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1.
Article in Chinese | WPRIM | ID: wpr-910425

ABSTRACT

Objective:To investigate the value of radiotherapy in patients with stage Ⅳ B thoracic esophageal squamous cell carcinoma (ESCC) at initial diagnosis. Methods:A total of 199 patients with stage Ⅳ B thoracic ESCC at initial diagnosis (according to UICC/AJCC Eighth Edition Esophageal and Esophagogastric Junction Cancer TNM Staging) who were treated in the Fourth Hospital of Hebei Medical University between January 2010 to December 2016 were recruited. Winthin the whole group, 130 patients (65.3%) had distant lymph node metastases alone, 51 cases (25.6%) of solid organ metastases alone and 18 cases (9.0%) of solid organ complicated with distant lymph node metastases. Among them, 16 patients (8.0%) were treated with chemotherapy alone, 50 cases (25.1%) of radiotherapy alone, 133 cases (66.8%) of radiochemotherapy (81 patients treated with concurrent radiochemotherapy and 52 patients treated with sequential radiochemotherapy). The survival rate was calculated by Kaplan-Meier method and the difference was analyzed by log-rank test. Clinical prognosis was assessed by multivariate Cox regression model. Results:The median overall survival (OS) of the entire cohort was 12.3 months (95% CI: 10.6-15.4m), and the 1-, 2-, 3-and 5-year OS rates were 52.1%, 25.2%, 19.1%, and 11.5%, respectively. Multivariate analysis showed that tumor length, the number of metastatic organs, and treatment modalities were the independent prognostic factors for OS. There was no significant difference in OS between concurrent radiochemotherapy and sequential radiochemotherapy ( P=0.955). The OS of patients in the radiotherapy dose of ≥6000 cGy group was significantly longer than that of their counterparts in the 4500-5039 cGy and 5040-6000 cGy groups (both P<0.001). Conclusions:For stage Ⅳ B thoracic ESCC patients at initial diagnosis, tumor length ≤3cm, single organ metastasis, and radiochemotherapy strategy are significantly correlated with longer OS. For stage Ⅳ ESCC patients with good physical status, radiotherapy can be supplemented on the basis of systemic chemotherapy. Concurrent or sequential radiochemotherapy needs to be individualized. If patients are tolerable, radiochemotherapy is recommended to the primary tumor or non-regional metastatic lymph nodes, aiming to prolong the OS of patients.

2.
Article in Chinese | WPRIM | ID: wpr-885285

ABSTRACT

Objective:To study the relationship between gastric fundus size and postoperative gastroparesis and to find effective ways to prevent postoperative gastroparesis in high-risk patients.Methods:We retrospectively reviewed the clinical data of 276 gastric cancer patients undergoing radical gastrectomy from 2015 to 2016. The gastric fundus volume/total gastric volume (FV/TV) ratio was measured by computed tomography (CT) and comparative study between the gastroparesis group and the non-gastroparesis group was carried out in terms of postoperative gastroparesis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance. Single-factor and multiple-factor analyses were performed to filter clinically significant predictive factors of gastroparesis. Then, we increased the sample size to 304 patients whose FV/TV ratio was >19.4%. The different surgical methods and perioperative management of these patients were analysed. The chi-square test and logistic regression analysis were performed to identify effective independent factors for preventing gastroparesis.Results:The FV/TV ratio in the gastroparesis group was significantly higher than that in the non-gastroparesis group ( P<0.05). A cut-off value of 19.4% was selected by ROC curve analysis, at which the FV/TV ratio had a sensitivity of 76.2% and a specificity of 53.7%. In 304 patients in the second retrospective study, the incidence of gastroparesis was 9.2%. Gastroparesis was significantly reduced in patients with residual gastric size <1/3 ( P<0.05) and early postoperative gastrointestinal decompression ( P<0.05). Conclusions:The FV/TV ratio can effectively predict the risk of postoperative gastroparesis preoperatively. Small residual stomach and early postoperative gastrointestinal decompression are effective measures to prevent gastroparesis in high-risk patients.

3.
Article in Chinese | WPRIM | ID: wpr-882907

ABSTRACT

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.

