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1.
Cancer Research and Clinic ; (6): 184-188, 2021.
Article in Chinese | WPRIM | ID: wpr-886031

ABSTRACT

Objective:To investigate the efficacy and safety of dexmedetomidine and dexamethasone in inhibiting opioid-induced cough (OIC) during general anesthesia induction in patients with gynecological tumors.Methods:A total of 180 patients who were scheduled for elective gynecological tumor surgery under general anesthesia in Shanxi Provincial Cancer Hospital from March to November 2019 were selected. They were randomly divided into blank control group, dexmedetomidine group and dexamethasone group according to the random number table method, each group had 60 cases. Firstly, all patients had a 10-minute rest (T 0) after they entered the operate room. Treatment before general anesthesia induction:dexmedetomidine group was pumped dexmedetomidine 0.5 μg/kg (diluted to 10 ml with 0.9% NaCl injection) using an electronic infusion pump; dexamethasone group was injected intravenously dexamethasone 10 mg; blank control group was pumped with 10 ml 0.9% NaCl injection. The pumping was finished within 5 minutes, and the end time of pumping was denoted as T 1. Induction of general anesthesia was performed 5 minutes after the end of pumping: firstly, sufentanil was given intravenously at 0.3 μg/kg, and the injection was finished within 5 seconds (T 2). Two minutes after sufentanil injection (T 3), cis-atracurium 0.3 mg/kg and propofol medium/long-chain injection 2 mg/kg were sequentially injected. Then preoxygenation, endotracheal intubation and mechanical ventilation were implemented in turn. One minute after intubation was recorded as T 4. The incidence and severity of cough in patients within T 2-T 3 of each group were recorded, as well as the incidence of tachycardia, bradycardia, hypertension, hypotension, respiratory depression and myotonia during T 1-T 4. Results:The incidence of OIC in the dexmedetomidine group (10.0%, 6/60) and dexamethasone group (8.3%, 5/60) was lower than that in the blank control group (33.3%, 20/60), and the difference among the three groups was statistically significant ( χ2 = 16.445, P < 0.01), while there was no significant difference in the incidence of OIC between the dexmedetomidine group and the dexamethasone group ( P > 0.05). The incidence of sinus bradycardia in the dexmedetomidine group (16.3%, 10/60) was higher than that in the blank control group (0, 0/60) and dexamethasone group (8.4%, 1/60), and the difference was statistically significant ( P < 0.05). Respiratory depression and myotonia did not occur in the three groups. Conclusions:Pretreatment with dexmedetomidine or intravenous dexamethasone before anesthesia induction can effectively reduce the incidence of OIC in patients with gynecological tumors, and there is no significant difference between the effects of the two drugs. The incidence of sinus bradycardia increases significantly after dexmedetomidine infusion.

2.
Cancer Research and Clinic ; (6): 28-32, 2021.
Article in Chinese | WPRIM | ID: wpr-886009

ABSTRACT

Objective:To study the effect of intravenous injection with butorphanol at different time points on stress response, recovery time after drug withdrawal, emergence agitation and postoperative pain in lung cancer patients undergoing thoracoscopic lobectomy.Methods:A total of 90 lung cancer patients who underwent elective thoracoscopic lobectomy from September 2019 to May 2020 in the Second Hospital of Shanxi Medical University were selected and randomly divided into three groups according to random number table, 30 cases in each group. Group A was set as a preemptive analgesia group, and 20 μg/kg butorphanol was injected intravenously at 15 min before anesthesia induction; group B was injected with 20 μg/kg butorphanol at 30 min before the end of operation; and the blank control group (group C) was given with the same volume of 0.9% NaCl injection at the same time points. The following data including blood glucose, cortisol, heart rate and mean arterial pressure (MAP), recovery time after skin suture and drug withdrawal, emergence agitation score and incidence rate of restlessness, postoperative pain visual analogue scale (VAS) were observed.Results:The level of blood glucose [(5.25±0.32), (5.17±0.58) mmol/L] and cortisol [(253.63±48.29), (222.17±35.73) ng/ml] in group A were lower than those in group B [(5.85±0.53), (5.52±0.48) mmol/L; (302.83±48.63), (274.87±47.93) ng/ml] and group C [(6.07±0.70), (5.68±0.52) mmol/L; (319.97±32.05), (295.57±46.83) ng/ml] immediately after skin suture and 6 h after the operation (all P < 0.05). There were no significant differences in MAP and heart rate at intubation among the three groups (all P > 0.05). The levels of MAP and heart rate in group A at intubation were higher than those before anesthesia induction (all P < 0.05); there were no statistical differences of the levels of MAP and heart rate at 30 min after one-lung ventilation and at extubation compared with those before anesthesia induction (all P > 0.05). In group B and group C, heart rate and MAP at intubation, 30 min after one-lung ventilation and extubation were higher than those before anesthesia induction (all P < 0.05). Among them, the recovery time after drug withdrawal in group B [(16.53±3.64) min] was longer than that in group A [(13.83±3.24) min] and group C [(12.47±3.35) min] (all P < 0.05), while there was no significant difference between group A and group C ( P > 0.05). In addition, in terms of emergence agitation score and agitation incidence, group A [(3.20±0.41) scores, 0 (0/30)] was lower than group B [(3.73±0.74) scores, 7% (2/30)] and group C [(4.00±0.79) scores, 10% (3/30)] (all P < 0.05). The pain VAS in group A [(3.10±0.61) scores, (3.27±0.52) scores] at 3 h and 12 h after operation were lower than those in group B [(3.53±0.86) scores, (3.70±0.53) scores] and group C [(4.00±0.83) scores, (4.10±0.71) scores] at the same time points (all P < 0.05). However, there was no significant difference in pain VAS among the three groups at 24 h and 48 h after operation (all P > 0.05). Conclusions:For lung cancer patients who underwent thoracoscopic lobectomy, preemptive analgesia with butorphanol not only can reduce the stress response and increase the stability of hemodynamics, but also can effectively reduce the incidence of postoperative pain and restlessness without prolonging the recovery time after stopping drug.

