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1.
Chinese Journal of Nephrology ; (12): 803-808, 2021.
Article in Chinese | WPRIM | ID: wpr-911902

ABSTRACT

Objective:To investigate the efficacy and safety of adrenocorticotropic hormone (ACTH) in treating primary nephrotic syndrome in children with dual resistance to glucocorticoids and calcineurin inhibitors (CNIs).Methods:Clinical data of 6 children with primary nephrotic syndrome treated with ACTH in the Children's Hospital of Zhejiang University School of Medicine from January 1, 2015 to December 31, 2019 were retrospectively collected. All the enrolled patients were children with primary nephrotic syndrome with dual resistance to glucocorticoids and CNIs. All the 6 children were given 0.4-1.0 IU·kg -1·d -1 ACTH (total ≤25 IU)+5% glucose 500 ml intravenous infusion for 8 h during the hormone reduction process, with a course of treatment for 5 days, once a month, and continuous treatment for 3-6 months. Clinical data such as 24 h urinary protein quantification, serum albumin, serum cholesterol, estimated glomerular filtration rate (eGFR) level and glucocorticoid dosage were collected at equal time points at 6 months before treatment, at the beginning of treatment, at the end of treatment and at 6 months of follow-up after treatment of ACTH to evaluate the efficacy and adverse reactions. Results:The onset age of 6 children was (4.89±1.77) years, and the age of the first treatment with ACTH was (9.49±3.06) years. All the 6 children completed 3 to 6 months of ACTH treatment, with 2 cases of complete remission, 2 cases of partial remission and 2 cases of no remission. At the end of ACTH treatment, 24 h urinary protein was significantly decreased ( P=0.026), serum albumin level was significantly increased ( P=0.003), and glucocorticoid dosage was significantly decreased ( P<0.001) than before treatment. At 6 months after the end of ACTH treatment, there was no statistical significance in 24 h urinary protein, serum albumin and hormone dosage compared with the end of ACTH treatment (all P>0.05), and the blood cholesterol level continued to decrease ( P=0.039). There was no significant change in eGFR during observation period ( P>0.05). In the process of ACTH infusion, all the 6 children showed transient decrease in urine output, rash in 2 cases, and elevated blood glucose in 1 case, which could be spontaneously relieved after drug withdrawal. There were no serious cardiovascular events, renal impairment, infection and other adverse reactions. Conclusions:ACTH has a good effect on children with primary nephrotic syndrome who are dual resistant to glucocorticoids and CNIs. ACTH can reduce proteinuria, decrease the dosage of glucocorticoids, improve the clinical remission rate, and has good security.

2.
Article in Chinese | WPRIM | ID: wpr-907430

ABSTRACT

Objective:To explore the detection capability of p16/Ki-67 double staining technique in women with various abnormal thinprep cytologic test (TCT) results and its diagnostic value for cervical intraepithelial neoplasia Ⅱ+ grade (CIN2+).Methods:A total of 225 women with abnormal TCT results, i.e. the atypical squamous cells of undetermined significance(ASC-US), in the Tianjin Central Hospital of Gynecology Obstetrics, Nankai University Affiliated Maternity Hospital from December 2018 to December 2019 were enrolled. p16/Ki-67 double staining were detected and compared with the high risk human papillomavirus (HR-HPV) and pathological results.Results:The positive rates of p16/Ki-67 double staining increased with cytologic and pathologic categories. For diagnosis of CIN2+, p16/Ki-67double staining (90.1%) was less sensitive than HR-HPV testing (98.2%)( P<0.05), but the specificity of p16/Ki-67 double staining (58.8%) was significantly higher than HR-HPV(21.6%) ( P<0.001). Conclusions:Compared with HR-HPV, p16/Ki-67 double staining has better effect on diagnosing CIN2+. p16/Ki-67 double staining can be considered as triaging method for management of ASC-US and LSIL patients, significantly reduce the colposcopy referral rate (nearly 50%), which has high clinical application value.

