Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 97
Filter
1.
Article in Chinese | WPRIM | ID: wpr-885965

ABSTRACT

The study aims to improve the level of fine management of medical equipments, give full play to the functions and roles for better patient service, and explore methods for evaluating the benefits of medical equipment that can take into account and reflect the needs of multiple parties. Based on objectives and key results(OKR) methods and concepts, a benefit evaluation system was developed with the goal of giving full play to the functions and roles of medical equipments, with corresponding evaluation indexes and supervision and evaluation mechanisms formulated as well. This index system could take into account the needs and concerns of hospitals, the departments in use, the management authorities and patients at large, while contributing to process supervision and continuous improvement. In the OKR practice of large medical equipments(CT, MR) from 2018 to 2019, they had performed significantly better in inspections, inspection positive coincident rates, clinical service capabilities, maintenance assurance levels, patient satisfaction, scientific research and academics among others. The use of a medical equipment benefit evaluation system based on OKR concepts and methods can provide effective evaluation indicators for the operation and management of medical equipments. In addition, the system can maintain internal improvement momentum leveraging process supervision and continuous improvement methods, in order to assure the elevation of fine management level of medical equipments of modern hospitals, thus offering better medical services for patients at large.

2.
Article in Chinese | WPRIM | ID: wpr-884323

ABSTRACT

Objective:To assess the urethral mobility of normal parous women in China and explore the impacts of related risk factors on it using translabial ultrasound.Methods:Females who met the inclusion criteria in 37 tertiary hospitals from February 2017 to August 2018 were included. All women underwent standardized translabial ultrasound examination and the urethral rotation angle (URA), bladder neck position at maximum Valsalva maneuver (BNP-V) and bladder neck descent (BND) were measured. Questionnaires were used to collect basic information including age, height, weight, body mass index (BMI), past medical history, maternity history, and urinary incontinence related history. Mann-Whitney U test and multiple linear regression analysis were adopted to explore the influences of age, BMI, delivery mode and parity on normal parous women′s urethral mobility. Then, the study subjects were divided into different groups and the corresponding values of URA, BNP-V and BND were compared. Results:Compared with parous women with normal BMI and no history of vaginal delivery, those who were overweight and/or had a history of vaginal delivery were more likely to gain greater URA and BND ( P<0.05). The URA and BND were not significantly different between women with different times of cesarean sections ( P>0.05); while for women with a history of vaginal delivery, these two parameters increased with the increase of the number of transvaginal deliveries ( P<0.05). Conclusions:BMI and vaginal delivery are important risk factors for the urethral mobility of normal parous women. The urethral mobility increases with the increase of BMI and the number of vaginal deliveries.

3.
Article in Chinese | WPRIM | ID: wpr-882974

ABSTRACT

Objective:To understand the problems and countermeasures of information support for dentofacial deformities patients, so as to provide reference for optimizing the whole process of information support for orthognathic-orthodontics treatment.Methods:Using a descriptive research method, 10 orthognathic surgery and orthodontics specialists from a tertiary level A hospital were selected for semi-structured interviews in August and September, 2019 using the method of target sampling. The QSR Nvivo 12.0 software was used for analysis by adopting traditional content analysis.Results:According to the analysis, medical experts believed that the problems of information support in the whole treatment process of orthognathic-orthodontics treatment include the following three aspects: information content problems (incomplete information content, lack of "time" dimension, patient's psychological expectation and treatment outcome information asymmetry, lack of information for main caregivers), difficulties in information support (clinical workload, professional limitations, many key time nodes), existing network information problems (poor quality of network information, lack of pertinence of information content and the existing network resources were not effectively utilized); and three suggestions were put forward: customizing the treatment schedule of patients, developing diversified information support methods, optimizing patient treatment process.Conclusion:Medical staff should pay attention to the construction and improvement of the whole treatment information support content of dentofacial deformities patients, pay attention to the diversity of information support methods, optimize the patient treatment process, encourage the health care to cooperate with the homogenization management of the whole treatment information support, and explore the information support system suitable for the situation of dentofacial deformities patients in China.

