RESUMEN
Breast cancer is the malignant tumor with the highest incidence among women in China, and axillary lymph node metastasis is one of the main metastatic pathways of breast cancer. Early detection and accurate assessment of axillary lymph node metastasis has great significance in guiding treatment and judging prognosis. Currently, imaging techniques are widely used in the diagnosis of breast diseases. Ultrasound, as a commonly used clinical imaging method, has become the preferred method for breast cancer lymph node assessment because of its low price, simple operation and multiple testing. This article review the current status of research on the commonly used ultrasound assessment of axillary lymph node metastasis in breast cancer to provide reference for clinical diagnosis and treatment.
RESUMEN
Objective To calculate median effective dose(ED50)of remimazolam combined with sufentanil for inhibition of nasopharyngeal airway insertion reaction in elderly patients.Methods Thirty-eight patients,aged≥65 years,BMI 18-25 kg/m2,ASA physical statusⅠ-Ⅲ,undergoing elective cata-ract surgery under nasopharyngeal airway were selected.Patients received intravenous sufentanil injections of 0.1 μg/kg,followed by intravenous remimazolam injection 3 minutes later,then nasopharyngeal airway in-sertion after 2 minutes.The initial dose of remimazolam was 0.2 mg/kg and adjusted by 0.01 mg/kg,based on the modified Dixon sequential method.A positive reaction was defined as head shaking,choking,body movement,an increase in HR＞20%of the basal value,or an increase in SBP or DBP＞20%of the basal value at the time of nasopharyngeal airway placement.The procedure was stopped after seven crossovers.The ED50,95%effective dose(ED95)of remimazolam,and 95%confidence intervals(CI)were calculated by probabilistic unit(Probit)regression analysis.Results When combined with sufentanil,the ED50 and ED95 of remimazolam for inhibition of nasopharyngeal airway insertion in elderly patients was 0.193 mg/kg(95%CI 0.191-0.195 mg/kg)and 0.209 mg/kg(95%CI 0.205-0.213 mg/kg),respectively.Conclusion The ED50 of remimazolam combined with sufentanil for inhibition of nasopharyngeal airway in-sertion reaction in elderly patients were 0.193 mg/kg(95%CI 0.191-0.195 mg/kg).
RESUMEN
Bupleuri Radix is commonly used in the traditional Chinese medicine, and saikosaponins are the important active ingredients. In this study, we first established a relative quantitative method for 25 saikosaponins using ultra high performance liquid chromatography-triple quadrupole mass spectrometry (UHPLC-QTrap-MS) in the scheduled multiple reaction monitoring (sMRM) mode. The established method showed good intra-day and intra-day precision, linearity, repeatability and stability. Then the method was applied to compare 37 batches of Bupleuri Radix from different planting areas. The results showed that there was no significant difference in the saikosaponins composition of Bupleuri Radix from different planting areas in Shanxi Province, which indicating that Bupleuri Radix is well adapted to the environment, so it is suitable for widely planting. However, Bupleuri Radix harvested at spring and autumn were differed from those harvested at summer, which indicated that the traditional harvesting experience was reasonable. Correlation analysis showed that saikosaponins a and d were positively correlated with some saponins, and 4 saponins (such as clinoposaponin XII) showed bigger content variation were identified by coefficient of variation analysis. The LC-MS based pseudotargeted metabonomic method established in this study can be applied to the comprehensive detection of saikosaponins, which providing new method for the quality evaluation of Bupleuri Radix.