3.
Clinical Medicine of China ; (12): 105-111, 2021.
Article in Chinese | WPRIM | ID: wpr-884141

ABSTRACT

Objective:To compare the difference between the combined diagnostic effect of plasma Septin9(SEPT9) and polyligand Syndecan-2(SDC2) methylation with four serum tumor markers in the diagnosis of colorectal cancer.Methods:In this study, 128 patients who were treated in the affiliated Hospital of Xuzhou Medical University from March to December in 2019 were selected for a case-control study.All the subjects were examined by gastroenteroscopy.According to the pathological results, they were divided into three groups: colorectal cancer group( n=74) and colorectal adenoma group( n=7). The patients with no abnormal or inflammatory polyps or proliferative polyps examined by gastroenteroscopy were taken as the control group( n=47). The methylation levels of SEPT9 gene and SDC2 gene were detected by Roche Lightcycler 480 II real-time fluorescence quantitative polymerase chain reaction, and the concentrations of alpha-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199 were detected by Roche Cobas 8000 electrochemiluminescence instrument.Chi-square test was used to compare the positive rate of each marker in the three groups.Medcalc was used to draw the receiver operating characteristic curve (ROC) curve of the subjects′ working characteristic curve, and the value of each index in the diagnosis of colorectal cancer was analyzed. Results:The positive rates of SEPT9 gene and SDC2 gene methylation were 81.1%(60/74) and 67.6%(50/74) respectively in colorectal cancer group, and increased to 85.1%(63/74) after combined detection.The positive detection rates of alpha-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199 in colorectal cancer group were 1.4%(1/74), 33.8%(25/74), 6.8%(5/74) and 13.5%(10/74), respectively.When the four tumor markers were detected together, the positive detection rates were only increased to 43.2%(32/74), except for AFP and carbohydrate antigen 125(χ 2=3.847, 2.430, all P>0.05). The differences were statistically significant (χ 2=48.230, 30.487, 43.285, 3.847, 8.788, 6.988, 8.722, all P<0.05). The area under the curve (AUC) of SEPT9 methylation, SDC2 methylation, alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199 were 0.854 (0.781, 0.910), 0.795 (0.715, 0.861), 0.575 (0.485, 0.662), 0.685 (0.597, 0.764), 0.603 (0.513, 0.689) and 0.631 (0.541, 0.715), respectively.The AUC of combined detection of two DNA methylation markers was better than that of alpha fetoprotein, carcinoembryonic antigen, carbohydrate antigen 125 and carbohydrate antigen 199, and the differences were statistically significant (alpha fetoprotein: Z=4.990, P<0.001; carcinoembryonic antigen: Z=3.743, P<0.001; carbohydrate antigen 125: Z=4.951, P<0.001; carbohydrate antigen 199: Z=3.983, P<0.001). The combined detection of two kinds of gene methylation was better than the combined detection of four kinds of serum markers in the diagnosis of colorectal cancer, and the difference was statistically significant ( Z=3.334, P<0.001). Conclusion:The combined detection of SEPT9 gene and SDC2 gene methylation in plasma is more suitable for non-invasive diagnosis of colorectal cancer than the combined detection of 4 serum tumor markers.

