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1.
International Journal of Surgery ; (12): 123-128, 2021.
Article in Chinese | WPRIM | ID: wpr-882452

ABSTRACT

The incidence of diffuse gastric cancer is increasing year by year, comprehensive therapy is the main treatment. The main reason of surgical treatment failure is local recurrence, and the long-term curative effect is generally poor. Radiotherapy is an important part of comprehensive treatment for diffuse gastric cancer, which can reduce tumor stage before surgery and prevent recurrence and metastasis after surgery. Effective neoadjuvant radiotherapy is one of the approaches to improve surgical resection rate in patients with diffuse gastric cancer. In this paper, the clinical application of radiotherapy for diffuse gastric cancer will be reviewed, including the selection of reasonable radiotherapy system, precise location, dose setting, application of sensitization technology and mechanism of sensitization, in addition, the prevention and treatment of neoadjuvant radiotherapy and radiotherapy complications will be introduced.

2.
Article in Chinese | WPRIM | ID: wpr-879511

ABSTRACT

OBJECTIVE@#To analyze the hematological phenotypes of Hb J-Bangkok and concomitant thalassemia.@*METHODS@#In total 72 397 samples were screened by using capillary electrophoresis. Samples with Hb J-Bangkok were identified by DNA sequencing and analysis of red blood cell parameters. Gap-PCR and PCR-reverse dot blotting (PCR-RDB) were used for analyzing the thalassemia genes.@*RESULTS@#Thirty one cases of Hb J-Bangkok were identified, all of which were heterozygotes. The hematological phenotype index (Hb, mean corpuscular volume, mean corpuscular hemoglobin, Hb J-Bangkok, Hb A@*CONCLUSION@#Hb J-Bangkok heterozygotes have normal hematological phenotypes, though they may show different hematological characteristics when concomitant with different types of thalassemia, for which genetic counseling should be provided accordingly.


Subject(s)
Female , Hemoglobins, Abnormal/genetics , Heterozygote , Humans , Male , Phenotype , Thailand , beta-Thalassemia/genetics
3.
International Journal of Surgery ; (12): 441-445, 2020.
Article in Chinese | WPRIM | ID: wpr-863358

ABSTRACT

Objective:To investigate the clinical outcomes of arthroscopic adhesiolysis on patients with primary frozen shoulder and its effect on shoulder joint function.Methods:The clinical data of 54 patients with primary frozen shoulder who visited Civil Aviation General Hospital from March 2017 to July 2018 were retrospectively analyzed. According to different treatment regimens, the patients were divided into a study group and a control group, with 27 patients in each group, there were 11 males and 43 females, aged (47.6±3.4) years, and the age ranged from 41 to 64 years. Patients in the control group were treated with conventional conservative treatment measures, and patients in the study group were treated with loose adhesion under arthroscope on the basis of the control group. The shoulder joint activity (range of motion angles for flexion, abduction and lateral rotation), Constant score, UCLA score and VAS score as well as the complications of the two groups were compared. The measurement data were expressed as mean±standard deviation ( Mean± SD), the t test was used for comparison between groups. The count data were expressed as percentage and the chi-square test was used for comparison between groups. Results:In the study group, postoperative anterior flexion, abduction, lateral external rotation were (160.2±20.7)°, (163.6±20.1)°, (50.5±8.9)°, respectively. The patients in the control group experienced (119.5±19.5)° of anterior flexion, (121.2±19.5)° of abduction, (35.6±6.4)° of lateral external rotation. After treatment, the activity of the shoulder joint in the study group was significantly better than that in the control group, there were statistically significant differences between the two groups( P<0.05). In the study group, the postoperative Constant score was (83.1± 9.3) scores, VAS score was (2.8±0.3) scores, UCLA score was (31.7±3.1) scores; in the control group, the postoperative Constant score was (71.7±9.7) scores, VAS score was (4.4±0.3) scores, UCLA score was (22.8±3.6) scores ( P<0.05). Compared with the control group, the Constant score and UCLA score in the study group were significantly higher, and the VAS score was significantly lower, differences were statistically significant( P<0.05). The difference in the incidence of complications between the two groups was not statistically significant ( P>0.05). Conclusions:For patients with primary frozen shoulder, arthroscopic adhesiolysis can significantly improve the shoulder function of patients. At the same time, this operation has significant clinical treatment effect, which is conducive to the clinical application and promotion.