4.
Article in Chinese | WPRIM | ID: wpr-882874

ABSTRACT

Objective:To investigate the changes of plasma ghrelin levels and insulin(INS) sensitivity of full-term infants small for gestational age (SGA) and the effects of breast feeding on it.Methods:Full-term SGA hospitalised in the Department of Neonatology, Wuhan Children′s Hospital from October 2014 to April 2019 were re-cruited as the SGA group (120 cases), with full-term infants appropriate for gestational age (AGA) born in the same period as the AGA group (96 cases) in this study with recorded birth weight and length.The levels of fasting blood glucose (FG), triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL), INS and ghrelin were measured 7 days after birth.Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated.The SGA group was subdivided into breast feeding group and formula feeding group.The above indexes were tracked and mea-sured in the 3 rd and 6 th month, respectively, and their growth parameters were recorded. Results:There were no diffe-rences in serum FG, TG, LDL and HDL levels between the SGA and the AGA group (all P>0.05). Compared with the AGA group, the serum INS[(4.21±0.83) mIU/L vs.(3.54±1.10) mIU/L], ghrelin levels[(0.80±0.23) μg/L vs.(0.69±0.19) μg/L] and HOMA-IR (0.85±0.25 vs.0.72±0.25) increased in the SGA group, the differences were statistically significant (all P<0.05). Serum INS, HOMA-IR and ghrelin levels changed with the duration of breast feeding, the differences were statistically significant( F=12.394, 9.810, 5.531, all P<0.05). Conclusions:The serum ghrelin levels of SGA infants increased and INS sensitivity decreased.Breastfeeding can decrease levels of serum INS, HOMA-IR and ghrelin, and can improve INS sensitivity of SGA infants.

5.
Article in Chinese | WPRIM | ID: wpr-872112

ABSTRACT

Objective To evaluate the effectiveness of computer aided design (CAD) and three bit printing in the management of orthognathic surgery.Methods A total of 5 cases of patients with jaw deformity were involved in this study;jaw teeth and CT scanning laser scanning hefore surgery,virtual surgery design of 3D reconstruction and fusion data were analyzed,according to the design scheme of double jaw surgery combined with genioplasty;design and 3D printing of maxillary Le Fort Ⅰ osteotomy,genioplasty titanium alloy resin osteotomy and positioning guide,sagittal split ramus osteotomy by 3D printing and plate technology were used in this approach.The postoperative results were compared with the surgical planning by three-dimensional measurement and statistical analysis.Results When the operation guide plate was applied smoothly,the maximum error for maxilla was 1.2 mm (0.3-1.2 mm),and the maximum error for genioplasty was 1.7 mm,(0.5-1.7 mm),and the mean error was less than 1 mm.Follow-up for 12 months showed no adverse reaction.Conclusions Three dimensional printing surgical guide plate can accurately provide the osteotomy information,effectively control the jaw movement,and improve the orthognathic surgery accuracy of patients with partial jaw deformity.

6.
Article in Chinese | WPRIM | ID: wpr-871998

ABSTRACT

Small nucleolar RNAs(snoRNAs) constitute a large group of non-coding RNAs. Canonical snoRNAs contain C/D box and H/ACA box types, with the length of 60-300 nucleotides. They are predominantly engaged in 2′-O-methylation or pseudouridylation of ribosomal RNAs. Mounting evidence supported that snoRNAs were a kind of detectable modulators affecting multiple cell behavior and eventually triggered tumorigenesis. The aberration of snoRNAs could regulate cancer-related signal pathways, expedite degradation of p53 protein and induce self-renewal. Herein, the snoRNAs′ structure and the latest progress of snoRNAs research in malignancy were briefly summarized, hoping to provide a new idea for the discovery of effective therapeutic targets and promising tumor prognosis markers.

