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1.
Chinese Journal of Urology ; (12): 824-829, 2021.
Article in Chinese | WPRIM | ID: wpr-911127

ABSTRACT

Objective:To evaluate the feasibility, safety and efficacy of the magnetic resonance imaging guided focused ultrasound surgery (MRgFUS) in the treatment of localized prostate cancer (PCa).Methods:The data of 5 patients treated by MRgFUS from August 2020 to June 2021 in our institution were retrospectively analyzed. The median age was 73 (58-80) years, with the median PSA of 7.34 (5.19-8.40) ng/ml, and a median prostate volume of 27.96 (21.50-37.91) ml. The median pretreatment international prostate symptom score (IPSS) was 13(0-18). Of the 3 patients with intention of erectile function preservation, the pretreatment international index of erectile function-15 (IIEF-15) score was 12, 23 and 3, respectively. All patients had histopathology-proven PCa of grade group ≤ International Society of Urological Pathology (ISUP) 3, pre-operative PSA level <20 ng/ml, and a clinical stage ≤T 2b. A total of 6 lesions was confirmed by biopsy, with 3 of ISUP grade group 3 and 3 of ISUP grade group 1. All 5 patients underwent MRgFUS which was guided by a real-time magnetic resonance imaging (MRI). PSA, MRI and repeated biopsy were conducted to monitor recurrence. Questionnaires consisted of IPSS, IIEF-15, and the International Consultation on Incontinence-questionnaire-Short Form (ICI-Q-SF) were recorded before and after MRgFUS to evaluate the impact on functional preservation. Results:A total of 5 patients received MRgFUS. In total, 5 of the 6 lesions were treated. 1 lesion unvisible on MRI was not clinically significant and was left untreated. The median time in MRI scanner was 190 (140-355) min, and the median sonication time was 64 (35-148) min with the median sonications of 8 (5-13). The median catheter indwelling time was 1 (1-8) days. No other adverse effects were reported. The PSA level of all 5 patients decreased, with the nadir PSA of 1.196 ng/ml, 4.398 ng/ml, 4.135 ng/ml, 1.562ng/ml and 1.350ng/ml, respectively. 4 of the patients had a PSA decrease over 50%. No PCa lesion was seen on MRI at 3-month follow-up visit. As for functional preservation, the post-MRgFUS IPSS declined compared with the baseline score, and the IPSS of last follow-up was 5(0-14). Of the 3 patients with intention to preserve the erectile function, the erectile function score of IIEF-15 were 12, 30 and 9 three months after the treatment, respectively. No incontinence occurred postoperatively.Conclusions:MRgFUS is a feasible and safe way for the treatment of low- to intermediate-risk localized PCa, with satisfactory performance on functional preservation and low incidence of complications. The oncological outcomes still need to be establised with longer follow-up time and larger sample studies.

2.
Article in Chinese | WPRIM | ID: wpr-910576

ABSTRACT

With the development of precision medicine and individualized treatment, tissue biopsy in cancer patients diagnosis and therapy has been broadly used. However, because it’s hard to collect enough samples for biliary tract tumors, liquid biopsy was broadly applied for the diagnosis. In liquid biopsy, circulating tumor cells, circulating tumor DNA, and tumor-derived exosomes carrying tumor-specific information are released from tumor tissue into blood, bile, and other body fluids, which makes tumor biopsy samples easily to be obtained in a non-invasive way. At the same time, through a series of morphological and molecular measurements as well as genetic characterization, liquid biopsy can be used to look for the new early diagnostic markers, and therapeutic targets, monitoring progression and prognosis of diseases. This article outlined the current technology used to detect circulating tumor cells, circulating tumor DNA, and tumor-derived exosomes, and summarizes the latest advances in the clinical application of liquid biopsy in biliary tract cancers.

3.
Article in Chinese | WPRIM | ID: wpr-910411

ABSTRACT

Objective:To carry out investigation and analysis of an extensive skin radiation injury to the back accidentally caused by interventional procedure and to explore the problems faced in the event with emphasis on avoiding the reoccurance of similar events in the future.Methods:The data were collected by consulting the patient′s detailed medical history, collecting and analyzing clinical diagnosis and treatment data, tracking and observing their clinical manifestations and signs. The patient′s peripheral blood samples were also collected, together with the biological dose estimated and the equipment data collected on the site of the interventional treatment hospital.Results:The whole body dose to the patient was estimated to be 0.95 Gy. The typical values of kerma rate of radiation incident on the body surface due to fluoroscopic procedures were 373.5 mGy/min in subtraction modality and 47.8 mGy/min in fluoroscopy modality, respectively. The annual effective dose to the interventional radiologist was 20.51 mSv due to his operation in long-time radiation exposure conditions, higher than 3.09 mSv for other interventional radiologists with similar workload in the same department. The whole body and local clinical manifestations of the patients were in line with radiation injury. No clear diagnosis has been obtained in several hospitals, nor can obvious treatment outcomes be obsevered.Conclusion:Combined with the biological dose estimation result and clinical manifestations, the case was diagnosed as degree Ⅳ skin radiation injury. Radiation injury is closely related to whether the operation is conducted according to the standard and the output dose of X-ray machine. Non-specialized hospitals should strengthen clinical diagnosis and treatment of radiation injury.