4.
Article in Chinese | WPRIM | ID: wpr-871977

ABSTRACT

Objective:To analyze the phenotype and genotype of a Chinese pedigree with congenital dysfibrinogenemia and investigate the molecular mechanism of the disease.Methods:Pedigree analysis. Peripheral blood samples were collected from 7 members of the pedigree and routine coagulation tests were conducted. The activity of fibrinogen was measured using Clauss method, and fibrinogen antigen was measured by immunoturbidimetry. All the exons and exon-intron boundaries of FGA, FGB and FGG genes were amplified using PCR, which was followed by direct sequencing. Electrophoretic and immunological analysis of fibrinogen, fibrinogen clottability measurement, fibrin polymerization measurement and scanning electron microscopy were used to investigate the pathogenesis of this disease. Results:The proband showed normal activated partial thromboplastin time (APTT) , prolonged prothrombin time(PT), thrombin time (TT),and reptilase time (RT).The antigen level of fibrinogen in the proband (1.6 g/L) decreased slightly, while the activity level of fibrinogen (0.7 g/L) decreased significantly. His father and grandmother showed normal APTT and PT, prolonged TT and RT. The antigen levels of fibrinogen in both of them were normal (2.0 g/L and 2.2 g/L, respectively), while the activity levels of fibrinogen were low (1.0 g/L and 1.1 g/L, respectively). The results of other members from the pedigree were all within the normal range. Genetic analysis revealed a heterozygous A>G mutation at nucleotide 4774 in exon 6 of FGG gene in the proband, which was predicated to be a novel Gln195Arg mutation. The mutation was also found in his father and grandmother.Western blot results showed that no abnormal bands of plasma fibrinogen were found in the proband, his father and grandmother. The fibrinogen clottability in the proband was 49.3%, while that in the heathy control was 98.9%. Both thrombin-induced fibrin polymerization and reptilase-induced fibrin polymerization were significantly impaired in the proband, compared to that in the heathy control. Scanning electron microscopy revealed that compared with the heathy control, the average fiber diameters of the fibrin clot in the proband increased significantly ( P<0.001), while the density of fibers decreased and the arrangement of fibers was sparse. Conclusions:The heterozygous Arg19Gly mutation, which probably damages functions of fibrinogen, should be responsible for the congenital dysfibrinogenemia in this pedigree. This mutation has not been reported.

5.
Article in Chinese | WPRIM | ID: wpr-871969

ABSTRACT

Objective:To establish clinical detection of coagulation factor Ⅷ activity by chromogenic substrate assay and evaluate its clinical application.Methods:A total of 40 hemophilia Apatients, 20 acquired hemophilia A patients, 26 patients with positive lupus anticoagulant and 60 apparently healthy people were enrolled from January 2018 to May 2019 in Ruijin Hospital of Medical College, Shanghai Jiaotong University. According to Clinical and Laboratory Standards Institute(CLSI), the accuracy, within-run and between-run imprecision, lower detection limit, linear range, carryover rate, reference range, and reportable range of chromogenic substrate assay for detecting coagulation factor Ⅷ activity was evaluated, and compared with coagulation assay. The clinical application was evaluated by detecting F Ⅷ activity in acquired hemophilia A patients and patients with lupus anticoagulant by chromogenic substrate assay.Results:The results of two constant quality control products were within range provided by the manufacturer(the bias was 3.93%-6.79%). The within-run imprecision was 1.86%-2.06%(≤5%). The between-run imprecision was 4.83%-6.90%(≤15%). The chromogenic substrate assay had a good performance in sensitivity(CV=11.23%<20%). The recommended reference range was appropriate for our laboratory. The maximum dilution was 1∶16. The linear range was 5.00%-193.50% (a=1.0243, R 2=1.000). The clinical reportable range was 0.50%-387.00%. The method had a low carryover rate (0.04%). The chromogenic substrate assay had good consistency with coagulation assay in detecting coagulation factor Ⅷactivity (R 2=0.961) as well as the titer of FⅧ inhibitor(R 2=0.973).The difference of FⅧ activity in patients with lupus anticoagulant between these two assays was statistically significant(t=9.232,P<0.05). Conclusion:The chromogenic substrate assay has a good performance in clinical detection of coagulation factor Ⅷactivity with wider clinical application and less interference.

