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Aim In this study, a mouse model of psoriasis-like lesions induced by 62. 5 mg imiquimod was used to explore the effect and mechanism of Sophorae Flavescentis Radix and Rhizoma Smilacis Glabrae combination for the topical treatment of psoriasis. Methods Firstly, the topical administration of Sophorae Flavescentis Radix and Rhizoma Smilacis Glabrae combination for treating psoriasis in progressive and recurrent stages was evaluated by psoriatic mouse model and HE staining. Secondly, immunohistochemistry was used to study the regulatory effects of Sophorae Flavescentis Radix and Rhizoma Smilacis Glabrae combination on the pivotal pathological mechanism of psoriasis-the positive feedback loop between the abnormal proliferation of keratinocytes and skin immune microenvironment. Finally, metabolomics technology was used to explore whether Sophorae Flavescentis Radix and Rhizoma Smilacis Glabrae combination topically treat psoriasis by regulating inflammation-related metabolism and lipid metabolism pathways. Results The combination of Sophorae Flavescentis Radix and Rhizoma Smilacis Glabrae alleviated psoriasis-like lesions in mice. It effectively relieved the recurrence after the cure of psoriatic lesions in mice, and the efficacy is comparable to that of benweimod. The combination of Sophorae Flavescentis Radix and Rhizoma Smilacis Glabrae inhibited the proliferation of mouse epidermal keratinocytes and reduced the number of T cells in the skin. The potential molecular mechanism was that the combination of Sophorae Flavescentis Radix and Rhizoma Smilacis Glabrae regulated arachidonic acid metabolism, sphin- golipid metabolism, tryptophan metabolism and phenylalanine metabolism. Conclusions The combination of Sophora Flavescens Radix and Rhizoma Smilacis Glabrae can relieve psoriasis-like lesions in mice by inhibiting the proliferation of epidermal keratinocytes and reducing the number of T cells in the skin and regulating metabolism to intervene psoriasis recurrence. This study provides a potential topical drug of psoriasis for relieving psoriasis recurrence.
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Objective:To investigate the association of monocyte to lymphocyte ratio (MLR) with all-cause mortality and cardiovascular disease (CVD) mortality in patients with continuous ambulatory peritoneal dialysis (CAPD).Methods:It was a retrospective cohort study. The clinical data of 495 incident CAPD patients in the First Affiliated Hospital of Zhengzhou University from January 1, 2013 to December 31, 2019 were retrospectively analyzed. The optimal cut-off value of baseline MLR was determined by the receiver operating characteristic (ROC) curve for predicting all-cause death in the first year of CAPD, and then the patients were divided into high MLR group and low MLR group. The differences of clinical data and laboratory tests were compared between the two groups. The endpoint events were death (all-cause death and CVD death), conversion to hemodialysis, conversion to kidney transplantation, or follow-up until March 31, 2020. The survival curve was drawn by the Kaplan-Meier method, and the Log-rank test was used to compare the survival difference between the two groups. A Cox regression model was established to analyze the relevant factors of all-cause mortality and CVD mortality in CAPD patients.Results:The study included 495 patients, with age of (43.79±12.16) years and 308 (62.22%) males. The median age of dialysis was 17(10, 30) months. By the end of follow-up, 61(12.32%) of 495 patients had died, 51(10.51%) had been converted to hemodialysis, and 28(5.66%) had been converted to kidney transplantation. Of the 61 patients who died, 36(59.02%) died of cardiovascular events. ROC curve analysis results showed that the optimal cut-off value was 38.24%, so there were 246 cases in the high MLR group (MLR>38.24%) and 249 cases in the low MLR group (MLR≤38.24%). The all-cause mortality rates were 6.83% in the low MLR group and 17.89% in the high MLR group, and the CVD mortality rates were 3.21% in the low MLR group and 11.38% in the high MLR group, respectively. The Kaplan-Meier survival curve showed that the survival rate of the low MLR group was significantly higher than that of the high MLR group (all-cause mortality, Log-rank χ2=18.369, P<0.001; CVD mortality, Log-rank χ2=16.142, P<0.001). Using all-cause death as the end event, the 1-year, 3-year and 5-year cumulative survival rates were 99.5%, 89.4% and 79.9%, respectively, with a median survival time of 64 months in the low MLR group. The 1-year, 3-year and 5-year cumulative survival rates were 95.0%, 68.3% and 49.6%, respectively, with a median survival time of 54 months in the high MLR group. Using CVD death as the end event, the 1-year, 3-year and 5-year cumulative survival rates were 99.5%, 95.2% and 91.2%, respectively, with a median survival time of 69 months in the low MLR group. The 1-year, 3-year, and 5-year cumulative survival rates were 97.8%, 78.6%, and 60.8%, respectively, with a median survival time of 60 months in the high MLR group. Multivariate Cox regression analysis showed that MLR was independently associated with all-cause mortality ( HR=2.744, 95% CI 1.484-5.075, P=0.001) and CVD death ( HR=3.249, 95% CI 1.418- 7.443, P=0.005) in CAPD patients. According to the competing risk model analysis, MLR was still independently associated with all-cause mortality and CVD mortality in CAPD patients. Conclusion:MLR is associated with all-cause mortality and CVD mortality in CAPD patients, and can be used as a valuable indicator for judging the prognosis of CAPD patients.