4.
Article in Chinese | WPRIM | ID: wpr-813316

ABSTRACT

China is one of the regions with a high incidence of gastric cancer worldwide. Low detection rate and poor curative effect lead to unsatisfied prognosis and low five-year survival rate. Surgery combined with radiotherapy and chemotherapy is the mainstream comprehensive treatment scheme, however, multi-drug resistance may gradually prevail in the chemotherapy process. Chemotherapy, miRNA and autophagy interact with each other, but the mechanism is complex. MiR-155 is abnormally expressed in gastric cancer, which could promote autophagy, inhibit apoptosis, and interact with Helicobacter pylori to induce gastric cancer. Through its regulatory effect on autophagy, miR-155 can be used to treat gastric cancer, improve chemotherapy sensitivity and reverse drug resistance. The high expression of miR-155 in gastric cancer tissues suggests poor prognosis.


Subject(s)
Autophagy , Cell Line, Tumor , China , Gene Expression Regulation, Neoplastic , Humans , MicroRNAs , Genetics , Stomach Neoplasms , Genetics
5.
Article in Chinese | WPRIM | ID: wpr-745350

ABSTRACT

Postoperative complications of ERCP include pancreatitis,cholangitis,hemorrhage,mechanical damage (such as perforation) of the digestive tract and drug reaction.Since the the complications definition,surgical indications,operation technique,data collection and processing method were inconsistent,there were controversies for the incidences of complications after ERCP and its risk factors for different institutions.This paper discussed the evolution of ERCP risk factors,current situation and prophylaxis of major complications after ERCP and summarized the current research progress in order to provide theoretical help for prevention and prophylaxis of postoperative complications of ERCP.

6.
International Journal of Surgery ; (12): 272-277, 2019.
Article in Chinese | WPRIM | ID: wpr-743035

ABSTRACT

Helicobacter pylori (HP) is a kind of gram-negative bacillus parasitizing in human gastric mucosal tissue,which coevolved with human body.HP is one of the most genetically diverse bacterial species,which is mainly attributed to its high mutation and recombination rate.After tens of thousands of years of historical evolution,HP experienced numerous genetic polymorphisms and adaptive evolution in order to maintain a relatively stable colonization relationship with human hosts,making it became one of the species with the largest genome variation among prokaryotes.With such a long history with human beings,HP can be used as reference information for human migration in a sense.With the development of biological information technology,multilocus-sequence typing (MLST) technology plays a great role in the study of the evolution of bacterial strains.It has the characteristics of high repeatability and resolution,and the analysis results can be compared between different countries and laboratories.This paper mainly reviews the research and application progress of MLST technology in the genetic evolution of HP.

7.
Article in Chinese | WPRIM | ID: wpr-821290

ABSTRACT

Objective@#To identify a α-globin gene mutation-IVS-Ⅱ-55 (T→A) and analyze hematological characteristics of IVS-Ⅱ-55 (T→G) carriers. @*Methods@#The peripheral blood samples were collected from the members of five family and three sporadic IVS-Ⅱ-55(T→G) carriers for the analysis of RBC parameters and hemoglobin electrophoresis. Gap-PCR, PCR-RDB (reverse dot blot) and DNA sequencing were carried out for the identification of gene deletion and mutation of α-globin and β-globin. @*Results@#The results of RBC parameters of five infant probands which presented with microcytic hypochromic anemia were below the normal reference interval. One of the adult carriers of IVS-Ⅱ-55 (T→G) heterozygote alone presented with microcytic hypochromic anemia, and the others showed normal RBC parameters. The hematological phenotype index (MCV, MCH and HbA 2 ) of one adult carrying a compound heterozygote for IVS-Ⅱ-55 (T→G) and βCD27-28M/N were 65.0 fL, 20.3 pg and 5.8% respectively. The hematological phenotype index (MCV, MCH, HbA 2 and HbF) of one adult carrying a compound heterozygote for IVS-Ⅱ-55 (T→G) and SEA-HPFH were 81.9 fL, 26.5 pg, 3.0% and 29.0% respectively. The HbA 2 levels of all carriers of IVS-Ⅱ-55 (T→G) heterozygote alone were in normal range. No abnormal hemoglobin band was detectable on hemoglobin electrophoresis for all the carries. @*Conclusion@#The carriers of IVS-Ⅱ-55(T→G) heterozygote alone were asymptomatic. The phenotype of compound heterozygote for β-thalassemia was similar to that of β-thalassemia alone.