3.
Chinese Journal of School Health ; (12): 1645-1649, 2021.
Article in Chinese | WPRIM | ID: wpr-906547

ABSTRACT

Objective@#This study explored the relationships among psychological stress, achievement motivation and psychological capital in college students to provide a reference for improving the level of psychological capital in college students.@*Methods@#A multi stage stratified cluster sampling method was used to select 9 940 college students from ten universities in Anhui Province. The achievement motivation scale (AMS), psychological stress scale (SRQ-20) and psychological capital scale (PPQ) were applied. The moderating effect of the questionnaire was analyzed with χ 2 tests, Spearman rank correlation and stratified regression.@*Results@#Statistical differences were found in psychological stress according to major, whether students leader, family economic status and whether students had left behind experience ( χ 2=15.50, 10.25, 28.61, 25.55, P <0.05). The rank correlation results indicated that psychological stress was negatively correlated with the pursuit of success ( r =-0.27) and four dimensions of self efficacy,optimism,hope and resilence in psychological capital ( r =-0.43, -0.41,-0.36,-0.45)( P <0.05), and was positively correlated with the avoidance of failure ( r =0.25, P <0.05). The stratified regression model indicated that psychological stress in the dimensions of college students achievement motivation (pursuit of success: β =0.02, Δ R 2=0.01, P <0.01; failure avoidance: β = 0.03 , Δ R 2=0.01, P <0.01) played a moderating role in the relationship between psychological capital and psychological capital.@*Conclusion@#Being female, senior students, low household economic status, and left behind experience are associated with more psychological stress among college students. Psychological stress is correlated with achievement motivation and psychological capital, and has a moderating effect on the relationship between achievement motivation and psychological capital.

4.
Article in Chinese | WPRIM | ID: wpr-866420

ABSTRACT

Objective:To explore the effect of sequel reperfusion percutaneous coronary intervention (PCI) therapy on heart rate variability (HRV) during myocardial reperfusion in patients with acute ST segment elevation myocardial infarction(STEMI).Methods:With a randomly case controlled study method, 180 patients with STEMI in Yidu Central Hospital Affiliated to Weifang Medical College were selected as study objects, and they were randomly divided into two groups: sequel recanalization PCI(sPCI) group(observation group) and conventional primary PCI(pPCI) group(control group), with 90 cases in each grouop.The rate of SDNN<70 mm of the two groups and other indicators of HRV were observed at 14 d after successful PCI.Results:There was statistically significant difference between the two groups in MBG3(77.78% vs.63.33%, χ 2=4.51, P=0.03). There was statistically significant difference between the two groups in the incidence of SDNN<70 mm at 14 d after PCI(10.00% vs.23.33%, χ 2=5.69, P=0.02). If sequel recanalization PCI was served as a variable for predicting SDNN<70 mm, the results of Logistic regression analysis showed that odds ratio ( OR) value was 0.36, 95% confidence interval ( CI) was 0.16-0.85, P=0.02.The other factors that affected the incidence rate of SDNN<70 mm were the level of MBG3( OR=0.45, 95% CI: 0.16~0.95, P=0.03), time-to-reperfusion( OR=2.65, 95% CI: 1.06~5.98, P=0.04), blood sugar level of admission ( OR=1.96, 95% CI: 1.04~7.71, P=0.04), TnI value( OR=2.06, 95% CI: 1.03~5.68, P=0.04), heart function( OR=2.18, 95% CI: 1.08~6.89, P=0.04). Conclusion:The sequel recanalization PCI may be better than conventional PCI for the patients with STEMI in obtaining myocardial blush grades.Meanwhile, it can increase the indicators of HRV and decrease the incidence rate of SDNN<70 mm.

5.
Chinese Journal of Nephrology ; (12): 203-206, 2020.
Article in Chinese | WPRIM | ID: wpr-870952

ABSTRACT

Objective:To investigate the causes and outcomes in the children who did not immediately receive glucocorticoids therapy after initial diagnosis of primary nephrotic syndrome (PNS).Methods:The clinical data of PNS patients not immediately receiving glucocorticoids therapy after initial diagnosis at the Department of Nephrology, the Children's Hospital, Zhejiang University School of Medicine from January 1, 2005 to December 31, 2014 were retrospectively analyzed.Results:A total of 1 431 cases were initially diagnosed with PNS, including 1 061 males and 370 females. Among them, 130 cases did not receive conventional glucocorticoids treatment immediately, accounting for 9.1%. Of whom, 75 cases were found showing spontaneous remission after symptomatic treatment; 23 cases were directly treated with adrenocorticotropic hormone (ACTH), one case with mycophenolate mofetil (MMF), and 31 cases not given glucocorticoids or immunosuppressants because of parental refusal. Among 75 cases with spontaneous remission, 16 cases were found in sustained remission; 39 cases were treated with glucocorticoids and 6 cases with ACTH at relapse; 14 cases were lost. Among 29 cases using ACTH, 7 cases were found in sustained remission. Among the 31 cases who refused glucocorticoids or immunosuppressants therapy, one died. The case treated with MMF, later were given with halved hormone because of no-effective response.Conclusions:Spontaneous remission is found in a small proportion of PNS patients at first-onset, but most subsequently relapse. Hormone therapy should be routinely given unless remission has occurred before application. Some children's parents refuse hormone therapy, and need further communication. Some cases initially treated with ACTH are found in sustained remission, which should be further observed and studied to clear the efficacy and safety of ACTH.

