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1.
Article in Chinese | WPRIM | ID: wpr-920814

ABSTRACT

@#Resection is one of the most important treatments for esophageal squamous cell carcinoma, and routine postoperative follow-up is an effective method for early detection and treatment of recurrent metastases, which can improve patients' quality of life and prognosis. This consensus aims to provide a reference for colleagues responsible for postoperative follow-up of esophageal squamous cell carcinoma patients in China, and further improve the standardization of the diagnosis and treatment of esophageal squamous cell carcinoma.

2.
Article in Chinese | WPRIM | ID: wpr-912620

ABSTRACT

Objective:Explore the " project-talent-base" combining international science and technology cooperation management model and mechanism through summarizing the practical experience of a tertiary pediatric hospital in Beijing in recent years, to provide reference for strengthening the hospital′s international science and technology cooperation.Methods:Main problems existing in the management of international science and technology cooperation in domestic medical institutions are analyzed, and management methods of international science and technology cooperation adopted by the hospital are classified through policy sorting, literature research, summarization and classification.Results:The hospital has established an efficient and high-quality international science and technology cooperation management model mainly through four aspects: improving the international cooperation management system, enriching international cooperation and exchange projects, building different types of international science and technology cooperation platforms, and strengthening personnel training.Conclusions:Under the background of the globalization of science and technology and the accelerating pace of scientific research in China, improving the hospital′s international science and technology cooperation management model will effectively promote the introduction of international advanced technologies and concepts, and enhance the overall science and technology innovation capabilities and discipline construction.

3.
Article in Chinese | WPRIM | ID: wpr-912574

ABSTRACT

Objective:To explore the hospital-institute integration mode based on project cooperation.Methods:Focusing on the management innovation of clinical and basic scientific research cooperation mode, the method of hospital-institute integration mode based on project cooperation and the key points in practice were discussed, to develop better understandings of the construction and development such mode.Results:Several key points of developing hospital-institute integration mode based on project cooperation were proposed. Main measurements adopted including the integration of scientific research and clinic service, comprehensive construction of management concept, scientific research capacity, teaching organization and service concept, cultivation of high-level research talents, construction of research departments, according to which formed the main structure of the hospital. Furthermore, it is important to change the development mode in time to promote the healthy development of the hospital.Conclusions:It is a new direction of the clinical and basic research cooperation innovation to encourage the hospital-institute integration mode based on project cooperation. It is also an effective strategy to promote the improvement of diagnosis and treatment level under the new medical reform situation.

4.
Article in Chinese | WPRIM | ID: wpr-907283

ABSTRACT

Natural killer group 2 member D(NKG2D) is an immune receptor expressed by NK cells that recognizes the human major histocompatibility complex class I polypetide-related chain(MIC) A/B on the cell surface.The interaction between NKG2D and MICA/B plays an important role in the immunosurveillance of viruses infection and cancers.In this article, we review the research progress of the MICB/NKG2D signaling pathway in immune escape including three parts: down-regulation of membrane-bound MICB, increase of secretory MICB, and polymorphism of MICB genes.

5.
Chinese Critical Care Medicine ; (12): 241-243, 2021.
Article in Chinese | WPRIM | ID: wpr-883866

ABSTRACT

Objective:To explore the effect of self-made protective clothing in tracheal intubation for the patients with respiratory infectious diseases.Methods:Self-made protective clothing were made by adult model plastic raincoat with sleeve lets and goggles. A prospective randomized controlled study was conducted. Patients with severe respiratory infectious diseases who needed tracheal intubation admitted to the department of intensive medicine of the Third Affiliated Hospital of Gansu University of Chinese Medicine from January 1st 2018 to March 31st 2020 were enrolled. According to the random number table method, they were divided into two groups. The control group was wearing standard protective clothing, while the test group was wearing self-made protective clothing for endotracheal intubation. The wearing time, infection rate of operators and costs of protective clothing were compared between the two groups. The patients were sprayed with trypanosome blue diluent before tracheal intubation, and the whole body of the operator was photographed with fluorescence before wearing self-made protective clothing and after doing tracheal intubation to take off the self-made protective clothing, in order to evaluate the permeability resistance of self-made protective clothing.Results:A total of 86 patients were enrolled. There were 46 cases in the test group, included 28 cases of influenza A (H1N1) virus infection, 11 cases of influenza B virus infection and 7 cases of adenovirus infection. There were 40 cases in the control group, included 15 cases of H1N1 virus infection, 10 cases of influenza B virus infection, 10 cases of adenovirus infection and 5 cases of unknown pathogen. There was no significant difference in respiratory etiology between the two groups ( χ2 = 3.789, P = 0.435). The wearing protective clothing time of the control group was 11.6 times than that of the test group (minutes: 22.23±1.45 vs. 1.86±0.24, χ2 = 19.023, P < 0.001). The cost of standard protective clothing was 12.5 times than that of self-made protective clothing (Yuan/set: 500 vs. 40). Fluorescent photography showed that the whole body of the operator was not stained after tracheal intubation, indicating that the protective clothing had good anti permeability and achieved the protective effect. There was no operator infection in the test group and the control group. Conclusion:Self-made protective clothing has short wearing time, low cost and equivalent isolation effect compared with standard protective clothing, which is worthy of clinical promotion.

