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1.
Journal of Clinical Hepatology ; (12): 699-702, 2022.
Article in Chinese | WPRIM | ID: wpr-922984

ABSTRACT

Intestinal flora imbalance plays a certain role in the development and progression of liver cancer, while probiotics have a certain impact on liver cancer, both of which are the focus of clinical research. This article introduces the mechanism of action of intestinal flora imbalance in the pathogenesis of liver cancer and the preventive effect of probiotics against liver cancer. Intestinal flora imbalance can participate in the pathological process of liver cancer by activating Toll-like receptor 4, regulating the level of metabolites, producing endotoxin, and inducing bacterial translocation and intestinal bacterial overgrowth, while probiotics can effectively prevent liver cancer by maintaining enterohepatic circulation, enhancing immune function, promoting the reproduction of intestinal probiotics, and reducing the toxicity of carcinogens, which can be further studied as the focus of subsequent liver cancer prevention in clinical practice.

2.
Journal of Clinical Hepatology ; (12): 347-351, 2022.
Article in Chinese | WPRIM | ID: wpr-920883

ABSTRACT

Objective To investigate the level of glycosylated albumin (GA) in liver cirrhosis patients with different Child-Pugh classes and its application value in predicting liver function. Methods A total of 486 patients with liver cirrhosis who were hospitalized in Tianjin Third Central Hospital from January 1 to December 31, 2019, were enrolled, among whom 227 patients had liver cirrhosis without diabetes and 259 patients had liver cirrhosis with diabetes. The patients were divided into groups according to Child-Turcotte-Pugh (CTP) score, and fasting blood glucose, glycosylated hemoglobin, and percentage of GA (GA%) were measured. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between three groups, and the Dwass-Steel-Critchlow-Fligner test was used for further comparison between two groups. Scatter plots and fitting curves were plotted for CTP score and GA% to evaluate the association between them and calculate the cut-off value. Results For the cirrhosis patients without diabetes, there were significant differences between the patients with different Child-Pugh classes in GA% ( χ 2 =24.809, P < 0.001), fasting blood glucose ( χ 2 =11.899, P =0.003), and glycosylated hemoglobin ( χ 2 =13.607, P =0.001); further pairwise comparison showed that there was a significant difference in GA% between Child-Pugh class A/B liver cirrhosis patients without diabetes and Child-Pugh class C liver cirrhosis patients ( P < 0.05), Child-Pugh class A patients had a significantly higher level of fasting blood glucose than Child-Pugh class B patients ( P < 0.05), and Child-Pugh class A patients had a significantly higher level of glycosylated hemoglobin than Child-Pugh class B/C patients ( P < 0.05). For the patients with liver cirrhosis and diabetes, there were significant differences between the patients with different Child-Pugh classes in GA% ( χ 2 =10.734, P =0.005) and fasting blood glucose ( χ 2 =16.295, P < 0.001); further pairwise comparison showed that Child-Pugh class C liver cirrhosis patients with diabetes had a significantly lower GA% than Child-Pugh class A/B patients ( P < 0.05) and Child-Pugh class A patients had a significantly lower fasting blood glucose level than Child-Pugh class B patients ( P < 0.05). The fitting curve showed that GA% increased with the increase in CTP score in the liver cirrhosis patients without diabetes, reached the highest value at the CTP score of 6.5, and then started to decrease, with the lower value at the CTP score of 11.5, which showed a curvilinear relationship; in the liver cirrhosis patients with diabetes, GA% first increased and then decreased with the increase in CTP score, with a cut-off value of 8. Conclusion GA% first increases and then decreases along with the progression of liver cirrhosis. There is a significant difference in GA between liver cirrhosis patients with different Child-Pugh classes, suggesting that the reduction in GA is closely associated with liver function decompensation in end-stage liver cirrhosis.

3.
Journal of Clinical Hepatology ; (12): 2478-2481, 2021.
Article in Chinese | WPRIM | ID: wpr-904975

ABSTRACT

With the increasing incidence rates of metabolic diseases such as obesity and type 2 diabetes, the incidence rate of nonalcoholic fatty liver disease (NAFLD) has also gradually increased year by year. NAFLD has complex underlying pathogeneses which have not yet been fully clarified. As the carrier of intercellular communication, exosomes play an important role in the development and progression of liver diseases. This article summarizes the mechanism of action of exosomes in the pathogenesis of NAFLD and their effect on lipid metabolism, insulin resistance, liver inflammation, and fibrosis, and it is pointed out that exosomes have great potential in the diagnosis and treatment of diseases, which will be the focus of future research.