6.
Chinese Journal of Oncology ; (12): 873-877, 2019.
Article in Chinese | WPRIM | ID: wpr-801336

ABSTRACT

Objective@#This study aimed to investigate the clinicopathological characteristics and prognosis of adult rhabdomyosarcoma (RMS) patients.@*Methods@#The clinical data of 34 adult RMS patients were retrospectively analyzed. Based on their intervention and treatment, patients were divided into operation group (n=7), chemotherapy group (n=8) and operation plus chemotherapy group (n=19). The clinical characteristics and treatment outcomes of the three groups were compared.@*Results@#A statically significant difference was found in IRSG surgical-pathological stage among the three groups (P=0.026), while no significant difference existed in gender, age of disease onset, primary site, tumor size, pathological subtypes and IRSG risk group in the three groups (all P>0.05). In the operation group, three CR, one PR, one SD and two PD were achieved and one CR, one PR, one SD and five PD were obtained in the chemotherapy group. While in the chemotherapy plus operation group, four CR, twelve PR, one SD and two PD were achieved. A significant difference was found in response (P=0.043) and median overall survival (OS) (P=0.036) among the three groups, which were 44.7, 26.9 and 53.6 months, respectively.@*Conclusions@#Pleomorphic RMS was the main histological subtype for adult RMS patients, and the prognosis for adult RMS was usually poorer than that for pediatric RMS patients. Single therapeutic approach could not achieve satisfactory outcomes, while multimodal treatment consisted of surgery, chemotherapy and radiotherapy are helpful to improve the prognosis of adult patients with RMS.

7.
Article in Chinese | WPRIM | ID: wpr-797743

ABSTRACT

Objective@#To investigate the correlation between cord blood IgE level and allergic diseases (atopic dermatitis, food allergy, wheezing and allergic rhinitis) in 36 months old children and explore the susceptibility factors of allergy.@*Methods@#A cohort study was designed and Cord blood was collected during delivery of 779 women with full term, and the IgE level of the sample was detected by chemiluminescence immunoassay in Department of Laboratory Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine between October 1, 2012 and May 31, 2014. 638 children were followed up at the age of 36 months. The incidence of atopic dermatitis, food allergy, wheezing and allergic rhinitis were investigated by questionnaire, and the relationship between cord blood IgE level and allergic diseases in children was analyzed by multiple logistic regression.@*Results@#A total of 638 pregnant women and children were included in this study. The age of pregnant women was (29.7±3.3) years, and the IgE level in cord blood ranged from 0.1 to 8.43 IU/mL.In caesarean women, higher cord blood IgE was associated with increased risk of allergic dermatitis, wheezing and allergic rhinitis in children, OR=1.87, P<0.01; OR=1.86, P=0.01; OR=1.28, P=0.01; OR=1.98, P=0.01.@*Conclusion@#During cesarean section, the elevated IgE level of umbilical cord blood is correlated with the incidence of allergic diseases in children.

8.
Chinese Journal of Pathology ; (12): 358-363, 2019.
Article in Chinese | WPRIM | ID: wpr-810604

ABSTRACT

Objective@#To investigate the clinicopathological features of long-term tumor-free survival in patients with untreated primary diffuse large B-cell lymphoma (DLBCL) of the tonsil.@*Methods@#The study included 80 consultation cases of primary tonsillar DLBCL from April 2006 to July 2017 in the Department of Pathology, Beijing Friendship Hospital, Capital Medical University. The patients were divided into two groups: experimental groups of 10 untreated patients with long-term tumor-free survival, and 70 patients who had been treated (control group). The clinical data, histopathological features, immunohistochemical staining, and molecular biology test results of the patients were analyzed retrospectively.@*Results@#Patients who had long-term tumor-free survival with untreated primary diffuse large B-cell lymphoma had the disease mostly confined to the tonsil. Biopsy showed that the tonsil structure was only partially effaced and the lesions were relatively "fresh". EBER and FISH test for t (14;18) results were negative. Gene rearrangement detection showed monoclonality. There was statistically significant difference between the age, bcl-2 expression, CMYC protein expression and co-expression of CMYC and bcl-2 between the untreated group and the treated group(P<0.05). Patient gender, tumor site, histological type and clinical stage showed no difference between the untreated group and the treated group (P>0.05); The median overall survival of the untreated group and treated group was 81 months and 20 months, respectively, and the difference was not statistically significant (P>0.05).In patients younger than 40 years of age, the untreated group had a statistically significant difference in primary site and CMYC protein expression compared with the treated group (P<0.05), and there was no statistical significance in other aspects.@*Conclusions@#Long-term tumor-free survival patients with untreated tonsillar primary DLBCL have relatively unique clinical characteristics. There is no significant difference in the prognosis between the untreated and treated groups, indicating radiotherapy and chemotherapy may not be required and therefore, avoiding related side effects.

