malignant lesions) were enrolled.All the patients underwent multiple b value DWI and dynamic contrast enhancement MRI (DCE-MRI) scans.The values of ADC,DDC and water molecular diffusion heterogeneity index (α) were calculated,and the time signal intensity curve (TIC) was obtained.All the parameters were compared between benign and malignant breast lesions.The diagnostic performance of different parameters was evaluated with ROC curve.Results ADC,DDC and α value of malignant lesions was (1.01±0.19)×10-3 mm2/s,(0.89±0.23)×10-3 mm2/s and 0.75±0.09,while of benign lesions was (1.41±0.27)× 10-3 mm2/s,(1.49±0.29)× 10-3mm2/s and 0.87±0.07,respectively.All 3 parameters in malignant lesions were lower than those in benign lesions (all P<0.01).Taking 1.22 × 10-3 mm2/s as the optimal threshold,the area under the curve (AUC) of DDC was the largest as 0.958,and the corresponding diagnostic sensitivity and specificity was 96.67% and 81.82%,respectively.AUC value was 0.976 by combining DDC with TIC,and the corresponding diagnostic sensitivity and specificity was 93.33% and 93.94%,respectively.Conclusion The stretched-exponential model DWI can differentiate breast lesions,and diagnostic performance of combination of DDC and TIC is better than ADC or DCE.

11.
Journal of Chinese Physician ; (12): 243-246, 2018.
Article in Chinese | WPRIM | ID: wpr-705818

ABSTRACT

Objective To explore the clinical efficacy of intensity-modulated radiotherapy combined with chemotherapy in the treatment of advanced cervical cancer.Methods All 121 patients with advanced cervical cancer (stage Ⅱ B &Ⅲ A & Ⅲ B) selected in our hospital from June 2012 to June 2014, who were treated with combined chemoradiotherapy, were divided into observation group [intensity modulated radiation therapy (IMRT)group)] and control group [3-dimensional conformal radiation therapy (3D-CRT) group].There was no significant difference between two groups in mean age, body mass index, International Federation of Gynecology and Obstetrics (FIGO) clinical stage, pathological type and chemotherapy mode (P > 0.05).The clinical features of two groups were compared.The treatment and follow-up of two groups were recorded.Results The bone marrow suppression [32.2% (19/59) vs 51.6% (32/ 62)], gastrointestinal reaction [42.4% (25/59) vs 62.9% (39/62)], and rectal reaction rate [27.1% (16/59) vs 45.2% (28/62)] of the observation group were significantly less than that of the control group (P < 0.05).The incidences of genitourinary tract injury [18.6% (11/59) vs 24.2% (15/62)], radiation proctitis [23.7% (i4/59) vs 25.8% (16/62)] and radiation cystitis [16.9% (10/59) vs 20.9% (13/ 62)] of two groups had no significant difference (P > 0.05).Two groups were followed up for 3 years, the local control rate of the observation group was significantly higher than that of the control group (86.3% vs 70.1%) (P < 0.05).Conclusions IMRT combined with chemotherapy in the treatment of advanced cer vical cancer can improve the local control rate of tumor, protect the endangered organ, and reduce the side effects of radiotherapy.

12.
Chinese Journal of Geriatrics ; (12): 947-950, 2017.
Article in Chinese | WPRIM | ID: wpr-607664

ABSTRACT

Objectives To investigate MRI patterns of functional connectivity(FC)in different brain areas of the subthalamic nucleus (STN)in Parkinson's Disease (PD)and its correlation with cognition.Methods We used functional magnetic resonance imaging to investigate the difference in whole-brain resting-state FC of STN between 32 patients with PD during the medicatiom ON state and 25 healthy control group(HC)matched for age,gender,and cognition,and examine the correlation between functional connectivity strength and montreal cognitive assessment (MoCA)scores.Results Compared with HC,the PD group showed increased FC in the right lingual gyrus of the left STN and the right STN showed decreased FC in the left superior frontal gyrus and the supplementary motor area(t=4.29,-3.61,and-3.83,respectively,each P < 0.05),while the right STN showed only decreased FC in the right bilateral cingulate gyrus and the precuneus(t=-4.44,4.29,and-4.30,respectively,each P< 0.05).In addition,PD patients' connectivity strength between RSTN and the bilateral precuneus was positively correlated with MoCA scores(t =0.58 and 0.57,respectively,each P<0.05).Conclusions Compared with HC,PD patients exhibit decreased FC between RSTN and the precuneus,with FC strength positively correlated with MOCA scores.The cognitive decline caused by deep brain stimulation in STN may be related to injuries of the precuneus.