7.
Article in Chinese | WPRIM | ID: wpr-871923

ABSTRACT

Objective:To explore the expression level of serum exosomal miR-223-3p in patients with multiple myeloma (MM) and evaluate its clinical application.Methods:A case-control study was performed. Serum samples were collected from the Department of Hematology, Affiliated Hospital of Nantong University from March 2018 to August 2019, including 68 newly diagnosed untreated MM patients (16 in stage Ⅰ, 22 in stage Ⅱ and 30 in stage Ⅲ), 56 healthy controls and 30 patients with recurrent MM in the same period, and follow-up patients who underwent chemotherapy for 3 months after initial diagnosis. Serum exosomes were purified and identified, RNA was extracted, and RT-qPCR was performed to compare the levels of miR-223-3p in serum exosomes between the groups. The correlation between exosomal miR-223-3p levels and clinical pathological data was analyzed, and the diagnostic efficacy was evaluated by ROC curve.Results:Compared with healthy controls (0.92±0.29), the expression level of serum exosomal miR-223-3p in newly diagnosed MM patients (0.52±0.23) decreased significantly ( U=565, P<0.000 1). According to the international staging system of MM, the expression level of serum exosomal miR-223-3p in patients with stage Ⅰ(0.67±0.26) was significantly higher than that in patients with stage Ⅱ (0.47±0.21) and Ⅲ (0.48±0.19) ( U values were 96.5 and 138 respectively, P were all less than 0.05). In addition, the expression level of serum exosomal miR-223-3p increased after 3 months of chemotherapy (0.69±0.19) compared with that before chemotherapy (0.50±0.22) ( U=228.5, P=0.000 8). Compared with the healthy control group (0.84±0.21), the expression level of serum exosomal miR-223-3p in recurrent MM patients (0.65±0.18) was also decreased ( U=244, P=0.002). At the same time, the expression level of serum exosomal miR-223-3p may be related to the low expression of albumin ( U=411.5, P=0.043 1) and bone damage ( U=309, P=0.001). The ROC curves showed that the AUC of serum exosomal miR-223-3p in the diagnosis of MM was 0.853, which was higher than that of β 2-microglobulin (β 2-MG) (AUC=0.805) and albumin (AUC=0.743). The AUC of the three combined detection was 0.918. Conclusions:Serum exosomal miR-223-3p can be used as a potential marker for auxiliary diagnosis of MM, and its combination with β 2-MG and albumin can improve the diagnostic efficacy of MM.

8.
Article in Chinese | WPRIM | ID: wpr-871856

ABSTRACT

At present, nucleic acid testing technology has been widely used in clinical laboratory diagnosis. Conventional detection technique such as real-time PCR is complicated, time consuming, and dependent on specific instruments. Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR associated protein (Cas) system is an adaptive immune defense system against viruses in bacteria and archaea, which has been developed into a powerful technology for genome editing. Recently, the leading groups engaged in CRISPR have set up new tools for nucleic acid detection based on Cas13a, Cas12a and newly discovered protein-Cas14, which plays an important role in rapid diagnosis of infectious diseases, detection of gene mutations in cancer and genotyping. Since they are ultrasensitive, specific, rapid and cost-effective, it is expected to bring great potential for molecular diagnosis. In this review, the mechanism of CRISPR/Cas system and the principle, the applications of the newly-developed diagnostic platforms are introduced. What′s more, the advantages, limitations and prospects of the technologies are summarized.

9.
Article in Chinese | WPRIM | ID: wpr-798853

ABSTRACT

At present, nucleic acid testing technology has been widely used in clinical laboratory diagnosis. Conventional detection technique such as real-time PCR is complicated, time consuming, and dependent on specific instruments. Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR associated protein (Cas) system is an adaptive immune defense system against viruses in bacteria and archaea, which has been developed into a powerful technology for genome editing. Recently, the leading groups engaged in CRISPR have set up new tools for nucleic acid detection based on Cas13a, Cas12a and newly discovered protein-Cas14, which plays an important role in rapid diagnosis of infectious diseases, detection of gene mutations in cancer and genotyping. Since they are ultrasensitive, specific, rapid and cost-effective, it is expected to bring great potential for molecular diagnosis. In this review, the mechanism of CRISPR/Cas system and the principle, the applications of the newly-developed diagnostic platforms are introduced. What′s more, the advantages, limitations and prospects of the technologies are summarized.