6.
Article in Chinese | WPRIM | ID: wpr-870116

ABSTRACT

Objective:This study aimed to evaluate the accuracy of a portable REF-XT01 uric acid meter in measuring blood uric acid concentration, and to determine whether the results of the uric acid meter could be used to guide the adjustment of uric acid-lowering drugs.Methods:1 551 subjects were enrolled from the Gout Clinical Medical Center of the Affiliated Hospital of Qingdao University. The fasting venous blood was collected and the serum uric acid was measured by an automatic biochemical analyzer. Meanwhile, the capillary blood uric acid was measured by fingertip puncture using the REF-XT01 uric acid meter. Linear regression, intra-group correlation coefficient(ICC), and Bland-Altman plots were used to analyze the uric acid concentration correlation between the biochemical analyzer(sUA BA)and the uric acid meter(sUA UM). The receiver operating characteristic curve(ROC curve)was conducted to evaluate whether sUA UM can be used as a reference for the gout patients to take uric acid-lowering drugs. Results:The regression analysis showed correlation between sUA BA and sUA UM, with the regression formula Y=0.875X+ 39.525( r=0.84, P<0.01)and the ICC was 0.829(95% CI 0.814-0.844, P<0.01). The Bland-Altman diagram showed a good consistence(the absolute deviation was-143.4-114.5 μmol/L, mean deviation was -14.4 μmol/L)between sUA BA and sUA UM. The sensitivity was 96.61%, specificity was 48.81%, and the area under the ROC curve(AUC)was 0.926( P<0.01)when 300 μmol/L was defined as the detection threshold of the uric acid meter, the sensitivity was 90.98%, specificity was 66.78%, and the area under the ROC curve(AUC)was 0.914( P<0.01)when 360 μmol/L was defined as the detection threshold of the uric acid meter. Conclusion:REF-XT01 uric acid meter is applicable for the adjustment of uric acid-lowering drugs for the gout patients, because of its high accuracy for the detection of uric acid.

7.
Article in Chinese | WPRIM | ID: wpr-912425

ABSTRACT

Rare bleeding disorders (RBD) are autosomal recessive inherited diseases caused by one or more coagulation factor defects, including the deficiency of fibrinogen (FG), prothrombin, factor (F)V, Ⅶ, Ⅹ,Ⅺ, Ⅷ and so on. Due to the low prevalence of RBD, and lack of large-scale randomized controlled studies in the world, where are great challenges to clinicians in diagnosis and treatment of this series of diseases. Facing in the heterogeneity of clinical phenotype and laboratory characteristics, it is more necessary to strengthen the communication and cooperation between the clinical and laboratory, realizing comprehensive management.

8.
Journal of Clinical Hepatology ; (12): 847-849, 2020.
Article in Chinese | WPRIM | ID: wpr-819190

ABSTRACT

ObjectiveTo investigate the clinical value of ultrasound-guided real-time percutaneous transhepatic-cholangial or transhepatic-cholecyst drainage (PTCD) in the treatment of patients with acute obstructive cholangitis in primary hospitals. MethodsA retrospective analysis was performed for the clinical data of 38 patients with acute obstructive cholangitis who underwent ultrasound-guided real-time PTCD in Tengchong People’s Hospital from February 2012 to June 2018, and among these patients, 4 had malignant biliary obstruction and cholangitis and 34 had acute obstructive suppurative cholangitis caused by hepatolithiasis. ResultsOf all patients, 30 underwent puncture of the bile duct in the right lobe of liver, 6 underwent puncture of the bile duct in the left lobe of liver, and 2 underwent puncture of the gallbladder. The success rate of first-time needle insertion was 91.2% (35/38), and the overall success rate of puncture was 100%. There were no complications such as massive hemorrhage, biliary peritonitis, and biliary-vascular fistula. At 2 weeks after surgery, 89.5% (34/38) of the patients had a bilirubin level reduced by ≥1/2, and 32 patients (84.2%) had a level of alanine aminotransferase reduced to normal. As for the 34 patients with hepatolithiasis, second-stage surgeries including bile duct exploration/cholecystolithotomy and hepatic lobectomy were performed after the infection was under control, or they were referred to superior hospitals with tube indwelling for further treatment. The 4 patients with neoplastic bile duct obstruction were referred to superior hospitals with tube indwelling, among whom 3 underwent radical surgery and 1 underwent biliary stent placement via the former deep blind fistula. ConclusionUltrasound-guided real-time PTCD can be used as an effective, simple, and safe biliary drainage technique for the early treatment of acute biliary obstruction in primary hospitals. This technique has a high success rate and low requirements for medical equipment, and therefore, it holds promise for clinical application in primary hospitals after related technical procedures are standardized.