8.
Organ Transplantation ; (6): 570-2019.
Article in Chinese | WPRIM | ID: wpr-780497

ABSTRACT

Objective To evaluate whether sofosbuvir (SOF)-based direct-acting antiviral agents (DAAs) combined with ribavirin (RBV) (combined RBV) can yield benefits to the recipients infected with hepatitis C virus (HCV) genotype 1 (GT1) after liver transplantation through systematic evaluation and Meta-analysis. Methods Multiple databases at home and abroad were systematically searched, the literature screening was conducted according to relevant standards, the quality of literatures was evaluated and data extraction was performed. The literature was divided into two groups according to the recipients with HCV-GT1 hepatitis after liver transplantation who received the treatment combined RBV or SOF-based DAAs alone without RBV (not combined RBV). Meta-analysis of the data was carried out using Rev Man 5.3 and R3.4.3 software. The incidence of sustained virological response 12 weeks (SVR12) after therapy was evaluated. Results A total of 2 195 articles were retrieved, and 6 articles published in English were eventually included according to the inclusion criteria. The Meta-analysis results demonstrated that the incidence of SVR12 did not significantly differ between the combined RBV and not combined RBV groups (P=0.28). However, the incidence of anemia in the combined RBV group was significantly higher than that in the other group (P < 0.01). Both combined RBV and not combined RBV therapies were efficacious in treating HCV-GT1a and HCV-GT1b subtypes after liver transplantation with similar clinical efficacy (P=0.33). The incidence of SVR in HCV-GT1 recipients did not significantly differ after receiving 12- and 24-weeks therapy after liver transplantation (P=0.95). Conclusions When SOF-based DAAs regimen is adopted to treat HCV-GT1 in recipients after liver transplantation, combination with RBV not only fails to improve the virus clearance rate and bring clinical benefits, but also increases the risk of anemia in the recipients.

9.
Chinese Journal of Hepatology ; (12): 371-376, 2018.
Article in Chinese | WPRIM | ID: wpr-806562

ABSTRACT

Objective@#The aim was to investigate the genotype distribution of two major epitopes of large surface protein (PreS1) of hepatitis B in Chinese patients and to explore the association between the genotypes of these two epitopes, and to determine whether PreS1 full-length genotype could be revealed according to the polypeptide sequence of key epitopes. @*Methods@#HBV DNA was extracted from the serum of patients for PCR amplification. 278 samples amplified successfully were sequenced and compared with the known HBV sequences in Genbank to determine the two key epitopes of HBV PreS1 genotype (amino acid epitope 21-47 and 94-117, abbreviated as P21 and P94) and PreS1 full-length genotypes. The correlation among three genotyping approaches was analyzed by Cohen’s kappa coefficient to verify the consistency between the key-epitope genotyping and the full-length preS1 genotyping. @*Results@#232 samples were successfully sequenced. The genotyping based on the kind of P21 epitope protein sequence, 201 cases for genotype C, 23 cases for genotype B and 8 cases for uncertain genotypes and genotyping based on the form of P94 epitope protein sequence, 199 cases for genotype C, 25 cases for genotype B and 8 cases for indeterminate genotypes. Lastly, the genotyping based on sequence of the full-length PreS1 sequence, 207 and 25 cases for genotype C and B. P21 or P94 epitope genotyping and PreS1 full length genotyping were highly consistent, respectively, 96.55% and 96.12%, and the two epitopes (P21and P94) genotyping have parallel consistency (93.10%). @*Conclusion@#In this study, an innovatively genotyping method based on the amino acid sequence of key epitopes was proposed. The genotypes of HBV in china were mainly B and C genotypes, and the genotypes of key conserved epitopes of HBV PreS1 were highly consistent with the full-length genotyping ( > 96%). Moreover, genotyping with one or two key epitopes can be used in place of the full-length genotyping.