10.
Article in Chinese | WPRIM | ID: wpr-868088

ABSTRACT

Objective:To investigate the feasibility of transperineal ultrasound in quantitative assessment of posterior compartment prolapse among Chinese women.Methods:The prospective multicenter study enrolled 485 women between January 2017 and January 2019. All patients underwent a standard clinical interview, pelvic organ prolapse quantification (POP-Q) examination and transperineal ultrasound examination. Volume data of transperineal ultrasound examinations were obtained at rest and in maximal Valsalva maneuver.Results:The higher POP-Q stage of posterior compartment, the lower rectal ampulla position in maximal Valsalva maneuver (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥2, P<0.001), and the greater rectal ampulla hypermobility (POP-Q stage=0 vs POP-Q stage=1, P<0.001; POP-Q stage=1 vs POP-Q stage≥ 2, P=0.007). The rectal ampulla position at rest and in maximal Valsalva maneuver and rectocele depth were correlated with prolapse symptoms ( r=-0.200, P<0.001; r=-0.252, P<0.001; r=0.086, P=0.045). The corresponding cut-off values of rectal ampulla position in maximal Valsalva in diagnosing posterior compartment prolapse (POP-Q stage ≥1) and clinical significant posterior compartment prolapse (POP-Q stage ≥2) were 7.32 mm below the symphysis pubis and 12 mm below the symphysis pubis, respectively, with the area under the ROC curve as 0.75 and 0.85, respectively. Conclusions:The ultrasonic measurements by transperineal ultrasound is significantly associated with POP-Q examination in posterior compartment, and it is demonstrated as a useful tool in quantitative assessment of the severity of posterior compartment prolapse.

11.
Article in Chinese | WPRIM | ID: wpr-868073

ABSTRACT

Objective:To investigate the association between levator hiatus area, pelvic organ prolapse quantification (POP-Q) examination and prolapse symptoms.Methods:The prospective multicenter study enrolled 996 female patients between January 2017 and January 2019. All enrolled patients underwent a standard clinical interview, POP-Q examination and transperineal ultrasound examination. Volume data of pelvic floor ultrasound examinations were obtained at rest, during contraction and during maximal Valsalva maneuver. The association between levator hiatus area, POP-Q examination and prolapse symptoms was analyzed. The performance of levator hiatus area on maximal Valsalva for assessing significant POP(POP-Q stage≥2) and prolapse symptoms were also evaluated.Results:There were significant differences of levator hiatus area at rest, during contraction and during maximal Valsalva among patients with different POP-Q stages (all P<0.001). Levator hiatus area during maximal Valsalva showed the highest correlation with abdominal dragging sensation ( r=0.277, P<0.001). The area under the ROC curve (AUC) of levator hiatus area during maximal Valsalva for significant POP (POP-Q stage≥2) was significantly higher than that for prolapse symptoms (AUC: 0.77 vs 0.69, P<0.001). Conclusions:Levator hiatus area on transperineal has moderate correlation with POP-Q examination and their association is stronger than the correlation between ultrasound findings and prolapse symptoms.

12.
Article in Chinese | WPRIM | ID: wpr-863874

ABSTRACT

Objective:To explore whether endoscopic surgery can achieve the same effect on thyroid cancer as open surgery.Method:44 cases were selected to endoscopic thyroidectomy with breast areola approach, who were prepared to accept the surgical treatment of thyroid cancer with cT1N0 stages, female, ≤60 years old, no history of neck surgery and beauty desire. Fifty patients with the same conditions undergoing thyroid open surgery were as the control group.Results:Operative time of endoscopic group[ (170.0±28.0) min] was longer than that of the open operation group[ (90.0±21.0) min ( t=15.610, P=0.000) ]. There was no significant difference between the two groups in surgical complications ( P>0.05) . There was no statistical difference between the number of paratracheal and anterior tracheal lymph nodes of endoscopic group (6.0 ±4.2) and open surgery group (5.5 ±3.7) ( t=0.692, P>0.05) . There was no statistical difference between the number of anterior laryngeal lymph nodes of endoscopic group (0.7 ±1.1) and open surgery group (0.5 ±0.9) ( t=1.186, P>0.05) . Conclusion:The breast areola approach endoscopic thyroidectomy is safe and reliable in treatment of thyroid cancer, and the central cervical lymph node dissection is sufficient, which can be used as the choice of operation mode for thyroid cancer patients in cT1N0 stage.