9.
Article in Chinese | WPRIM | ID: wpr-861488

ABSTRACT

Objective To assess the value of three-dimensional pseudo-continuous arterial spin labeling(3D-pcASL)in assessment of imaging progress in acute ischemic stroke with unilateral middle cerebral artery (MCA) stenosis. Methods MRI data of 31 patients of acute ischemic stroke with unilateral MCA stenosis were analyzed retrospectively. According to the whole brain DWI characteristics at the time of admission and within 7 days after admission, the patients were divided into progressive group (n=20) and non-progressive group (n=11). 3D-pcASL with post-labeling delay (PLD) of 1.5 s and 2.5 s were performed. The value of blood flow of collateral circulation (ΔCBF) in bilateral (involved side and healthy side) brain regions,including frontal, parietal, temporal and occipital cortices, anterior watershed, internal watershed, posterior watershed and basal ganglia were measured and compared between 2 groups. ROC curve was used to evaluate the efficacy of each region's ΔCBF at involved side in diagnosis of imaging progress of acute ischemic stroke with unilateral MCA stenosis. Results Progress group had significantly lower ΔCBF value in the posterior watershed of both sides compared with non-progressive group (both P<0.05). The area under ROC curve (AUC) of ΔCBF value in posterior watershed at involved side was 0.750, the sensitivity and specificity was 0.85 and 0.64, while in internal watershed were 0.709, 0.95 and 0.55, respectively. Conclusion 3D-pcASL can estimate the compensatory status of collateral circulation in acute ischemic stroke patients with unilateral MCA stenosis, being helpful to early diagnosis of imaging progress of acute ischemic stroke.

10.
Journal of Leukemia & Lymphoma ; (12): 641-646, 2019.
Article in Chinese | WPRIM | ID: wpr-801608

ABSTRACT

Objective@#To investigate calreticulin (CALR) gene mutations classification in BCR-ABL1 negative myeloproliterative neoplasms (MPN), and its relationship with clinical manifestations.@*Methods@#Genomic DNA polymerase chain reaction (PCR) amplification product Sanger sequencing method was used to detect the mutation of exon 9 of CALR gene in 236 patients with BCR-ABL1 negative MPN (excluding polycythemia vera and negative CALR mutations) in Ruijin Hospital of Shanghai Jiao Tong University School of Medicine from November 2015 to November 2018. The mutations were classified into 52 bp deletion (type 1) mutation, 5 bp insertion (type 2) mutation and other mutation types according to PCR sequencing analysis. The clinical characteristics of the carriers with two kinds of mutations in 198 patients with essential thrombocythemia (ET) and 38 primary myelofibrosis (PMF) were compared. For the types of mutations that could not be determined, they were classified according to the α-helix propensity score of the mutant protein peptide chain or the degree of retention of the negatively charged amino acid residues, and the differences between the two classification methods were also compared.@*Results@#Among 236 patients, the CALR gene type 1 or type 2 mutation was detected in 206 cases (87.3%), including 173 ET patients (99 cases of type 1 mutation and 74 cases of type 2 mutation) and 33 PMF patients (28 cases of type 1 mutation and 5 cases of type 2 mutation). The CALR non-type 1 or non-type 2 mutation was detected in 30 cases, including 25 ET patients and 5 PMF patients. Among 173 ET patients with CALR gene mutation, the white blood cell count (WBC) of patients with type 1 mutation was higher than that of patients with type 2 mutation [(8.6±2.7)×109/L vs. (7.6±2.4)×109/L, t = 2.45, P = 0.015]. Among 33 PMF patients with CALR gene mutation, the age of patients with type 1 mutation was older than that of patients with type 2 mutation [(58±13) years old vs. (41±16) years old, t = 2.51, P = 0.018]. According to the α-helix propensity score of mutant protein peptide chain and the degree of retention of the negatively charged amino acid residues, 27 kinds of non-type 1 or non-type 2 mutations were classified by using sequencing method, and there were differences between the two methods. According to the α-helix propensity score of the mutant protein peptide chain, the proportion of type 1/type 1-like mutation in PMF patients was higher than that in ET patients [78.9% (30/38) vs. 56.6% (112/198), P < 0.01]. According to the degree of retention of negatively charged amino acid residues in the mutant protein peptide chain, the isoelectric point (pI) value of the mutant protein peptide chain was higher than that of the wild type sequence. The pI value of the type 1-like mutant protein peptide chain was higher than that of the type 2-like mutation (11.79±0.15 vs. 10.02±0.42, t = 11.51, P < 0.01).@*Conclusions@#Type 1 mutated ET patients may be closely related to the high risk of myelofibrosis transformation. The results of the classification of CALR mutations are different according to the α-helix propensity score of the mutant protein peptide chain and the degree of retention of the negatively charged amino acid residues. Further study is necessary to identify the pathogenesis of MPN caused by CALR mutation, and to determine the relationship between mutation type and prognosis of disease.