4.
Article in Chinese | WPRIM | ID: wpr-910333

ABSTRACT

Objective:To study the prognostic impact of prognostic nutritional index (PNI) before radiotherapy in clinical stage Ⅲ esophageal cancer patients.Methods:We retrospectively reviewed 125 esophageal cancer patients with clinical stage Ⅲ undergoing definitive radiotherapy in Fourth Hospital of Hebei Medical University from 2013 to 2017. The PNI and nutritional risk index (NRI) were calculated before radiotherapy. The optimal cutoff value of PNI was determined by time-dependent receiver operating characteristics (ROC) at 49.925.The patients were divided into low PNI group(PNI<49.925) and high PNI group (PNI≥49.925). Based on NRI, the patients were divided into normal NRI group (NRI≥100) and abnormal NRI group (NRI<100). Kaplan-Meier method was used to calculate the overall survival (OS) and progression-free survival (PFS) and to perform univariate analysis. The mutlivariate analysis was performed by Cox regression model.Results:PNI was positively correlated with hemoglobin ( r=0.505, P<0.001) and NRI ( r=0.594, P<0.001). The 1-, 3- and 5-year OS rates in the low PNI group were significantly lower than those of the high PNI group (67.5%, 27.3%, 11.4% vs. 85.4%, 45.8%, 27.4%, respectively, χ2=8.569, P<0.05). Moreover, the 1-, 3- and 5-year PFS rates in the low PNI group were obviously higher than those in the high PNI group (59.7%, 23.2%, 4.9% vs. 79.2%, 35.4%, 24.9%, respectively, χ2=6.715, P<0.05). Univariate analysis showed that GTV, radiotherapy dose, chemotherapy, albumin, NRI and PNI were significantly correlated with OS and PFS (OS: χ2=6.822, 4.326, 4.474, 13.123, 8.846, 8.569, P<0.05: PFS: χ2=7.869, 4.636, 5.874, 10.911, 8.544, 6.715, P<0.05). Multivariate analysis showed that GTV, radiotherapy dose and PNI were independent prognostic factors for OS ( P<0.05). And GTV, radiotherapy dose, chemotherapy and PNI were independent prognostic factors for PFS ( P<0.05). Conclusions:The PNI before radiotherapy is a significant and independent predictor for survival of clinical stage Ⅲ esophageal cancer patients. Based on simple and inexpensive standard laboratory measurements, PNI could be a promising prognostic biomarker for esophageal cancer patients.

5.
Chinese Journal of Endemiology ; (12): 830-834, 2021.
Article in Chinese | WPRIM | ID: wpr-909106

ABSTRACT

Objective:To understand the current situation of water improvement and the prevalence of dental fluorosis in children aged 8 to 12 in drinking-water-type endemic fluorosis (referred to as drinking-water-type fluorosis) areas in Inner Mongolia Autonomous Region (referred to as Inner Mongolia), and to evaluate the effectiveness of prevention and control measures, and provide a basis for timely adjustment of prevention and control strategies.Methods:In 2019, a cross-sectional survey was conducted to investigate the situation of water improvement and water fluoride content in all villages of 85 drinking-water-type fluorosis banners (counties) in Inner Mongolia, and all the children aged 8 to 12 were examined for dental fluorosis.Results:Among the 9 623 disease affected villages in the region, the water improvement projects were completed in 8 547 villages, and the water improvement rate was 88.82%. There were 7 145 water improvement villages whose water fluoride content met the national drinking water hygiene standard, which accounted for 83.60% (7 145/8 547) of the total villages with water improvement projects. A total of 118 857 children aged 8 to 12 were examined, and 9 123 cases of dental fluorosis were detected. The detection rate of dental fluorosis was 7.68%, which was lower than the upper limit of the dental fluorosis detection rate of fluorosis area standards (30%).Conclusions:The accomplishment rate of water improvement projects in drinking-water-type fluorosis areas of Inner Mongolia is high, and the condition of children's dental fluorosis has been effectively controlled. However, it is still necessary to strengthen the water quality monitoring, improve the qualified rate of water improvement projects, and effectively implement various comprehensive prevention and control measures.