4.
Chinese Critical Care Medicine ; (12): 472-477, 2021.
Article in Chinese | WPRIM | ID: wpr-883909

ABSTRACT

Objective:To screen out the potential key genes of endotoxin tolerance (ET), and to provide theoretical and experimental evidence for treatment and prognosis of sepsis.Methods:①Experiment 1 (gene chip and bioinformatics analysis): ET related data set GSE47783 was downloaded from the Gene Expression Omnibus (GEO). The data set was obtained from lipopolysaccharide (LPS) stimulated mouse macrophages to establish sepsis model (LPS group) and ET model (ET group). IDEP 0.92 software was used to screen differential expressed gene (DEG) between the two groups, analyze gene ontology (GO), and locate the main functions and signaling pathways of differential genes. The protein-protein interaction (PPI) network of DEG was constructed by the Search Tool for the Retrieval of Interacting Genes Database (STRING) to screen core genes hepatitis A virus cell membrane protein receptor 2 (HAVCR2) for following up validation study. ②Experiment 2 (reproduction of mouse macrophage RAW264.7 model): RAW264.7 cells were cultured in vitro, the ET model (ET group, cells were cultured with 10 μg/L LPS for 24 hours and then with 100 μg/L LPS for 4 hours) and sepsis model (LPS group, cells were cultured with 100 μg/L LPS for 4 hours) were reproduced by LPS stimulation. Phosphate buffer saline (PBS) group was given equal volume of solvent PBS for 4 hours. The mRNA and protein expressions of HAVCR2 were detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) and Western blotting. ③Experiment 3 (RAW264.7 cells transfected with HAVCR2 lentiviral vector): to further clarify whether HAVCR2 was involved in the formation of ET, after knockdown of HAVCR2 in RAW264.7 cells by lentiviral short hairpin RNA (shRNA) technology, the ET model (HAVCR2 --ET group) was constructed again, and the control group (ET group) without knockdown of HAVCR2 was set up. RT-qPCR method was used to detect the mRNA expressions of macrophage polarization key proteins [arginase 1 (ARG1), CD206, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), nitric oxide synthase 2 (NOS2)] in cells. Results:①Experiment 1: a total of 1 013 DEG were identified, compared with LPS group, 521 genes were up-regulated and 492 genes were down-regulated in ET group. The function of these DEG was to increase biosynthesis and reduce inflammatory reaction. Signal pathways were mainly enriched in Janus kinase/signal transducers and activators of transcription (JAK/STAT) , NOD like receptor, Toll-like receptor (TLR), TNF, hypoxia inducible factor-1 (HIF-1). The first up-regulated HAVCR2 in the ET group was selected as the target of the study. ②Experiment 2: the results of in vitro experiment showed that the mRNA expression of HAVCR2 after high-dose LPS stimulation was down-regulated as compared with PBS group, and the mRNA expression of HAVCR2 in ET group was significantly higher than that in LPS group (2 -ΔΔCT: 1.10±0.10 vs. 0.60±0.10, P < 0.05). The results of Western blotting were consistent with RT-qPCR results. ③Experiment 3: the mRNA expressions of ARG1 and CD206 in HAVCR2 --ET group were significantly lower than those in ET group [ARG1 mRNA (2 -ΔΔCT): 0.50±0.10 vs. 1.00±0.10, CD206 (2 -ΔΔCT): 0.73±0.10 vs. 1.00±0.10], and the mRNA expressions of TNF-α and IL-1β were significantly higher than those in ET group [TNF-α mRNA (2 -ΔΔCT): 2.20±0.10 vs. 1.00±0.10, IL-1β mRNA (2 -ΔΔCT): 9.00±0.10 vs. 1.00±0.10), with significant differences (all P < 0.05). There was no significant difference in the expression of NOS2 mRNA between the two groups. Conclusion:HAVCR2 is involved in the regulation of inflammatory factors downstream of sepsis and the formation of ET, which is expected to become a new therapeutic target of sepsis.

5.
Article in Chinese | WPRIM | ID: wpr-883546

ABSTRACT

Objective:To investigate the application effects of SBAR communication mode (situation, background, assessment and recommendation) combined with 3D printing model technology in bed-side teaching of trauma orthopaedics.Methods:A total of 80 clinical medicine students were randomly divided into two groups according to the order of the school number, with 40 students in each group. One was experimental group which received SBAR communication mode combined with 3D printing model technology teaching, and the other one was the control group, which received regular reaching mode. At the end of teaching, the teaching effects were evaluated, including the scores of theoretical examinations and operational examinations, total scores and the anonymous questionnaires. SPSS 22.0 was used for recording and statistical analysis.Results:The average scores of theoretical examinations (48.30±1.41), operational examinations (42.20±1.48) and total scores (90.70±1.38) of experimental group were significantly higher than those of control group [(43.40±1.52); (34.80±1.53); (78.10±1.51)], with significant differences ( P <0.05). The anonymous questionnaires showed that the students in the experimental group had a significant advantage in autonomous learning ability, learning enthusiasm, the ability of literature retrieval and analysis and clinical thinking ability, and enhancing students' humanistic care consciousness in clinical work ( P <0.05). While the two groups had the same recognition in improving problem solving ability, teamwork ability and communication ability with patients, with no significant difference ( P > 0.05). Conclusion:The new teaching mode, SBAR mode combined with 3D printing model technology, applied to trauma orthopaedics bed-side teaching is helpful for students to improve their learning interest and autonomous learning ability, cultivate their lifelong learning habits and their comprehensive quality, so this mode will significantly improve the teaching effects, with good application value.