11.
Article in Chinese | WPRIM | ID: wpr-798180

ABSTRACT

Objective@#To explore the effect of acupuncture and massage combined with sulfasalazine enteric-coated tablets on ankylosing spondylitis (AS) and its influence on bone mineral density and serum MMP-3.@*Methods@#A total of 88 AS patients who met the criteria were divided into two groups by the random number table method, 44 cases in each group. The control group was treated with sulfasalazine enteric-coated tablets, while the observation group was treated with acupuncture and massage on the basis of the control group. Both groups were treated for 6 months and followed up for 6 months. TCM syndromes were scored before and after treatment. The Bone Glaprotein (BGP), hematocrit (Hct), alkaline phosphatase (ALP), matrix metalloproteinase-3 (MMP-3), CRP and TNF-α were detected by double antibody sandwich enzyme-linked immunosorbent assay. The bone mineral content of lumbar spine, trochanter and whole body were measured by DPX-NT X-ray bone mineral density analyzer. The quality of life (QOL) was assessed by four items in the Medical Outcomes Study Short-Form 36 (SF-36), including physiological function, physical pain, social function and mental health. The clinical efficacy was evaluated and the recurrence rate was recorded.@*Results@#After treatment, the BGP, ALP, MMP-3, CRP, TNF-α and somatic pain scores in the observation group were significantly lower than those in the control group (t value were 9.561, 7.983, 9.641, 7.027, 3.488, 4.146, all Ps<0.01), while the Hct, BMD (lumbar spine 1-4, large rotor, whole body), physiological function, social function and mental health scores in the observation group were significantly higher than those in the control group (t value were 8.057, 2.341, 4.482, 4.200, 8.469, 9.210, 8.608, P<0.05). The total effective rate of the observation group was 95.5% (42/44) higher than 77.3% (34/44) of the control group (χ2=4.728, P=0.029); There was no significant difference in recent recurrence rate between the two groups (4.8% in the observation group and 11.8% in the control group, χ2=0.435, P=0.509).@*Conclusions@#TCM massage combined with acupuncture can significantly improve the level of bone metabolism, increase bone mineral density, reduce the levels of MMP-3, CRP and TNF-α, and improve the quality of life.

12.
Yonsei Medical Journal ; : 352-359, 2019.
Article in English | WPRIM | ID: wpr-742548

ABSTRACT

PURPOSE: Previous studies have confirmed that microRNAs play important roles in the pathogenesis of acute aortic dissection (AAD). Here, we aimed to explore the role of miR-145 and its regulatory mechanism in the pathogenesis of AAD. MATERIALS AND METHODS: AAD tissue samples were harvested from patients with aortic dissection and normal donors. Rat aortic vascular smooth muscle cells (VSMCs) were transfected with miR-145 mimic/inhibitor or negative control mimic/inhibitor. Gene and protein expression was measured in human aortic dissection tissue specimens and VSMCs by qRT-PCR and Western blot. Luciferase reporter assay was applied to verify whether connective tissue growth factor (CTGF) was a direct target of miR-145 in VSMCs. Methyl thiazolyl tetrazolium assay was used to detect VSMC viability. RESULTS: miR-145 expression was downregulated in aortic dissection tissues and was associated with the survival of patients with AAD. Overexpression of miR-145 promoted VSMC proliferation and inhibited cell apoptosis. Moreover, CTGF, which was increased in aortic dissection tissues, was decreased by miR-145 mimic and increased by miR-145 inhibitor. Furthermore, CTGF was confirmed as a target of miR-145 and could reverse the promotion effect of miR-145 on the progression of AAD. CONCLUSION: miR-145 suppressed the progression of AAD by targeting CTGF, suggesting that a miR-145/CTGF axis may provide a potential therapeutic target for AAD.


Subject(s)
Animals , Apoptosis , Blotting, Western , Connective Tissue Growth Factor , Humans , Luciferases , MicroRNAs , Muscle, Smooth, Vascular , Rats , Tissue Donors
13.
Article in Chinese | WPRIM | ID: wpr-751806