6.
Article in Chinese | WPRIM | ID: wpr-883477

ABSTRACT

Objective:To explore the effect of locking compressing plates (LCP) internal fixation under arthroscopy combined with Zhuyu Tongluo method in the treatment of distal radius fractures (DRF) and its effects on joint function, hemorheology, serum basic fibroblast growth factor (bFGF) and bone morphogenetic protein 2 (BMP-2).Methods:A total of 78 patients with DRF admitted to the Second Hospital of Tangshan City from June 2017 to January 2020 were selected and grouped according to the random number table method, with 39 cases in each group. The control group was treated with LCP internal fixation under arthroscopy, and the study group was treated with Zhuyu Tongluo method on the basis of the control group. The recovery, hemorheology (plasma viscosity, whole blood viscosity high cut, whole blood low cut, hematocrit), serum bFGF, BMP-2 levels, before and after the operation were compared between the two groups. They were followed up for 6 months and the range of motion of the wrist joints before and after the operation and the excellent and good rate of wrist joint function between the two groups were compared.Results:The swelling subsidence time, pain disappearance time, ecchymosis disappearance time, and fracture imaging healing time in the study group were shorter than those in the control group: (10.37 ± 3.13) d vs. (14.62 ± 3.38) d, (12.39 ± 2.97) d vs. (17.14 ± 4.02) d, (19.15 ± 2.35) d vs. (24.36 ± 3.27) d, (68.21 ± 7.12) d vs. (80.07 ± 8.24) d, and the differences were statistically significant ( P<0.05). The plasma viscosity, whole blood viscosity high-cut, whole blood low-cut, and hematocrit in the study group were lower than those in the control group at 1 and 2 weeks after operation ( P<0.05). The levels of serum bFGF and BMP-2 in the study group were higher than those in the control group at 1 and 2 weeks after operation: at 1 week after operation: (356.27 ± 46.29) μg/L vs.(236.51 ± 37.42) μg/L, (614.28 ± 61.47) μg/L vs. (487.39 ± 48.24) μg/L; at 2 weeks after operation:(502.07 ± 113.21) μg/L vs. (381.59 ± 82.75) μg/L, (910.77 ± 97.20) μg/L vs. (731.35 ± 92.13) μg/L, and the differences were statistically significant ( P<0.05). The palm flexion, back extension, radial deviation, and ulnar deviation in the study group were better than those in the control group at 6 months after operation ( P<0.05). The excellent and good rate of wrist joint function in the study group was higher than that in the control group at 6 months after operation: 89.5%(34/38) vs. 70.3%(26/37), and the difference was statistically significant ( P<0.05). Conclusions:LCP internal fixation under arthroscopy combined with Zhuyu Tongluo method in the treatment of patients with DRF can increase the expression of serum bFGF and BMP-2, reduce inflammation, improve blood rheology, promote fracture healing, and improve wrist range of motion and wrist function.

7.
Article in Chinese | WPRIM | ID: wpr-882858

ABSTRACT

Objective:To understand the clinical characteristics and prognosis of Langerhans cell histiocytosis (LCH) with skin-limited lesion.Methods:A retrospective analysis was performed on clinical characteristics and prognosis of 16 skin-limited LCH patients, out of 578 LCH patients who were hospitalized in Beijing Children′s Hospital during December 2013 to June 2018.Results:A total of 16 skin-limited LCH cases, accounted for 2.7% of all 578 cases, were included.Among which, sex ratio (male vs.female) was 1.28∶1.00.Median ages of skin eruption occurrence and of diagnosis of the disease were 3.5 months (3 days to 2 years and 5 months) and 6 months (2 months 14 days to 2 years and 8 months) in this group.Among the 16 cases, seborrheic dermatitis-like lesions(11 cases, 68.7%) was the most common, and the trunk was most frequently involved[75.0% (12 cases)]. Serine/threonine protein kinase gene V600E [ BRAF (p.V600E)] mutation was detected in pathological specimens from 10 skin-limi-ted cases, with 9 cases being positive.Plasma samples from 5 positive cases were further detected for BRAF (p.V600E) mutation, and 4 positive results were gained.Of all 16 patients, 11 cases (68.7%) were treated.Remission were achieved in 3-6 months from treatment start in patients treated whether according to the Histiocyte Society′s LCH-2009 protocol for 25 weeks(6 cases, 37.5%), or with topical mometasonefuroate for 3 months (3 cases, 18.8%). Two patients(12.5%) with solitary cutaneous lesions underwent excision biopsy (one face and one prepuce) and were considered to be in remission immediately after surgery.None of these patients suffered from the recurrence of the disease.The remaining 5 patients (31.3%) with skin-limited LCH were just evaluated regularly, and achieved remission in 3-6 months of commencing observation.Among these untreated patients, 1 with consistently positive BRAF (p.V600E) mutation in plasma had bone involvement in the 24 th month of assessment, and was then treated based on the Histiocyte Society′s LCH-2009 Protocol.No clinical or imageological evidence supporting disease progression was found on this patient.Median follow-up period was 32.8 months (2.9-63.9 months). Except one patient, none of the rest cases had active disease till follow-up ended.Two-year event free survival(EFS) of this research was (92.3± 7.4)%.There was no significant difference between EFS of treated group and that of observation group( χ2=1.250, P=0.264). Conclusions:Skin-limited LCH often occurs in infants and newborns, with strong heterogeneity in clinical manifestations, laboratory indicators, and pathogenesis.Seborrheic dermatitis-like lesions were the most common cutaneous type.The prognosis of the patients is excellent despite progressing into multisystem involvement can be seen in a few patients.