6.
Article in Chinese | WPRIM | ID: wpr-883281

ABSTRACT

Objective:To investigate the application value of three-dimensional (3D) printing technology assisted laparoscopic anatomic liver resection of segment 8 (Lap-S8).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 8 liver cancer patients including 7 cases with hepatocellular carcinoma and 1 case with intrahepatic cholangio-carcinoma who underwent 3D printing technology assisted Lap-S8 in the Hunan Provincial People′s Hospital from January 2019 to December 2020 were collected. There were 7 males and 1 female, aged from 49.0 to 80.0 years, with a median age of 56.5 years. Of the 8 patients, 6 cases underwent laparoscopic anatomic liver resection of the entire segment 8, 1 case underwent laparoscopic anatomic liver resection of ventral subsegmental of the segment 8 and 1 case underwent laparoscopic anatomic liver resection of dorsal subsegmental of the segment 8. 3D printing technology was used to assist preoperative evaluation and intraoperative navigation for all 8 patients. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using outpatient examination, internet or telephone interview to detect survival and tumor recurrence of patients after operation up to March 2021. Measurement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations: all the 8 patients underwent 3D printing technology assisted Lap-S8 successfully, without conversion to open surgery. The operation time, hepatic portal occlusion time and volume of intraoperative blood loss of the 8 patients were (216±41)minutes, (56±11)minutes and 75 mL(range, 50 to 300 mL), respectively. There was no intraoperative blood transfusion in 8 patients, and the surgical margin of the 8 patients was negative. (2) Postoperative situations: the duration of postoperative hospital stay of the 8 patients were (9±3)days. There was no complication such as postoperative hemorrhage, biliary fistula, liver abscess or abdominal infection occurred. (3) Follow-up: all the 8 patients were followed up for 3.0?24.0 months, with a median follow-up time of 12.5 months. During the follow-up, 1 of 8 patients with preoperative diagnosis of recurrent hepatocellular carcinoma developed tumor recurrence at 5 months after operation. The patient underwent laparoscopic surgery followed with the transcatheter arterial chemoembolization and target therapy, and survived with tumor. There was no tumor recurrence in the other 7 patients.Conclusion:3D printing technology assisted Lap-S8 is safe and feasible.

7.
Article in Chinese | WPRIM | ID: wpr-882879

ABSTRACT

Objective:To analyze the clinical features and CYP17A1 gene mutation of 17α-hydroxylase/17, 20-lyase deficiency (17OHD). Methods:The clinical data, laboratory examination and genetic results of 6 children with 17OHD in the Department of Endocrinology, Children′s Hospital Affiliated to Capital Institute of Pediatrics from March 2014 to December 2019 were enrolled and analyzed retrospectively.Meanwhile, the clinical types of all congenital adrenocortical hyperplasia (CAH) patients were calculated and then the incidence of 17OHD was calculated.Results:The 6 cases were from 5 families, and the age at diagnosis was ranged from 1 year and 6 months to 15 years old, in which 2 cases were 46, XX and 4 cases were 46, XY.Their gender were all female.Three cases presented with hypertension (50.0%), 4 cases with hypokalemia (66.7%), and 1 case with labia mass (16.7%). The gonad developed into a testis in patients with 46, XY, and patients with 46, XX had ovarian hypoplasia.The laboratory tests revealed an decrease in the cortisol at 8 AM in all cases, ranging from 0.62 to 5.93 mg/L.Five cases displayed an increase in adrenocorticotropic hormone (ACTH) in the range of 84-271 ng/L, and 1 patient with normal ACTH (58 ng/L) had a peak cortisol of 1.75 mg/L after the ACTH challenge test.Elevated progesterone was detected in 6 patients with a normal 17 hydroxyprogesterone level.Further results proved low levels of testosterone and estradiol, and high levels of luteinizing hormone (LH), and follicle stimulating hormone (FSH). CT scan showed mild adrenal hyperplasia in all cases.Among 114 CAH patients during the same period, the incidence of 17OHD came second at 5.3%.The CYP17A1 gene mutation results indicated that 2 unrelated patients were homozygous mutation for p. Y329fs (c.985_987delTACinsAA), 2 siblings were compound heterozygous mutations for p. Y329fs and exon 1-7 deletion, 1 patient was compound heterozygous mutations of p. Y329fs and p. R416C (c.1246C>T), and 1 patient was homozygous mutations for p. L465P (c.1394T> C), which was first reported in China. Conclusions:17OHD is not rare in CAH.Female children with hypokalemia, hypertension, and hypogonadism can lead to diagnostic suspicion of 17OHD.The p. Y329fs mutation in Chinese 17OHD children is a hotspot.The p. L465P (c.1394T>C) mutation is a new mutation in China and it could enrich the mutant spectrum of CYP17A1 gene in China.