6.
Chinese Journal of Endemiology ; (12): 593-595, 2021.
Article in Chinese | WPRIM | ID: wpr-909059

ABSTRACT

Objective:To understand the characteristics and diagnosis and treatment of brucellosis with joint pain as the first clinical manifestation, and summarize the clinical classification of brucellosis complicated with joint pain, so as to provide reference for clinical diagnosis and treatment.Methods:Cases of brucellosis with first symptom of joint pain diagnosed in the 940th Hospital of PLA Joint Logistic Support Force from January 2015 to January 2020 were selected. The main clinical features, laboratory examination, diagnosis and treatment were analyzed.Results:A total of 82 patients with joint pain of the first symptom were selected, including 61 males and 21 females. Joint pain was the main complaint of the patients, 63.4% (52/82) of the patients visited spine surgery department, 17.1% (14/82) visited minimally invasive orthopedics department, 12.2% (10/82) visited rheumatic immunology department, and 7.3% (6/82) visited traditional Chinese medicine department. Brucellosis patients with cervical lesions accounted for 22.0% (18/82), combined with lumbar lesions accounted for 51.2% (42/82). The patients with elevated C-reactive protein accounted for 68.3% (56/82), abnormal liver function accounted for 52.4% (43/82), anti "O" positive accounted for 3.7% (3/82), abnormal autoantibodies accounted for 6.1% (5/82), and human leukocyte antigen-B27 (HLA-B27) positive accounted for 12.2% (10/82). Four patients with HLA-B27 positive had sacroiliac arthritis. All patients were cured after standard and full course therapy.Conclusion:Joint pain may be the first symptom of brucellosis, and the lumbar spine and cervical spine are the most vulnerable parts.

7.
Article in Chinese | WPRIM | ID: wpr-908679

ABSTRACT

Objective:To evaluate the effect of total intravenous anesthesia combined with transversus abdominis plane block (TAPB) and rectus sheath block (RSB) in patients undergoing laparoscopic total hysterectomy.Methods:One hundred and twenty patients who required a laparoscopic total hysterectomy under total intravenous anesthesia from April 2019 to June 2020 in General Hospital of Eastern Theater Command were selected. The patients were divided into 4 groups by random digits table method with 30 cases each: total intravenous anesthesia group (C group), total intravenous anesthesia combined with TAPB group (T group), total intravenous anesthesia combined with RSB group (R group) and total intravenous anesthesia combined with TAPB and RSB group (S group). The narcotic (propfol and remifentanil) dosage, changes of resting visual analogue score (VAS) within 48 h after operation, pressure number of analgesia pump within 48 h after operation, anesthesia satisfaction score and incidence of emergence agitation were compared among 4 groups.Results:The remifentanil dosage, propfol dosage and pressure number of analgesia pump within 48 h after operation in S group were significantly lower than those in T group, R group and C group: (1.09 ± 0.23) mg vs. (1.49 ± 0.21), (1.47 ± 0.26) and (1.48 ± 0.23) mg, (543.53 ± 41.78) mg vs. (618.96 ± 37.21), (598.67 ± 37.86) and (607.87 ± 36.93) mg, (3.52 ± 2.03) times vs. (5.47 ± 1.83), (6.63 ± 2.08) and (9.77 ± 2.16) times, the anesthesia satisfaction score was significantly higher than that in R group and C group: (18.13 ± 3.22) scores vs. (21.43 ± 2.42) and (21.44 ± 2.56) scores, and there were statistical differences ( P<0.05). The resting VAS extubation and 12, 24, 48 h after operation in S group was significantly lower than that in C group and R group, the resting VAS 12, 24 and 48 h after operation was significantly lower than that in T group, and there were statistical differences ( P<0.05). The incidence of emergence agitation in S group was significantly lower than that in C group: 6.67% (2/30) vs. 26.67% (8/30), and there was statistical difference ( P<0.05). Conclusions:TAPB combined with RSB can reduce the narcotic dosage, reduce the incidence of emergence agitation and relieve perioperative pain in patients undergoing laparoscopic total hysterectomy. The effect is better than that of total intravenous anesthesia and total intravenous anesthesia combined with TAPB or RSB.