8.
Article in Chinese | WPRIM | ID: wpr-864193

ABSTRACT

Objective:To evaluate the prognostic value of Epstein-Barr virus (EBV)-DNA level in plasma and whole blood in treatment of children with EBV-associated hemophagocytic lymphohistiocytosis (EBV-HLH).Methods:Clinical data of 66 children with EBV-HLH, who were admitted to the Hematology and Oncology Center of Beijing Children′s Hospital, Capital Medical University from January 2016 to December 2017 were retrospectively reviewed and analyzed.The data included the dynamic changes of the EBV-DNA level in plasma (P-EBV-DNA) and whole blood (W-EBV-DNA) at the time of admission, 2 and 4 weeks after treatment.P-EBV-DNA was divided into the positive group and the negative group according to the copy number of EBV-DNA, and W-EBV-DNA was divided into the high and the low level group by the receiver operating characteristic curve(ROC); the incidence of poor prognosis was compared between different groups by Chi- Square test; the event-free survival (EFS)was evaluated by the Log- Rank test to identify its prognostic significance. Results:The analysis showed that both P-EBV-DNA and W-EBV-DNA at admission could not be associated with a poor outcome; P-EBV-DNA (≥500 copies/mL) or W-EBV-DNA [>(5.04-5.09)×10 5 copies/mL]after 2 and 4 weeks of treatment could be a good marker of a poor outcome and progression-free survival ( P<0.001). Besides, central nervous system (CNS) involvement ( P=0.025), sever leukopenia(WBC≤3×10 9/L, P=0.031), neutropenia (ANC ≤0.5×10 9/L, P=0.041), albumin reduction (≤26 g/L, P=0.012) and hemoglobin decrease (≤90 g/L, P=0.023) at diagnosis are also associa-ted with worse outcomes.In multivariate analysis, only P-EBV-DNA at 4 th week and CNS involvement were indepen-dent prognostic factors ( HR=7.139, P=0.032 and HR=6.455, P=0.042, respectively). The prognostic value of W-EBV-DNA at different time points and P-EBV-DNA after 2 weeks of treatment had a lower prognostic value. Conclusions:The P-EBV-DNA level after 4 weeks of treatment is a promising risk indicator for early diagnosis of disease and early recognition of poor prognosis in EBV-HLH children, so it provides the guidance for optimal treatment.

9.
Article in Chinese | WPRIM | ID: wpr-863032

ABSTRACT

Hemophagocytic lymphohistiocytosis(HLH)is a critical hematological disorder characterized by immune dysfunction with multiple organs and systems involved.HLH secondary to rheumatic disease is also named as macrophage activation syndrome(MAS). In children, MAS is often covered by primary diseases so that it is hard to be discovered early, associated with critical condition and the difficulty of diagnosis and treatment.In this review, we summarize the advances on pathogenesis, diagnosis and treatment of MAS to improve the understanding of MAS and contribute to clinical diagnosis and treatment.

10.
China Pharmacy ; (12): 1887-1891, 2020.
Article in Chinese | WPRIM | ID: wpr-823361

ABSTRACT

OBJECTIVE:To investigate the correlation between CYP2C19 gene polymorphisms and antiplatelet reactivity of clopidogrel in Xinjiang Uygur patients with acute coronary syndrome (ACS). METHODS :Totally 90 Uygur patients with ACS who were admitted to the cardiovascular department of Xinjiang Kashi Second People ’s Hospital from Jan. 2018 to Jan. 2019 were selected as the study subjects. They were given anti-platelet therapy of asprin+clopidogrel ,and received the treatment continuously for one year after discharge. The platelet aggregation inhibition (DPAI)rate of the patients were determined ,and the response to clopidogrel was evaluated. PCR-fluorescence probe method was used to detect genotype of CYP2C19*2 and * 3,and PCR-direct sequencing method was used to detect genotype of * 17. Multivariate Logistic regression analysis was adopted to investigate the correlation of gene and non-gene factors with DPAI of patients. RESULTS :Among 90 patients,there were 10 patients with clopidogrel resistance (CR)and 80 patients with non-CR. There were 58,28 and 4 patients with CYP2C19*2 G/G,G/A,A/A genotype,respectively;there were 88 and 2 patients with CYP2C19*3 G/G,G/A genotype ,respectively;there were 64 and 26 patients with CYP2C19*17 C/C,C/T genotype ,respectively;the genotype frequency of each genotype was consistent with Hardy-Weinberg equilibrium (P>0.05). After treatment ,DAPIs of patients with CYP2C19*2 G/A,A/A genotype were decreased significantly,while those of the patients with A/A genotype were significantly lower than patients with G/A genotype patients (P< 0.05). DAPIs of patients with CYP2C19*17 C/T genotype were increased significantly ,compared with C/C genotype 2016D01C087) patients (P<0.05). There was no statistical significance in @fudan.edu.cn DAPIs between CYP2C19*3 G/A and A/A genotype patients (P>0.05). Multivariate Logistic regression analysis showed 85775264@qq.com that CYP2C19 gene pol ymorphism was independently related to DPAI in Xinjiang Uygur patients with ACS [OR =2.314,95%CI(1.569,3.144),P=0.009],while age ,gender,smoking and other non-gene factors were not related to DPAI (P>0.05). CONCLUSIONS :CYP2C19 gene polymorphism is associated with antiplatelet reactivity of clopidogrel in Xinjiang Uygur patients with ACS. * 2 wild type patients may have higher DPAI ,while * 17 wild type patients may have lower DPAI.