RESUMEN
To identify the active constituents in vitro and blood-absorbed ingredients in vivo from Yin Chen Hao decoction provides scientific evidence for probing its prevention and treatment mechanism on acute liver injury. An ultrahigh performance liquid chromatography quadrupole-time of flight-mass spectrometry (UPLC-QTOF/MS) method was applied for analysis of Yin Chen Hao decoction and the serum samples of mice with con-A induced acute liver injury after preventive oral administration for 14 days (the use of all laboratory animals in this study was approved by the Ethics Committee of the Naval Medical University, 19YF1459400). A total of 90 chemical constituents were identified from Yin Chen Hao decoction, mainly were flavonoids, terpenoids, tannins, quinones. 5 prototype compounds were identified in the serum, including chrysophanol, deoxyrhapontin-8-O-gallate, mussaenosidic acid, herniarin, emodin. The established UPLC-QTOF/MS method could efficiently and sensitively identify the constituents in vitro and blood-absorbed ingredients of Yin Chen Hao decoction, primarily clarify the material basis of its hepatoprotective effect, and provided a scientific basis for the quality marker selection and the pharmacodynamic material basis research on the decoction.
RESUMEN
Objective:To summarize the clinical manifestations, electrophysiological, muscle magnetic resonance imaging (MRI), pathological, and genetic characteristics of 8 patients with Emery-Dreifuss muscular dystrophy (EDMD) to improve the recognition and diagnosis of EDMD.Methods:Eight patients with EDMD confirmed by gene analysis admitted to Hebei Medical University Third Hospital from 2011 to 2022 were enrolled. The detailed clinical symptoms, neurophysiological examination, electrophysiological changes (electromyography and electrocardiography), skeletal muscle MRI characters, skeletal muscle pathological features and gene mutations were analyzed retrospectively.Results:The age of onset ranged from 2.0 to 6.0 (3.6±1.2) years. All patients had insidious onset and progressive development. Muscle weakness was the first symptom for 7 cases that manifested as difficulty in squatting and walking up stairs. Later, spinal ankylosis and joint contracture occurred. One patient had scoliosis as the first symptoms. Abnormal electrocardiogram was found in 4 cases. The electromyography of all patients showed myogenic damage. Muscle biopsy demonstrated dystrophic features in 1 patient, and other myopathic features, including a variation in muscle fiber size, a marked increase in internal nuclei, and, smaller diameter of typeⅠfibers. Next-generation sequencing result showed that 6/8 cases carried 4 LMNA heterozygous mutations (c.1583C>G, c.1357C>T, c.148C>T, c.1336A>G); 1/8 case carried EMD hemizygous mutation (c.501C>G); 1/8 carried SYNE1 heterozygous mutation (c.4364G>A). Conclusions:EDMD has highly clinical and genetical heterogeneity. The onset age is usually in childhood. The first symptom is characterized by weakness of lower limbs and abnormal walking posture. Electromyography shows myogenic lesion. Skeletal muscle MRI shows selective fat infiltrations. Muscle biopsy pathology lacks characteristic pathological findings. It is difficult to make diagnosis and differential diagnosis by clinical manifestations and auxiliary examination in the early stage of the disease. The second generation sequencing technology can improve the early diagnosis rate of EDMD.
RESUMEN
Giant axonal neuropathy is a rare neurodegenerative disease in children, which is autosomal recessive inheritance. Giant axonal neuropathy is caused by homozygous or compound heterozygous mutation in the gigaxonin gene on chromosome 16q23.2. Giant axonal neuropathy is a chronic polyneuropathy that affects both the peripheral and central nervous systems. Axonal loss and the presence of giant axonal swellings filled with neurofilaments on nerve biopsy are the pathologic hallmark of this neurodegenerative disorder. The article describes the pathogenesis, clinical manifestation, diagnosis and differential diagnosis of giant axonal neuropathy, to provide reference for clinical diagnosis and treatment of this disease.