8.
Article in Chinese | WPRIM | ID: wpr-880450

ABSTRACT

OBJECTIVE@#To understand the current situation of artificial intelligence production enterprise quality management system, so as to provide reference basis for the research and standardization of Artificial Intelligence Medical Device (AIMD) product quality management.@*METHODS@#Based on YY/T 0287-2017 Medical Device Quality Management System for Regulatory Requirements, Medical Equipment Production and the Quality Control Standard for Independent Software Appendix and Xavier GMLP report, the relevant factors were screened and the questionnaire was designed by combining expert consultation and literature review. Then, a total of 32 representative AIMD enterprises were invited to fill in the questionnaire. Descriptive statistical analysis was performed on the data results using Excel 2016.@*RESULTS@#Through in-depth analysis of the four themes in product planning and design, result output, product quality control and product change, it was found that it was necessary for enterprises participating in the survey to improve the quality management system of AIMD products to different degrees.@*CONCLUSIONS@#This study is the first time to systematically investigate the status quo of quality management of AIMD enterprises. The result will be useful for the establishment and continuous improvement of product quality management system. It will also provide a reference for the research of AIMD product quality management and the establishment of the standard.


Subject(s)
Artificial Intelligence , Quality Control , Reference Standards , Software
9.
Article in Chinese | WPRIM | ID: wpr-879895

ABSTRACT

OBJECTIVE@#To study the risk factors for the first ventilator weaning failure and the relationship between the weaning failure and prognosis in preterm infants receiving invasive mechanical ventilation.@*METHODS@#A retrospective analysis was performed for the preterm infants who were admitted to the Neonatal Intensive Care Unit of Peking University Third Hospital and received mechanical ventilation within 72 hours after birth. According to whether reintubation was required within 72 hours after the first weaning, the infants were divided into a successful weaning group and a failed weaning group.@*RESULTS@#A total of 282 preterm infants were enrolled, and there were 43 infants (15.2%) in the failed weaning group. Compared with the successful weaning group, the failed weaning group had significantly lower gestational age and birth weight (@*CONCLUSIONS@#Use of ≥ 2 vasoactive agents before ventilator weaning and PDA (≥ 2.5 mm) are risk factors for ventilator weaning failure, and ventilator weaning failure may be associated with adverse outcomes in hospitalized preterm infants.


Subject(s)
Ductus Arteriosus, Patent/therapy , Humans , Infant , Infant, Newborn , Infant, Premature , Respiration, Artificial , Respiratory Distress Syndrome, Newborn , Retrospective Studies , Risk Factors , Ventilator Weaning
10.
Article in Chinese | WPRIM | ID: wpr-879627

ABSTRACT

OBJECTIVE@#To explore the genetic basis for a child featuring global developmental delay.@*METHODS@#DNA was extracted from peripheral blood sample taken from the patient and subjected to whole exome sequencing. Suspected variants were verified by Sanger sequencing of his family members.@*RESULTS@#A heterozygous c.239T>C (p.Ile80Thr) variant of the GNB1 gene was detected in the proband, which was a verified to be de novo in origin.@*CONCLUSION@#The heterozygous c.239T>C (p.Ile80Thr) variant of the GNB1 gene probably underlay the disease in this child.


Subject(s)
Arthrogryposis , Child , Family , GTP-Binding Protein beta Subunits , Heterozygote , Humans , Intellectual Disability/genetics , Whole Exome Sequencing
11.
Chinese Medical Journal ; (24): 954-962, 2021.
Article in English | WPRIM | ID: wpr-878130

ABSTRACT

BACKGROUND@#Recently, T-helper 17 (Th17) cells have been proved to play an important role in promoting cervical cancer. But, till now, few study has been carried out to understand the involvement of these cells in efficacy of anti-tumor treatments. This study aimed to investigate the alterations in the percentage of circulating Th17 cells and related cytokines in locally advanced cervical cancer (LACC) patients before and after concurrent chemoradiotherapy (cCRT) and to analyze the correlations between the alterations in Th17 cells and treatment efficacy.@*METHODS@#A prospective study with 49 LACC (International federation of gynecology and obstetrics [FIGO] stage IIB-IIIB) patients and 23 controls was conducted. Patients received the same cCRT schedule and were followed up for 3 years. Circulating Th17 cells (CD3+CD8- interleukin [IL]-17+ T cells) and related cytokines IL-17, transforming growth factor-β (TGF-β), IL-10, IL-23, IL-6, and IL-22 were detected before and after cCRT. Correlations between alterations of circulating Th17 cells and treatment efficacy were analyzed. Kaplan-Meier analysis was used for overall survival (OS) and progression-free survival (PFS).@*RESULTS@#We found that 40 patients finished the entire cCRT schedule and met the endpoint of this study. The percentage of circulating Th17 cells in the LACC patients was higher than that in the controls, and it significantly decreased after cCRT (P < 0.05). After cCRT, patients were divided into two groups based on the average of the Th17 cells declined. The subgroup of patients with a prominent decrease in circulating Th17 cells after cCRT had a higher treatment efficacy and longer PFS and OS times. Compared with the control patients, LACC patients had higher IL-6, IL-10, IL-22, TGF-β levels and a lower IL-23 level (P < 0.05). After cCRT, IL-6, IL-10, IL-17, IL-23 level significantly increased and TGF-β level significantly decreased compared with the levels before cCRT (P < 0.05).@*CONCLUSION@#Circulating Th17 cells in the LACC patients (FIGO stage IIB-IIIB) were higher than those in the controls, but they generally decreased after cCRT. A more pronounced decrease in circulating Th17 cells after cCRT was correlated with better therapeutic effect and longer PFS and OS times.