13.
China Pharmacy ; (12): 1549-1556, 2020.
Article in Chinese | WPRIM | ID: wpr-822618

ABSTRACT

OBJECTIVE:To study the effects of Calpeptin inhibitor Calpeptin on the transformation and stemness markers expression induced by estradiol(E2),and to investigate its mechanism. METHODS :Taking human mammary epithelial cells MCF-10A as research object ,transformed cells were induced by E 2 treatment. Cells were divided into control group (0.1%DMSO), E2-transformed group (50 nmol/L),E2-transformed+Calpeptin group (50 nmol/L E 2+1 μmol/L Calpeptin),then continuously treated with corresponding drug-containing culture medium for 15 generations. Then ,MTT assay was used to determine the proliferation rate of cells (24,48 h);plate colony test was used to detect the Clone formation rate of cells ;the number of sphere-forming cells was measured by suspension spheroidization test ;mRNA expressions of stemness marker (CD44,Nanog,OCT4)and extracellular sigal-regulated kinase (ERK)were detected by RT-qPCR ,and protein expressions of CD 44,Nanog,OCT4 ,ERK and p-ERK were detected by Western blotting assay. Another E 2-transformed cells were divided into control group (0.1%DMSO)and U0126 (ERK inhibitor )group(10 μmol/L). Clone formation rate ,the number of sphere-forming ,protein expressions of CD 44,Nanog, OCT4,ERK and p-ERK were determined with above methods ,and to validate the relationship of ERK inhibition with transformed cell behavior and the expression of stemness markers. RESULTS :Compared with control group ,proliferation rate and clone formation rate of E 2 transformed group were increased significantly (P<0.01),and the number of sphere-forming was increased significantly(P<0.01);mRNA expression levels of CD 44,Nanog,OCT4,ERK and protein expression levels of CD 44,Nanog, OCT4 and p-ERK in cells were increased significantly (P<0.01). Compared with E 2-transformed group ,proliferation rate (24,48 h)and clone formation rate of E 2-transformed + Calpeptin group were decreased significantly (P<0.01),and the number of sphere-forming was decreased significantly (P<0.05);mRNA expression levels of CD 44,Nanog,OCT4 ,ERK and protein expression levels of CD 44,Nanog,OCT4,p-ERK in cells were decreased significantly (P<0.05 or P<0.01). After treated with ERK inhibitor U 0126,clone formation rate of E 2-transformed cells ,the number of sphere-forming ,protein expression levels of CD44,Nanog,OCT4 and p-ERK were increased significantly (P<0.05 or P<0.01). CONCLUSIONS :Calpeptin can inhibit the transformation and the expression of stemness markers of human mammary epithelial cells MCF- 10A,and the mechanism of it may be associated with inhibiting the activation of Calpain-ERK signaling pathway.

14.
Article in Chinese | WPRIM | ID: wpr-756564

ABSTRACT

Objective To evaluate the skeletal stability of joint orthognathic and orthodontic treatment for cleft patients compared with non-cleft patients.Methods Fifteen cleft patient diagnosed with dental facial deformities underwent joint orthognathic and orthodontic treatment.Cephalometric analysis was carried out at T0 (before treatment),T1 (2 weeks after surgery),T2 (6 months after surgery) and T3 (24 months after surgery).The comparison of maxillary anterior-posterior and superiorinferior movement was performed with non-cleft orthognathic group (n =15) at the same follow-up time point.Results The maxilla was move forward for (3.8 ± 1.5) mm and downward for (2.4± 0.8) mm of cleft group.The relapse distance was (1.2±-0.7) mm (T1-T2:31.6%) in AP direction and (0.9±0.6) mm (T1-T2:37.5%) in vertical direction.At the time of 24 months after operation,the relapse distance was (1.0±0.5) mm (T1-T3:26.0%) in AP direction and (0.8±0.8) mm (T1-T3:33.3%) vertically.In non-cleft group,the maxilla was move (4.3±1.2) mm anteriorly and (2.2± 1.9) mm vertically.The relapse distance was (0.9±1.2) mm (T1-T2:20.9%) anteriorly and (0.8± 0.9) mm (T1-T2:36.6%) vertically at 6 months post-operatively.At 24 months after surgery the relapse distance was (1.1±0.6) mm (T1-T3:25.6%) anteriorly and (0.9±0.5) mm (T1-T3:40.9%) vertically.There were no statistical significant in both 6 months and 24 months follow-up between cleft and non-cleft group (P>0.05).Conclusions There is no statistic difference of post-surgical relapse rate between cleft and non-cleft orthognathic and orthodontic treatments,although the relapse distances are greater than that in cleft group.

15.
Article in Chinese | WPRIM | ID: wpr-756508

ABSTRACT

Exosomes are a class of extracellular vesicles that secreted by a variety of cells, with the length of 40-100 nm and a lipid bilayer membrane structure. They are often observed in multiple body fluids and are important mediators in intercellular communication. Several researches demonstrated that exosomes are closely linked to the development, invasion, metastasis, and drug resistance of colorectal cancer (CRC). In this review, the role of CRC-derived exosomes in the pathogenesis, diagnosis, prognosis and treatment of CRC were briefly summarized to provide a strategy for new therapeutic targets in CRC .