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Objective:To investigate the metabolic profile of fatty acids in elderly frail patients, and its value as a biomarker of frailty.Methods:Forty-nine older adults were recruited, of whom 19 were non-frail while 15 were in the pre-frail or frail phase.Targeted metabolomics was used to detect the serum levels of fatty acids, concerning 38 short-, medium-and long-chain fatty acids.Results:Metabolomics indicated elevated levels of 9 long-chain fatty acids in the serum of the elderly frail patients, with a 1.056-fold increase in the risk of fatigue for every 1 unit increase in the level of HOMO-γ-linolenic acid( OR=2.056, P=0.016). No metabolic differences were found between the pre-frail and non-frail groups.Three and seven long-chain fatty acids were negatively correlated with the grip strength and gait speed, respectively.The γ-linolenic acid was positively correlated with body mass index(BMI), percent body fat, visceral fat area and other indicators reflecting adipose tissue.However, no correlation was found between skeletal muscle, laboratory indicators or fatty acids.Five metabolic pathways were correlated with frailty, namely fatty acid biosynthesis, fatty acid metabolism, fatty acid elongation in mitochondria, linoleic acid metabolism and α-linolenic acid metabolism. Conclusions:Nine unsaturated fatty acids, including HOMO-γ-linolenic acid and γ-linolenic acid, may be potential biomarkers of frailty in the elderly.However, the value of fatty acid metabolomics for identifying pre-frail elderly people needs to be further investigated.
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Cell mechanics is essential to cell development and function,and its dynamics evolution reflects the physiological state of cells.Here,we investigate the dynamical mechanical properties of single cells under various drug conditions,and present two mathematical approaches to quantitatively character-izing the cell physiological state.It is demonstrated that the cellular mechanical properties upon the drug action increase over time and tend to saturate,and can be mathematically characterized by a linear time-invariant dynamical model.It is shown that the transition matrices of dynamical cell systems signifi-cantly improve the classification accuracies of the cells under different drug actions.Furthermore,it is revealed that there exists a positive linear correlation between the cytoskeleton density and the cellular mechanical properties,and the physiological state of a cell in terms of its cytoskeleton density can be predicted from its mechanical properties by a linear regression model.This study builds a relationship between the cellular mechanical properties and the cellular physiological state,adding information for evaluating drug efficacy.