10.
Article in Chinese | WPRIM | ID: wpr-708481

ABSTRACT

Primary liver cancer is one of the most malignant tumor in the worldwide.5 years recurrence rate of patients in the early phase is exceeding 70%.Recurrence of HCC is one of the vital factors leading to adverse outcomes.Researchers found that characteristics of tumors,such as tumor size,differentiation and vascular invasion;operation aspect,such as surgical margin width,surgical approach,intraoperative bleeding and transfusion;patient-self and liver transplantation related factors,such as liver disease,donor's age,hepatitis B virus infection of recipient can affect the postoperative recurrence of hepatocellular carcinoma.We summarized the influence factors of postoperative recurrence of HCC via literature review.

11.
Article in Chinese | WPRIM | ID: wpr-699077

ABSTRACT

Objective To explore the protective effect and mechanism of hydrogen-rich water (HRW) on ethanol-induced acute gastric injury.Methods The experimental study was conducted.Forty kunming mice were divided into the 4 groups by random number table method:normal control group [0.01 mL/g normal saline (NS)+ 0.03 mL/g NS],HRW group (0.01 mL/g NS +0.03 mL/g HRW),ethanol model group (0.01 mL/g 56°alcoholic drinks +0.03 mL/g NS),HRW treated group (0.01 mL/g 56°alcoholic drinks +0.03 mL/g HRW).Ten mice in each group were administrated twice a day for 7 days.Testing indicators:(1) gastric ulcer index was measured,(2) pathological examination of gastric tissues,(3) activity of serum superoxide dismutase (SOD) and expressions of malondialdehyde (MDA),interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured,(4) expressions of SOD and MDA in gastric tissues were measured,(5) protein expressions of apoptosis related factors (caspase-3,bax,caspase-9,fas and caspase-8) in gastric tissues were measured by immunohistochemistry,(6) relative expressions of mRNA of apoptosis related factors (caspase-3,bax,caspase-9,fas and caspase-8) in gastric tissues were measured by realtime polymerase chain reaction (RT-PCR).Measurement data with normal distriburion were presented as (x)±s.Comparisons among groups were done using the one-way ANOVA and comparison between groups was done using the LSD-t test.Results (1) Gastric ulcer index was measured:gastric ulcer index of mice in the normal control group,HRW group,ethanol model group and HRW treated group were respectively 0,0,10.40± 1.64 and 3.92 ± 0.23,with statistically significant differences (F=175.050,P<0.05).There was a statistically significant difference between the ethanol model group and normal control group or HRW treated group (t =19.835,12.352,P< 0.05).(2) Pathological examination pathological examination of gastric tissues:① Macropathology of gastric tissues:the surface of the gastric mucosa was normal and smooth in the normal control group and the HRW group,without ulcer,erosion and inflammation.The partial gastric mucosal erosion and ulcer in the ethanol model group was large and very severe.Compared with the ethanol model group,the area of gastric mucosal lesion was reduced in the HRW treated group.② Results of pathological examination of gastric tissues:gastric mucosa in the normal control group and HRW group were integrity.Compared with the normal control group,the partial gastric surface epithelium was degenerate and impaired in the ethanol model group.Compared with the ethanol model group,the gastric mucosal erosion and inflammatory cell infiltration were alleviated in the HRW treated group.