ABSTRACT

Objective To explore the effect of acupuncture and massage combined with sulfasalazine enteric-coated tablets on ankylosing spondylitis (AS) and its influence on bone mineral density and serum MMP-3. Methods A total of 88 AS patients who met the criteria were divided into two groups by the random number table method, 44 cases in each group. The control group was treated with sulfasalazine enteric-coated tablets, while the observation group was treated with acupuncture and massage on the basis of the control group. Both groups were treated for 6 months and followed up for 6 months. TCM syndromes were scored before and after treatment. The Bone Glaprotein (BGP), hematocrit (Hct), alkaline phosphatase (ALP), matrix metalloproteinase-3 (MMP-3), CRP and TNF-α were detected by double antibody sandwich enzyme-linked immunosorbent assay. The bone mineral content of lumbar spine, trochanter and whole body were measured by DPX-NT X-ray bone mineral density analyzer. The quality of life (QOL) was assessed by four items in the Medical Outcomes Study Short-Form 36 (SF-36), including physiological function, physical pain, social function and mental health. The clinical efficacy was evaluated and the recurrence rate was recorded. Results After treatment, the BGP, ALP, MMP-3, CRP, TNF-α and somatic pain scores in the observation group were significantly lower than those in the control group (t value were 9.561, 7.983, 9.641, 7.027, 3.488, 4.146, all Ps<0.01), while the Hct, BMD (lumbar spine 1-4, large rotor, whole body), physiological function, social function and mental health scores in the observation group were significantly higher than those in the control group (t value were 8.057, 2.341, 4.482, 4.200, 8.469, 9.210, 8.608, P<0.05). The total effective rate of the observation group was 95.5% (42/44) higher than 77.3% (34/44) of the control group (χ2=4.728, P=0.029);There was no significant difference in recent recurrence rate between the two groups (4.8% in the observation group and 11.8% in the control group, χ2=0.435, P=0.509). Conclusions TCM massage combined with acupuncture can significantly improve the level of bone metabolism, increase bone mineral density, reduce the levels of MMP-3, CRP and TNF-α, and improve the quality of life.

14.
Article in Chinese | WPRIM | ID: wpr-821772

ABSTRACT

Objective@#To analyze the phenotype and genotype of a Chinese pedigree with inherited dysfibrinogenaemia and investigate the molecular mechanism of the disease. @*Methods@#Venous blood samples were collected from all family members, and routine coagulation tests were conducted. Functional fibrinogen in venous blood samples was measured by Clauss method, and the antigen level of fibrinogen in plasma was measured by immunoturbidimetry assay. All the exons and exon-intron boundaries of the three fibrinogen genes were analyzed by direct sequencing. Fibrinogen electrophoresis, fibrinogen clottability measurement, fibrin polymerisation measurement and electron microscopy scanning were also used to investigate the molecular characteristics and pathogenesis. @*Results@#The proband had normal activated partial thromboplastin time, prothrombin time and plasma fibrinogen antigen, but prolonged thrombin time, prolonged reptilase time and reduced fibrinogen activity level, which were also found in his father. The sequencing results of the proband revealed heterozygous A1211G in the exon 2 of FGA gene originating from his father, which caused Arg19Gly missense mutation. The western-blot results showed that no abnormal bands of plasma fibrinogen were found in the proband and his father. Both thrombin-induced fibrin polymerisation and reptilase induced fibrin polymerisation were significantly impaired compared to normal control. Fibrinogen clottability measurement showed that only about 20.8% molecules of plasma fibrinogen in the proband were involved in the clot formation. Scanning electron microscopy revealed that the proband′s average fibre diameters were found to be significantly thicker than that of the control(P<0.001), and the density was smaller than that of normal control. @*Conclusion@#The Arg19Gly mutation should be responsible for the proband′s dysfibrinogenaemia and the relevant clinical symptoms.

15.
Article in Chinese | WPRIM | ID: wpr-703198

ABSTRACT

Objective To investigate the effects of Qingzao Jiufei Tang(QJD)and its decomposing agent on the levels of TNF-α,INF-γ levels of TNF-α of Qingo, P1 and AQP5 in lung tissue of mice infected with Mycoplasma pneu-moniae(MP),and to clarify its molecular anti-infective mechanism. Methods One hundred-forty-four SPF grade BABL/c mice were randomly divided into the normal group(group A),model group(group B),QJD group(group C),QJD de-composition agent I group(group D)、QJD decomposition group II Group(group E)and azithromycin group(group F), with 24 rats in each group. Besides the group A,the other 5 groups of mice were treated with MP infection. After the mod-eling,the mice were given corresponding drugs by gastric gavage,and samples were obtained on the days 3,7,10,14 af-ter the model was established. The lung tissue sections were examined by histopathology, and the degrees of inflammation in lung tissues in the mice were evaluated,and the lung index and the ratio of dry and wet lung weight ratio in the mice were calculated. The levels of MPN372 and P1 genes were determined by qPCR assay. The serum TNF-α and INF-γ levels in the mice were assessed by enzyme linked immunosorbent assay(ELISA). The expression of AQP5 protein was detected by Westernblot. Results After MP infection, the pathological examination revealed thickening of alveolar septum and bronchioles,and extensive inflammatory cell infiltration in the lung tissues. The lung index was increased and the ratio of dry and wet lung weight(P<0.05). TNF- α and INF-γ cedd and was increased, and reached the peak on the seventh day. The expression of AQP5 protein showed a downward tendency,and began to gradually increase on the 14th day. Com-pared with the group B,the expression levels of MPN372,P1 and TNF-α in the group D were down-regulated,and the ex-pression levels of INF-γ levein the group E were up-regulated from the 7th day. Conclusions QJD can control pulmonary inflammation in mice after MP infection. The decrease of production of MP toxin MPN372 and the expression of adhesion protein P1,the up-regulation of expression of INF-γ and AQP5 proteins,and down-regulation of TNF-α expression are one of the mechanisms of its action.