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Objective:To investigate the association of peripheral axial lengths and retinal curvatures with refractive status.Methods:A cross-sectional study was conducted out.Two hundred and eighty-seven eyes of 287 consecutive children aged 6-15 years old who recieved eye examinations at Beijing Tongren Hospital from July to October 2021 were enrolled, including 154 males and 133 females.Uncorrected and best corrected visual acuity were tested with a standard logarithmic visual acuity chart.Spherical equivalent (SE) was measured via an auto refractometer after cycloplegia with tropicamide.The hyperopic, emmetropic and myopic groups were defined with a SE >+ 0.5 D, SE >-0.5 D to ≤+ 0.5 D and SE≤-0.5 D, respectively.Central and 30° peripheral eye lengths (nasal, temporal, superior, inferior) were obtained using the Lenstar LS900.Retinal coordinates were derived from partial coherence interferometry modeling and converted to retinal curvatures.According to the median horizontal peripheral eye length differences (absolute difference between nasal and temporal), participants were assigned to H1 group (absolute difference <0.35 mm) or H2 group (absolute difference ≥0.35 mm). According to the median vertical peripheral eye length differences (absolute difference between superior and inferior), participants were assigned to V1 group (absolute difference <0.32 mm) or V2 group (absolute difference ≥0.32 mm). Four groups of V1H1, V1H2, V2H1 and V2H2 were constructed according to the grouping methods in both directions above.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital, Capital Medical University (No.TRECKY2021-162). Written informed consent was obtained from guardians of each subject prior to any medical examination.Results:The central axial length was 23.53(22.93, 24.10)mm.Peripheral eye lengths of temporal, nasal, superior and inferior were 22.75(22.11, 23.22)mm, 22.99(22.32, 23.45)mm, 23.24(22.58, 23.75)mm and 23.12(22.52, 23.56)mm, respectively.Temporal eye length was shorter than nasal, showing a statistically significant difference ( Z=-3.58, P<0.01). Compared with H2 group, H1 group had shorter central, nasal, superior and inferior eye lengths, showing statistically significant differences (all at P<0.05). Compared with V2 group, V1 group had shorter central, nasal and superior eye lengths, showing statistically significant differences (all at P<0.05). SE of H1 group was + 0.06 (-1.06, + 0.75) D, which was significantly greater than -0.32 (-1.64, + 0.56) D of H2 group ( Z=-2.10, P=0.04). SE of V1 group was + 0.13 (-0.81, + 0.80) D, which was significantly greater than -0.56 (-1.83, + 0.48) D of H2 group ( Z=-3.39, P<0.01). The myopia ratio of V1 group was 33.5% (58/173), which was significantly lower than 50.5% (53/105) of V2 group ( χ2=7.83, P<0.01). There was a significant overall difference in SE among VIH1, V1H2, V2H1 and V2H2 groups ( H=24.79, P<0.01). SE was greater in V1H1 group than V1H2, V2H1 and V2H2 groups (all at P<0.01). There was a significant difference in both horizontal and vertical retinal curvatures among different refractive groups ( H=22.34, 19.30; both at P<0.01). The retical curvature in both directions of hyperopic and emmetropic groups were significantly larger than those of myopic group (both at P<0.01). Conclusions:Peripheral eye lengths are asymmetric in school-aged children.Higher asymmetry is associated with myopic shifts.Myopic children have a steeper retina than the hyperopic and emmetropic children.
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Objective To compare the prevalence and disease burden of thyroid cancer and their trends between China and the globe from 1990 to 2019.Methods With the global disease burden data in 2019,Joinpoint was used to predict the trends of the disease burden of thyroid cancer in China and the globe from 1990 to 2019,and logarithmic linear model was used to test the predicted trends.The R language was used for predictive analysis and graphic plotting of the disease burden from 2020 to 2035.Results From 1990 to 2019,the standardized incidence rate and the standardized mortality rate of thyroid cancer in China were lower than those in the globe.The standardized incidence rate in China and the globe showed an increasing trend(with the increases of 102.65% and 40.65%,respectively),while the standardized mortality rate showed a decreasing trend(with the decreases of 7.63% and 4.91%,respectively).Compared with those of the female population,the standardized incidence and mortality rates of the Chinese male population increased significantly from 1990 to 2019(the rates of change in the male population were 48.65% and 214.60%,respectively;and the rates of change in the female population were -39.01% and 60.44%,respectively).China's overall standardized years of life lost(YLL),years lived with disability(YLD),and disability-adjusted life years(DALY)rates during the 30-year period were lower than the global average.The Chinese and global populations showed the standardized YLL rate decreasing by 16.61% and 6.88% and the standardized DALY rate decreasing by 10.77% and 3.65%,respectively,while the rates of standardized YLD increased by 128.91% and 46.89%,respectively.The magnitude of DALY in China and the world was mainly influenced by YLL.The standardized incidence,mortality,and DALY rates of the Chinese male population were gradually approaching the global levels.From 1990 and 2019,thyroid cancer showed a higher mortality rate in the population with the age ≥ 75 years and a higher incidence rate in the population with the age <75 years.It is projected that from 2020 to 2035,the standardized incidence rates in China and the world will increase by 36.66% and 21.15%,respectively;the standardized mortality rates will decrease by 20.19% and 3.46%,respectively;and the standardized DALY rate is expected to decrease by 7.08% in China and increase by 4.35% in the world.Conclusions From 1990 to 2019,China's standardized incidence rate of thyroid cancer increased and had a higher increase than the global level,and the standardized mortality rate decreased,with a slightly higher decrease than the global level.However,the increases in the standardized incidence rate and mortality rate of this disease in China's ≥75 years male population were severe.Although China's disease burden of thyroid cancer showed a decreasing trend in line with the global trend as a whole,the disease burden in the Chinese males was higher than that in the females.Specifically,the disease burden due to premature death was predominant,and the burden in specific populations requires policy attention.