8.
Article in Chinese | WPRIM | ID: wpr-907588

ABSTRACT

Objective:To observe the short- and long-term efficacy of apatinib combined with chemoradiotherapy in the treatment of advanced gastric cancer and its effect on tumor markers.Methods:From January 2013 to January 2017, 84 patients with advanced gastric cancer admitted to the Department of Oncology of Chang′an Hospital of Xi′an City were selected as the subjects. The patients were divided into synchronous chemoradiotherapy group and targeted chemoradiotherapy group by prospective nested control method, with 42 cases in each group. The synchronous chemoradiotherapy group was treated with synchronous chemoradiotherapy, and the targeted chemoradiotherapy group was treated with apatinib combined with chemoradiotherapy, 2 weeks was a cycle, a total of 12 cycles. The short- and long-term efficacy, median overall survival, changes of gastric cancer-related markers and adverse reactions of the two groups were compared.Results:After 3 months of treatment, there was no significant difference in the efficacy distribution between the synchronous chemoradiotherapy group and the targeted chemoradiotherapy group ( Z=0.240, P=0.887). The disease control rates of the two groups were 69.05% (29/42) and 73.81% (31/42) respectively, with no statistically significant difference ( χ2=0.233, P=0.629). After 6 months of treatment, the difference of the efficacy distribution between the synchronous chemoradiotherapy group and the targeted chemoradiotherapy group was statistically significant ( Z=6.288, P=0.043), and the disease control rates of the two groups were 42.86% (18/42) and 69.05% (29/42) respectively, with a statistically significant difference ( χ2=5.845, P=0.016). The median overall survival in the targeted chemoradiotherapy group and synchronous chemoradiotherapy groups were 18.7 months (95% CI: 8.4-24.8) and 13.8 months (95% CI: 7.2-18.7), with a statistically significant difference ( χ2=7.542, P<0.001). After 3 months of treatment, the levels of carbohydrate antigen (CA) 19-9, CA125, carcino-embryonic antigen (CEA) were (16.27±2.13) U/ml, (13.25±2.26) U/ml, (2.97±0.85) ng/ml in the targeted chemoradiotherapy group and (29.34±3.69) U/ml, (21.63±2.69) U/ml, (6.19±1.23) ng/ml in the synchronous chemoradiotherapy group respectively, all of them were lower than those before treatment, and the CA19-9, CA125, CEA in the targeted chemoradiotherapy group were lower than those in the synchronous chemoradiotherapy group, and there were statistically significant differences ( t=19.880, P<0.001; t=15.458, P<0.001; t=13.957, P<0.001). The total incidence of grade 3-4 adverse reactions in the targeted chemoradiotherapy group was 23.81% (10/42) and 28.64% (12/42) in the synchronous chemoradiotherapy group, and there was no statistically significant difference ( χ2=0.186, P=0.667). Conclusion:The long-term efficacy of apatinib combined with chemoradiotherapy in the treatment of advanced gastric cancer is better than that of synchronous chemoradiotherapy, and it is safe and reliable. At the same time, it can prolong the overall survival and reduce the levels of serum tumor markers.

9.
Article in Chinese | WPRIM | ID: wpr-906586

ABSTRACT

@#Objective    To assess the correlation of WHO pathological classification and Masaoka stage of thymomas with its prognosis. Methods    A total of 468 patients with thymomas who received surgeries during 2009-2019 in Huashan Hospital, Fudan University, were collected. There were 234 males and 234 females with an average age of 21-83 (49.6±18.7) years. A total of 132 patients underwent video-assisted thoracic surgery (VATS) and 336 patients underwent thymectomy with median sternal incision. The follow-up time was 5.7±2.8 years. The clinical data of the patients were analyzed. Results    The amount of intraoperative bleeding was 178.3±133.5 mL in the median sternal incision group, and 164.8±184.1 mL in the VATS group (P=0.537). The operative time was 3.3±0.7 h in the median sternal incision group and 3.4±1.2 h in the VATS group (P=0.376). Postoperative active bleeding, phrenic nerve injury and chylothorax complications occurred in 8 patients, 9 patients and 1 patient in the VATS group, respectively, and 37 patients, 31 patients and 7 patients in the median sternal incision group, respectively. There was no statistical difference between the two groups (P=0.102, 0.402, 0.320). The 5-year cumulative progression free survival (PFS) rates of patients with WHO type A, AB, B1, B2, B3 and C thymomas were 100.0%, 100.0%, 95.7%, 81.4%, 67.5% and 50.0%, respectively (P<0.001). The 5-year PFS rates of patients with Masaoka stageⅠ-Ⅳ thymomas were 96.1%, 89.2%, 68.6% and 19.3%,  respectively (P<0.001). The 5-year PFS rate was 87.3% in patients with myasthenia gravis (MG) and 78.2% in patients without MG (P<0.001). The 5-year PFS rates of patients with different surgeries were 82.4% and 83.8%, respectively (P=0.904). Conclusion    WHO pathological classification and Masaoka stage have significant clinical prognosis suggestive effect. Thymoma patients combined with MG have better prognosis, which suggests early diagnosis and treatment of thymoma are important.