(3) Expressions of serum SOD,MDA,IL-6 and TNF-α:expressions of serum SOD,MDA,SOD/MDA and IL-6 were respectively (70±6)U/mL,(7.52±0.23) μmol/L,9.40 ± 1.07,(6.3 ± 1.8) ng/L in the normal control group and (74 ± 4) U/mL,(7.61 ±0.91) μmol/L,9.91 ± 1.55,(5.1 ± 1.6)ng/ L in the HRW group and (101 ± 4) U/mL,(16.95 ± 0.66) μmol/L,5.99±0.17,(19.2±4.9) ng/L in the ethanol model group and (115±5) U/mL,(14.02±0.58) μmol/L,8.23±0.32,(7.1±1.8)ng/L in the HRW treated group,with statistically significant differences among the 4 groups (F=97.405,269.950,16.486,25.663,P<0.05).The serum TNF-α levels were respectively (53± 14) ng/L,(67± 17) ng/L,(52± 13) ng/L,(58±21) ng/L in the above 4 groups,with no significant difference (F=0.862,P>0.05).(4) Expressions of SOD and MDA in gastric tissues were measured:expressions of SOD and MDA and SOD/MDA were respectively (93 ± 18) U/mL,(7.90± 1.72) μmol/L,12.48±4.54 in the normal control group and (93±13) U/mL,(6.96± 1.49) μmol/L,13.83±3.40 in the HRW group and (121±31) U/mL,(17.10±4.88) μmoL/L,7.88± 3.70 in the ethanol model group and (143 ± 26) U/mL,(7.31 ± 1.58) μmoL/L,20.00±4.68 in the HRW treated group,with statistically significant differences among the 4 groups (F=5.463,15.051,7.388,P< 0.05).(5) The expressions of apoptosis related factors in gastric tissues:the results of immunohistochemistry showed that the levels of caspase-3,bax and fas were repectively 0.065 5± 0.003 7,0.065 7±0.003 0,0.225 4±0.024 3 in the normal control group and 0.065 7±0.002 7,0.064 9±0.003 0,0.246 0±0.022 3 in the HRW group and 0.330 7±0.017 3,0.335 4±0.033 3,0.397 0±0.028 5 in the ethanol model group and 0.096 7±0.003 0,0.084 8±0.001 7,0.375 0±0.035 6 in the HRW treated group,showing statistically significant differences among the 4 groups (F=1 004.222,309.171,48.555,P<0.05).The levels of caspase-9 and caspase-8 were respectively 0.049 2±0.000 4,0.151 5±0.010 2 in the normal control group and 0.047 9±0.002 0,0.154 00.013 5 in the HRW group and 0.047 0±0.003 7,0.157 2±0.006 2 in the ethanol model group and 0.048 7±0.000 8,0.153 9±0.006 3 in the HRW treated group,with no statistically significant difference among the 4 groups (F=0.998,0.297,P>0.05).(6) The mRNA expressions of apoptosis related factors in gastric tissues:resutls of RT-PCR showed that relative expressions of mRNA of caspase-3,bax,caspase-9 and fas were respectively 1.00±0.00,1.00±0.00,1.00±0.00,1.00±0.00 in the normal control group and 0.72±0.43,0.66±0.26,1.57±0.31,0.50±0.19 in the HRW group and 3.19±0.87,1.58±0.76,3.04± 1.15,2.84±0.98 in the ethanol model group and 0.49±0.16,0.69±0.25,2.98±0.85,0.53±0.24 in the HRW treated group,showing statistically significant differences among the 4 groups (F=32.106,5.038,9.706,23.387,P<0.05).The mRNA levels of caspase-8 were respectively 1.00±0.00,1.50±0.60,1.36±0.34,1.32±0.43 in normal control group,HRW group,ethanol model group and HRW treated group,with no significant difference among the 4 groups (F=1.337,P>0.05).Conclusions Hydrogen-rich water could alleviate ethanolinduced acute gastric injury by antioxidant,anti-inflammatory and anti-apoptosis.Hydrogen-rich water is safe and reliable,without toxic and side effects on the body.

12.
International Journal of Surgery ; (12): 418-422,封4, 2018.
Article in Chinese | WPRIM | ID: wpr-693254

ABSTRACT

Cholangiocarcinoma is a malignant tumor originating from bile duct epithelial cells, among which hilar cholangiocarcinoma is the most common, accounting for about 58%-70% of cholangiocarcinoma. Due to its atypical clinical features, special anatomical site, low radical resection rate, high recurrence rate and poor prognosis, the 5-year survival rate of hilar cholangiocarcinoma was only 14.7%-33.8%. Hence, the most effective method of hilar cholangiocarcinoma lies in early diagnosis and radical resection. Good perioperative management can improve the rate of radical resection of hilar cholangiocarcinoma and contribute a lot to prognosis of the patients. The perioperative management of hilar cholangiocarcinoma is described as follows.