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Masculino , Humanos , Femenino , Anciano , Años de Vida Ajustados por Calidad de Vida , Estándares de Referencia , Costo de Enfermedad , China/epidemiología , Neoplasias de la Tiroides/epidemiología , IncidenciaRESUMEN
Pyroptosis is a newly discovered way of proinflammatory programmed cell death. Pyroptosis is mediated by caspase-1 (Caspase-1). Through the cleavage and activation of GSDM family proteins, small pores are formed on the cell membrane, thus rapid lysis of the cell membrane process, and then leads to intracellular inflammatory content release thereby causing inflammatory response. The three pyroptosis pathways are the classical pathway of Caspase-1, the non-classical pathway of Caspase-4, 5, and 11, and the special pathway of Caspase-3 or Hela cells. Pyroptosis plays an important role in the occurrence, invasion, and metastasis of breast cancer, and is closely related to the prevention and treatment of breast cancer. This article reviews the biological mechanism of pyroptosis and its research progress in breast cancer, to provide a new idea for clinicians in the treatment of breast cancer.
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Background: Gastroesophageal reflux disease (GERD) is strongly associated with sleep disturbances. Proton pump inhibitors (PPIs) are the main treatment to improve the reflux symptoms in GERD patients. Aims: To investigate the efficacy of PPIs on nighttime reflux symptoms and associated sleep disturbances in general GERD population in North China. Methods: In this multicenter, prospective observational study, adult GERD patients with nighttime heartburn or regurgitation were recruited from 11 tertiary hospitals in North China during July 2017 to March 2018. All the patients received oral PPIs treatment. Data on nighttime reflux symptoms and associated sleep disturbances were obtained by patient diary and self-report questionnaire, the quality of sleep was defined by the Pittsburgh Sleep Quality Index (PSQI). The efficacy of PPIs was estimated by the relief rate after 4-week treatment. Results: Of the 750 GERD patients analyzed, 585 (78.0%) reported nighttime reflux-associated sleep disturbances, and 427 (56.9%) were defined as poor sleepers with a PSQI score >5. After 4-week PPIs treatment, 51.3% of the patients achieved a relief of nighttime reflux symptoms. The complete relief rates for nighttime reflux symptoms and associated sleep disturbances were 32.5% and 51.5%, respectively. PSQI score was significantly improved from 6.82 ± 3.38 at baseline to 4.56±2.50 after 4-week PPIs treatment (P<0.05). Conclusions: PPIs treatment provides an effective relief of nighttime reflux symptoms and associated sleep disturbances and improving the sleep quality in general GERD population in North China.
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Objective:To evaluate the efficacy and safety of ribonucleic acid for injection Ⅱ combined with chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC).Methods:Based on the LinkDoc database, 2 111 patients who were diagnosed with stage Ⅲ B and Ⅳ NSCLC in 8 research centers such as Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2014 to December 2017 were included. Patients were divided into observation group (1 039 cases) and control group (1 072 cases) according to whether or not they had used ribonucleic acid for injection Ⅱ during chemotherapy. Inverse probability of treatment weighting was used to correct the confounding factors of patients, and there were 1 078 cases in the control group and 1 033 cases in the observation group; the overall survival (OS), progression-free survival (PFS) and the occurrence of adverse events and chemotherapy-related adverse reactions were compared between the two groups. Results:The median OS time of the observation group and the control group was 18.51 months and 15.65 months, and the median PFS time was 7.00 months and 5.49 months, and the differences were statistically significant ( P values ??were 0.001 and 0.003). The incidence of adverse events in the observation group was slightly higher than that in the control group [75.6% (781/1 033) vs. 74.1% (799/1 078)], and the incidence of chemotherapy-related adverse reactions in the observation group was slightly higher than that in the control group [43.9% (453/1 033) vs. 40.7% (439/1 078)], but the differences were not statistically significant (both P > 0.05). Conclusions:Ribonucleic acid for injection Ⅱ can prolong the OS and PFS time of patients with stage Ⅲ B and Ⅳ NSCLC receiving chemotherapy. It is safe and can increase the clinical benefit of patients to a certain extent.