16.
Article in Chinese | WPRIM | ID: wpr-756486

ABSTRACT

Objective To investigate the clinical diagnostic value of circulating tumor cells (CTCs)and circulating cell-free DNA (cfDNA) in peripheral blood samples in breast cancer. Methods From July 2017 to April 2018, 47 patients with BMC (7 in stage Ⅱ, 19 in stage Ⅲ and 21 in stage Ⅳ), 24 patients with benign breast diseases and 28 healthy people were selected. After collecting peripheral blood samples, serum and blood cells were separated. The size-based high-throughput microfluidic chip was used to capture CTCs. The real-time fluorescent quantitative PCR based on Alu sequence was used to detect the length of cfDNA(247 bp, 115 bp)in the serum, and the ratio of amplified products of long and short fragments was used as the index of DNA integrity. The Mann-Whitney U test or Kruskal-Wallis H test was used to compare the differences between the groups and analyze the relationship between CTCs and cfDNA and clinical parameters of breast cancer. The ROC curve was drawn and the area under the curve (AUC) was used to evaluate the feasibility of blood cell CTCs and plasma cfDNA detection as diagnostic criteria. Results The CTCs and cfDNA of 47 BMC patients were analyzed. The CTCs and cfDNA integrity index (Alu 247/115) of BMC patients were significantly higher than those of physical examination patients[(13.98± 12.36)cells / ml vs (1.14 ± 1.35) cells / ml; 0.7687 ± 0.3868 vs 0.5094 ± 0.2456], and the difference was statistically significant(the U value was 126.5,359.0;P<0.001), the area under ROC curve of CTCs was 0.885 (95%CI: 0.805-0.965), cut-off value was 7.68/ml, sensitivity was 80.4%, specificity was 96.4%. The area under ROC curve of Alu 247/115 was 0.727(95%CI: 0.608-0.847), cut-off value was 0.431, sensitivity was 71.7%, specificity was 71.4%. The AUC of CTCs and Alu 247/115 was 0.919 (95%CI 0.854-0.984), which was higher than the single test of each indicator. Conclusions CTCs and cfDNA may be the potential biological indicators for breast cancer diagnosis. The combined detection of CTCs and cfDNA maybe improve the diagnosis rate of breast cancer patients.

17.
Article in Chinese | WPRIM | ID: wpr-754460

ABSTRACT

Objective: To investigate the risk factors for central lymph node metastasis (CLNM) and lateral cervical lymph node metasta-sis in papillary thyroid carcinoma (PTC) patients. Methods: We retrospectively reviewed 1,835 PTC patients who underwent central lymph node dissection or thyroidectomy with lateral cervical lymph node dissection between January and November 2016 at Tianjin Medical University Cancer Institute and Hospital. Univariate and multivariate logistic regression models were used to analyze related factors that may affect lymph node metastasis in PTC patients. Results: Of the 1,835 patients included in this study, 1,007 (54.88%) pa-tients had CLNM and 371 (20.22%) patients had lateral cervical lymph node metastasis. In the univariate analysis, the following were identified as risk factors for CLNM and lateral cervical lymph node metastasis (P<0.05): male sex, age<45 years, primary tumor size>10 mm, multifocality,anti-thyroglobulin (anti-Tg) levels >100.00 IU/mL and ,Tg>130.70 μg/L. Anti-thyroid peroxidase antibody (anti-TPO) level>100.00 IU/mL is a protective factor that reduces the risk of CLNM. However, CLNM is a risk factor for lateral cervical lymph node metastasis in PTC patients. Multivariate analysis revealed that male sex, age<45 years, primary tumor size>10 mm, multifocality, and anti-TG levels>100.00 IU/mL were associated with an increased risk of CLNM in PTC patients. Anti-TPO levels>100.00 IU/mL are protective factors for CLNM. The male sex, age<45 years, tumor size>10 mm, multifocality, Tg levels>130.70 ug/L, anti-TG levels>100.00 IU/mL, and CLNM are risk factors for lateral lymph node metastasis. Conclusions: Thus, men aged<45 years with a multifocal primary tumor>10 mm in size and with anti-Tg levels>100.00 IU/mL are more likely to develop CLNM and lateral cervical lymph node metastasis; patients with CLNM are more likely to develop lateral cervical lymph node metastasis. However, patients with anti-TPO lev-el>100 IU/mL are less likely to develop CLNM.