16.
Chinese Journal of Surgery ; (12): 833-836, 2018.
Article in Chinese | WPRIM | ID: wpr-807612

ABSTRACT

Objective@#To investigate the feasibility and effectiveness of endoscopicretrograde cholangio-pancreatography(ERCP)in the management of long-term complications after pancreaticoduodenectomy.@*Methods@#From January 2009 to July 2018, the clinical data of 62 patients with biliary or pancreatic long-term complications after pancreatoduodenectomy were reviewed at Department of General Surgery, and the corresponding ERCP were carried out in the multi-disciplinary cooperation.There were 39 males and 24 females.The age was 56.5 years(aging from 13 to 76 years). The time of treatment was 3 months to 20 years after pancreatoduodenectomy.The long-term biliopancreatic complications after pancreatoduodenectomy included 51 cases of biliary calculi, 42 cases of bilioenteric anastomotic stenosis with proximal bile duct dilatation, and 11 cases of pancreaticointestinal anastomosis stenosis with distal pancreatic duct dilatation.All patients received conventional duodenoscopy or single-balloon enteroscopy assisted ERCP under general anesthesia.@*Results@#A total of 95 ERCP were performed in 62 patients, averaging 1.5 times per case.The long-term complications of cholangiopancreatic after pancreatoduodenectomy(ERCP indications) included 56 times of bile duct stones(58.9%), 45 times of bilioenteric anastomatic stricture(47.4%), 11 times of recurrent pancreatitis(11.6%), 6 cases(6.3%) of bilioenteric anastomatic foreign body, 3 times of intrahepatic bile duct stenosis(3.2%). Among the 95 times, 82 times(86.3%) achieved endoscopic endoscopy, 76 times(80.0%) were diagnosed successfully, and 72 times(75.8%) were successfully treated with ERCP.Small intestinal perforation occurred in 1 patient undergoing duodenoscopy, and then healed by surgical repair.@*Conclusion@#Multi-disciplinary collaboration of ERCP is safe and effective in the treatment of long-term complications after pancreaticoduodenectomy, but the long-term effect still needs further clinical follow-up.

17.
Article in Chinese | WPRIM | ID: wpr-807186

ABSTRACT

Objective@#To establish a set of rules for autoverification of blood analysis, in order to provide a way to validate autoverification rules for different analytical systems, which can ensure the accuracy of test results as well as shorten turnaround time (TAT) of test reports.@*Methods@#A total of 34 629 EDTA-K2 anticoagulated blood samples were collected from multicenter cooperative units including the First Hospital of Jinlin University during January 2017 to November 2017. These samples included: 3 478 cases in Autoverification Establishment Group, including 288 cases for Delta check rules; 5 362 cases in Autoverification Validation Group, including 2 494 cases for Delta check; 25 789 cases in Clinical Application Trial Group. All these samples were analyzed for blood routine tests using Sysmex XN series automatic blood analyzers.Blood smears, staining and microscopic examination were done for each sample; then the clinical information, instrument parameters, test results and microscopic results were summarized; screening and determination of autoverification conditions including parameters and cutoff values were done using statistical analysis. The autoverification rules were input into Sysmex Laboman software and undergone stage Ⅰ validation using simulated data, and stage Ⅱ validation for post-analytical samples successively. True negative, false negative, true positive, false positive, autoverification pass rate and passing accuracy were calculated. Autoverification rules were applied to autoverification blood routine results and missed detection rates were validated, and also data of autoverification pass rate and TAT were obtained.@*Results@#(1)The selected autoverification conditions and cutoff values included 43 rules involving WBC, RBC, PLT, Delta check and abnormal characteristics. (2)Validation of 3 190 cases in Autoverification Establishment Group showed the false negative rate was 1.94%(62/3 190)(P<0.001), autoverification pass rate was 76.74%, passing accuracy was 97.47%; Validation of 2 868 cases in Autoverification Validation Group, the false negative rate was 3.38%(97/2 868)(P=0.002), autoverification pass rate was 42.26%, passing accuracy was 92.00%; Validation of Delta check on 288 cases in Autoverification Establishment Group and 2 494 cases in Autoverification Validation Group showed the false negative rates were respectively 1.39% and 2.61%(P<0.001). (3)Three hospitals adopted these rules of autoverification for 25 789 blood routine samples, and found that the average TAT of blood routine test reports were shortened by 24min, 32min and 7min respectively, the rate of samples reported within 30min were elevated by 33%, 53% and 7%. The autoverification pass rates were 72%-74%.@*Conclusions@#The application of this set of 43 autoverification rules in blood sample analysis can ensure test quality while shortenTAT and improve work efficiency. It is worth pointing out that for the same analytical systems in this research, validation is necessary before application of this set of rules, and periodic validation is required during application to make necessary adjustment; for different analytical systems, as this research provide a way to establish autoverification rules for blood routine tests.Clinical labs may establish their own suitable autoverification rules on the basis of technological parameters. (Chin J Lab Med, 2018, 41: 601-607)