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Data of 643 patients who underwent endoscopic polypectomy with high-frequency electrotome in 6 hospitals of Sichuan Province between June 2020 and September 2020 were summarized. The rate of complete polypectomy and the incidence of delayed post-polypectomy bleeding (DPPB) and perforation were analyzed. DPPB occurred in 18 cases (2.80%) and postoperative perforation occurred in 1 case (0.16%). All of the 1 828 polyps were completely resected (100.0%). Univariate analysis showed that polyps′ diameter≥10 mm, long peduncle or laterally spreading tumor (LST), adenomatous polyp, endoscopic mucosal resection, mixed cutting mode 1 of electrocoagulation were significantly correlated with DPPB( P<0.05). Multivariate Logistic regression analysis revealed that polyp diameter≥10 mm ( P=0.001, OR=3.575, 95% CI: 1.175-9.955), morphology of long peduncle or LST ( P=0.004, OR=2.981, 95% CI: 1.233-14.858) were independent risk factors for DPPB. Endoscopic colorectal polypectomy with high-frequency electrotome is effective and safe. Polyps′ diameter≥10 mm, polyps with long pedicle or LST are the risk factors for DPPB.
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Objective:To compare the prognosis of hemodialysis (HD) and peritoneal dialysis (PD) in end-stage renal disease (ESRD) patients without diabetes mellitus and identify related influencing factors.Methods:Patients who started hemodialysis with an arteriovenous graft or fistula or PD in the First Affiliated Hospital of Zhengzhou University from January 1, 2013 to February 1,2019 were included. They were followed up until May 1, 2019. The patients were divided into HD group and PD group according to the initial dialysis modality. Kaplan-Meier method was used to obtain survival curves, the Cox regression model was used to evaluate influence factors for survival rates, and the inverse probability of treatment weighting (IPTW) was used to eliminate influence of the confounders in the groups.Results:There were 371 patients with maintenance dialysis enrolled in this study, including 113 cases (30.5%) in HD group and 258 cases (69.5%) in PD group. At baseline, the scores of standard mean difference ( SMD) in age, body mass index (BMI), combined with cerebrovascular disease, Charlson comorbidity index (CCI), blood potassium, plasma albumin and hemoglobin between the two groups were greater than 0.1. The score of SMD decreased after IPTW, and the most data were less than 0.1, which meant that the balance had been reached between the two groups. The Kaplan-Meier survival curve showed that the cumulative survival rates had no significant difference for all-cause death before using IPTW between the two groups (Log-rank χ2=0.094, P=0.759). After adjusting for confounders with IPTW, the Kaplan-Meier survival curve showed that the cumulative survival rates still had no significant difference for all-cause death between the two groups (Log-rank χ2=2.090, P=0.150). Univariate Cox regression analysis showed that there was no significant difference between HD and PD on survival rates in ESRD patients without diabetes mellitus for all-cause death (PD/HD, HR=1.171, 95% CI 0.426-3.223, P=0.760). Multivariate Cox regression analysis showed that there was no significant difference between HD and PD on survival rates in ESRD patients without diabetes mellitus (PD/HD, HR=1.460, 95% CI 0.515-4.144, P=0.477), and high plasma albumin ( HR=0.893, 95% CI 0.813-0.981, P=0.019) was an independent protective factor for survival in ESRD patients without diabetes mellitus. There was still no significant difference between HD and PD on survival rates in ESRD patients without diabetes mellitus after using IPTW (PD/HD, HR=1.842, 95% CI 0.514-6.604, P=0.348). Conclusion:The difference of cumulative survival rates between HD and PD is not significant in ESRD patients without diabetes mellitus.