11.
Article in Chinese | WPRIM | ID: wpr-829208

ABSTRACT

@#Objective    To give an annual data report of surgical treatment of esophageal cancer in Shanghai Chest Hospital to provide reference for treatment and research on esophageal cancer. Methods    The clinical data of 414 patients with esophageal cancer who underwent endoscopy (9 patients) and esophagectomy (405 patients) in Shanghai Chest Hospital in 2015 were reviewed, including 334 males and 80 females. Their tumor biological characteristics and short-term and long-term treatment results were analyzed. Results    Patients in this group were predominantly aged 60 to 69 years (46.9%), and the tumor was mainly located in the middle thorax (50.7%). About 79.9% of the patients received trans-right thoracic esophagectomy, 44.4% received minimally invasive surgery; 388 (93.7%) patients accepted upfront esophagectomy without induction therapy, and 179 (43.2%) patients received postoperative adjuvant therapy. The R0 resection rate was 90.6%, and the 30- and 90-day mortality rates were 1.4% and 2.4%, respectively. The 4-year overall survival rate of the R0 resection patients was 65.7%. Conclusion    Satisfactory long-term survival results can be obtained for thoracic esophageal cancer if R0 resection can be achieved by trans-right thoracic esophagectomy and extended lymphadenectomy combined with appropriate postoperative adjuvant treatment.

12.
Article in Chinese | WPRIM | ID: wpr-754591

ABSTRACT

Objective To observe the role of Zhenqi Fuzheng granules in the treatment of patients with severe pneumonia respiratory failure. Methods A retrospective research was conducted, 96 patients with severe pneumonia admitted to the Department of Critical Care Medicine of the First People Hospital of Baiyin were enrolled, and they were divided into a western medical conventional treatment group (47 cases) and a combined traditional Chinese and western medicine treatment group (49 cases) according to the different treatment methods. A variety of conventional rescue treatments were carried out in the western medicine routine treatment group (conventional group); while in the combined traditional Chinese and western medicine conventional treatment group (combined group), based on the western medical therapies in the conventional group, at the same time, additionally Zhenqi Fuzheng granules 5 g dissolved in 20 mL warm boiled water were given by nasal feeding to the patients, 2 times daily, 7-10 days constituting a therapeutic course, and after 3 courses, the clinical therapeutic effects were evaluated. The mortality and changes of pre- and post-treatment levels of immunoglobulin, procalcitonin (PCT), C-reactive protein (CRP), course of disease, times of using antibacterial drug and ventilator, and changes in lung exudation before and after treatment, and incidence of pulmonary fibrosis were observed in the two groups. Results The mortality of combined group was significantly lower than that of the conventional group [14.29% (7/49) vs. 36.17% (17/47), P < 0.05]. After treatment, the levels of immunoglobulins were significantly higher than those before treatment, while the levels of PCT and CRP were significantly lower than those before treatment in both groups, and the changes after treatment in the combined group were more obvious than those in conventional group [IgG (g/L): 12.48±2.36 vs. 10.35±3.01, IgA (g/L): 4.16±1.08 vs. 3.18±1.13, IgM (g/L): 5.01±1.15 vs. 3.62±1.02, PCT (mg/L): 1.48±1.36 vs. 2.35±1.01, CRP (mg/L): 8.48±2.36 vs. 10.35±2.01, all P <0.05]. Compared with those in conventional group, the patient's disease course, times of using antibacterial drug and ventilator were significantly shorter in combined group [the course of disease (days): 10.86±2.64 vs. 14.38±3.02, time of using antibacterial drug (days): 11.29±3.54 vs. 13.96±4.21, time of using ventilator (days): 8.26±2.64 vs. 10.25±3.08, all P <0.05]; Compared with those in the conventional group, the cases with significant reduction of pulmonary exudation and the cases with complete absorption of pulmonary exudation were markedly increased, while the cases of pulmonary fibrosis were obviously decreased in the combined group (cases of reduction of pulmonary exudation:15 cases vs. 10 cases, complete absorption of pulmonary exudation: 16 cases vs. 9 cases; cases of pulmonary fibrosis:8 cases vs. 10 cases, all P < 0.05). Conclusion Zhenqi Fuzheng granules can significantly reduce the mortality and inflammatory factor levels, raise immunoglobulin, shorten the course of disease and times of using antimicrobial drugs and ventilator, reduce pulmonary exudation and incidence of pulmonary fibrosis obviously in patients with severe pneumonia.