10.
Article in Chinese | WPRIM | ID: wpr-906039

ABSTRACT

Epilepsy is a common nervous system disorder characterized by repeated attacks and a protracted course, which can cause great harms to the physical and mental health of patients. Antiepileptic drugs have been proved effective, but the resulting toxic and side effects cannot be ignored. Traditional Chinese medicine (TCM) has a long history of dealing with epilepsy. At present, in addition to enriching the cognitive theory of epilepsy treatment with TCM, we have also focused on the role of TCM in regulating the epilepsy-related signaling pathways from the perspective of molecular biology. The review of literature in China and abroad has uncovered that epilepsy is closely related to such pathophysiological processes as cell proliferation, apoptosis, autophagy, inflammatory response, and immune response. At the same time, the modern research of Chinese and western medicines shows that the efficacy of Chinese herbal monomers, single Chinese herbs or Chinese herbal compounds in treating epilepsy is directly or indirectly related to their regulation of signaling pathways. To be specific, they control epileptic seizures and alleviate epileptic brain injury by regulating the expression of key molecules in corresponding signaling pathways. This paper summarized the research progress in China and abroad as follows: ①Tangeretin and ginkgolide B inhibit apoptosis and oxidative stress by activating the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. ②Baicalin and osthol suppress autophagy by inhibiting the mammalian target of rapamycin (mTOR) signaling pathway. ③Ganoderan and astragaloside reduce apoptosis by inhibiting the mitogen-activated protein kinase (MAPK) signaling pathway. ④Salidroside and resveratrol reverse oxidative stress and apoptosis by activating the nuclear factor E2-related factor 2/antioxidant reaction element/heme oxygenase 1 (Nrf2/ARE/HO-1) signaling pathway. ⑤Curcumin and baicalin diminish inflammatory response and apoptosis by inhibiting the nuclear transcriptional factor-κB (NF-κB) signaling pathway. The above summary is expected to provide reference for the in-depth study and clinical application of TCM for the treatment of epilepsy.

11.
China Pharmacy ; (12): 2619-2623, 2021.
Article in Chinese | WPRIM | ID: wpr-904520

ABSTRACT

OBJECTIVE:To study the hepatotoxicity of main components of Polygonum multiflorum ,and investigate its toxic mechanism based on metabolic enzymes. METHODS :ADMETlab 2.0 platform was used to forecast the toxic or carcinogenic effects of emodin ,physcion,rhein,stilbene glycoside and gallic acid on liver ,skin and heart. The effects of those components on cytochrome P 450 enzyme system (CYP1A2,CYP2C9,CYP2C19,CYP2D6,CYP3A4)were evaluated. The effects of different concentrations of emodin ,rhein,stilbene glycoside and gallic acid (10,20,40,80 μmol/L)on the survival rate of normal hepatocyte L 02 were detected. The effects of major components of P. multiflorum on the activity of UGT 1A1 enzyme were studied by in vitro reaction system ,using bilirubin as substrate. RESULTS :Main components of P. multiflorum ,ie. emodin ,physcion, rhein and gallic acid ,showed strong toxic effects on the liver ,while stilbene glycosides possessed weak toxic effects on the liver. Emodin and physcion had strong inhibitory effects on CYP 1A2 and medium inhibitory effects on CYP 2C9,CYP2D6 and CYP3A4;rhein showed medium inhibitory effects on CYP 1A2 and CYP 2C9,while stilbene glycoside and gallic acid possessed weak inhibitory effects on the above enzymes. Emodin (40,80 μmol/L)and gallic acid (40,80 μmol/L)could significantly reduce the survival rate of L 02 cells(P<0.01). The inhibition rate of 5,10,20,40,80 μmol/L emodin and gallic acid(except for 5 μmol/L emodin)on UGT 1A1 enzyme increased significantly (P<0.01),and the inhibition effect of emodin on UGT 1A1 enzyme was reversible competitive inhibition. CONCLUSIONS :The main components of P. multiflorum ,ie. emodin ,rhein and physcion , are hepatotoxic ;the mechanism of it may be associated with inhibiting the activity of CYP 1A2 and CYP 2C9 and competitively blocking rate-limiting enzyme UGT 1A1 in the process of bilirubin metabolism.

12.
Article in English | WPRIM | ID: wpr-888248

ABSTRACT

Objectives To investigate whether a longer time period of gadolinium ethoxybenzyl diethylenetriaminepen-taacetic acid (Gd-EOB-DTPA)-enhanced T1 mapping scanning, as well as dynamic contrast-enhanced (DCE) and multiple hepatobiliary phase magnetic resonance imaging (MRI) have the potential to provide information about liver function in rats with liver fibrosis. Methods Forty rats were divided into the carbon tetrachloride-induced hepatic injury groups [carbon tetrachloride for four (

13.
Article in Chinese | WPRIM | ID: wpr-888072

ABSTRACT

Eleven condensed tannins were isolated from the roots of Indigofera stachyodes by various column chromatography techniques including silica gel, octadecyl silica(ODS), Sephadex LH-20, and semi-preparative high performance liquid chromatography(HPLC). These compounds were identified on the basis of physicochemical properties, nuclear magnetic resonance(NMR) and mass spectrometry(MS) data as stachyotannin A(1), epicatechin-(2β→O→7,4β→8)-epiafzelechin-(4β→8)-catechin(2), cinnamtannin D1(3), cinnamtannin B1(4), epicatechin-(2β→O→7,4β→8)-epiafzelechin-(4α→8)-epicatechin(5), gambiriin C(6), proanthocyanidin A1(7), proanthocyanidin A2(8), aesculitannin B(9), proanthocyanidin A4(10), and procyanidin B5(11). Compound 1 is a new compound. Compounds 2-11 were isolated from Indigofera for the first time. Furthermore, compounds 1, 2, and 4-11 showed inhibitory effects on thrombin-induced ATP release in platelets.