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Objective:To investigate the diagnostic value of cerebrospinal fluid interleukin-6 (IL-6), neuron-specific enolase (NSE) and S100B protein in patients with central nervous system infection.Methods:The clinical data of 78 patients with central nervous system infection (infected group) from October 2015 to February 2019 in the Department of Neurology, Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. Among the patients, viral meningitis was in 41 cases, tuberculous meningitis was in 23 cases, and purulent meningitis was in 14 cases. Another 100 patients who were admitted to the hospital during the same period for cerebrospinal fluid and other related examinations and excluded central nervous system infection (control group) were selected. Enzyme-linked immunosorbent assay was used to detect the levels of IL-6, NSE and S100B protein.Results:The cerebrospinal fluid levels of IL-6, NSE and S100B protein in infected group were significantly higher than those in control group: 16.70 (8.54, 228.18) ng/L vs. 6.64 (4.96, 8.21) ng/L, 13.62 (11.50, 19.01) μg/L vs. 9.95 (7.54, 12.39) μg/L and 3.07 (0.24, 11.57) μg/L vs. 0.16 (0.12, 0.21) μg/L, and there were statistical differences ( P<0.05). The cerebrospinal fluid levels of IL-6, NSE and S100B protein in patients with tuberculous meningitis were significantly higher than those in patients with viral meningitis and patients with purulent meningitis: 173.30 (13.74, 503.80) ng/L vs. 9.37 (4.80, 113.55) and 89.96 (14.02, 239.60) ng/L, (30.82 ± 14.09) μg/L vs. (12.00 ± 2.33) and (17.62 ± 5.63) μg/L, (18.29 ± 16.05) μg/L vs. (2.12 ± 1.24) and (5.79 ± 4.82) μg/L; the indexes in patients with purulent meningitis were significantly higher than those in patients with viral meningitis, and there were statistical differences ( P<0.05). Conclusions:Cerebrospinal fluid IL-6, NSE and S100B proteins have different expressions in patients with different types of central nervous system infection, and have certain clinical application value for the diagnosis of central nervous system infection.
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Objective@#To report a case of rat poison with multiple hemorrhage after trauma.@*Methods@#The clinical data of a case of rodenticide poisoning with hemorrhage as the first symptom admitted to a third-class a hospital in July 2018 were analyzed and summarized.@*Results@#This patient is a rodent drug poisoning patient with hemorrhage as the first symptom.The disease was diagnosed as bromohamelin and bromadiolone poisoning through the analysis of poison detection because the rodent drug was taken in the market and the history of taking poison was concealed. The patient was given active comprehensive treatment of vitamin K1 and other drugs for clinical cure.@*Conclusion@#For patients with clinically unexplained hemorrhage, the possibility of rodenticide poisoning should be considered and the toxicant detection should be improved actively.
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Objective@#To investigate an occupational hazardous gas poisoning incident caused by gas leakage in the process of hazardous waste treatment.@*Methods@#An investigation was conducted on a case of occupational acute hazardous gas poisoning caused by waste treatment gas leakage in Shandong province in December 2017. Meanwhile, the clinical data of 5 cases of poisoning patients were analyzed, and the accident related poison test report and other relevant data were analyzed.@*Results@#The incident was caused by the toxic waste did not do labeling work, the workers' protection measures were not in place, the illegal operation and the blind rescue, resulting in a total of 5 people died on the spot, 12 people were hospitalized with poisoning. Among them, 5 patients admitted to our hospital showed varying degrees of damage to the nervous system and respiratory system. After active treatment, they all got better and were discharged.@*Conclusion@#The poisoning is mainly caused by hydrogen sulfide dichloromethane hydrogen cyanide gas leakage serious production liability accident, clinical main performance for the nervous system circulatory system respiratory system and other system damage.