18.
Article in Chinese | WPRIM | ID: wpr-754421

ABSTRACT

Objective: To investigate the characteristics, diagnosis, primary detection, and prognosis of cervical lymph node metastases of squamous cell carcinoma of unknown primary site (SCCUP). Methods: This study retrospectively analyzed the clinical features and follow-up data of 262 patients with SCCUP. The Chi-square test were used to analyze the clinical performances, characteristics of pri-mary lesions, and sensitivity and specificity of examinations to identify original lesions. Factors related to the overall survival (OS) and progression-free survival (PFS) were also analyzed. Results: The 262 patients with SCCUP comprised more men, with a median age of 57 years. At the follow-up, 70 patients were diagnosed with primary lesions (26.7%), and the detection rates of primary lymph nodes in those who were male (30.1%), with a single lesion site (31%), and with levelⅣdisease (39.3%) were higher than those in patients who were female (17.4%), with multiple lesion sites (18.7%), and with levelⅡ/Ⅲdisease (20.8%). Compared with traditional imaging examinations, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) had higher sensitivity and speci-ficity in detecting the primary tumor. Survival analysis showed that distant metastasis was an independent risk factor affecting OS and PFS, and the effect of N stage on PFS was statistically significant. Conclusions: In SCCUP patients, the proportion of patients who were male, with a single lesion site, and with cervicalⅣlymph node metastasis had higher rates of detection of the primary sites. PET/CT examination is important for the diagnosis of SCCUP, as well as the detection of primary lesions. Advanced N stage and distant metasta-sis indicated poor prognosis.

19.
International Journal of Surgery ; (12): 571-576, 2019.
Article in Chinese | WPRIM | ID: wpr-751676

ABSTRACT

Adrenocortical carcinoma is a malignant endocrine tumor.There is no unified standard for diagnosis and treatment because of the low incidence.There are two peaks in the age of onset,which are 0 to 10 years and 40 to 50 years,and the incidence of children and women is higher.The percentage of 60 to 70 ACC patients show clinical symptoms due to the excess hormone,but there are still many patients with poor clinical symptoms.The common endocrine symptoms include polycythemia,masculinity or male breast development.The prognosis of ACC is poor,and the classification and staging of the tumor and hypercortisol are associated with the prognosis.Surgical resection is the first choice,but the recurrence rate of the tumor is high and the overall survival rate is low after operation.In this paper,the clinical characteristics,diagnosis,differential diagnosis,prognosis and treatment of ACC are summarized by reviewing the past researches.

20.
Article in Chinese | WPRIM | ID: wpr-804848

ABSTRACT

Objective@#To summarize the effect of simultaneous orthognathic surgery along with mandibular ramus reconstruction using costochondral graft, for adult M3 hemifacial macrosomia.@*Methods@#From November 2015 to October 2017, 5 adults diagnosed with M3 hemifacial macrosomia were treated. There were 3 males and 2 females, aged from 19 to 26 years. Le Fort Ⅰ osteotomy and SSRO with simultaneous mandibular ramus reconstruction using contralateral sixth or seventh costochondral graft was performed to correct the facial asymmetry and occluding relation. The data of clinical examination and CTs were collected at the time point of immediately postoperative, 1, 3, 6, 12 months after surgery. The facial symmetry, joint function, occlusion and 3D measurements in CT image reconstruction were analysed to evaluate the surgery outcome.@*Results@#The length of rib and costal cartilage ranged from 47 mm to 67 mm. All the costal cartilage grafts survived, and 4 patients got primary healing. All patients were followed for 2-13 months (with the mean follow-up of 8 months). The ratio of ramus length of affected side to normal side was over 80%. The occlusion was stable. The facial structures were satisfactory after 6 months.@*Conclusions@#Orthognathic surgery with simultaneous mandibular ramus reconstruction using costochondral graft is suitable for the adult severe hemifacial macrosomia, with satisfactory cosmetic and functional results. This method is easily performed with reliable graft survival rate, aesthetic facial structure and stable occlusion.

SELECTION OF CITATIONS
SEARCH DETAIL