Subject(s)
Chromatography, High Pressure Liquid , Indigofera , Magnetic Resonance Spectroscopy , Plant Extracts , Proanthocyanidins
14.
China Pharmacy ; (12): 2400-2405, 2021.
Article in Chinese | WPRIM | ID: wpr-886924

ABSTRACT

OBJECTIVE:To evaluate the efficacy and safety of atomization inhalation of polymyxin combined in the adjunctive treatment for ventilator-associated pneumonia ,and to provide evidence-based reference for clinical treatment. METHODS : Retrieved from Cochrane Library ,Embase,PubMed,Web of Science ,CNKI,CBM,VIP and Wanfang database (from their inception to March 2021),randomized controlled trials (RCTs)about efficacy and safety of atomization inhalation of polymyxin combined with conventional treatment (trial group ) versus conventional treatment (control group ) for ventilator- associated pneumonia were collected. After data extraction and quality evaluation of included literatures met inclusion and exclusion criteria , Meta-analysis was performed by using Rev Man 5.4 software. RESULTS :A total of 13 clinical studies were included ,involving 2 RCTs and 11 cohort studies with a total of 1 066 patients. The results of Meta-analysis showed that clinical response rate [OR = 1.53,95%CI(1.17,2.00),P=0.002],microbial clearance rate [OR =1.46,95%CI(1.11,1.91),P=0.007] of trial group were significantly higher than those of control group ,with statistical significance. There was no statistical significance in the mortality rate [OR =0.88,95%CI(0.68,1.14),P=0.32] and the incidence of renal impairment [OR =1.04,95%CI(0.72,1.49),P=0.85] between 2 groups. CONCLUSIONS :Based on current evidence ,atomization inhalation of polymyxin combined with conventional treatment can significantly improve clinical response rate and microbial clearance rate of patients with ventilator- associated pneumonia. However , more strictly-designed , long-term follow-up and large-scale RCTs are needed.

15.
Chinese Journal of Urology ; (12): 23-27, 2021.
Article in Chinese | WPRIM | ID: wpr-884952

ABSTRACT

Objective:To evaluate the cancer detection rate in patients with multiparametric magnetic resonance imaging (mpMRI) PI-RADS 1-2 prior to initial biopsy, and analyze the risk factors of prostate cancer.Methods:A total of 196 patients undergoing initial prostate biopsy between July 2011 and June 2018 were retrospectively analyzed. According to ESUR PI-RADS system, the patients’ PI-RADS score was 1 and 2, with the mean age of 66.6±9.0 years, and the median PSA 7.44 ng/ml. Twenty-eight patients were enrolled with PSA<4 ng/ml but with abnormal directeral rectun examination. The rest 168 patients were enrolled with elevated PSA. According to the Epstein prostate risk classification criteria, clinically insignificant prostate cancer was defined as: PSA density ≤0.15 ng/ml 2, Gleason score≤6, less than 3 positive needles, <50% puncture length. If any of the above is not met, the diagnosis should be clinically significant prostate cancer(CsPCa). T test or Mann-Whitney U test were used for comparison between groups. Risk factors for diagnosis of prostate cancer and CsPCa were analyzed by chi square test(or Fisher’s exact probability method) and multivariate logistic regression analysis. Results:There were 42(21.4%) patients diagnosed with prostate cancer, 30(15.3%)patients were CsPCa. The negative predictive value of mpMRI was 78.6%(154/196)for prostate cancer overall, and 84.7%(166/196)for CsPCa. Patients with higher age and PSA density were associated with higher possibility of prostate cancer. Higher age, PSA level, PSA density, and lower PSA ratio were associated with higher possibility of CsPCa. Multivariate logistic regression analysis showed that PSA density>0.15 ng/ml 2( OR=2.94, 95% CI 1.45-5.95) was independent risk factor of prostate cancer.Ages over 70 years( OR=2.49, 95% CI 1.22-5.07), PSA ratio<0.2( OR=3.70, 95% CI 1.25-11.23), PSA density>0.15 ng/ml 2( OR=5.77, 95% CI 1.96-16.96) were independent risk factors of CsPCa ( P<0.05). Conclusions:The detection rate of prostate cancer was 21.4% in patients with elevated PSA or abnormal digital prostate examination but with PI-RADS score of 1-2. Higher age and PSA density were associated with higher risk of prostate cancer. The detection rate of CsPCa was 15.3%. Ages over 70 years, PSA ratio<0.2, PSA density>0.15 ng/ml 2 were independent risk factors of CsPCa.