4.
Journal of Clinical Hepatology ; (12): 2478-2481, 2021.
Article in Chinese | WPRIM | ID: wpr-904925

ABSTRACT

With the increasing incidence rates of metabolic diseases such as obesity and type 2 diabetes, the incidence rate of nonalcoholic fatty liver disease (NAFLD) has also gradually increased year by year. NAFLD has complex underlying pathogeneses which have not yet been fully clarified. As the carrier of intercellular communication, exosomes play an important role in the development and progression of liver diseases. This article summarizes the mechanism of action of exosomes in the pathogenesis of NAFLD and their effect on lipid metabolism, insulin resistance, liver inflammation, and fibrosis, and it is pointed out that exosomes have great potential in the diagnosis and treatment of diseases, which will be the focus of future research.

5.
Article in English | WPRIM | ID: wpr-891066

ABSTRACT

Purpose@#The present study determined the effects of saphenous nerve stimulation (SNS) at different stimulation frequencies on bladder reflex and explored a possible action mechanism of tibial nerve stimulation (TNS) on bladder activity in cats. @*Methods@#Two bipolar nerve cuff electrodes were implanted on the saphenous nerve and the contralateral tibial nerve in 13 cats, respectively. Multiple cystometrograms were obtained to determine the effects of single SNS at different frequencies and that of combined SNS and TNS on the micturition reflex by infusing normal saline. @*Results@#SNS at 1 Hz significantly reduced the bladder capacity (BC) to 59.8%±7.7% and 59.3%±5.8% of the control level at the intensity threshold (T) and 2T, respectively (P0.05), while combined stimulation at 1T significantly increased the BC to 122.7%±1.9% of the control level and induced an inhibitory effect which was similar to that TNS at 2T. @*Conclusions@#The current study revealed that SNS reduced and increased BC depending on different stimulation frequencies. The combined SNS and TNS maximized the clinical efficacy at a low intensity. Also, SNS may be a potential therapeutic mechanism of TNS.

6.
China Pharmacy ; (12): 241-246, 2021.
Article in Chinese | WPRIM | ID: wpr-862651

ABSTRACT

OBJECTIVE:To rapidly evaluate the effectiveness ,safety and economy of evolocumab in the treatment of hypercholesterolemia so as to provide evidence-based reference for clinical drug selection and decision. METHODS :Retrieved from PubMed,Cochrane Library ,CNKI,Wanfang database and HTA relative official website ,HTA reports ,systematic evaluation/ Meta-analysis and pharmacoeconomic studies about evolocumab alone or combined with standard plan versus standard plan or placebo or ezetimibe in the treatment of hypercholesterolemia were collected during the inception to Jan. 2020. Based on literature screening and data extraction ,HTA checklist ,system evaluation measurement tool AMSTAR- 2 scale,comprehensive healthy economic evaluation report standard scale were used to evaluate the quality of included HTA reports ,systematic evaluation/ Meta-analysis and pharmacoeconomic literatures. Quantitative description was performed for effectiveness and safety results ,and qualitative description was performed for economic evaluation results. RESULTS :A total of 13 literatures were included ,involving 6 Meta-analysis and 7 economic studies. The quality of Meta-analysis literatures was low ,and the quality of economic research was good. In terms of effectiveness ,compared with placebo or ezetimibe ,evolocumab significantly reduced the levels of LDL-C ,TC, TG and VLDL-C ,the incidence of cardiovascular events ,myocardial infarction ,coronary ischemia and stroke ,while increased the level of HDL-C (P<0.05). There was no statisti cal significance in the risk of hospitalizatio n,cardiac mortality or cardiovascular disease mortality in patients with unstable angina pectoris between placebo and evolocumab (P>0.05). In terms ofsafety,there was no significant difference in the incidence of 6237545。E-mail:zhangxu1130@163.com any adverse events ,any treatment emergency adverse events and back pain ,musculoskeletal and connective tissue diseases between evolocumab and placebo (P>0.05). In terms of economy,additional use of evolocumab ,based on standard plan ,had a cost-effectiveness advantage for patients with high-risk atherosclerotic cardiovascular disease (ASCVD)whose blood lipids were still not up to standard. CONCLUSIONS :Evolocumab has good effectiveness and safety in the treatment of hypercholesterolemia. For high-risk patients with ASCVD whose blood lipids are still not up to standard after standard plan ,evolocumab has certain economy and can be used as an alternative.