13.
Article in Chinese | WPRIM | ID: wpr-692831

ABSTRACT

Objective Non-muscle myosin heavy chain ⅡA (NMHC ⅡA ) plays a significant role in tumor progression and metastasis .Our prior study showed that the expression of NMHC ⅡA was much higher in human bladder cancer sample than that in adjacent tissue .The increased level of NM HC ⅡA expression was correlated with worse prognosis .However ,the role of NMHC ⅡA is unknown in the invasion and metastasis of bladder cancer .Methods RT-PCR and western blotting were used to examine NMHC ⅡA expression lev-els in normal bladder epithelial cells and bladder cancer cell lines .T he migration and invasion ability of cells was tested by wound healing assay and Transwell invasion assay ,respectively .Results Our study showed that knockdown of NMHC ⅡA inhibited migration and invasion in bladder cancer cell line .Conclusion The study indicated that NM HC ⅡA expression increased the invasion and metastasis ability of bladder cancer cell line in vitro .

14.
Article in Chinese | WPRIM | ID: wpr-734146

ABSTRACT

Objective To investigate the clinical features of hepatitis B core antibody (anti-HBc)positive patients with liver injury.Methods A total of 212 anti-HBc positive and HBsAg negative patients who were primarily diagnosed with liver injury from August 2013 to August 2014 at Ruijin Hospital were collected for this study.The patients were divided into cirrhosis group (n=60) and non-cirrhosis group (n =152) according to the status of cirrhosis.The 60 cases with cirrhosis were further compared with 60 cases with post-hepatitis B cirrhosis.The general information,biochemistry and immunology data were assessed.ANOVA was used to compare multiple groups of means,and Wilcoxon rank-sum test was used for non-parametric comparisons of the two groups.Results Only one case was positive for HBV DNA with the positivity rate of 0.5%.The causes for liver injury were as follows,60 cases with cryptogenic cirrhosis,which accounted for 28.3 %;45 cases with drug-induced hepatitis,which accounted for 21.2 %;33 cases with unexplained liver injury,which accounted for 15.6%;28 cases with acute hepatitis E,which accounted for 13.2% and 15 cases with autoimmune hepatitis,which accounted for 7.1%.There were significant differences of T cell subpopulation,hepatitis B surface antibody (HBsAg) and hepatitis B e antibody (anti-HBe) quantitative level,red blood cells (RBC),platelet counts (PLT),prealbumin,albumin,alamine aminotransferase (ALT),aspartate transaminase (AST),international normalized ratio (INR),hyaluronic acid (HA),collagen Ⅲ (COL-Ⅲ) and collagen Ⅳ (COL-Ⅳ) between the cirrhosis group and non-cirrhosis group (all P<0.05).The CD3+ CD4+ and CD3+ CD8+ counts,white blood cells (WBC),ALT,AST,total bilirubin (TBil) and albumin in anti-HBc-positive cirrhosis group were statistically different from those in post-hepatitis B cirrhosis group (all P<0.05).Conclusions Some patients with positive anti-HBc still have HBV replication and infectivity.HBV anti-HBc positivity and HBsAg negativity may be associated with some cryptogenic cirrhosis and primary liver cancer.Patients with positive anti-HBc are prone to be complicated with drug-induced hepatitis,autoimmune hepatitis,and other liver damage related to immune mechanisms.Patients with cirrhosis have a higher risk to induce immune tolerance and progress to chronic disease than non-cirrhotic patients.Quantitative anti-HBc might be used as an indicator to predict disease progression after HBV infection.Disease condition in cirrhotic group with positive anti-HBc and negative HBsAg is less severe than that in post-hepatitis B cirrhosis group.