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Chinese Journal of Neurology ; (12): 17-23, 2017.
Article in Chinese | WPRIM | ID: wpr-509150

ABSTRACT

Objective To investigate the changed brain areas of functional connectivity ( FC ) patterns of subthalamic nucleus ( STN) between different subtypes of Parkinson′s disease ( PD) and healthy controls and their clinical significance .Methods Twenty-three PD patients and 12 health controls were enrolled, and PD patients were divided into 11 tremor dominant PD patients and 12 postural instability and gait disorder (PIGD) dominant PD patients.The difference of whole-brain resting-state FC with STN among the three groups was investigated and the relationship between the changed areas and clinical symptoms was calculated.Results Compared with healthy controls , PIGD dominant group showed increased FC between STN and right calcarine and decreased FC between STN and right precuneus , and tremor dominant PD patients showed decreased FC between STN and precuneus , right angular gyrus and left middle frontal gyrus , while the FC strength between the STN and left middle frontal gyrus showed positive relationship with MMSE scores ( r=0.64, P=0.034 ) .Compared with tremor dominant PD patients , PIGD dominant patients showed increased FC in the area of left calcarine .Conclusions Decreased FC between STN and precuneus was gained in different subtypes of PD , and PIGD dominant patients showed increased FC between STN and calcarine.Changed areas based on the FC of STN in different subtypes of PD were found related with cognition and mood control .

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Chinese Journal of Geriatrics ; (12): 553-556, 2015.
Article in Chinese | WPRIM | ID: wpr-475854

ABSTRACT

Objective To investigate the effect of lycopene (Lyc) on H9c2 cell apoptosis induced by angiotensin Ⅱ (Ang Ⅱ).Methods Using Ang Ⅱ (10 μmol/L) to stimulate H9c2 cells,we observed the protective effect of Lyc on H9c2 cells apoptosis.The H9c2 cells viability induced by different consideration of Lyc or Ang Ⅱ or both was detected by CCK8 assay.The expression levels of Bax and Bcl-2 in H9c2 cells were determined by real-time quantitative reverse transcription polymerase chain reaction (RT-PCR).Western blot was conducted to detect the protein expressions of Bax,Caspase 3,Caspase 9 and Bcl-2 in H9c2 cells.The apoptotic ratio of H9c2 cells was observed by TUNEL assay.Results Compared with control group,Ang Ⅱ could decrease the viability of H9c2 cells to (92.87±4.37)%.The result of RT-PCR showed that Ang Ⅱ decreased the expression level of Bcl-2,and Bax level was increased under the stimulation of Ang Ⅱ (P<0.05),while the expression level of Bcl-2 was increased and Bax level was decreased under the co-stimulation of Ang Ⅱ and Lyc in a concentration dependent manner,which indicated that Lyc ameliorated the apoptosis of H9c2 cells.The result of western blot showed that the protein expressions of Bax,Caspase 3 and Caspase 9 were increased,but Bcl-2 was decreased after the stimulation of Ang Ⅱ (P<0.05).While these phenomenon reversed apparently under the co stimulation of Ang Ⅱ and Lyc.A large number of apoptotic cells were observed under the stimulation of Ang Ⅱ through TUNEL assay.But the number of apoptotic cells reduced significantly under the co-stimulation of Lyc and Ang Ⅱ (P <0.05).Conclusions Lyc ameliorates the H9c2 cell apoptosis induced by Ang Ⅱ,which indicates that Lyc may have an important role in the treatment of various cardiovascular diseases.