9.
Chinese Journal of Oncology ; (12): 309-314, 2019.
Article in Chinese | WPRIM | ID: wpr-805066

ABSTRACT

Objective@#To compare the clinical efficacy and drug safety between oral apatinib combined with conventional chemotherapy and conventional chemotherapy alone for the treatment of osteosarcoma and soft tissue sarcoma patients with pulmonary metastasis.@*Methods@#Thirty-three osteosarcoma and soft tissue sarcoma patients with pulmonary metastasis who were treated in the Department of Bone and Soft Tissue Tumor Surgery, Cancer Hospital of China Medical University from January 2015 to December 2017 were enrolled in this study. Patients with osteosarcoma received methotrexate, adriamycin (ADM), cisplatin (CDDP), ifosfamide (IFO) sequential regimen; patients with soft tissue sarcoma were treated with IFO and ADM regimen. Eighteen of these patients received an additional oral dose of apatinib. The patients were followed up regularly for changes in primary tumors and metastases, adverse reactions and prognosis.@*Results@#Before treatment, the maximum diameter of pulmonary metastases in patients of apatinib group and routine treatment group were (4.46±1.70) cm and (4.53±2.00) cm, respectively, without significant difference (P=0.909). After treatment, the maximum diameter of pulmonary metastases in patients of apatinib group was (1.46±1.39) cm, significantly smaller than (3.02±1.20) cm of routine treatment group (P=0.002). After treatment, the maximum diameter of the primary lesions in the apatinib group and the conventional treatment group median decreased 0.31 cm and 0.12 cm, respectively, without significant difference (P=0.542). After treatment, the maximum diameter of the lung metastases in the apatinib group median decreased 0.59 cm, significantly more than 0.18 cm of the conventional treatment group (P=0.027). The median progression-free survival (PFS) was 9.4 months in the 33 patients. The median PFS was 9.6 months and 8.3 months in the apatinib group and the conventional treatment group, respectively, without significant difference (P=0.593). Specific adverse reactions both occurred in apatinib group and routine treatment group, mainly including oral mucosal reactions and digestive tract reactions (including nausea, vomiting and diarrhea).@*Conclusions@#Apatinib can effectively reduce the volume of primary and metastatic lesions in patients with bone and soft tissue sarcoma accompanied by lung metastasis without reducing the survival rate or causing uncontrollable adverse reactions. The safety and clinical efficacy of apatinib are significant.

10.
Cancer Research and Clinic ; (6): 500-504, 2019.
Article in Chinese | WPRIM | ID: wpr-756786

ABSTRACT

Osteosarcoma is a malignant tumor of mesenchymal origin and occurs mostly in young people, which is characterized with high malignancy, poor prognosis, easy recurrence and metastasis, as well as a great difficulty in treatment. Osteosarcoma is rich in blood supply, and its growth, invasion and metastasis highly depend on the tumor new angiogenesis. The process of angiogenesis is mainly initiated by various pro-angiogenic factors secreted by tumor cells, and the anti-angiogenic targeted therapy has been taken based on the targets spot and signal pathways of various angiogenic factors, which can effectively suppress the various biological behaviors of the osteosarcoma and improve the survival rate. However, a series of problems, such as drug resistance, side effects, different evaluation criteria, and difficulties in selecting effective treatment strategies also exist in the process of anti-angiogenesis therapy, and thus, further studies are needed. This paper mainly reviews the clinical trials of anti-angiogenic drugs, main barriers in usage, as well as the feasible treatment strategies in clinical practice.

11.
Article in Chinese | WPRIM | ID: wpr-756635

ABSTRACT

In order to identify 35 key work items indicating the workload, difficulty of nursing technology and nursing risk of different wards scientifically, a mathematical model of classification of wards was established by literature review, conference discussions, expert consultation, brainstorming, and field measurement, and information technology as well. On such basis, scores of the wards were calculated, and the total scoring of each ward was ranked from high to low into three categories and six grades. Each grade of wards was assigned with different performance distribution weights. Such a mathematical model for ward categorizing and grading based on HIS system and key item and weights, can monitor ward nursing in real time, and provide nursing administrators at all levels with clinical risk early warning by means of vertical and horizontal comparisons. These administrators can take precautions in time in terms of human resources and materials. Ward categorizing and grading as an indicator for performance distribution ensures the rationality of such distribution, enhances nursing motivation and stabilizes front-line nursing teams in the end.