13.
Article in Chinese | WPRIM | ID: wpr-752371

ABSTRACT

Objective To investigate the clinical characteristics and outcomes of pediatric Langerhans cell histiocytosis (LCH) with craniofacial bone involvement.Methods A retrospective analysis was performed on 145 pediatric LCH patients with craniofacial bone involvement registered at Beijing Children's Hospital Affiliated to Capital Medical University from January 2007 to July 2013.The patients were divided into 2 groups:central nervous system risk craniofacial bone involvement group(CNS-RISK) and non-central nervous system risk craniofacial bone involvement group(non-CNS-RISK).All patients were assessed at 5 weeks,11 weeks,25 weeks and 52 weeks respectively after chemotherapy started,and 3 months,6 months,1 year and 3 years after chemotherapy withdrawal.Statistics and related risk analysis was performed respectively.Results A total of 145 craniofacial bone involved LCH cases were included,which was composed of 62.5% of 232 LCH cases hospitalized during the same period.The median age of these patients was 29 months,and median follow-up time period was 31 months.The most commonly involved craniofacial bone was parietal bone(78 cases,53.8%),followed by temporal bone(59 cases,40.7%) and frontal bone(57 cases,39.3%).The onset age was significantly different (26 months vs.54 months,Z =-2.777,P < 0.05) between CNS-RISK group (103 cases) and non-CNS-RISK group (42 cases).Moreover,compared with non-CNS-RISK group,CNS-RISK group showed higher ratio of patients classified as multisystem involvement of risk organs (72/103 cases,69.9%) vs.(15/42 cases,35.7%) (x2 =16.908,P < 0.05),and a higher rate of overall relapse rate (45/103 cases,43.7%) vs.(7/42 cases,16.7%) (x2 =9.427,P < 0.05),a lower survival rate of 3-year relapse-free survival rate [(66.9 ± 5.7) % vs.(88.2 ± 7.8) %,Z =2.205,P < 0.05].The incidence of diabetes insipidus was 13.7% in 232 LCH patients.Compared with patients without craniofacial bone involvement,patients with craniofacial bone involvement demonstrated a higher rate of diabetes insipidus [(27/145 cases,18.6%) vs.(5/87 cases,5.7%),x2 =7.579,P =0.006].But the incidence of diabetes insipidus showed no statistical difference between CNS-RISK group and non-CNS-RISK group (21.3 % and 11.9 %,x2 =1.760,P =0.185).Diabetes insipidus was not found in single system LCH with Single-Bone CNS-RISK lesions.Till the end of follow-up,1 out of 145 patients died.Among 145 patients,5 cases had a single-bone CNS-RISK lesion.They received systemic chemotherapy.One showed reactivation,and none of them died.Multivariate analysis of variance showed that all the independent factors indicating diabetes insipidus included parietal bone,frontal bone,maxilla and mandible involvement (HR =2.697,3.487,5.425,all P < 0.05),while independent factors indicating relapse included temporal bone,maxilla and mandible involvement (HR =3.712,3.380,all P < 0.05).Conclusions Among involved craniofacial bones,the parietal bone is most commonly involved.LCH occurs averagely at an earlier age in CNS-RISK group,along with lower 3-year relapse-free survival rate,high relapse rate,and more patients classified as multisystem LCH involvement of risk organs.The incidence of diabetes insipidus in children with craniofacial bone involvement with single system CNS-RISK is low.Patients with the parietal bone,frontal bone,maxilla and mandible involvement at diagnosis are at a increasing risk a significantly to develop DI during the course of disease.

14.
Article in Chinese | WPRIM | ID: wpr-752214

ABSTRACT

Hkmophagocetic sendromk,which also is callkd hkmophagocetic lemphohistiocetosis( HFH),is a rapidle progrkssivk and lifk-thrkatkning hkmatological sestkm diskasks. Thk tepical fkaturks of thk diskask is thk kxck-ssivk activation of thk inflammatore rksponsk,mainle pkrformanck that a lot of kxckssivk activation CD8+ T cklls and macrophagks filtratkd in tissuks and organs,which can produck largk amounts of cetocinks,such as intkrfkron-γ,tumor nkcrosis factor-α,intkrlkucin-6 and intkrlkucin-18,and which kvkntualle lkd to thk inflammatore cetocinks storm and tissuk damagk. Llthough,HFH is a bknign histiocetic diskask,it can progrkss quiccle,its clinical manifkstations ark divkrsk,with high mortalite ratk. In rkcknt ekars,thk rkskarch of HFH pathogknksis and trkatmknt has bkkn wkll-rk-skarchkd bkfork. Thk latkst pathogknksis and trkatmknt ark summarizkd in this articlk.