15.
Article in Chinese | WPRIM | ID: wpr-733524

ABSTRACT

Hepatic echinococcosis is a common zoonotic parasitic disease and popular in animal husbandry developed areas of the world,which seriously endangers human health and economic development.It is a crucial public health problem.At present,the main diagnostic measures are imaging and laboratory examinations.Surgery is the main treatment of hepatic echinococcosis,and drug therapy also plays a certain role.The diagnosis and treatment methods of hepatic echinococcosis were analyzed and summarized in this article,in order to provide a reference for clinical diagnosis and treatment.

16.
International Journal of Surgery ; (12): 841-845, 2018.
Article in Chinese | WPRIM | ID: wpr-732773

ABSTRACT

Wnt/β-catenin signaling pathway is an evolutionarily conserved signaling pathway that plays an important role in embryonic and organ development,which is not only invovled in regulating several cellular proliferation,differentiation,polarity,migration and apoptosis,but aslo playing an critical role in initiation,invasion,metastasis,progression and drug resistance of gastric cancer.This article will review the newest studies about gastric cancer of Wnt/β-catenin and provide fundamenal theories to design new drugs for the treatment of gastric cancer.

17.
Article in Chinese | WPRIM | ID: wpr-662919

ABSTRACT

Portal hypertension is a common clinical syndrome in chronic liver disease,such as schistosomiasis,portal vein occlusion cirrhosis and so on,which can be diagnosed when the hepatic venous pressure gradient is (HVPG) > 5 mmHg (1 mmHg =0.133 kPa).It could lead to gastroesophageal varicose veins rupture,ascites,spontaneous bacterial peritonitis,hepatorenal syndrome,hepatopulmonary syndrome,hepatic encephalopathy and some other serious complications,and is the primary death cause in cirrhosis and liver transplantation.The development of portal hypertension has experienced 4 phases ineluding the research about portal hypertension related theories and animal trial phase,preclinical tests and data accumulation phase,devascularization and shunts rapid development phase,the development phase of new technologies such as interventional and endoscopic surgical treatment,liver transplantation since the middle of the 19th century.The surgical procedures have been modified,which greatly reduce the complication and improve the life quality after operation.But so far none of them can cure portal hypertension thoroughly.This paper not only introduces the pathophysiologic basis of the surgical treatment,but also reviews the history of its development to summarize the recent progress,which may facilitate its surgical treatment.

18.
Article in Chinese | WPRIM | ID: wpr-661875

ABSTRACT

Objective To evaluate the effect of isosceles right angle triangulation on deep vein puncture under ultrasound localization. Methods In this prospective randomized case-controlled clinical study, the enrolled patients who required deep veins puncture to establish transient hemodialysis pathway were randomly divided into treatment group treated with ultrasound localization puncture based on isosceles right triangle theory, and control group treated with traditional localization puncture following exploration of blood vessels using color doppler ultrasound, with 46 cases in each group. The differences in gender, age, causes for hemodialysis, puncture sites, successful rate of initial puncture, rates of complications and cathetering-consuming time were compared between two groups. Results The differences in gender, age, causes for hemodialysis and puncture sites between two groups were not statistically significant. In control group, 30 patients received puncture through internal jugular veins, among whom 16 received successful initial puncture, with the successful rate of initial puncture of 53.33%, and the cathetering-consuming time of (545.5 ± 120.3) s; and 16 patients received puncture through femoral veins, among whom 8 received successful initial puncture, with the successful rate of initial puncture of 50.00%, and the cathetering-consuming time of (500.6 ± 120.6) s. Meanwhile, in control group, 3 patients had hematoma in puncture sites, and another 3 had arterial mis-puncture, with the total rate of complications of 13.04%(6/46). In treatment group, 32 patients received puncture through internal jugular veins, among whom 31 received successful initial puncture, with the successful rate of initial puncture of 96.88%, and the cathetering-consuming time of( 99.5 ± 34.8) s;and 14 patients received puncture through femoral veins, among whom 14 succeed in initial puncture, with the successful rate of initial puncture of 14/14, and the cathetering-consuming time of (99.8 ± 44.8) s. None in treatment group had hematoma in puncture sites or arterial mis-puncture. Both groups finished deep veins puncture intubation successfully. Treatment group was markedly higher in the successful rate of initial puncture (P<0.05), notably shorter in cathetering-consuming time (P<0.05), and prominently lower in the total rate of complications than control group (P<0.05), and all differences were statistically significant. Conclusions Ultrasound localization based on isosceles right triangle theory has superiority to traditional B-ultrasound localization in deep veins puncture in that it can promote the successful rate of initial puncture and shorten cathetering-consuming time without increasing the occurrence rates of complications, and can be completely operated by single clinical physician independently, thus deserving to be popularized in clinical practice.