12.
Article in Chinese | WPRIM | ID: wpr-756501

ABSTRACT

Objective To investigate the correlation between cord blood IgE level and allergic diseases (atopic dermatitis, food allergy, wheezing and allergic rhinitis) in 36 months old children and explore the susceptibility factors of allergy. Methods A cohort study was designed and Cord blood was collected during delivery of 779 women with full term, and the IgE level of the sample was detected by chemiluminescence immunoassay in Department of Laboratory Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine between October 1, 2012 and May 31, 2014. 638 children were followed up at the age of 36 months. The incidence of atopic dermatitis, food allergy, wheezing and allergic rhinitis were investigated by questionnaire, and the relationship between cord blood IgE level and allergic diseases in children was analyzed by multiple logistic regression. Results A total of 638 pregnant women and children were included in this study. The age of pregnant women was (29.7± 3.3) years, and the IgE level in cord blood ranged from 0.1 to 8.43 IU/mL.In caesarean women, higher cord blood IgE was associated with increased risk of allergic dermatitis, wheezing and allergic rhinitis in children, OR=1.87, P<0.01;OR=1.86, P=0.01;OR=1.28, P=0.01;OR=1.98, P=0.01. Conclusion During cesarean section, the elevated IgE level of umbilical cord blood is correlated with the incidence of allergic diseases in children.

13.
Journal of Practical Radiology ; (12): 519-522, 2019.
Article in Chinese | WPRIM | ID: wpr-752385

ABSTRACT

Objective Toinvestigatethecharacteristicsofclinicalpathologyand MRIofintracranialsolitaryfibroustumor/hemangiopericytoma (SFT/HPC).Methods ThisstudyanalyzedtheMRIimages,pathologicalandclinicaldataof14SFT/HPCpatientsretrospectively. AllthecasesweresubjectedtoMRIplainscanandenhancementexamination.CharacteristicsofMRIofallcaseswerereviewedtogetherwith clinicopathologicchanges.Results AllSFT/HPClesionswerelocatedintheintracranialbutextra-cerebralspace.6werelocatedabovethe tentoriumofcerebellum,and2werelocatedbelowit.Lesionsof6patientswereacrossthetentoriumofcerebellumandspreadfrom supratentorialtosubtenorialspace.Amongalllesions,4wereroundinshape,10werelobulated,and3weresmallnodulesaroundthe edge.9ofthemexhibitednecrosisandcysticstructures.11lesionsshowedhypointensityand3casesshowedisointensityonT1WI.All thelesionswereheterogeneoushyperintensetyonT2WI,and5ofthemdisplayed"yin-yang"patternonT2WI.11casesexhibitededema.Signalof vascularvoidflow wasobservedin6cases.Thesolidpartsofthetumorsshowedsignificanthomogeneousenhancementon MRI. StrongpositiveSTAT6stainingwasobservedforthenuclearoftumorcells.Conclusion ItisdifficulttodifferentiateSFT/HPCfrom meningeoma.The"yin-yang"patternonT2WIisthecharacteristicofSFT/HPC.Inaddition,nuclearpositivestainingofSTAT6isalsospecific featureofSFT/HPCcell.

14.
Article in Chinese | WPRIM | ID: wpr-751994

ABSTRACT

Objective To carry out a meta-analysis,in order to evaluate the effectiveness and safety of the duodenum-preserving pancreatic head resection (DPPHR) and pancreaticoduodenectomy (PD) or pylorus-preserving pancreaticoduodenectomy(PPPD) for surgical treatment of chronic pancreatitis.Methods Medline,EMBASE,Cochrane library and other medical databases were searched for the clinical trials (randomized controlled trials) of comparing DPPHR Versus PD/PPPD.A total of 5 clinical trials (8 references) met the inclusion criteria.The data were analyzed using the RevMan 5.3 software.Results The two methods don't have statistical differ ence in terms of operation time (P=0.007),postoperative morbidity (P=0.35) and mortality (P=0.18),pain relief(P=0.36),new onset of diabetes(P=0.11),exocrine insufficiency(P=0.18),short-term(P=0.14) and long-term(P=0.16) quality of life score,the length of hospital stay (P=0.69),and pancreatic fistula (P=0.78).Weight gain (P<0.000 01) and occupational rehabilitation (P=0.03)were significantly improved in the DPPHR group.However,PD/PPPD group was associated with fewer readmission due to pancreatic diseases.Conclusions DPPHR offers more advantages with regard to the quality of life.However,it needs more high-quality clinical trials to verify the results.