7.
Article in English | WPRIM | ID: wpr-913800

ABSTRACT

Purpose@#Current variability in methods for tumor mutational burden (TMB) estimation and reporting demonstrates the urgent need for a homogeneous TMB assessment approach. Here, we compared TMB distributions in different cancer types using two customized targeted panels commonly used in clinical practice. @*Materials and Methods@#TMB spectra of 295- and 1021-gene panels in multiple cancer types were compared using targeted next-generation sequencing (NGS). The TMB distributions across a diverse cohort of 2,332 cancer cases were then investigated for their associations with clinical features. Treatment response data were collected for 222 patients who received immune-checkpoint inhibitors (ICIs) and their homologous recombination DNA damage repair (HR-DDR) and programmed death-ligand 1 (PD-L1) expression were additionally assessed and compared with the TMB and response rate. @*Results@#The median TMB between gene panels was similar despite a wide range in TMB values. The highest TMB was 8 and 10 in patients with squamous cell carcinoma and esophageal carcinoma according to the classification of histopathology and cancer types, respectively. Twenty-three out of 103 patients (22.3%) were HR-DDR‒positive and could benefit from ICI therapy; out of those 23 patients, seven patients had high TMB (p=0.004). Additionally, PD-L1 expression was not associated with TMB or treatment response among patients receiving ICIs. @*Conclusion@#Targeted NGS assays demonstrated the ability to evaluate TMB in pan-cancer samples as a tool to predict response to ICIs. In addition, TMB integrated with HR-DDR‒positive status could be a significant biomarker for predicting ICI response in patients.

8.
Chinese Journal of Microsurgery ; (6): 483-486, 2021.
Article in Chinese | WPRIM | ID: wpr-912264

ABSTRACT

Objective:To describe the reconstruction of palmar soft tissue defect of digit using dorsal digital flaps including double dorsal branches of the proper palmar digital nerves (DBPPDN) and report the results of the application of the flaps.Methods:From May, 2005 to April, 2019, a retrospective study was conducted on 113 digits of 113 patients who had palmar soft tissue defects in single digit treated with 4 types of dorsal digital flaps with bilaterally DBPPDN. Flap types: ① Modified cross-digit flap in 29 digits of 29 cases; ②Dorsal digital flap based on the dorsal branch of proper palmar digital artery (DBPPDA) in 43 digits of 43 cases; ③First dorsal metacarpal artery flap in 23 digits of 23 cases; ④ Free dorsal digit flap in 18 digits of 18 cases. In control group, single-innervated flap was used for repair of the defects, only one of injured proper palmar digital nerves on both sides was repaired with DBPPDN. Static TPD, VAS and patient satisfaction of the injured digits were evaluated by means of outpatient follow-up. The t test was applied to compare the 2 groups in relation to the quantitative outcomes. P<0.05 was considered statistically significant. Results:In the dual-innervated flap group, flap ischemia was shown in 11 digits and venous congestion was noted in 7 digits. Partial necrosis was noted in 9 flaps and healed without surgical intervention. In the dual-innervated and single-innervated flap groups, the mean static TPD were (6.92±0.12) mm and (8.92±0.20) mm, the score of VAS were (0.46±0.08) and (1.11±0.28), and patient satisfaction were (4.45±0.06) and (4.00±0.16). Significant difference was found between the 2 groups in static TPD, VAS and patient satisfaction. Dual-innervated flaps presented better discriminatory sensation on the flap ( P<0.01) and lower pain incidence ( P=0.0032) and higher patient satisfaction ( P=0.0014). Conclusion:The 4 types of dual-innervated flap are useful in reconstruction of palmar soft tissue defects of digits, especially in prevention of neuropathic pain.

9.
Chinese Journal of Dermatology ; (12): 951-954, 2021.
Article in Chinese | WPRIM | ID: wpr-911552

ABSTRACT

Neurosyphilis is one of the most serious clinical manifestations of syphilis. In recent years, more and more neurosyphilis cases have been reported in Chinese literature. However, the exact incidence of neurosyphilis is unknown, and there are still some key scientific problems urgent to be solved in clinical diagnosis and treatment, pathogenesis, and prevention and control of neurosyphilis. Therefore, in order to provide a reference for the prevention and treatment of neurosyphilis, this article proposes the CARE-NS strategy, including the following 6 aspects: Comprehensive management including multiple disciplinary treatment (C) , Alleviating neurological impairment and sequelae (A) , Risk factors and clinical epidemiology (R) , Etiology and pathogenesis (E) , New diagnostic indicators and strategies (N) , Social impact and cost-effectiveness analysis (S) .