RESUMEN
Objective:Investigate the safety and feasibility of using the new self-designed implanting applicator in vaginal three-dimensional intracavitary brachytherapy after hysterectomy for gynecological cancer, and to explore the clinical value of the self-designed implanting applicator.Methods:Sixty-two gynecological cancer patients who underwent brachytherapy in Sun Yat-sen University Cancer Center were selected in this study. Each patient received three-dimensional intracavitary brachytherapy because of the indication of postoperative radiotherapy. Each patient was treated with different types of self-designed implanting applicators according the condition of postoperative vagina,and the vaginal tube and implant needle were placed in the template according to the preset channnel. Based on the actual CT images, the high-risk clinical target volume (HR-CTV), and organs at risk were defined according to unified target area delineation criteria and then the brachytherapy plan was conducted. The prescription dose of high-risk clinical target volume (HR-CTV) was 5.5 Gy/time. The parameters such as target area, organs at risk volume and irradiated dose were evaluated by DVH diagram.Results:Sixty-two patients successfully completed brachytherapy under the guidance of self-designed implanting applicator. A total of 140 implantation treatments were performed. The total average dose of HR-CTV D90% was (575.48±22.30) cGy, the mean dose D 2cm3 of bladder, rectum and sigmoid colon were (328.69±102.71), (369.14±46.59) and (27.28±71.27) cGy, the small intestine did not drop the target area, so there was no statistics. There was statistical significance between target volume and organs at risk dose ( P<0.05). Conclusions:The new self-designed implanting applicator has obvious clinical advantages in vaginal three-dimensional intracavitary brachytherapy after hysterectomy for gynecological cancer, meets the requirements of the preset planning dose,and it is sample to operate and highly safe,which indicated a bright future of the clinical application.
RESUMEN
Objective:To provide evidence for the selection of fixation devices and CTV to PTV margins (M ptv) in precision radiotherapy for pelvic tumors by analyzing three fixation devices in precision radiotherapy for prostate cancer. Methods:From April 2015 to December 2020, 133 prostate cancer patients treated with pelvic drainage area irradiation in our center were retrospectively analyzed. The patients were fixed with 1.2m vacuum bag (n=39), 1.8m vacuum bag (n=44) and personalized prone plate by our center (n=50). Each patient was asked to complete our bowel and bladder preparation process before positioning and radiotherapy. The registration of CBCT to planned CT before each treatment adopted the same registration box and algorithm. Setup errors in the SI, LR and AP directions under qualified bowel and bladder conditions were recorded. Setup errors in three directions under three fixation devices and corresponding M ptv values were analyzed. The correlation between setup errors with age and body mass index (BMI) was analyzed. Results:Analysis of 3333 setup errors data showed: in the SI and LR directions, the mean setup errors of 1.2m vacuum bag (3.26mm, 2.34mm) were greater than those of 1.8m vacuum bag (2.51mm, P<0.001; 1.90mm, P<0.001), and personalized prone plate (3.07mm, P=0.066; 2.10 mm, P=0.009). In the AP direction, the mean setup errors of 1.2m vacuum bag (supine)(2.20mm) were smaller than those of 1.8m vacuum bag (3.33mm, P<0.001) and personalized prone plate (3.61mm, P<0.001). The setup errors of 1.8m vacuum bag in all directions were smaller than those of personalized prone plate (P≤0.028). According to Van Herk's expansion formula, the M ptv of 1.2m vacuum bag in three directions was approximately 4 mm. The M ptv of 1.8m vacuum bag and personalized prone plate in the SI and LR directions was approximately 3 mm, and more than 5 mm in the AP direction. The setup errors were not correlated with age or BMI. Conclusions:From the setup errors results of three devices, 1.8m vacuum bag is the best, followed by personalized prone plate. And supine position is better than prone position in the AP direction.