15.
Article in Chinese | WPRIM | ID: wpr-743980

ABSTRACT

Microvascular invasion (MVI) is one of the invasive characteristics of hepatocellular carcinoma (HCC) and also an independent risk factor for intrahepatic and distant metastasis of hepatocellular carcinoma.The occurrence of MVI in patients with hepatocellular carcinoma is universal and can occur in different stages of hepatocellular carcinoma,which is the result of the joint action of multiple factors,including tumor diameter,tumor morphology,tumor pathological grading,and hepatitis B virus activity and replication.For patients with preoperative assessment of MVI risk factors,reasonable surgical plans should be made according to the basic conditions of patients.Non-anatomic hepatectomy is performed to expand the resection scope as far as possible (at least > 1 cm),and anatomic hepatectomy is performed with complete Laennec cystectomy along the Glisson system.Pathological examination is the gold standard of MVI diagnosis,and standardized diagnosis can improve the detection rate of MVI.MVI is mainly related to early postoperative recurrence of hepatocellular carcinoma (within 1 year).For patients with positive MVI after HCC resection,selective combination with transcatheter arterial chemoembolization,radiotherapy and molecular targeted drugs can reduce tumor recurrence and prolong the survival time of patients with liver cancer without recurrence.Therefore,MVI has important clinical significance for the comprehensive diagnosis and treatment of hepatocellular carcinoma.

16.
Article in Chinese | WPRIM | ID: wpr-733895

ABSTRACT

Objective To study the clinical value of whole -body magnetic resonance diffusion weighted imaging(WB-DWI) in evaluating the chemotherapy response for lung cancer,thus to provide evidence for optimizing clinical imaging examination. Methods From October 2017 to May 2018,60 patients with lung cancer confirmed by histopathology in Linfen Central Hospital were selected. The patients underwent DWI examinations before chemotherapy and after two cycles of chemotherapy. The change of tumor size,distant metastasis and apparent diffusion coefficient (ADC) value were compared before and after chemotherapy. The correlation between the change rate of ADC value and the shrinkage rate of tumor size in the effective group was analyzed. Results Of 60 cases,1 case had new cerebral metastases after chemotherapy. There were statistically significant differences in ADC value [(1. 12 ± 0.33) ×10 -3mm2/svs.(1.56±0.40) ×10 -3mm2/s]andtumorsize[(4.63±2.75)cmvs.(2.28±1.45)cm] between before and after chemotherapy in the effective group(t= -3. 954,4. 711,all P<0. 01). There was correlation between the change of ADC value and tumor size(r=0. 34,P<0. 05). Conclusion WB-DWI can not only detect the change of tumor size and distant metastasis quickly and effectively,but also can observe the microscopic changes of tumor cells by measuring ADC value. So it can predict the early therapeutic response of the tumor and make effective evaluation for the staging and chemotherapy response of lung cancer.