10.
Chinese Journal of Urology ; (12): 834-838, 2021.
Article in Chinese | WPRIM | ID: wpr-911129

ABSTRACT

Objective:To investigate the technical points and clinical effect of thulium fiber laser lobes-enucleation of the prostate (ThuLLEP).Methods:A total of 90 patients underwent ThuLLEP and plasmakinetic enucleation of prostate (PKEP) in our hospital from November 2018 to December 2020 were collected. The age of patients in the two groups was (67.7±6.8) years and (65.7±7.1) years, the prostate volume was 56.0 (46.0-83.5) ml and 61.0 (53.5-79.5) ml, the serum PSA was 3.6 (2.2-6.0) ng/ml and 4.4 (1.8-7.3) ng/ml, the international prostate symptom score (IPSS) was 27 (22-31) and 28 (23-30), the quality of life score (QOL) was 5 (5-6) and 5 (5-6), the maximum urinary flow rate (Q max) was (8.5±5.7) ml/s and (7.8±3.8) ml/s, the post-void residual volume (PVR) was 127 (47-250) ml and 100 (27-209) ml. The differences had no statistical significance ( P>0.05). The glands were bluntly dissected to establish the surgical capsule plane on both sides of the verumontanum after the verumontanum being located. And then the middle lobe was removed. The glands formed grooves at 12 o'clock after vaporization, which served as anatomical marker. The left and right lobes were removed step by step. Finally, tissue crushing was performed. The PKEP group was enucleated by three lobes enucleation. Perioperative indicators were compared between the two groups. Results:All the operations were completed successfully. The median operative time in ThuLLEP and PKEP groups was 60 (50-73) minutes and 75 (60-100) minutes, the postoperative bladder irrigation time was 2.8 (2.3-3.6) d and 3.8 (2.6-4.7) d, the catheter indwelling time was 4.1 (3.7-4.9) d and 4.9 (4.7-6.0) d, the postoperative hospital stay was 5 (4-6) d and 6 (5-7) d. The decreased hemoglobin was 8.0 (1.5-14.5) g/L and 15.0 (6.5-21.0) g/L. The differences had statistical significance ( P<0.05). Follow-up was performed for 6 months after surgery. The median IPSS score of the two groups was 5 (2-11) and 6 (3-9), the QOL score was 1 (1-2) and 1 (1-2) respectively, which had statistical significance compared with the preoperative parameters ( P<0.05), but no statistical significance between the two groups ( P>0.05). The ThuLLEP group had 1 case of postoperative blood transfusion, 1 case of transient urinary incontinence and 2 cases of urethral stricture. The PKEP group had 1 case of fever and blood transfusion, 3 cases of transient urinary incontinence and 3 cases of urethral stricture. Conclusions:ThuLLEP has definite clinical effect because of less bleeding, quicker recovery and fewer complications. The relatively simple operation steps are beneficial for beginners to master.

11.
Chinese Journal of Urology ; (12): 675-678, 2021.
Article in Chinese | WPRIM | ID: wpr-911094

ABSTRACT

Objective:To investigate the characteristics of 18F-DCFPyL PET/CT imaging in castration-resistant prostate cancer (CRPC) patients with different PSA levels. Methods:The imaging and clinical data of 50 patients with CRPC who underwent 18F-DCFPyL PET/CT examination in Chinese PLA General Hospital from January 2018 to December 2020 were analyzed retrospectively. The average age was 72 (54-95) years old. Serum total PSA was 92.28(0.36-2000.00) ng/ml. According to the total PSA level, the patients were divided into low PSA group(total PSA ≤ 1 ng/ml, n=9), medium PSA group (1 ng/ml<total PSA ≤ 10 ng/ml, n=18) and high PSA group(total PSA>10ng/ml, n=23). According to the standardized evaluation standard of molecular imaging, the suspicious tumor lesions on 18F-DCFPyL PET/CT imaging were scored by molecular imaging PSMA(miPSMA), and the miPSMA score ≥2 was defined as positive lesions. According to the number of lesions displayed by 18F-DCFPyL PET/CT, patients were divided into oligofocal group (the number of lesions ≤3) and multiple lesions group (the number of lesions >3). The imaging characteristics of patients in different groups were summarized. Results:The 18F-DCFPyL PET/CT imaging results of 50 cases in this study were all positive, including oligofocal group (n=27) and multiple lesions group (n=23). Of the 30 patients with unresected prostate, 18 had local recurrence of the prostate, while the other 12 patients with unresected prostate and 20 patients with resected prostate had no signs of local recurrence. The oligofocal group showed local recurrence, regional lymph node metastasis or bone metastasis. Patients with multiple lesions showed multiple lymph nodes and/or bone metastasis with or without local recurrence. There were 9, 18 and 4 patients with oligofoci in low, middle and high PSA groups, respectively.There were 27 patients in the oligonucleogenous group, and 21 of the 22 patients receiving local treatment were effective. All 3 patients treated with systemic treatments were effective. PSA progressed in 2 untreated patients. In the multi-foci group of 23 patients, 6 of 9 patients treated with abiraterone were effective. Two patients treated with enzalumide were ineffective. One of the 4 patients with chemotherapy was effective. One of the two patients treated with 177 Lu-PSMA nuclide was effective. One case did not respond to treatment with 89SrCl 2. Radiotherapy failed in 2 cases. PSA progressed in 3 untreated patients. Conclusions:18F-DCFPyLPET/CT imaging has a high detection rate of lesions in patients with CRPC and has potential guiding significance for follow-up treatment. The number of lesions in CRPC patients with different PSA levels was different, and the patients with low PSA levels were mainly oligofoci.