Subject(s)
Chemoradiotherapy , Disease-Free Survival , Female , Humans , Neoplasm Staging , Prospective Studies , Retrospective Studies , Th17 Cells , Treatment Outcome , Uterine Cervical Neoplasms/therapy
12.
Article in Chinese | WPRIM | ID: wpr-877657

ABSTRACT

A new type of handshape


Subject(s)
Humans , Massage , Medicine, Chinese Traditional , Pain , Technology
13.
Article in Chinese | WPRIM | ID: wpr-876064

ABSTRACT

@#The World Health Organization (WHO) released the WHO 2020 guidelines on physical activity and sedentary behaviour in November 2020. Compared with the 2010 WHO guidelines, this guideline has incorporated more extensive medical evidence and made targeted recommendations for special populations. The main content includes physical activity and sedentary behaviour advice for children and adolescents, adults, older adults, pregnant and postpartum women, people with chronic conditions, and disability. This review will interpret the 2020 WHO guidelines in detail.

14.
Organ Transplantation ; (6): 184-2021.
Article in Chinese | WPRIM | ID: wpr-873728

ABSTRACT

Objective To improve the surgical efficacy of bilateral lung transplantation for pediatric cystic fibrosis through multi-disciplinary team (MDT). Methods Preoperative MDT consultation was delivered for a 10-year-old child with rare end-stage cystic fibrosis to establish the corresponding treatment protocol. Results The child was diagnosed with cystic fibrosis for 5 years, and the indication of lung transplantation were confirmed. After preoperative MDT consultation, bilateral lung transplantation via a Clam-shell incision was determined. The vital signs were maintained stable during operation. Postoperatively, ventilator-assisted ventilation, anti-infection, immunosuppression, acid suppression, prevention of stress ulceration and other treatments were delivered. Individualized treatment was given according to the characteristics of the child, and the child was well recovered. Conclusions Through preoperative MDT consultation, lung transplantation yields satisfactory surgical efficacy in treating pediatric cystic fibrosis and lowers the risk of postoperative complications, which deserves application in clinical practice.

15.
Chinese Journal of School Health ; (12): 277-281, 2021.
Article in Chinese | WPRIM | ID: wpr-873691

ABSTRACT

Objective@#To explore the influence of birthweight and delivery mode on overweight/obesity and abdominal obesity in primary school students, and to provide evidence for childhood obesity prevention.@*Methods@#After physical examination, questionnaire survey was conducted among 3 361 students and their parents from 3 primary schools in Guangzhou selected through stratified clustering sampling. Information about birthweight and delivery mode was collected. Logistic regression model was used to analyze the association of birthweight and delivery mode with overweight/obesity and abdominal obesity. The multiplicative interaction term and the Delta method was used to explore the potential interaction.@*Results@#The prevalence rate of overweight and obesity for primary school students was 21.33%, and the rate of abdominal obesity was 12.08%. Multivariate Logistic regression analysis showed that delivery by cesarean section was associated with 44% increased risk of overweight/obesity(OR=1.44, 95%CI=1.16-1.80), as compared to vaginal delivery. Higher birthweight was linked to increased risk of overweight/obesity(OR=1.62, 95%CI=1.09-2.42). There was no significant association of birth weight and delivery mode with abdominal obesity in multivariate analysis(P>0.05). Additionally, a positive additive interaction was seen between delivery mode and parental obesity for students risk of overweight/obesity(RERI=0.33, 95%CI=0.02-0.65), as well as for the risk of abdominal obesity(RERI=0.39, 95%CI=0.12-0.65).@*Conclusion@#Cesarean section delivery and higher birthweight are linked to increased risk of overweight and obesity in primary school students. The synergistic effect of cesarean section and parental obesity may increase the risk of childhood obesity.