17.
Article in Chinese | WPRIM | ID: wpr-699149

ABSTRACT

Objective To investigate the effect of microvascular invasion (MVI) on tumor recurrence of hepatocellular carcinoma (HCC) patients after hepatectomy,the efficacy of sequential transcatheter arterial chemoembolization (TACE) on positive MVI patients after hepatectomy,and the effect of comprehensive treatment on the prognosis of patients with tumor recurrence.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 136 HCC patients who underwent hepatectomy in the First Affiliated Hospital of Air Force Medical University from February 2015 to December 2016 were collected.Patients were treated with TACE,radiofrequency ablation (RFA) and molecular-targeted drugs after hepatectomy,and patients with tumor recurrence selected 1 or 2 above treatments.The patient received postoperatively outpatient reexaminations every 3 months to detect tumor recurrence and survival.Follow-up was from the day of the surgery to death or December 2017.Observation indicators:(1) treatment after hepatectomy;(2) effect of MVI on tumor recurrence of HCC patients after hepatectomy:clinicopathological features and tumor recurrence rate between positive and negative MVI patients;(3) efficacy of TACE on positive MVI patients:clinicopathological features and tumor recurrence rate in positive MVI patients with or without TACE;(4) effect of comprehensive treatment on the prognosis of patients with tumor recurrence.Measurement data with normal distribution were represented as x±s and analyzed using the independent-samples t test.Comparisons of count data were analyzed using chi-square test or Fisher exact probalility.The tumor recurrence rate and survival rate were calculated by the Kaplan-Meier method,and Log-rank test was used for survival analysis.Results (1) Treatment after hepateetony:of 136 patients undergoing hepatectomy,117 underwent single hepatectomy and 19 combined sequential TACE;59 had HCC recurrence,including 22 receiving comprehensive treatment.(2) Effect of MVI on tumor recurrence of HCC patients after hepatectomy:① Clinicopathological features:of 117 patients undergoing single hepatectomy,positive MVI was detected in 49 patients,including 44 males and 5 females,with an age of (52-± 10)years old;49 patients were in Child-Pugh grade A,including 36 combined with liver cirrhosis and 13 without liver cirrhosis;positive and negative alpha-fetoproteins (AFPs) were respectively detected in 34 and 15 patients.Negative MVI was detected in 68 patients,including 54 males and 14 females,with an age of (55± 11)years old;65 and 3 patients were respectively in Child-Pugh grade A and B,including 52 combined with liver cirrhosis and 16 without liver cirrhosis;positive and negative AFPs were respectively detected in 39 and 29 patients.There was no statistically significant difference in gender,age,Child-Pugh score of liver function,liver cirrhosis and comparison of AFP between positive and negative MVI patients (x2 =2.258,t =-1.626,x2 = 0.804,0.138,1.758,P>0.05).② Tumor recurrence rate:The 6-month and 1-year tumor recurrence rates after hepatectomy were respectively 30.77%,30.61% in 117 patients undergoing single hepatectomy and 42.86%,51.02% in 49 of 117 patients with positive MVI and 22.06%,27.94% in 68 of 117 patients with negative MVI,showing statistically significant differences in 6-month and 1-year tumor recurrence rates between positive and negative MVI patients (x2 =5.738,6.465,P<0.05).(3) Efficacy of TACE on positive MVI patients:① Clinicopathological features of 56 patients with positive MVI,7 received postoperatively sequential TACE,including 7 males,with an age of (50±4) years old;56 patients were in Child-Pugh grade A,including 5 combined with liver cirrhosis and 2 without liver cirrhosis;positive and negative AFPs were respectively detected in 2 and 5 patients.Forty-nine patients didn't combine sequential TACE,including 44 males and 5 females,with an age of (52± 10)years old;49 patients were in Child-Pugh grade A,including 36 combined with liver cirrhosis and 13 without liver cirrhosis;positive and negative AFPs were respectively detected in 34 and 15 patients.There was no statistically significant difference in gender,age,Child-Pugh score of liver function,liver cirrhosis and comparison of AFP between patients with and without sequential TACE (x2 =0.784,t =-0.512,x2 =0.013,2.844,P>0.05).② Tumor recurrence:the 6-month and 1-year tumor recurrence rates after hepatectomy were respectively 0,28.57% in 7 positive MVI patients with sequential TACE and 42.86%,51.02% in 49 positive MVI patients without sequential TACE,showing a statistically significant difference in 6-month tumor recurrence rate (x2=4.800,P<0.05) and no statistically significant difference in 1-year tumor recurrence rate (x2 =1.236,P > 0.05).(4) Effect of comprehensive treatment on the prognosis of patients with tumor recurrence:of 59 patients with tumor recurrence,37 didn't receive comprehensive treatment,34 of 37 died within 1-year postoperatively,including 30 deaths within 6-month postoperatively,and 1-year survival rate was 8.10%;22 received comprehensive treatment,including 4 deaths within 1-year postoperatively,and 1-year survival rate was 81.80%,showing a statistically significant difference in 1-year survival rate (x2=32.698,P<0.05).Conclusions MVI is one of the important risk factors affecting HCC recurrence and metastasis after hepatectomy.The combined TACE after hepatectomy can reduce the HCC recurrence rate of MVI positive patients,and active comprehensive treatment after HCC recurrence can significantly prolong the survival time of patients.

18.
Cancer Research and Clinic ; (6): 298-302, 2018.
Article in Chinese | WPRIM | ID: wpr-712816

ABSTRACT

Objective To explore the value of ultra-high b-value diffusion-weighted imaging(DWI) in diagnosis of prostate cancer. Methods According to inclusion and exclusion criteria, 73 consecutive examinees in Chinese PLA General Hospital from June 2014 to May 2015 were screened. Written informed consent was obtained from all patients. T2WI, conventional DWI with b-value of 1 000 s/mm2and ultra-high b-value DWI with 2 000 s/mm2and 3 000 s/mm2were performed in each examinee. Images were interpreted and were corresponding to histological results conducted by ultrasound guided prostate systematic biopsy. Reference biopsy as the gold standard,the sensitivity,specificity, positive predictive value(PPV) and negative predictive value (NPV) were calculated for each image. Sensitivity and specificity differences between ultra-high b-value DWI and conventional DWI were analyzed. The areas under the curves (AUCs) between ultra-high b-value DWI and other modalities were compared. Results The sensitivity and specificity for ultra-high b-value DWI were 92.5 % and 68.8 % with b-value of 3 000 s/mm2, and they were 88.1 % and 53.1 % for 2 000 s/mm2in peripheral zone. The sensitivity and specificity for ultra-high b-value DWI were 88.0 % and 88.2 % with a b-value of 3 000 s/mm2, and they were 80.0 % and 52.9 % for 2 000 s/mm2in transition zone. The values of sensitivity for ultra-high b-value DWI were significantly higher than those for conventional DWI both in peripheral zone and transition zone (all P <0.000 1). The detection of lesions was comparable with ultra-high b-value DWI at 2 000 s/mm2and 3 000 s/mm2in peripheral zone (P >0.05), whereas the value of specificity for 3 000 s/mm2were significantly higher than that for 2 000 s/mm2in transition zone (P<0.000 1). PPV and NPV for 3 000 s/mm2were significantly higher than those for the other three modalities both in peripheral zone(86.1 % and 81.5 %) and transition zone (91.7 % and 83.3 %). In peripheral zone, the AUCs were 0.591, 0.553, 0.698 and 0.806 in T2WI, conventional DWI and ultra-high b-value DWI at 2 000 s/mm2 and 3 000 s/mm2respectively, for the diagnosis of transition zone cancer were 0.693, 0.506, 0.665 and 0.881 respectively, and the AUCs for the ultra-high b-value with 3 000 s/mm2were the largest. Conclusion Ultra-high b-value DWI is an accurate and reliable method in the diagnosis of prostate cancer.