15.
Article in Chinese | WPRIM | ID: wpr-802712

ABSTRACT

Objective@#To investigate the clinical characteristics and outcomes of pediatric Langerhans cell histiocytosis (LCH) with craniofacial bone involvement.@*Methods@#A retrospective analysis was performed on 145 pediatric LCH patients with craniofacial bone involvement registered at Beijing Children′s Hospital Affiliated to Capital Medical University from January 2007 to July 2013.The patients were divided into 2 groups: central nervous system risk craniofacial bone involvement group(CNS-RISK) and non-central nervous system risk craniofacial bone involvement group(non-CNS-RISK). All patients were assessed at 5 weeks, 11 weeks, 25 weeks and 52 weeks respectively after chemotherapy started, and 3 months, 6 months, 1 year and 3 years after chemotherapy withdrawal.Statistics and related risk analysis was performed respectively.@*Results@#A total of 145 craniofacial bone involved LCH cases were included, which was composed of 62.5% of 232 LCH cases hospitalized during the same period.The median age of these patients was 29 months, and median follow-up time period was 31 months.The most commonly involved craniofacial bone was parietal bone(78 cases, 53.8%), followed by temporal bone(59 cases, 40.7%) and frontal bone(57 cases, 39.3%). The onset age was significantly different (26 months vs.54 months, Z=-2.777, P<0.05) between CNS-RISK group (103 cases) and non-CNS-RISK group (42 cases). Moreover, compared with non-CNS-RISK group, CNS-RISK group showed higher ratio of patients classified as multisystem involvement of risk organs (72/103 cases, 69.9%)vs.(15/42 cases, 35.7%)(χ2=16.908, P<0.05), and a higher rate of overall relapse rate (45/103 cases, 43.7%) vs. (7/42 cases, 16.7%) (χ2=9.427, P<0.05), a lower survival rate of 3-year relapse-free survival rate [(66.9±5.7)% vs.(88.2±7.8)%, Z=2.205, P<0.05]. The incidence of diabetes insipidus was 13.7% in 232 LCH patients.Compared with patients without craniofacial bone involvement, patients with craniofacial bone involvement demonstrated a higher rate of diabetes insipidus [(27/145 cases, 18.6%) vs.(5/87 cases, 5.7%), χ2=7.579, P=0.006]. But the incidence of diabetes insipidus showed no statistical difference between CNS-RISK group and non-CNS-RISK group (21.3% and 11.9%, χ2=1.760, P=0.185). Diabetes insipidus was not found in single system LCH with Single-Bone CNS-RISK lesions.Till the end of follow-up, 1 out of 145 patients died.Among 145 patients, 5 cases had a single-bone CNS-RISK lesion.They received systemic chemotherapy.One showed reactivation, and none of them died.Multivariate analysis of variance showed that all the independent factors indicating diabetes insipidus included parietal bone, frontal bone, maxilla and mandible involvement(HR=2.697, 3.487, 5.425, all P<0.05), while independent factors indicating relapse included temporal bone, maxilla and mandible involvement(HR=3.712, 3.380, all P<0.05).@*Conclusions@#Among involved craniofacial bones, the parietal bone is most commonly involved.LCH occurs averagely at an earlier age in CNS-RISK group, along with lower 3-year relapse-free survival rate, high relapse rate, and more patients classified as multisystem LCH involvement of risk organs.The incidence of diabetes insipidus in children with craniofacial bone involvement with single system CNS-RISK is low.Patients with the parietal bone, frontal bone, maxilla and mandible involvement at diagnosis are at a increasing risk a significantly to develop DI during the course of disease.

