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Tetanus consists of neonatal tetanus and non-neonatal tetanus. Non-neonatal tetanus remains a serious public health problem, although neonatal tetanus has been eliminated in China since 2012. Non-neonatal tetanus is a potential fatal disease. In the absence of medical intervention, the mortality rate of severe cases is almost 100%. Even with vigorous treatment, the mortality rate remains 30%-50% globally. These specifications aim to regulate non-neonatal tetanus diagnosis and treatment in China, in order to improve medical quality and safety. These specifications introduce the etiology, epidemiology, pathogenesis, clinical manifestations and laboratory tests, diagnosis, differential diagnosis, grading and treatment of non-neonatal tetanus.
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Tetanus consists of neonatal tetanus and non-neonatal tetanus.Non-neonatal tetanus remains a serious public health problem,although neonatal tetanus has been eliminated in China since 2012.Non-neonatal tetanus is a potential fatal disease.In the absence of medical intervention,the mortality rate of severe cases is almost 100％.Even with vigorous treatment,the mortality rate remains 30％-50％ globally.These specifications aim to regulate non-neonatal tetanus diagnosis and treatment in China,in order to improve medical quality and safety.These specifications introduce the etiology,epidemiology,pathogenesis,clinical manifestations and laboratory tests,diagnosis,differential diagnosis,grading and treatment of non-neonatal tetanus.
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Tetanus consists of neonatal tetanus and non-neonatal tetanus. Although neonatal tetanus in China has been eliminated since 2012, non-neonatal tetanus remains a serious public health problem. Non-neonatal tetanus is a potential fatal disease, and the mortality rate of severe cases is almost 100% in the absence of medical intervention. Even with vigorous treatment, the mortality rate is still 30~50% globally. In order to standardize the diagnosis and treatment of non-neonatal tetanus in China, this specification is hereby formulated. This standard includes etiology, epidemiology, pathogenesis, clinical manifestations, laboratory tests, diagnosis, differential diagnosis, classification, grading and treatment of non-neonatal tetanus.
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Objective To analyze the correlation between the pathological types of parathyroid and clinical manifestations in patients with renal secondary hyperparathyroidism (SHPT),so as to improve the efficacy and safety of treatment.Methods The pathological and clinical data of 130 patients with renal SHPT and maintenance hemodialysis (MHD) who had undergone total parathyroidectomy with autotransplantation (TPTX + AT) were collected.A total of 545 parathyroid glands were obtained and 998 slices were made and read.According to the pathological types of parathyroid hyperplasia,the patients were divided into diffuse hyperplasia (DH) group,diffuse between hyperplasia and nodular hyperplasia (DH/NH) group as well as nodular hyperplasia (NH) group.The clinical and biochemical characteristics of different groups before and after operation (1-,3-,6-,9-,12-month) were compared and analyzed by statistical tests.Results (1) The preoperative status:the dialysis age,serum calcium as well as incidence of bone pain,skin itching and shorten height in the NH group were significantly higher than those in the DH group (all P ＜ 0.05),and the serum phosphorus and iPTH in the NH group were significantly higher than those in DH and DH/NH group (all P ＜ 0.05).(2) The postoperative status:the serum calcium of the NH group at 1-month was lower than that of the DH group,and the incidence of hypocalcemia of the NH group at 1-month was higher than that of the DH group (P ＜ 0.05);the serum phosphorus at 3-,6-,9-month and iPTH at 1-,3-month of the NH group were significantly lower than that of the DH group (all P ＜ 0.05),and the serum phosphorus at 3-month and iPTH at 1-month of the NH group were lower than that of the DH/NH group (all P ＜ 0.05).Among the 3 groups the serum phosphorus change from 1 to 12 months had difference (F=3.241,P=0.042),while the differences of serum calcium and iPTH changes were statistically insignificant.Conclusions The clinical manifestations,serum calcium,phosphorus and iPTH in patients with renal SHPT before and after TPTX+AT are closely related to the pathological types of parathyroid hyperplasia.Compared with the DH patients,before the operation the NH patients have longer dialysis age,more serious the clinical symptoms such as bone disease,higher calcium,phosphorus and iPTH,while greater reduction of the serum calcium,phosphorus and iPTH in the short term after operation.
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Objective To establish the analytical method of oleandrin and adynerin in human blood by HPLC-MS/MS. Methods After protein sediment by acetonitril, the concentrations of oleandrin and adynerin in human blood were quantitatively determined by HPLC-MS/MS. The qualitative analysis was conducted based on retention time and MRM ions. Besides, the standard curve method was used for quantification. Results The detection limits of both oleandrin and adynerin were 0.5ng/mL, the linear range was from 1ng/mL to 1mg/mL, with a recovery rate of 75.2%~95.7%. Conclusion The detecting protocol has the advantages of high sensitivity, fast and high accuracy with a relatively wide linear range, which is especially suitable for rapid detection of oleander toxins, alexandrine and adynerin in particular, in human blood in poisoning cases.