12.
Chinese Journal of Urology ; (12): 502-506, 2021.
Article in Chinese | WPRIM | ID: wpr-911058

ABSTRACT

Objective:To explore the feasibility and safty of robot assisted trans-diaphragmatic intropericardial inferior vena cava occlusion and thrombectomy in treatment of Ⅳa grade tumor thrombus without cardiopulmonary bypass and thoracotomy.Methods:The clinical data of 4 patients with renal cell carcinoma and Ⅳa grade tumor thrombus by robot assisted trans-diaphragmatic intropericardial inferior vena cava occlusion and thrombectomy from January 2013 to June 2019 were retrospectively analyzed. The median age was 53.5 (53-70) years. The average body mass index was 23.25 (20.7-26.3) kg/m 2. The tumors were located on the right side in 2 cases. The average maximum diameter of the tumor was 8.1 (3.6-11.2) cm.Preoperative tumor thrombus of all patients was classified as Ⅳa. The average preoperative length of tumor thrombus in vena cava was 12.3 (11.8-18.0) cm. All the operations were performed under multidisciplinary cooperation of urology, hepatobiliary, cardiovascular, ultrasound and anesthesiologist team. Surgical procedure: Robot assisted liver mobilization was used to expose the inferior vena cava. Under the guidance of intraoperative ultrasound, the central tendon and pericardium of diaphragm were dissected until the inferior vena cava and right atrium in the superior pericardium were exposed. The first porta hepatis and inferior vena cava were blocked in turn.The vena cava thrombectomy and inferior vena cava reconstruction were performed. Results:All the operations were completed without conversion. The median operation time was 553.5 (338-642) minutes, and the median time of the first porta hepatis occlusion was 18.1 (14-32)minutes. The median blood loss was 1 900(1 000-2 600)ml. All patients were transferred to ICU after operation. The median length of stay in ICU was 7(4-8) days, and the median time of indwelling drainage tube was 8(4-12) days. The average postoperative hospital stay was 13(11-20) days. There were 1 case of grade Ⅱ and 3 cases of grade Ⅲ complications (Clavien classification). One case had paroxysmal supraventricular tachycardia, one case had lymphatic fistula, one case had pleural effusion with atelectasis, and one case had hepatic and renal insufficiency and lymphatic fistula. The complications were improved after treatment. There was no perioperative death.Conclusions:Robot assisted trans-diaphragmatic intropericardial inferior vena cava occlusion and thrombectomy is an alternative method for the treatment of Ⅳa grade inferior vena cava tumor thrombus. Using this method, Ⅳa grade tumor thrombus can be treated without cardiopulmonary bypass and thoracotomy, with controllable complications and zero perioperative mortality.

13.
Chinese Journal of Urology ; (12): 497-501, 2021.
Article in Chinese | WPRIM | ID: wpr-911057

ABSTRACT

Objective:To evaluate the efficacy of holographic image technology in robot-assisted laparoscopic radical prostatectomy (RARP).Methods:The clinical data of 34 patients with prostate cancer who underwent RARP in our hospital during October 2020 and December 2020 was analyzed retrospectively. The average age of the patients was 67.8 (52-78) years. The mean BMI was 25.8 (18.0-32.3) kg/m 2. The median level of PSA before surgery was 13.4 (2-149) ng/ml. Median prostate volume was 31.7 (9.5-159.1) ml. EAU risk groups for biochemical recurrence of localised and locally advanced prostate cancer were list as below: 5 cases of low-risk, 7 cases of medium-risk, 22 cases of high-risk. There were 9, 16, 9 cases with the ASA score of 1, 2, 3 point, respectively. Preoperative Gleason score of 34 patients were list as below: 9 cases in score ≤6 group, 15 cases in score=7 group, 10 cases in score ≥8 group. For clinical stage before the surgery, 13 cases ≤T 2a stage, 1 case in T 2b stage, 20 cases ≥T 2c stage. The engineers established holographic images of 34 patients based on multiparametric magnetic resonance imaging (mpMRI) and the reports before the operation. Surgeons can obtain the size and location of tumors, surrounding neurovascular bundles visually by revolving, assembling, disassembling and concealing images, which was helpful for pre-surgery planning. By manipulating the holographic images extracorporeally, surgeons can discriminate Internal sphincter of urinary bladder and vesicoprostatic muscle, neurovascular bundles, membranous part, seminal vesicle easily, which improves the operation accuracy. Results:All 34 cases underwent operation successfully without transferring to open surgery. The median operative time was 157.5 (95-276) min with an estimated blood loss of 50 (20-300) ml. The median drainage removal time was 2 d and median hospitalization time was 3.5 d, respectively. The catheters were removed within an average time of 20.5 d. For postoperative Gleason score, there were 2 cases in score ≤6 group, 16 cases in score =7 group, 8 cases in score ≥8 group and 8 cases can’t make a score. For clinical stage after the surgery, 10 cases were ≤T 2a stage, 1 case was T 2b stage, 23 cases were ≥cT 2c stage. 22 cases underwent pelvic lymph node dissection, including a patient with right iliac fossa lymph node metastasis. There were 2 cases with positive surgical margin and 3 cases with Clavien-DindoⅠcomplications. The rate of 1-month and 3-month urinary continence were 47.1% and79.4%, respectively, 8 cases recovered erectile function after 3 month. Conclusions:Holographic image technology can promote cancer dissection completely, achieve urinary continence early and reduce perioperative complications tremendously. The technology is the "intraoperative security" for the accurate surgical treatment of prostate cancer.