16.
Chinese Critical Care Medicine ; (12): 1440-1444, 2019.
Article in Chinese | WPRIM | ID: wpr-800005

ABSTRACT

Objective@#To explore the effects of different mild hypothermia therapy time on the efficacy and complications of patients with severe traumatic brain injury (STBI).@*Methods@#A retrospective research method was used. 132 patients with STBI given mild hypothermia therapy admitted to the Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine from January 2010 to December 2018 were enrolled. According to the days of mild hypothermia therapy, the patients were divided into 2-day mild hypothermia treatment group, 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group. Glasgow coma score (GCS) after treatment of 10 days and 30 days, 30-day disability rate and mortality, coma time, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), D-dimer, and the incidence of complications such as decreased blood pressure, decreased gastrointestinal motility, infection, nonunion of scalp, cerebrospinal fluid leakage, etc. were compared among three groups.@*Results@#Among the 132 patients with STBI, there were 44 cases in the 2-day mild hypothermia treatment group, 45 cases in 5-day mild hypothermia treatment group, and 43 cases in 14-day mild hypothermia treatment group. There was no significant difference in gender, age, GCS score before treatment or time from injury to admission among three groups. Compared with 2-day mild hypothermia treatment group, the GCS score 10 days and 30 days after treatment in 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group were significantly higher (11.61±2.23, 10.17±2.03 vs. 6.79±1.49; 13.15±2.53, 11.24±2.24 vs. 8.79±1.59), the coma time were shorten (days: 5.79±1.89, 5.45±1.72 vs. 13.65±2.73), and 30-day disability rate and mortality were significantly decreased [13.33% (6/45), 11.63% (5/43) vs. 22.73% (10/44); 17.78% (8/45), 16.28% (7/43) vs. 31.82% (14/44)], PT and APTT were reduced obviously (s: 20.14±4.12, 22.54±3.56 vs. 30.67±5.19; 35.14±12.41, 38.59±13.54 vs. 56.67±10.62), Fib rose obviously (g/L: 1.84±0.25, 1.98±0.27 vs. 0.67±0.12), and D-dimer reduced obviously (mg/L: 53.10±19.84, 49.20±20.13 vs. 102.60±20.13), with statistically significant differences (all P < 0.05). But there was no significant difference in above indicators between the 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group (all P > 0.05). The incidence of complications in 14-day mild hypothermia group was significantly higher than those in 2-day mild hypothermia group and 5-day mild hypothermia group [decrease of blood pressure: 55.56% (20/36) vs. 36.67% (11/30), 35.14% (13/37); weakening of stomach intestinemotive power: 72.22% (26/36) vs. 46.67% (14/30), 45.95% (17/37); urethral infection: 52.78% (19/36) vs. 36.67% (11/30), 35.14% (13/37); lungs infection: 47.22% (17/36) vs. 36.67% (11/30), 37.84% (14/37); disunion of scalp: 5.56% (2/36) vs. 0% (0/30), 0% (0/37); leak of cerebrospinal fluid: 5.56% (2/36) vs. 0% (0/30), 0% (0/37), all P < 0.05], but there was no significant difference between the 2-day mild hypothermia treatment group and 5-day mild hypothermia treatment group (all P > 0.05).@*Conclusions@#The optimal time frame for mild hypothermia treatment in patients with STBI is 5-day, which shortens the coma time, and reduces the mortality and the disability rate. The shorter mild temperature time cannot effectively prevent secondary brain injury. However, the prolonged period of mild temperature will affect the repair of the patient's injury tissue, which is not conducive to the recovery of patient's mechanical function and is prone to complications.

17.
Chinese Critical Care Medicine ; (12): 1440-1444, 2019.
Article in Chinese | WPRIM | ID: wpr-824221

ABSTRACT

Objective To explore the effects of different mild hypothermia therapy time on the efficacy and complications of patients with severe traumatic brain injury (STBI). Methods A retrospective research method was used. 132 patients with STBI given mild hypothermia therapy admitted to the Third Affiliated Hospital of Gansu University of Traditional Chinese Medicine from January 2010 to December 2018 were enrolled. According to the days of mild hypothermia therapy, the patients were divided into 2-day mild hypothermia treatment group, 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group. Glasgow coma score (GCS) after treatment of 10 days and 30 days, 30-day disability rate and mortality, coma time, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), D-dimer, and the incidence of complications such as decreased blood pressure, decreased gastrointestinal motility, infection, nonunion of scalp, cerebrospinal fluid leakage, etc. were compared among three groups. Results Among the 132 patients with STBI, there were 44 cases in the 2-day mild hypothermia treatment group, 45 cases in 5-day mild hypothermia treatment group, and 43 cases in 14-day mild hypothermia treatment group. There was no significant difference in gender, age, GCS score before treatment or time from injury to admission among three groups. Compared with 2-day mild hypothermia treatment group, the GCS score 10 days and 30 days after treatment in 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group were significantlyhigher (11.61±2.23, 10.17±2.03 vs. 6.79±1.49; 13.15±2.53, 11.24±2.24 vs. 8.79±1.59), the coma time were shorten (days: 5.79±1.89, 5.45±1.72 vs. 13.65±2.73), and 30-day disability rate and mortality were significantly decreased [13.33% (6/45), 11.63% (5/43) vs. 22.73% (10/44); 17.78% (8/45), 16.28% (7/43) vs. 31.82% (14/44)], PT and APTT were reduced obviously (s: 20.14±4.12, 22.54±3.56 vs. 30.67±5.19; 35.14±12.41, 38.59±13.54 vs. 56.67±10.62), Fib rose obviously (g/L: 1.84±0.25, 1.98±0.27 vs. 0.67±0.12), and D-dimer reduced obviously (mg/L:53.10±19.84, 49.20±20.13 vs. 102.60±20.13), with statistically significant differences (all P < 0.05). But there was no significant difference in above indicators between the 5-day mild hypothermia treatment group and 14-day mild hypothermia treatment group (all P > 0.05). The incidence of complications in 14-day mild hypothermia group was significantly higher than those in 2-day mild hypothermia group and 5-day mild hypothermia group [decrease of blood pressure: 55.56% (20/36) vs. 36.67% (11/30), 35.14% (13/37); weakening of stomach intestinemotive power: 72.22%(26/36) vs. 46.67% (14/30), 45.95% (17/37); urethral infection: 52.78% (19/36) vs. 36.67% (11/30), 35.14% (13/37); lungs infection: 47.22% (17/36) vs. 36.67% (11/30), 37.84% (14/37); disunion of scalp: 5.56% (2/36) vs. 0% (0/30), 0% (0/37);leak of cerebrospinal fluid: 5.56% (2/36) vs. 0% (0/30), 0% (0/37), all P < 0.05], but there was no significant difference between the 2-day mild hypothermia treatment group and 5-day mild hypothermia treatment group (all P > 0.05). Conclusions The optimal time frame for mild hypothermia treatment in patients with STBI is 5-day, which shortens the coma time, and reduces the mortality and the disability rate. The shorter mild temperature time cannot effectively prevent secondary brain injury. However, the prolonged period of mild temperature will affect the repair of the patient's injury tissue, which is not conducive to the recovery of patient's mechanical function and is prone to complications.