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Objective To investigate the incidence situation of metabolic syndrome (MS) in patients with continuous ambulatory peritoneal dialysis (CAPD),and analyze the correlation between MS and prognosis of patients.Methods The patients who received peritoneal dialysis from June 1,2002 to April 30,2018 and followed up regularly were divided into MS group and non-MS group according to the diagnostic criteria of MS.Follow-up was until July 31,2018.The differences of clinical data,metabolic indexes and clinical outcomes between the two groups were compared.The survival rates of the two groups were compared by Kaplan-Meier survival curve,and the risk factors of all-cause death and cardiovascular disease (CVD) death were analyzed by Cox regression analysis.Results A total of 516 patients with CAPD were enrolled in this study,including 340 males (65.9％)and 176 females (34.1％).Their age was (47.29± 12.20) years.The median follow-up time was 20 (9,39) months.According to the diagnostic criteria of MS,the patients were divided into MS group (210 cases,40.7％) and non-MS group (306 cases,59.3％).At baseline,there was no significant difference in age,educational background,duration of peritoneal dialysis,smoking history and drinking history between the two groups (P ＞ 0.05),but the patients in MS group were more exposed to high glucose peritoneal dialysate (P ＜ 0.05).The body mass index (BMI),blood phosphorus,blood glucose,blood potassium,triglyceride,cholesterol and systolic blood pressure in MS group were significantly higher than those in non-MS group (all P ＜ 0.05),and HDL-C level was significantly lower in MS group than in non-MS group (P ＜ 0.05).There were no significant differences in other indicators between the two groups (P ＞ 0.05).Kaplan-Meier survival curve showed that the cumulative survival rate in MS group was significantly lower than that in non-MS group,and the difference was statistically significant (Log-rank x2=14.87,P ＜ 0.001).If CVD death was taken as the end event,the cumulative survival rate in the non-MS group was significantly higher than that in the MS group (Log-rank x2=14.49,P ＜ 0.001).Multivariate Cox regression analysis showed that MS and high 4 h dialysate creatinine/serum creatinine ratio (4hD/Pcr) were independent risk factor for all-cause death (HR=1.982,95％CI 1.240-3.168,P=0.004;HR=3.855,95％CI 1.306-11.381,P=0.015) and CVD death (HR=2.499,95％CI 1.444-4.324,P=0.001;HR=5.799,95％ CI 1.658-20.278,P=0.006) in patients with CAPD.Conclusion The prevalence of MS in patients with CAPD is high,and MS and high 4hD/Pcr are independent risk factor for all-cause and CVD death in CAPD patients.They can be used as valuable indicators to predict the treatment outcomes and long-term prognosis of patients with CAPD.
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Objective@#In order to investigate the clinical features and influence factors for incidence in patients with radiation-induced external auditory canal carcinoma (RIEACC).@*Methods@#The nasopharyngeal carcinoma (NPC) 16 patients who were diagnosised RIEACC after radiotherapy in the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from January 1990 to December 2017 were retrospectively analysis. The influence factors analysis were used Logistic regression analysis.@*Results@#Univariate analysis showed that age, somking history, family history of cancer and NPC stage were the influencing factors. Multi-factor logistic regression analysis showed that age, family history of cancer and NPC stage were independent risk factors.@*Conclusions@#RIEACC is rare complication of NPC patients received radiotherapy, which is also a multifactorial outcome. Age, family history of cancer and NPC stage is preliminary the main influencing factor. Although RIEACC has a low incidence, its malignancy should be highly vigilant.
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Objective In order to investigate the clinical features and influence factors for incidence in patients with radiation-induced external auditory canal carcinoma (RIEACC).Methods The nasopharyngeal carcinoma (NPC) 16 patients who were diagnosised RIEACC after radiotherapy in the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from January 1990 to December 2017 were retrospectively analysis.The influence factors analysis were used Logistic regression analysis.Results Univariate analysis showed that age,somking history,family history of cancer and NPC stage were the influencing factors.Multi-factor logistic regression analysis showed that age,family history of cancer and NPC stage were independent risk factors.Conclusions RIEACC is rare complication of NPC patients received radiotherapy,which is also a multifactorial outcome.Age,family history of cancer and NPC stage is preliminary the main influencing factor.Although RIEACC has a low incidence,its malignancy should be highly vigilant.
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Objective To investigate the difference of styrofoam and breast carrier in postposition fixation of intensity-modulated radiotherapy after breast conservative surgery for breast cancer patients.Methods From February 2018 to August 2018,tweenty-four patients with breast cancer in Sun Yet-Sen Memorial Hospital of Sun Yet-sen University were selected for this study,who underwent hypofactionationed radiotherapy after breast conservative surgery with total dose 42.56 Gy/16Fractions.They were randomized into styrofoam test group and breastcarrier control group.Cone beam CT as used to record the positioning error under the directions of left and right (x),head and foot (y),abdomen and back (y) within two groups at the first,third,fifth,seventh,eleventh time before irradiation.Furthermore,the PTV extension margin was calculated and the positioning time of two groups was recorded.Two sets of pendulum errors were analyzed by independent sample T-test,and the outspread value of inter-fractional set up error of the PTV was calculated.Results The errors of the test group and the control group in the direction of x,y,z were as follows:(2.36±1.89) and (2.56±2.05) mm (P=0.49),(1.76± 1.78) and (3.28±2.79) mm (P＜0.05),(1.47± 1.49) and (1.73± 1.81) mm (P=0.28).The extension values of inter-fractional set up error of CTV to PTV were 2.97,2.92,2.21 mm and 3.41,4.09,2.59 mm respectively.The time of single positioning was (3.4± 1.1) and (5.5 ± 3.1) min respectively (P=0.01).Conclusion Styrofoam has better positioning accuracy and efficiency compared with breast carrier.