16.
China Pharmacy ; (12): 623-629, 2021.
Article in Chinese | WPRIM | ID: wpr-873680

ABSTRACT

OBJECTIVE:To establish quantitative e valuation system of the prophylactic use of antibiotics in orthopedic type Ⅰ incision surgery ,and to provide reference for evaluating the rational prevention use of antibiotics in this type surgery scientifically. METHODS:Based on the Guidelines of Clinical Use of Antimicrobial Agents (2015 edition),drug instructions ,related guidelines and references ,experts from relevant departments jointly discussed and formulated the evaluation criteria for the rationality of the use of antibiotics in type Ⅰ incision in orthopedic surgery. AHP method was used to assign the weights for various indexes of evaluation criteria ;TOPSIS method was used to retrospectively analyze and evaluate the rationality of 120 cases of type Ⅰ incision surgery from 3 orthopedic departments in Peking University People ’s Hospital during Sept. 1st-30th,2019. RESULTS :Established evaluation system included 4 primary indicators (medication indication ,usage and dosage ,medication timing ,other factors )and 12 secondary indicators. Among the secondary indicators ,indications,drug selection and timing of preoperative administration were the most important (weights were 0.209,0.140,0.117). Among 120 cases,30.83% of drug use were reasonable ,47.50% were basically reasonable and 21.67% were unreasonable. Evaluation results obtained by AHP-TOPSIS were consistent with the actual situation. CONCLUSIONS :The rationality evaluation method of prophylactic use of antibiotics in type Ⅰ incision surgery based on AHP-TOPSIS method can quantitatively evaluate the rationality of drug use by combining multiple indicators. The method is feasible ,operable,and the evaluation results can be quantified ,which has a wide range of application.

17.
J. appl. oral sci ; 29: e20200733, 2021. graf
Article in English | LILACS | ID: biblio-1154616

ABSTRACT

Abstract Enterococcus faecalis (E. faecalis), one of the main pathogens responsible for refractory periapical periodontitis and nosocomial infections, exhibits markedly higher pathogenicity in biofilms. Objectives Studies have shown that caseinolytic protease P (ClpP) is involved in biofilm formation. However, to date, few studies have investigated the role of ClpP in the survival of E. faecalis, and in enhancing biofilm formation. Therefore, we investigated the role of ClpP in the formation of E. faecalis biofilms. Methodology In our study, we used homologous recombination to construct clpP deleted and clpP complement strains of E. faecalis ATCC 29212. A viable colony counting method was used to analyze the growth patterns of E. faecalis. Crystal violet staining (CV) and confocal scanning laser microscopy (CLSM) were used to characterize biofilm mass formation and scanning electron microscopy (SEM) was used to observe the biofilm microstructure. Data was statistically analyzed via Student's t-test or one-way analysis of variance (ANOVA). Results The results exhibited altered growth patterns for the clpP deletion strains and depleted polysaccharide matrix, resulting in reduced biofilm formation capacity compared to the standard strains. Moreover, ClpP was observed to increase biofilm formation in E. faecalis. Conclusion Our study shows that ClpP can increase biofilm formation in E. faecalis and emphasizes the importance of ClpP as a potential target against E. faecalis.


Subject(s)
Humans , Enterococcus faecalis , Biofilms , Peptide Hydrolases , Virulence , Microscopy, Electron, Scanning , Microscopy, Confocal , Endopeptidase Clp
18.
Article in Chinese | WPRIM | ID: wpr-879405

ABSTRACT

OBJECTIVE@#To compare the clinical effecty of Wiltse approach combined with contralateral transforaminal lumbar interbody fusion (TLIF) and traditional TLIF in the treatment of lumbar disc herniation and its affect on injury of multifidus muscle.@*METHODS@#From June 2014 to September 2017, 90 patients with lumbar disc herniation combined with lumbar spine instability were divided into two groups (Wiltse approach group and traditional group) depend on the procedure of operation. Wiltse approach group was treated with Wiltse approach screw placement in one side combined with contralateral TLIF. There were 50 patients in Wiltse approach group, including 36 males and 14 females, aged 45 to 72 yearswith an average of (60.4± 3.1) years. The traditional group was treated with traditional TLIF operation. There were 40 patients in the traditional group, including 25 males and 15 females, aged 45 to 74 years with an average of (62.1±3.4) years. The operative time, intraoperative blood loss, accuracy of screw implantation, postoperative drainage volume and drainage tube removal time were recorded in two groups. Visual analogue scale (VAS) and Oswestry Disability Index (ODI)were observed before and 12 months after operation. All patients underwent CT examination preoperative and 12 months postoperative, and the CT values of bilateral multifidus muscle were measured.@*RESULTS@#All the patients were followed up, 40 patients in traditional group were 12 to 18 months with an average of (15.3±4.3) months; and 50 patients in Wiltse approach group were 13 to 24 months with an average of (16.5± 4.1) months. There were no statistically significant differences in operative time and intraoperative blood loss between two groups (@*CONCLUSION@#Compared with traditional surgical procedures, the Wiltse approach nail placement combined with contralateral TLIF has the advantage of accurate nail placement, reducing multifidus muscle damage, and reducing the incidence of postoperative intractable low back pain.