16.
Chinese Journal of Endemiology ; (12): 118-123, 2021.
Article in Chinese | WPRIM | ID: wpr-883676

ABSTRACT

Objective:To understand the change trend of people's condition in tea drinking endemic fluorosis area of Inner Mongolia Autonomous Region, and to provide scientific basis for formulating prevention and control strategies.Methods:From 2009 to 2018, a cross-sectional survey was conducted in 30 villages of 6 banners (counties) of drinking tea type of endemic fluorosis of Inner Mongolia Autonomous Region. The tea drinking habits of residents were investigated. Ten families were selected from each monitoring village to collect brick tea samples, and the fluorine content in brick tea was detected for health risk assessment. In each monitoring village, one water sample was collected from each drinking water source. Fluoride ion selective electrode method was used to detect fluorine in tea and water. The prevalence of dental fluorosis in children aged 8-12 years old was examined and the X-ray examination and analysis were carried out for all the permanent residents aged 36-45 years and living in the local area for more than 5 years.Results:From 2009 to 2018, a total of 3 000 brick tea samples were collected. The geometric mean value of tea fluorine was 522.01 mg/kg, and the annual per capita consumption of brick tea by permanent residents was 2.52 kg. The average daily intake of fluorine in brick tea was 4.11 mg. According to the standard of "Total Fluoride Intake of Population" (WS/T 87-2016), there were 6 years of risk quotient > 1 in 10 years, while according to the World Health Organization (WHO) recommend standard, there were 5 years of risk quotient > 1. From 2012 to 2018, 210 water samples were detected, and the geometric mean value of fluorine in water was 0.90 mg/L, and the qualified rate was 84.76% (178/210). A total of 5 384 children aged 8-12 years old were examined and 1 562 dental fluorosis patients were detected. The total detection rate of dental fluorosis in children was 29.01% (1 562/5 384), and the dental fluorosis index was 0.62 (very mild). A total of 1 890 adults aged 36 to 45 years old were examined by X-ray. The detection rate of skeletal fluorosis was 18.10% (342/1 890). There were 77 patients with moderate and severe skeletal fluorosis.Conclusions:The brick tea fluorine content of residents in Inner Mongolia Autonomous Region is high, and there are health risks. The dental fluorosis of children aged 8-12 years old is very mild, and there are still moderate and severe skeletal fluorosis patients in adults. Therefore, it is necessary to strengthen the supervision of brick tea market and strengthen health education for residents.

17.
Article in Chinese | WPRIM | ID: wpr-882717

ABSTRACT

Objective:To find out predictors of the testicular ischemia caused by incarcerated inguinal hernia and evaluate the ischemic injury of the testis more accurately, which can indicate testicle exploration in time or prevent unnecessary testicle exploration.Methods:Pediatric patients (median: 9 months) undergoing operation of unilateral incarcerated inguinal hernia and ipsilateral testicular exploration from 1 Jul. 2013 to 30 Jun. 2019 were retrospectively investigated. Age at surgery, incarcerate duration, degree of intestinal and testicular injury, times of manual reduction and preoperative ultrasound data were collected. Statistical analysis was performed by SAS 9.4 (Copyright ? 2016 SAS Institute Inc.Cary, NC, USA) .Results:460 patients (median: 9 months) , of which 57 (12.39%) (median: 1.4 months, interquartile range 0.8-10.7 months) had severe testicular injury, and their average incarceration time was (23.9±9.3) h. Univariate logistic regression revealed that increased times of manual reduction, ultrasound scores, incarcerate duration and degree of intestinal injury were positively correlated with the degree of testicular ischemia, while age at surgery was negatively correlated with the degree of testicular ischemia ( P<0.05) . A model for calculating the probability of severe testicular ischemia injury was established: P= through multivariate analysis with backward stepwise logistic regression and 10-fold cross-validation was used for preliminary verification of the model. Conclusion:This study provides a relative reliable model to predict the risk of irreversible testicular ischemia due to incarcerated inguinal hernia using readily available clinical characteristics in young pediatrics with testicular ischemia.

18.
Article in Chinese | WPRIM | ID: wpr-876470

ABSTRACT

Objective To analyze the correlation between intestinal flora changes and neonatal necrotizing enterocolitis (NEC)through 16S rRNA metagenomic sequencing and bacterial culture. Methods From September 2018 to March 2019, 10 NEC cases and 6 controls were randomly selected in the neonatal ICU ward of Nanjing maternal and child health care hospital to analyze the 16S rRNA metagenomic diversity of the for intestinal flora. The fecal samples and corresponding environmental samples were corrected from 51 cases of NEC children and their case controls to isolate and culture Clostridium. Results The dispersion of samples within the case group was smaller than that of the control group, and the sample diversity was higher than that of the control group. In the isolation and culture of Clostridium, the overall detection rate of Clostridium in the case group was 43.14% (22/51), and the detection rate of Clostridium butyricum was the highest (19.61%, 10/51). There was a statistical difference between the two groups (χ2=5.85, P=0.015 58). All Clostridium strains did not carry the A, B and E type neurotoxin genes. Conclusion: Increased intestinal flora diversity, intestinal flora abundance and changes in the abundance of Clostridium may be closely related to the intestinal environment of children with NEC; Clostridium, especially Clostridium butyricum, may be related to the occurrence of NEC.