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Purpose To study the expression of zeb-1 and c-jun in gastric cancer and its influence of occurrence and development of tumor. Methods The expression zeb-1, c-jun and E-cadherin were assessed in 100 specimens of gastric cancer and their tissue adja-cent to cancer by immunohistochemistry. Results The positive rates of zeb-1,c-jun and E-cadherin expression in gastric cancer were 81%, 70%, 35%, and in tissue adjacent to cancer were 17%, 25%, 100%. The expression of zeb-1 and c-jun in gastric cancer were higher than those in their tissue adjacent to cancer (P<0. 05). zeb-1 expression was closely correlated with the degree of tumor differentiation, depth of invasion, lymph node metastasis and TNM stage (P<0. 05), which were not correlated with patient s age, sex and tumor size. c-jun expression was closely correlated with the degree of tumor differentiation (P<0. 05), which were not correlated with other pathological features. The expression of zeb-1 was negatively correlated with the expression of E-cadherin and was positively correlated with the expression of c-jun in gastric cancer. Patients with high expression of zeb-1 and c-jun had lower five-year survival rate than patients with negative expression. Conclusion zeb-1 and c-jun are closely correlated with occurrence and development of gastric cancer. They can be a index of judging prognosis of gastric cancer.
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Objective To investigate the relationship between the expressions of TMPRSS4 and clinical pathologi-cal parameters in gastric carcinoma. To explore its significance in judging the prognosis of patients. To analyze the expression of TMPRSS4 in the epithelial-mesenchymal transition. Methods The expressions of TMPRSS4, E-cad-herin and Vimentin were detected by immunohistochemistry ( SABC) in 100 cases of gastric carcinoma specimens and corresponding adjacent normal tissue. Results In gastric carcinoma, TMPRSS4, E-cadherin and Vimentin positive rate was 47%,45%,37%. In adjacent tissues,their positive rate was 9%,30%,4%. The differences be-tween tumor tissues and adjacent tissues had statistical significance ( P0.05). The 5-year survival rate of patients with high TMPRSS4 expression was significantly lower than that in patients with low expression. The high TMPRSS4 expression was significantly correlated in gastric carcinoma accompanied by low expression of E-cadherin (rs = -0.207,P=0.038) and high Vimentin expression (rs=0.233,P=0.020). Conclusion The expression of TMPRSS4 is closely related to the biological characteristics in gastric carcinoma,detection the expression of TMPRSS4 is valuable in predicting tumor prognosis,invasion and metastasis. TMPRSS4 may promote invasion, metastasis of human gastric carcinoma through epithelial-mesenchymal transition by reduce the expession of E-cadherin.
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<p><b>BACKGROUND</b>With the development of social industrialization and aging of the population, patients with lung cancer have the tendency of becoming youthful and elderly, therefore the way of treatment should be also changed. In resent years, lung cancer in young and elderly patients have been reported respectively, but simultaneous contrast analysis of clinical feature and prognosis in elderly, normal and youthful patients have been rarely reported. Based on the clinic data in the patients, the clinical feature and prognosis of patients with non-small cell lung cancer at different ages were analyzed.</p><p><b>METHODS</b>From January 1996 to January 2003, 1380 patients with NSCLC were treated surgically in thoracic department in our hospital, the patients were divided into three group based on their age, group 1 (G1) (range ≤40), group 2 (G2) (range 41-69), group 3 (G3) (range ≥70). The clinical feature and prognosis were analyzed in each group.</p><p><b>RESULTS</b>The mean age in the whole group was 58.16±0.26, and 35.76±0.57 (range 12-40) in G1, 58.00±0.22 (range 41-69) in G2, 72.30±0.21 (range 70-80) in G3. The ratio of lung cancer in female between G1 and G3 was significant different (P=0.024). The coexisting diseases in G3 were more common than those of other groups (P=0.000). Squamous cell carcinoma was the main type in histology, accounting for 41.79% (28/67), 54.12% (644/1190) and 58.54% (72/123) in each group respectively (P=0.080), but the ratio of adenocarcinoma, higher than that of other groups, were 43.28% (29/67), 29.50% (351/1190) and 26.82% (33/123) (P=0.036). Lobectomy and pneumonectomy were the main surgical procedures, accounting for 58.21%, 65.29%, 78.86% (P=0.004) and 34.33%, 26.22%, 12.20% (P=0.001), respectively. The ratio of stage III were 43.28% (29/67), 38.82% (462/1190), and 26.02% (32/123) in each groups (P=0.015). 55.22% (37/67) in G1 received adjuvant chemotherapy, 47.48% (565/1190) in G2, and 29.27% (36/123) in G3 (P=0.000). 5-year survival rate was 38.96% in the whole group, 29.99% in G1, 39.61% in G2, and 37.99% in G3 (P=0.494).</p><p><b>CONCLUSIONS</b>In young patients with non-small cell lung cancer, female and adenocarcinoma make up the majority of the number, and a lot of patients are in advanced stage and likely to adopt adjuvant chemotherapy. While in elderly, squamous cell carcinoma accounts for the majority of the number, and more coexisting diseases are accompanied, much more complications occur after surgical procedure. Nevertheless, their prognosis has no significant difference.</p>