14.
Chinese Journal of Rheumatology ; (12): 516-520,C8-1, 2021.
Article in Chinese | WPRIM | ID: wpr-910200

ABSTRACT

Objective:By analyzing the clinical and pathologic manifestations of systemic mastocytosis (SM) to improve the recognition of the disease.Methods:Clinical manifestations, diagnosis and treatment of a middle-aged male patient with SM was reported with multidisciplinary discussions.Results:A middle-aged man with bone pain, thyroid nodules and lymphadenectasis came to our clinic. Thyroid cancer with lymph node and bone metastasis was suspected by imaging examination. The pathological results showed cell proliferation with transparent cytoplasm and irregular nuclear in the trabecular bone. Toluidine blue staining showed the proliferated cells were mast cells(+). Immunohistochemistry showed proliferating mast cells stained with CD117 and CD2. SM with extensive bone marrow involvement was diagnosed and treated with thalidomide and calcitriol.Conclusion:Knowing the characteristics of SM is helpful for accurate diagnosis and treatment.

15.
Article in Chinese | WPRIM | ID: wpr-910086

ABSTRACT

Objective:To evaluate the value of ultrasound imaging in cervical lymphoma by constructing a prediction model of cervical lymphoma based on gray-scale ultrasonography radiomics.Methods:Retrospective analysis of ultrasonic sonographic data of 294 patients with cervical lymphadenopathy from June 2016 to June 2020 in the Affiliated Hangzhou Chest Hospital of Zhejiang University School of Medicine. The image features were extracted by imaging method, and the computer-generated random numbers were assigned to the training queue and the verification queue according to 7∶3 ratio. The minimum absolute contraction and selection algorithm (LASSO) were used to screen the optimal features, and support vector machine (SVM) was used to construct the imaging prediction model. The area under the ROC curve (AUC) was calculated to evaluate the performance of the prediction model.Results:Of the 294 cervical lymph nodes, 95 were lymphoma (32 Hodgkin′s lymphoma, 63 Non-Hodgkin′s lymphoma ), 199 cases were other lymph node diseases(34 metastatic lymph nodes, 67 lymph node tuberculosis, 98 reactive proliferative lymph nodes). A total of 107 features were extracted from gray scale ultrasound images, and after pretreatment and screening, 5 features were significantly associated with lymphoma. AUC, sensitivity, specificity and accuracy in the training and validation cohorts were 0.835, 85.1%, 85.7%, 85.5%, 0.793, 82.1%, 83.1%, 82.8%, respectively. The AUC, sensitivity, specificity and accuracy for a senior ultrasund doctor were 0.714, 65.3%, 79.9%, 75.2% in the idagnosis of cervical lymphoma.The diagnostic efficacy of the imaging prediction model was better than that of senior ultrasound doctor (AUC: 0.793 vs 0.714, Z=0.434), and the difference was statistically significant ( P<0.05). Conclusions:The imaging features based on gray scale ultrasound can provide more information on the diagnosis of lymphoma, and have good efficacy in the diagnosis of cervical lymphoma. Its diagnostic efficacy is better than that of the senior ultrasound attending physician.

16.
Article in Chinese | WPRIM | ID: wpr-910073

ABSTRACT

Objective:To investigate the clinical efficacy of robotic navigation and percutaneous internal fixation in the treatment of fresh undisplaced scaphoid lumbar fractures.Methods:From November 2019 to October 2020, 8 patients were treated at Department of Hand Surgery, Xuzhou Renci Hospital for fresh undisplaced scaphoid lumbar fractures. There were 7 males and one female with an average age of 27.5 years (from 18 to 42 years), and 5 left and 3 right cases. Navigation by a Tianji orthopedic robot was conducted to decide the positions for implantation of percutaneous Herbert screws to fixate the fractures. The bone healing was followed up by regular X-ray and CT examinations. The functional recovery was evaluated by Mayo wrist score, grip strength, pinch strength and wrist range of motion, and the wrist pain was evaluated by visual analogue scale (VAS).Results:All the 8 patients were followed up for a mean time of 12.8 months (from 6 to 19 months). All the wounds healed by the first intention without any inflammation or infection. CT examination at 3 months postoperation found that all the fracture ends got united. At the final follow-up, the average active motions of the injured wrist were: 67.9° in flexion, 64.1° in extension, 21.2° in radial deviation and 52.2° in unlar deviation, respectively. The average grip strength was recovered to 31.3 kg, reaching up to 85.2% (from 66.7% to 100.0%) of the contralateral wrist; the average pinch force was recovered to 19.5 kg, reaching up to 89.3% (from 77.8% to 100.0%) of the contralateral wrist. At the last follow-up, the Mayo wrist function scores averaged 97.5 (from 95 to 100) and all the 8 cases were excellent. The VAS pain score of the wrist averaged 0.88 (from 0 to 2).Conclusion:In the treatment of fresh undisplaced scaphoid lumbar fractures, navigation with a Tianji orthopedic robot can be used to visualize percutaneous minimally invasive screw fixation so that accurate positioning and precise screw placement are ensured, leading to rapid rehabilitation.