Subject(s)
Aged , Case-Control Studies , Female , Humans , Intervertebral Disc Degeneration , Intervertebral Disc Displacement/surgery , Lumbar Vertebrae/surgery , Male , Middle Aged , Minimally Invasive Surgical Procedures , Retrospective Studies , Spinal Fusion , Treatment Outcome
19.
Article in Chinese | WPRIM | ID: wpr-869825

ABSTRACT

Objective:To evaluate the effect of general anesthesia on microelectrode recording (MER) during deep brain stimulation (DBS) of subthalamic nucleus (STN) in the patients with primary Parkinson′s disease (PD).Methods:Forty-four patients of both sexes with primary PD (duration of disease ≥ 5 yr and/or obvious symptom fluctuation), undergoing bilateral STN DBS from March 2008 to March 2018, aged<80 yr, were selected and divided into 2 groups by a random number table method: awake group ( n=26) and general anesthesia group ( n=18). In awake group, 0.5% ropivacaine was used for incision infiltration at skin incision.Patients in GA group received propofol and remifentanil by target-controlled infusion with Narcotrend to monitor the depth of anesthesia, and 0.5% ropivacaine was used for incision infiltration at skin incision.The total number of trajectories and length of STN were recorded during MER.Movement disorders were evaluated at 1 week before surgery and 6 months after surgery, and the improvement rate of dyskinesia was calculated.The postoperative anesthesia-, hardware- and stimulation-related complications were recorded. Results:There were no significant differences between the two groups in the total number of trajectories, length of STN and improvement rate of postoperative movement disorders ( P>0.05). Conclusion:General anesthesia does not affect the MER during STN DBS in the patients with primary PD.

20.
Chinese Journal of Urology ; (12): 779-783, 2020.
Article in Chinese | WPRIM | ID: wpr-869745

ABSTRACT

Objective:To explore the therapeutic effect of low-intensity extracorporeal shock wave (Li-ESW) in model rats with chronic prostatitis and its optimal parameters.Methods:From April to August 2019, 90 healthy male SD rats aged 8 weeks were randomly divided into control group (group C, n=15), model group (group M, n=15) and shock wave treatment group (group T, n=60), which were treated with Li-ESW after being modeled successfully. The rats in group T were supine and treated with focused Li-ESW, and the probe was placed above the anatomical position of the prostate. Treatment scheme was 3 Hz of frequency, 500 pulses, and once a week for 4 weeks. Group T was divided into group T1(0.09 mJ/mm 2), T2(0.20 mJ/mm 2), T3(0.30 mJ/mm 2) and T4(0.40 mJ/mm 2) according to energy flux density, with 15 rats in each group. Before the establishment of the model, the rats in each group were tested with von Frey fiber of 2 g, 4 g and 6 g at the scrotum respectively, and the positive reaction was recorded. There was no significant difference between the three groups ( P>0.05). After one week, the rat model with CP was established by injecting 3% carrageenan into the bilateral lobes of the prostate under anesthesia. And one week after the modeling was completed, the rats in each group underwent von Frey test again to measure pain and evaluate the modeling effects. Group T was then treated once a week for a 4-week period. During the treatment, von Frey test was performed before each treatment to evaluate the treatment effect of the previous week. After the von Frey test for one, two and four weeks of treatment, 5 rats were sacrificed in each group, and the bilateral lobes of the prostate were dissected under aseptic conditions for paraffin inclusion and HE staining. Result:The positive reaction in group M and each group T was significantly more than those in group C ( P<0.001) one week after the modeling was completed, and there was no significant difference between group M and group T. The number of positive reactions in group T2 was lower than that in group M at each time point after treatment ( P<0.05), and it is also less in group T1, T3 and T4 were than that in group M after 3 weeks, 3 and 4 weeks and 2 weeks respectively( P<0.05). In group T2, the number of positive reactions began to decrease after 1 week of treatment, and reached the lowest after 4 weeks, with significant difference in pain measurement results at different time points ( P<0.05). The results of pathological examination showed that there were more inflammatory cells in prostatic stroma and disordered arrangement of epithelial cells in group M than that in group C. The pathological scores of group M, T1, T2, T3 and T4 were 8, 7, 4, 6, 9 after 1 week treatment, 8, 5, 3, 4, 7 points after 2 weeks treatment, and 7, 3, 2, 4, 7 points after 4 weeks treatment, respectively. Conclusions:Low-intensity extracorporeal shock wave treatment had a significant effect on the improvement of symptoms in model rats with chronic prostatitis. Under the scheme of frequency 3 Hz, 500 pulses, once a week for 4 weeks, the optimal parameters is 0.20 mJ/mm 2.

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