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China Occupational Medicine ; (6): 366-372, 2021.
Article in Chinese | WPRIM | ID: wpr-923201

ABSTRACT

OBJECTIVE: To analyze the relationship between the neurobehavioral functions of individuals exposed to low-level lead and the levels of serum copper-related proteins glutathione S-transferase M1(GSTM1), hypoxia inducible factor-1 alpha(HIF1α), cyclooxygenase 1(COX1) and metallothionein(MT), and to screen biomarkers for changes in neurobehavioral function caused by occupational lead exposure. METHODS: A total of 194 workers who exposed to low-level lead(lead-exposed group) and 120 workers without lead exposure(control group) were selected from a battery factory as the research subjects by judgment sampling method. The inductively coupled plasma-mass spectrometry was used to determine blood lead levels of the two groups, and the State of Mood Scale(POMS) was investigated to assess the emotional state. The computerized neurobehavioral evaluation system in Chinese version 3(NES-C3) was used to test the neurobehavioral ability index(NAI) of related indicators of learning memory and mental activity. Enzyme-linked immunosorbent assay was used to detect the levels of copper-related protein in serum. After using principal component analysis to extract the principal components of emotional state, learning memory and mental activity, multiple linear regression was used to analyze the influencing factors of neurobehavioral function. RESULTS: The blood lead level of the lead-exposed group was increased [(57.15±11.12) vs(177.86±80.04) μg/L, P<0.01], and the incidence of symptoms such as dizziness, memory loss, sleep disturbance, fatigue, weakness, cold sweats in extremities, cold extremities, tingling of extremities, tingling sensation in the distal extremities, tetany, instability of holding things, metallic taste in the mouth, nausea and vomiting, anorexia, constipation, abdominal distension, abdominal pain, toothache/tooth loosening were increased(all P<0.01) compared with the control group. Meanwhile, the scores of tension-anxiety, depression-dejection, fatigue-inertia, anger-hostility, confusion-bewilderment of POMS were increased(all P<0.01), and the scores of vigor-activity were decreased(P<0.01). The NAI of the lead-exposed individuals in the NES-C3 test of 6 indicators(series addition and subtraction, visual retention, memory scanning, listening to digital breadth, visual simple reaction time, target tracking) were lower than that of the control group(all P<0.01). The serum levels of GSTM1 and HIF1α of the lead-exposed group decreased(all P<0.01), and the COX1 and MT levels increased(all P<0.01) compared with the control group. The serum GSTM1, HIF1α, COX1 and MT of the lead-exposed group were correlated with their emotional state, learning and memory and mental activity to varying degrees(all P<0.05). The results of multiple stepwise linear regression showed that serum COX1 level was an independent influencing factor of emotional state(P<0.01), serum GSTM1, COX1 and lead working years were independent influencing factor of learning and memory(all P<0.05), and work length with lead exposure and alcohol consumption was an independent influencing factor of mental activity(all P<0.05). CONCLUSION: Low-level lead exposure can cause central nervous system symptoms in workers, and the change in neurobehavioral function and serum levels of copper-related proteins GSTM1, HIF1α, COX1 and MT. Serum levels of GSTM1 and COX1 can be used as candidate biomarkers for indicating neurobehavioral function caused by lead exposure.

20.
Journal of Experimental Hematology ; (6): 1671-1675, 2021.
Article in Chinese | WPRIM | ID: wpr-922315

ABSTRACT

Chronic lymphocytic leukemia (CLL) patients usually show immune dysfunction, which often leads to autoimmune hemocytopenia. Immune thrombocytopenia (ITP) is one of the common complications. The pathogenesis of CLL-related ITP is complex and has not been fully elucidated. At present, the researches mainly focus on humoral immunity, cellular immunity and innate immune disorders. Recent studies suggest that genomic abnormalities and microRNAs are also involved in CLL-related ITP. Traditional ITP standard therapy has a poor effect on CLL-related ITP. Chemotherapy or monoclonal antibody therapy against the primary pathogenesis of CLL can effectively treat thrombocytopenia, and the emergence of new targeted drugs also provides new treatment options for the disease. In this paper, the progresses of CLL-related ITP pathogenesis, prognosis and treatment in recent years are reviewed.


Subject(s)
Antibodies, Monoclonal , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/complications , MicroRNAs , Purpura, Thrombocytopenic, Idiopathic , Thrombocytopenia
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