RESUMEN
Objective:To evaluate the efficacy of ultrasound-guided modified brachial plexus block at costoclavicular space (CCS) for forearm surgery.Methods:Eighty patients of both sexes, aged 18-75 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective forearm surgery from September 2020 to May 2021 in our hospital, were randomized into 2 groups ( n=40 each) using a random number table method: single-injection control group (group C) and double-injection modified group (group T). Single-injection was performed in the anterior chamber of CCS in group C, double-injection was performed in the anterior and posterior chambers of CCS in group T, and the solution injected in both groups was a mixture (20 ml) of 1.0% lidocaine and 0.375% ropivacaine.The effect of block, onset time of block, completion time of block and duration of block for each nerve branch and anesthesia-related adverse reactions were recorded at 5, 10, 15, 20, 25 and 30 min after injection of local anesthesia. Results:Compared with group C, the rate of motor block of radial nerve at 5-20 min after injection of local anesthesia, the rate of sensory block of musculocutaneous nerve and radial nerve at 10 and 15 min after injection of local anesthesia, the rate of motor block of median nerve at 15-30 min after injection of local anesthesia and the rate of sensory and motor block of ulnar nerve at 20-30 min after injection of local anesthesia were significantly increased, and the onset time and completion time of block were shortened in group T ( P<0.05). There was no significant difference between the two groups in the duration of block and anesthesia-related adverse reactions ( P>0.05). Conclusions:Ultrasound-guided modified brachial plexus block at CCS provides better efficacy for forearm surgery.
RESUMEN
Objective:To explore the value of multi-dimensional interaction combined with problem-based learning (PBL) teaching in the nursing practice teaching of emergency and critical care.Methods:A total of 110 nursing students who practiced in the First Affiliated Hospital of Xinjiang Medical University from June 2019 to March 2020 were selected as the control group, and the traditional teaching was adopted. In addition, 89 nursing students who practiced from June 2020 to December 2020 were selected as the research group, and multi-dimensional interaction combined with PBL teaching was adopted. The teaching quality was assessed through the comprehensive scores of the nursing students (departure examination + regular performance assessment) and nursing students' feedback on the teaching. SPSS 22.0 was used for t-test and Chi-square test. Results:The comprehensive scores of the nursing students in the research group were higher than those in the control group, and the difference was statistically significant ( P<0.001). Compared with the control group, the nursing students in the research group believed that multi-dimensional interaction combined with PBL teaching could improve nursing knowledge and skills, overall clinical nursing ability, self-management ability, clinical thinking ability, and the ability to analyze, judge and solve clinical nursing problems, group cooperation ability, communication ability between doctors, nurses and patients, emergency ability and rescue ability, and professional quality, with statistically significant differences ( P<0.001). Conclusion:Multi-dimensional interaction combined with PBL teaching can improve the theoretical and clinical practice level of nursing interns, and at the same time help to cultivate nursing talents with excellent comprehensive quality.
RESUMEN
Objective:To investigate the clinical feasibility of the Unity radiotherapy system guided by magnetic resonance imaging.Methods:Twenty-four patients were enrolled and received a total of 384 fractions of treatment at Unity system. According to the treatment site, all patients were divided into head-neck, abdomen-thorax, pelvic, spine and limb groups. The patients were set-up without external laser. And then, the time required at different stages in online treatment process and the registration error of each fraction were separately calculated. The geometric deformations of MR images were weekly measured by using MR geometric deformation phantom. At last, the Arccheck was used to perform the dose verification of reference plan, online plan and offline plan.Results:The mean duration of radiotherapy in the five groups were 29.1, 27.6, 26.6, 25.6 and 32.0 min, respectively. The set-up errors in the left-right, superior-inferior and anterior-posterior direction in the five groups were: head-neck group (0.08±0.06 cm, 0.16±0.13 cm, 0.08±0.05 cm), abdomen-thorax group (0.23±0.18 cm, 0.50±0.47 cm, 0.12±0.1 cm), pelvic group (0.25±0.19 cm, 0.32±0.25 cm, 0.11±0.09 cm), spine group (0.46±0.38 cm, 0.26±0.26 cm, 0.13±0.07 cm) and limb group (0.33±0.30 cm, 0.34±0.23 cm, 0.08±0.06 cm), respectively. In the central region, the geometric deformation of MR was less than 0.3 mm, and that of the sphere with a diameter of 500 mm was less than 2.1 mm. The meanγ pass rate of the reference plan, online plan and offline plan were 97.92%, 97.84% and 94.58%, respectively.Conclusions:MR-guided radiotherapy has great potential for clinical application, whereas the process of Unity system is relatively complex. The synergy of different departments has a great impact on the treatment, which needs further optimization.