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Article in Chinese | WPRIM | ID: wpr-482363

ABSTRACT

Objective To investigate effect of interferon gemma on immune factor and CD69, CD107a in patients with delayed type hypersensitivity by interferon gamma.Methods 76 cases with delayed type hypersensitivity were selected and divided into 2 groups.38 cases in control group were treated conventional therapy, 38 cases in experiment group were treated by interferon gamma.Peripheral blood CD69, CD107a, immune factor, T cell subsets and the treatment efficiency were compared after the treatment.Results Compared with the control group, the serum CD69 and CD107a levels were lower in the experimental group (P<0.05), serum IgG and IgA levels were higher, the serum IgE level was lower (P<0.05), and the CD3 +,CD4 +,CD4 +/CD8 +level was higher, serum CD8 + was lower (P<0.05) .The effective rate of the treatment group was significantly higher than that of the control group (P<0.05) .Conclusion Interferon gamma has good clinical effect in the patients with delayed type hypersensitivity, and can effectively reduce the levels of CD69 and CD107a in the peripheral blood, and regulate the immune function of the body.

16.
Article in Chinese | WPRIM | ID: wpr-353763

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the effects of different treatments on the prognosis of patients with synchronous colorectal liver metastasis(CLM).</p><p><b>METHODS</b>Clinicopathological data of 121 patients with synchronous CLM in The First Affiliated Hospital of Xinjiang Medical University between January 2010 and December 2014 were retrospectively analyzed. According to the metastatic lesions, patients were divided into simple operation group(22 patients, receiving operation only), simple chemotherapy group(43 patients, receiving chemotherapy only), and combination group(56 patients, receiving chemotherapy based on operation). The prognosis of patients in three groups was investigated. Univariate and multivariate analyses were performed through the long-rank test and Cox model to evaluate the related factors affecting prognosis.</p><p><b>RESULTS</b>The median survival time was 10(3-39) months in simple operation group, 7(3-36) months in simple chemotherapy group, and 18 (4-66) months in combination group. The differences among groups were all statistically significant (all P<0.05). Extent of lymph node metastasis, number of liver metastatic lesion, size of liver metastatic lesion, resection edge extent of liver metastatic lesion, and treatment method were independent factors of synchronous CLM(all P<0.05).</p><p><b>CONCLUSION</b>Combination therapy of a variety of treatment can prolong the survival of patients with synchronous CLM.</p>

17.
Article in Chinese | WPRIM | ID: wpr-317801

ABSTRACT

<p><b>OBJECTIVE</b>This study was performed to determine the feasibility of digital virtual positioning of braces in clinical applications.</p><p><b>METHODS</b>We determined the positions of brackets in 28 teeth of 15 cases according to positioning methods that use bracket height or root information. Final status was generated by OrthoRx software. Treatment results were assessed with American board of orthodontics objective grading system (ABO-OGS).</p><p><b>RESULTS</b>The deduction points in the marginal ridge height were significantly decreased after treatment using the two methods (P<0.05). However, no statistically significant difference was found in the deduction points in the marginal ridge height between the two methods (P>0.05). No improvement was found in the deduction points in root parallelism with both methods. No statistical significance was found in the deduction points in root parallelism before and after treatments using both methods. The deduction points in alignment and the three scoring components were significantly decreased after treatment using the two positioning methods. In addition, statistically significant differences were found in the deduction points in alignment between two methods (P<0.05).</p><p><b>CONCLUSION</b>By using OrthoRx software, we achieved effective therapeutic treatment in reconstructing three-dimensional digital modes using two different bracket-positioning methods. The positioning method that used root information is more accurate compared with the bracket height positioning method. This study provides an experimental basis for bracket accuracy in the mouth.</p>


Subject(s)
Bicuspid , Humans , Models, Biological , Orthodontic Brackets , Orthodontics , Software
18.
Article in Chinese | WPRIM | ID: wpr-489458