19.
Chinese Journal of Radiology ; (12): 913-918, 2018.
Article in Chinese | WPRIM | ID: wpr-734282

ABSTRACT

Objective To learn the endocardial strain patterns of the left ventricles on the short-axis views in normal youth volunteers using feature tracking techniques on cine cardiac MR imaging,and to build up the reference ranges of strain peak and time to peak (TTP) for endocardial strain analysis.Methods Twenty-nine normal youth volunteers aged from 24-34 years old were enrolled in the study in march 2015.The Cine MR imaging were acquired using balance FFE sequence with 24 phases for each cardiac cycle.The standard short-axis imaging planes were basal,mid-cavity and apical levels and divided into 16 segments.The peaks and TTPs of myocardial displacement and its velocity,radial and circumferential strain and strain rate and its velocity in each segment were calculated using feature tracking techniques.The data with normal distribution were analyzed by ANOVA and Student-Newman-Keuls (SNK) method,and Kruskal-Wallis and Wilcoxon rank sum test were used for the data without normal distribution.Results The peaks and TTPs of radial strain and strain rate differed in 16-segmental levels and basal,middle and apical plane levels and had no concordant reference ranges.The circumferential strain and strain rate were homogeneous at basal and middle plane levels [(-27.09 ±9.51)%,(1.94 ±0.98)/s,respectively].Their TTPs were homogenous [0.38 (0.08)RR,0.54 (0.08)RR,respectively],and there were no significant differences in planar-segments or inter-segment level.Except for middle level,the peaks of radial displacement and velocity differed in basal and apical levels and had no concordant reference ranges.But radial velocity TTPs were homogeneous in all 16 segments [0.21 (0.04)RR].Except for the radial strain rate,TTPs showed no significant difference between basal level and middle level.The measurements at apical level revealed high variance.No regular pattern could be found on individual peak and TTP curves of velocity and strain rate.Conclusion The peaks and TTPs of radial strain are different in segmental and planar levels without a concordant reference range.The peaks and TFPs of circumferential strain and the radial velocity rTTPs are homogeneous in middle and apical plane level and have homogeneous reference range.

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Article in Chinese | WPRIM | ID: wpr-508342

ABSTRACT

Objective To explore the effects of Pannexin1 (Px1) channel protein on osteogenic differentiation of mesen?chymal stem cells (MSCs) under mechanical stress stimulation. Methods Bone marrow was extracted from Sprague Dawley (SD) rats (3 weeks, weighing 100-120 g) and cultured following 1st generation cellular technology. The safe dose of CBX (an inhibitor of Px1 channel protein) on MSCs was determined by CCK8 method and 100 μmol/L was used. The MSCs were cultured by the whole marrow culture method. When the cell was passaged to 3-4 generation, high purity of the MSCs were harvested. MSCs were divided into three groups:control group, stress?stimuli group (4 000μstrain) and stress stimuli+CBX group. The duration of stress was 15 min and CBX pre?treatment time point was 3 h, 6 h, 12 h, and 24 h, respectively. The alkaline phosphatase (ALP) activity, type I collagen expression, intracellular calcium ion (Ca2+) concentration, and Px1 channel protein, p?p38MAPK and p?ERK ex?pression were determined. Results ALP activities were highest in the stress group, and it was reduced by pretreatment of CBX. Similarly, stress increased the expression of type I collagen, concentration of Ca2+, and expressions of Px1 channel protein and p?p38MAPK was reduced by CBX. p?ERK was down?regulated by stress but not affected by CBX treatment. Conclusion Mechani?cal stress could promote osteogenic differentiation of MSCs and this promotion was inhibited by pretreatment of CBX, which might result in regulation of p?p38MAPK.

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