17.
Article in Chinese | WPRIM | ID: wpr-909257

ABSTRACT

Objective:To investigate the effects of obesity before pregnancy and excessive weight gain during pregnancy on the characteristics of offspring metabolism and the underlying mechanism.Methods:Pregnant women who delivered from April 2016 to December 2018 in Jiaxing Xiuzhou District Maternal and Child Health Hospital after providing written informed consent and their singleton newborns were considered for recruitment for this study. Finally, 2000 pregnant women and their newborns were included in this study. These pregnant women were divided into study control ( n = 1 576, normal body weight) and ( n = 424, overweight) groups according to their body mass before and during pregnancy. The levels of leptin, blood lipid, fasting blood glucose, fasting insulin, long form of leptin receptor (OB-Rb), suppressor of cytokine signaling 3 (SOCS3) gene expression, insulin resistance index, and insulin sensitivity index were compared between the control and study groups. Results:The body mass index before pregnancy and body mass during pregnancy in the study group were (30.91 ± 1.86) kg/m 2 and (21.25 ± 2.61) kg, respectively, which were significantly higher than those in the control group [(26.87 ± 1.05) kg/m 2, (14.57 ± 1.36) kg, t = 7.972, P = 0.013; t = 9.786, P = 0.001]. The levels of leptin, triglyceride, total cholesterol and low-density lipoprotein cholesterol in the study group were (1.23 ± 0.29) ng/mL, (0.65 ± 0.16) mmol/L, (1.40 ± 0.24) mmol/L, (0.76 ± 0.13) mmol/L, respectively, which were significantly higher than those in the control group [(0.63 ± 0.11) ng/mL, (0.38 ± 0.16) mmol/L, (1.13 ± 0.32) mmol/L, (0.56 ± 0.09) mmol/L, t = 7.701, P = 0.010; t = 7.329, P = 0.019; t = 5.734, P = 0.030; t = 9.387, P = 0.001]. The level of high-density lipoprotein cholesterol in the study group was significantly lower than that in the control group [(1.26 ± 0.17) mmol/L vs. (1.75 ± 0.26) mmol/L, t = 8.072, P = 0.008]. The expression of SOCS3 mRNA and OB-Rb mRNA in newborns from the study group was (1.44 ± 0.29) and (1.33 ± 0.39), respectively, which was significantly greater than that in the control group [(0.33 ± 0.19), (0.50 ± 0.21), t = 9.987, P < 0.001; t = 11.037, P < 0.001]. Fasting blood glucose and fasting insulin levels as well as insulin resistance index in the study group were (22.06 ± 3.94) mmol/L, (20.02 ± 4.61) mU/L, (19.79 ± 6.29) respectively, which were significantly higher than those in the control group [(11.73 ± 2.92) mmol/L, (13.31 ± 3.43) mU/L, (6.96 ± 2.52), t = 8.133, P = 0.001; t = 4.498, P = 0.027; t = 7.352, P = 0.002]. Insulin sensitivity index in the study group was significantly lower than that in the control group [(-6.07 ± 0.32) vs. (-4.98 ± 0.37), t = 8.244, P < 0.001]. Conclusion:Obesity before pregnancy and excessive weight gain during pregnancy will increase the expression of SOCS3 mRNA and further affect the expression of STAT3-SOCS3-leptin/insulin signaling pathway in offspring.

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Article in Chinese | WPRIM | ID: wpr-907944