ABSTRACT

Objective To explore the efficacy and safety of improved covered metallic stents for proximal malignant esophageal strictures.Methods A total of 56 patients with proximal malignant esophageal strictures were treated with improved covered metallic stents whose diameter was 14 mm or 16 mm at Shanxi Province Tumor Hospital from Feburary 2013 to August 2014.Swallowing condition, physical and life quality were compared before and after surgery and analyzed.At the same time, side effects and complications were recorded during and after surgery.Results All 56 patients were treated successfully with improved covered metallic stents, no complications related with stents occurred after surgery.Swallowing conditions were improved after surgery, there were 45 patients with obvious improvement, 10 patients with better improvement and 1 patient's stent taken out due to stent intolerance.Remission rate of swallowing conditions was 98.2% (55/56).Two weeks after surgery, Stooler of swallowing conditions obviously improved (t =7.05, P < 0.05), physical conditions (ZPS) also improved (t =22.49, P < 0.05), but there was no significant difference in life quality (Kamofsky scores) (t =1.07, P > 0.05).During 90 days of follow-up there was no hemorrhage or perforation.Conclusion The application of improved covered metallic stents for proximal malignant esophageal strictures is safe and effective.

19.
Chongqing Medicine ; (36): 2183-2185,2188, 2015.
Article in Chinese | WPRIM | ID: wpr-601311

ABSTRACT

Objective To investigate the effects of prostaglandin E1 (PGE1) on the levels of myocardium nuclear factor‐κB (NF‐κB) and plasma tumor necrosis factor‐α (TNF‐α) in patients underwent heart valve replacement .Methods Forty ASA Ⅱ orⅢ degree patients (NYHA Ⅱ or Ⅲ degree) ,aged 32 to 67 years with body mass index of 17 to 28 kg/m2 ,underwent heart valve replacement ,were randomly divided into 2 groups (n=20):control group (group C) and PGE1 group (group P) .After induction of anesthesia ,PGE1 20 ng · kg -1 · min-1 was infused intravenously in group P ,while the equivalent volume of normal saline was giv‐en in group C ,and the infusion was completed at the end of operation .Arterial blood samples were collected at the time of before cardiopulmonary bypass (T0 ,baseline) ,30 min after the begin of cardiopulmonary bypass (T1 ) ,the end of cardiopulmonary bypass (T2 ) ,and 12 h(T3 ) ,24 h(T4 ) after the end of cardiopulmonary bypass .Myocardial specimens were obtained from right auricular appendage at T0 and T2 for microscopic examination and determination the activity of NF‐κB .Results The plasma mass concentra‐tions of TNF‐αwas significantly lower (P<0 .05) at T1 to T4 ,while the myocardial histopathological damage was lighter and the activity of NF‐κb significantly attenuated (P<0 .05) at T2 in group P than that in group C .Conclusion PGE1 can attenuate myo‐cardial injury in patients underwent heart valve replacement ,the mechanism is related to inhibit the activity of myocardium NF‐κB and decrease the plasma mass concentrations of TNF‐α.

20.
Chongqing Medicine ; (36): 2609-2612, 2015.
Article in Chinese | WPRIM | ID: wpr-460267

ABSTRACT

Objective To study the effect of morin on LPS induced acute lung injury mouse model and its mechanism .Meth‐ods Thirty male C57B/L mice were randomly divided into control group ,LPS group and LPS+ morin group ,with 10 in each group .5 mg/kg LPS was instilled into the lung from an trachea intubation in LPS group and LPS+morin group .Then the mice in LPS+morin group received an intraperitoneal injection of morin (40 mg/kg) every day for the next 3 d .Others received an equal a‐mount of saline .After 72 h ,the mice were sacrificed .The bronchoalveolar lavage fluid (BALF) was collected and centrifuged;the sediments were stained with Wright‐Giemsa for total cell and neutrophil count and the supernates were prepared for ELISA .The wet and dry weight of lung was weighed to calculate the wet/dry weight ratio .HE staining was performed to examine the pathologi‐cal change of lung .Western blot was used to determined the expression of TLR4 ,IKK and NF‐κB .Results Intratracheal instillation of LPS successfully established ALI model in mouse .LPS caused significant pathological changes including inflammatory cells infil‐tration ,alveolar septa thickness ,hemorrhage and edema .The wet/dry weight ratio ,the total cell count ,neutrophil count ,TNF and IL‐1βlevel in BALF ,and the expression of TLR4 ,NF‐κB ,and IKK were all increased significantly (P<0 .05) ,which were allevia‐ted by intraperitoneal injection of morin .Conclusion Morin can dampen the inflammatory response during LPS induced ALI in mouse ,which is potentially attributed to its inhibitory effect on the activation of NF‐κB .

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