18.
Article in Chinese | WPRIM | ID: wpr-752065

ABSTRACT

Objective: To observe the effects of music electro-acupuncture and pulsed electro-acupuncture on locomotor avtivity and hippocampal astrocytes in fast-aging (SAMP8) mice, and to compare the anti-dementia mechanism.Methods: Thirty 8-month-old male SAMP8 mice were randomly divided into model group (group M), music electroacupuncture group (group MA), pulsed electro-acupuncture group (group EA) (n=10), with homologous normal aging SAMR1 mice as control group (group C) (n=10) . Acupuncture stimulation was applied to"Baihui" (GV20) 、"Yintang" (GV29) and"Renzhong" (DU26) for 20 min per day for 15 days. The Morris water maze was used to assess learningmemorize ability. Immunohistochemical DAB staining was used to observe GFAP exptession in hippocampus. Detect GFAP protein levels by Western blot in hippocampus. Results: The Morris water maze test showed: Compared with group C, the escape latency were increased (P < 0.01), swimming distance were increased in space exploration experiment in group M (P < 0.01) . Compared with group M, the escape latency were reduced in group MA and EA (P < 0.01, P < 0.05) and the swimming distance were shortened (all P < 0.05) . The immunohistochemical DAB staining showed: Compared with group C, the average optical density of GFAP in the hippocampal CA1 area of group M increased significantly (P <0.01); the optical density of GFAP in CA1 area of hippocampus in both groups MA and EA was significantly decreased (all P < 0.01), while the optical density of GFAP in MA group was lower than that of EA group (P < 0.05) . Western blot test showed: Compared with group C, the expression of GFAP protein obviously increased (P < 0.01) . Compared with group M, the expression of GFAP protein obviously decreased and had a downregulation tendency in group MA and EA (all P < 0.05), while the expression of GFAP protein decreased in MA group compare with EA group (P < 0.05) .Conclusion: Both music electro-acupuncture and pulsed electro-acupuncture can improve the learning and memory abilities of SAMP8 mice and decrease the expression of GFAP, which may be related to its mechanism of reducing neuroinflammatory reaction, improving apoptosis and eventually protecting neurons, and music electro-acupuncture has a better tendency than pulsed electro-acupuncture.

19.
Chinese Journal of Surgery ; (12): 312-315, 2018.
Article in Chinese | WPRIM | ID: wpr-809911

ABSTRACT

Robotic assisted surgery system is the most advanced minimally invasive surgical platform in the world, and this system has been widely used in cardiac surgery, urology surgery, gynecology surgery and general surgery. Although the application of this system was relative late in esophageal surgery, it has been developing vigorously. According to the research progress and practical experience in the world, robot assisted minimally invasive esophagectomy (RAMIE) has the same safety and effectiveness as traditional open esophagectomy (OE) and thoracoscopic laparoscopic esophagectomy (TLE). In this paper, several aspects on this novel operation were demonstrated, including the origin, safety evaluation, lymph node dissection, learning curve, prognosis of RAMIE, comparison among RAMIE, OE and TLE and the role of RAMIE in multidisciplinary treatment of esophageal cancer, in order to promote the rational application of RAMIE in esophagectomy.

20.
Chinese Journal of Surgery ; (12): 299-302, 2018.
Article in Chinese | WPRIM | ID: wpr-809909

ABSTRACT

Objective@#To evaluate the safety and effectiveness of esophageal replacement with ileocolon graft.@*Methods@#Totally 34 cases of esophageal replacement with ileocolon graft from July 2015 to November 2017 at Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University were analyzed retrospectively, including 24 male and 10 female, aging from 7 to 72 years old. Esophageal replacement with ileocolon graft by right and/or middle colic artery as a blood supply using retrosternal route except one subcutaneous route. The primary esophageal disease, postoperative complication rate and quality of life were analyzed.@*Results@#The overall postoperative complication rate was 23.5% (8/34), cervical anastomotic leakage rate of 5.9% (2/34), necrosis of colon graft of 5.9% (2/34). There were 3 patients experienced re-operation including 2 patients with colon graft necrosis and 1 patient with intestinal obstruction after ERC. One patient with colon graft necrosis died of septic shock after reoperation. Six cases of cervical esophago-jejunal anastomosis stenosis and 1 case of diarrhea occurred in the later time. All patients were followed up for a median time of 9 months (range: 1 to 28 months), 32 cases survived but 1 patient died until last follow-up by the end of December 2017.@*Conclusion@#Esophageal replacement with ileocolon graft by right and/or middle colic artery as a blood supply using retrosternal route was safe and effective.

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