ABSTRACT

Objective:To evaluate the auxiliary diagnosis value of bacterial culture, polymerase chain reaction (PCR) and serum anti-pertussis toxin immunoglobulin G (AntiPT-IgG) level detection in suspected pertussis.Methods:A total of 110 suspected cases of pertussis treated in the Department of Pediatrics of Wuhu No.1 People′s Hospital from June 2018 to May 2019 were recruited for the study.The nasopharyngeal swabs of all cases were collected for Bordetella pertussis culture and specific nucleic acid PCR detection.Serum samples of 78 cases were collected for the detection of AntiPT-IgG level by enzyme linked immunosorbent assays.Results:The positive rates of bacterial culture group and PCR group were 21.8% and 30.0%, respectively, with no statistically significant difference ( χ2=1.198, P>0.05). The culture positive rate of cases with the duration of cough<2 weeks was 32.1%, which was signi-ficantly higher than that of cases with the duration of cough about 2-4 weeks (14.3%) or >4 weeks (9.1%) ( χ2=6.522, P<0.05). The PCR positive rate of cases with the duration of cough <2 weeks was 39.6%, which was also significantly higher than that of cases with the duration of cough about 2-4 weeks (25.7%) or > 4 weeks (13.6%) ( χ2=6.126, P<0.05). The mean value for serum AntiPT-IgG level of 78 cases was (75.727±78.454) IU/mL, the median AntiPT-IgG levels of cases with the duration of cough<2 weeks and about 2-4 weeks were 5.909 IU/mL and 20.948 IU/mL, respectively, and the positive rates were 14.7% and 38.1%, respectively.The AntiPT-IgG level of cases with the duration of cough> 4 weeks and that at convalescent stage were (79.281±68.254) IU/mL and (107.242±75.750) IU/mL, and the positive rates were 39.1% and 57.1%, respectively. Conclusions:In the vaccine era, the results of pathogenic and serological tests should be combined to assist the clinical diagnosis of pertussis.The positive rate of bacterial culture and specific nucleic acid pathogen detection in children with cough duration less than 2 weeks is high, and the serological diagnosis is more effective after the duration of cough is over 4 weeks.

19.
Article in Chinese | WPRIM | ID: wpr-906368

ABSTRACT

Objective:An ultra-high performance liquid chromatography coupled with quadrupole-orbitrap high resolution mass spectrometry (UPLC-Q-Orbitrap HRMS) was developed to analyze and identify the chemical constituents in <italic>Coptis chinensis</italic> inflorescence. Method:The chromatographic separation was performed on ACQUITY UPLC BEH C<sub>18</sub> column (2.1 mm×100 mm, 1.7 μm) with the mobile phase of 0.1% formic acid aqueous solution (A)-acetonitrile (B) for gradient elution (0-15 min, 10%-22%B; 15-20 min, 22%B; 20-25 min, 22%-44%B; 25-35 min, 44%-50%B; 35-40 min, 50%-60%B; 40-55 min, 60%-85%B), the flow rate was 0.15 mL·min<sup>-1</sup>, the injection volume was 3 μL and the column temperature was 30 ℃. HRMS was equipped with electrospray ionization (ESI) and scanned in positive and negative ion modes by means of full scan/data dependent secondary scan (Full MS/dd-MS<sup>2</sup>). Compound Discoverer 3.0 software combined with mzCloud, mzVault, ChemSpider databases and HRMS database of components in traditional Chinese medicine were used to analyze and identify the collected data by HRMS, based on accurate relative molecular mass, retention time and characteristic ion fragmentation of the compounds, as well as literature information and relevant reference materials. Result:A total of 51 chemical constituents were identified in <italic>C</italic>.<italic> chinensis</italic> inflorescence, including 16 alkaloids, 14 flavonoids, 7 phenylpropanoids, 7 organic acids and 7 others. Among them, 10 components [berberine, palmatine, coptidine, rutin, quercetin, isoquercitrin, chlorogenic acid, cryptochlorogenic acid,<italic> D</italic>-(-) quinic acid and <italic>D</italic>-proline] were unambiguously identified by comparing with reference standards. Conclusion:The established UPLC-Q-Orbitrap HRMS can be used to accurately analyze and identify chemical constituents of <italic>C. chinensis</italic> inflorescence. A total of 41 chemical constituents are reported from <italic>C. chinensis</italic> inflorescence for the first time and 6 alkaloids are found from the <italic>C. chinensis</italic> for the first time. These findings can provide methodological reference and experimental basis for the basic research of quality evaluation and efficacy materials of <italic>C. chinensis</italic> inflorescence, and lay a foundation for its further development and utilization.

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Article in English | WPRIM | ID: wpr-898770

ABSTRACT

Purpose@#The present study determined the effects of saphenous nerve stimulation (SNS) at different stimulation frequencies on bladder reflex and explored a possible action mechanism of tibial nerve stimulation (TNS) on bladder activity in cats. @*Methods@#Two bipolar nerve cuff electrodes were implanted on the saphenous nerve and the contralateral tibial nerve in 13 cats, respectively. Multiple cystometrograms were obtained to determine the effects of single SNS at different frequencies and that of combined SNS and TNS on the micturition reflex by infusing normal saline. @*Results@#SNS at 1 Hz significantly reduced the bladder capacity (BC) to 59.8%±7.7% and 59.3%±5.8% of the control level at the intensity threshold (T) and 2T, respectively (P0.05), while combined stimulation at 1T significantly increased the BC to 122.7%±1.9% of the control level and induced an inhibitory effect which was similar to that TNS at 2T. @*Conclusions@#The current study revealed that SNS reduced and increased BC depending on different stimulation frequencies. The combined SNS and TNS maximized the clinical efficacy at a low intensity. Also, SNS may be a potential therapeutic mechanism of TNS.

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