18.
Article in Chinese | WPRIM | ID: wpr-668961

ABSTRACT

Objective To observe the characteristics of spectral-domain optical coherence tomography (SD-OCT) for leakage point in acute central serous chorioretinopathy (CSC).Methods A total of 21 acute CSC patients (21 eyes) were enrolled in this retrospective study,including 17 men (17 eyes) and 4 women (5 eyes).The mean age was (47.3±8.8) years (range 35-66 years).The mean duration was (1.6±0.8) months (range 0.5-3.0 months).All patients were underwent mydriatic fundus photography,SD-OCT examination and fluorescein fundus angiography (FFA).SD-OCT and FFA images were carefully compared to observe the SD-OCT examination characteristics of fluorescence leakage point.Results 21/21 eyes had one fluorescein leakage point.In addition to serous retinal detachment,leakage point in the SD-OCT examination showed retinal pigment epithelium (RPE) protrusion in 10 eyes (47.6 %),RPE detachment in 7 eyes (33.3 %),highly reflective areas suggesting fibrinous exudate in the subretinal space in 3 eyes (14.3 %),and RPE defect in 1 eye (4.8 %).Conclusion The SD-OCT characteristics of acute CSC include RPE protrusion,RPE detachment,highly reflective areas suggesting fibrinous exudate in the subretinal space and RPE defect.

19.
Article in Chinese | WPRIM | ID: wpr-696144

ABSTRACT

This study was aimed to evaluate the clinical effect and safety of Qing-Fei Tong-Luo (QFTL) ointment for treating children with pneumonia.Randomized controlled trial (RCT) was conducted among 460 cases of children with pneumonia.The observation group was given QFTL ointment combined with basic treatment.And the control group was only treated by basic treatment.Evaluation was given on the total clinical efficacy,disappeared time of fever,cough,expectoration,shortness of breath,and medication safety.The incidence of respiratory diseases was followed up on the 30th days after drug withdrawal.The results showed that in the aspect of clinical efficacy between two groups,the cure rate of the observation group was 98.26%,and that of the control group was 93.89%,with statistic significance (P < 0.05).The cure rate of the observation group was better than that of the control group.There was statistical difference on expectoration disappeared time (P < 0.05).There was no statistical difference on disappeared time of fever,cough and shortness of breath (P > 0.05).There was statistical difference on the incidence of respiratory diseases on the 30th days followed-up after drug withdrawal (P < 0.05).There was no statistical difference on the incidence of upper respiratory tract infection,pneumonia and asthma (P > 0.05).No adverse reactions occurred in the observation group.It was concluded that QFTL ointment combined with basic therapy on the treatment of pneumonia in children was significantly better than the control group in the aspect of clinical efficacy,expectoration disappeared time and the incidence of bronchitis.It is safe and effective.The prognosis is good and worthy of promotion in the clinical practice.

20.
Article in Chinese | WPRIM | ID: wpr-696114

ABSTRACT

Mycoplasma pneumoniae (MP) is an important pathogen of community-acquired pneumonia (CAP) in children.Mycoplasma pneumoniae pneumonia (MPP) is a common lower respiratory tract infection (LRTI) in children.It accounts for 10-40% of CAP in hospitalized children.This article discussed the correlation between MPP and windwarmth diseases in traditional Chinese medicine (TCM) from the similar epidemiological features and clinical manifestations such as long disease term and disease process.The treatment method of clearing lung heat and removing pathogenic factors received good curative effect in the clinical practice.

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