19.
Article in Chinese | WPRIM | ID: wpr-661015

ABSTRACT

Portal hypertension is a common clinical syndrome in chronic liver disease,such as schistosomiasis,portal vein occlusion cirrhosis and so on,which can be diagnosed when the hepatic venous pressure gradient is (HVPG) > 5 mmHg (1 mmHg =0.133 kPa).It could lead to gastroesophageal varicose veins rupture,ascites,spontaneous bacterial peritonitis,hepatorenal syndrome,hepatopulmonary syndrome,hepatic encephalopathy and some other serious complications,and is the primary death cause in cirrhosis and liver transplantation.The development of portal hypertension has experienced 4 phases ineluding the research about portal hypertension related theories and animal trial phase,preclinical tests and data accumulation phase,devascularization and shunts rapid development phase,the development phase of new technologies such as interventional and endoscopic surgical treatment,liver transplantation since the middle of the 19th century.The surgical procedures have been modified,which greatly reduce the complication and improve the life quality after operation.But so far none of them can cure portal hypertension thoroughly.This paper not only introduces the pathophysiologic basis of the surgical treatment,but also reviews the history of its development to summarize the recent progress,which may facilitate its surgical treatment.

20.
Article in Chinese | WPRIM | ID: wpr-658956

ABSTRACT

Objective To evaluate the effect of isosceles right angle triangulation on deep vein puncture under ultrasound localization. Methods In this prospective randomized case-controlled clinical study, the enrolled patients who required deep veins puncture to establish transient hemodialysis pathway were randomly divided into treatment group treated with ultrasound localization puncture based on isosceles right triangle theory, and control group treated with traditional localization puncture following exploration of blood vessels using color doppler ultrasound, with 46 cases in each group. The differences in gender, age, causes for hemodialysis, puncture sites, successful rate of initial puncture, rates of complications and cathetering-consuming time were compared between two groups. Results The differences in gender, age, causes for hemodialysis and puncture sites between two groups were not statistically significant. In control group, 30 patients received puncture through internal jugular veins, among whom 16 received successful initial puncture, with the successful rate of initial puncture of 53.33%, and the cathetering-consuming time of (545.5 ± 120.3) s; and 16 patients received puncture through femoral veins, among whom 8 received successful initial puncture, with the successful rate of initial puncture of 50.00%, and the cathetering-consuming time of (500.6 ± 120.6) s. Meanwhile, in control group, 3 patients had hematoma in puncture sites, and another 3 had arterial mis-puncture, with the total rate of complications of 13.04%(6/46). In treatment group, 32 patients received puncture through internal jugular veins, among whom 31 received successful initial puncture, with the successful rate of initial puncture of 96.88%, and the cathetering-consuming time of( 99.5 ± 34.8) s;and 14 patients received puncture through femoral veins, among whom 14 succeed in initial puncture, with the successful rate of initial puncture of 14/14, and the cathetering-consuming time of (99.8 ± 44.8) s. None in treatment group had hematoma in puncture sites or arterial mis-puncture. Both groups finished deep veins puncture intubation successfully. Treatment group was markedly higher in the successful rate of initial puncture (P<0.05), notably shorter in cathetering-consuming time (P<0.05), and prominently lower in the total rate of complications than control group (P<0.05), and all differences were statistically significant. Conclusions Ultrasound localization based on isosceles right triangle theory has superiority to traditional B-ultrasound localization in deep veins puncture in that it can promote the successful rate of initial puncture and shorten cathetering-consuming time without increasing the occurrence rates of complications, and can be completely operated by single clinical physician independently, thus deserving to be popularized in clinical practice.

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