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Objective To re-evaluate the potential risk of small gastric stromal tumor ( diameter less than 2 cm), and to assess the safety and efficacy of endoscopic resection and further treatment strategy for small gastric stromal tumor. Methods Data of 584 patients undergoing endoscopic submucosal dissection ( ESD) and diagnosed as gastric submucosal tumor ( SMT) in Tianjin Medical University General Hospital from September 2008 to December 2015 were retrospectively analyzed. The clinical and pathological features and potential risk of small gastric stromal tumor were analyzed. The therapeutic outcomes, complications and follow-up results of ESD were summarized, and the follow-up results of patients undergoing ESD were compared with 45 patients who were suspected as small gastric stromal tumor and followed-up regularly by endoscopic ultrasonography ( EUS) in the same period. Results Among 584 cases of gastric SMT, stromal tumor ( 239 cases, 40. 9％) was the most common type, of which small gastric stromal tumor was found in 203 cases (84. 9％, 203/239). The mitotic index of all cases was no more than 5/50 high power field. However, adverse factors under EUS, mainly including strong echo and heterogeneity, were reported in 94 (46. 3％) out of 203 cases and were confirmed to be related to tumor size (P=0. 000). ESD was successfully performed in 203 patients with small gastric stromal tumor, and no serious complication or perioperative death occurred. Symptoms of 81. 4％ ( 144/177 ) patients were improved after ESD, and no stromal tumor recurrence or metastasis was observed during a follow-up of 12-84 months. Of the 45 patients followed-up regularly by EUS, 38 (84. 4％) patients had gastrointestinal symptoms and 84. 2％ (32/38) were not relieved during follow-up, and 12 (26. 7％) had a heavier psychological burden, seriously affecting the quality of life. Conclusion The incidence of adverse factors under EUS is high in patients with small gastric stromal tumor, and increased with tumor size. ESD is safe and effective for small gastric stromal tumor, which contributes to the diagnosis, further improves therapeutic effects and reduces psychological pressure.
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OBJECTIVE: This study aimed to illustrate the magnetic resonance venography (MRV) manifestations of obstructed hepatic veins (HVs), the inferior vena cava (IVC), and accessory hepatic veins (AHVs) in patients with Budd-Chiari syndrome (BCS) and to evaluate the visualization capacity of MRV in the diagnosis of BCS. MATERIALS AND METHODS: Fifty-two patients with chronic BCS were included in this study. All patients were examined via MRV performed with a 3T system following injections of gadolinium-diethylene triamine pentaacetic acid (Gd-DTPA) or Gd-ethoxibenzyl-DTPA. HV and IVC lesions were classified, and their characteristics were described. HV cord-like occlusions detected via MRV were compared using ultrasonography (US). Digital subtraction angiography (DSA) was performed as a contrast in the MRV detection of IVC lesions. The HVs draining collaterals, mainly AHVs, were carefully observed. HV lesions were classified as segmental stenosis, segmental occlusion, membranous stenosis, membranous occlusion, cord-like occlusion, or non-visualized. Except for patent IVCs, IVC lesions were classified as segmental occlusion, segmental stenosis, membranous occlusion, membranous stenosis, and hepatomegaly-induced stenosis. RESULTS: All patients (52/52, 100%) showed HV lesions of different degrees. MRV was inferior to US in detecting cord-like occlusions (6 vs. 19, χ2 = 11.077, p < 0.001). Dilated AHVs, including 50 (50/52, 96.2%) caudate lobe veins and 37 (37/52, 71.2%) inferior HV and AHV lesions, were well-detected. There were no significant differences in detecting segmental lesions and thrombosis between MRV and DSA (χ2 = 0.000, p1 = 1.000, p2 = 1.000). The capacity of MRV to detect membranous lesions was inferior to that of DSA (7 vs. 15, χ2 = 6.125, p = 0.013). CONCLUSION: In patients with BCS, MRV can clearly display the lesions in HVs and the IVC, as well as in AHVs, and it has diagnostic and therapeutic value.