RESUMEN
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide and has high mortality and recurrence rates and low survival rates. Circular RNAs (circRNAs) are a class of single-stranded closed circular RNA molecules with tissue- and development-specific expression and play a regulatory role in organisms. These circRNAs regulate the progression of HCC by acting as miRNA sponges and targeted protein-coding genes, but the basic mechanism is still unclear. This article summarizes the formation mechanism and biological functions of circRNAs, reviews the research advances in the role of circRNAs in the pathogenesis of HCC, and points out their potential value as diagnostic markers and therapeutic targets for HCC.
RESUMEN
Objective: To investigate the preventive effect of total flavonoids from Nymphaea candida (NCTF) on carbon tetrachloride (CCl4)-induced hepatic fibrosis in rats. Methods: Wistar rats were randomly divided into control group, model group, NCTF groups (50, 100, 200 mg/kg) and colchicine group (0.2 mg/kg). Rats were subcutaneously injected with 50% CCl4 peanut oil solution (0.1 mL/100g, twice a week for 12 weeks) to induce hepatic fibrosis. In addition to control and model group given with 0.5% CMC-Na, the other groups were intragastrically administered with drugs (1.0 mL/100 g, once a day for 12 weeks), all rats were put to death. Blood, hepatic and splenic tissue were collected to detect liver indexes. Pathological histology observation by Masson and HE staining were performed for other hepatic tissues. The expression of α-smooth muscle actin (α-SMA) in hepatic tissue was analyzed by immunohistochemical technique. The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), total protein (TP) and albumin (ALB), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH) and nitric oxide (NO) were determined by automatic biochemical analyzer. The levels of serum laminin (LN), type III procollagen (PCIII), type IV collagen (CIV), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were measured by enzyme-linked immunoassay assay (ELISA). Serum hyaluronic acid (HA) was detected by radioimmunoassay. Hepatic tissue hydroxyproline (Hyp) was measured by spectrophotometric method. Result Compared with the control group, the rats showed energielos, liver and spleen index of those were increased, as well as inflammatory cell infiltration and obvious fibrosis of hepatic tissue were appeared in the model group; The levels of ALT, AST, ALP, HA, LN, PCIII, CIV, MDA, NO, TNF-α, IL-1β and IL-6 in serum in model group were increased significantly (P < 0.05, 0.01); The levels of TP, ALB, GSH and SOD in serum were decreased significantly (P < 0.01); The expressions of α-SMA and Hyp in hepatic tissue were significantly improved (P < 0.01). Compared with the model group, the levels of ALT, AST, ALP, MDA, NO in serum in NCTF group were significantly reduced (P < 0.05, 0.01); The levels of HA, LN, PC III, CIV, TNF-α, IL-1β and IL-6 were significantly reduced (P < 0.05, 0.01); The levels of TP, ALB, GSH and SOD were significantly increased (P < 0.05, 0.01); The expressions of α-SMA and Hyp in hepatic tissue were significantly reduced (P < 0.05, 0.01). Compared with the model group, the pathological damage of hepatic tissue was significantly improved, the degeneration and necrosis of liver cells in rat were significantly reduced (P < 0.05). Conclusion: NCTF has a better anti-hepatic fibrosis effect, its mechanism is related to antioxidant, regulation of collagen synthesis and inhibition of the proinflammatory factors expression.
RESUMEN
OBJECTIVE@#To compared the therapeutic effect between filiform fire needle assisted 308 nm excimer laser and simple 308 nm excimer laser on vitiligo of different parts.@*METHODS@#Target lesions of 134 patients were divided into an observation group and a control group according to the principle of self-controlled, 201 pieces in each one. In the observation group, filiform fire needle was performed at target lesions. Then target lesions both of the two groups were irradiated with 308 nm excimer laser at the same time. Once every 2 weeks, totally 10 treatments were required. The effective rate and effective rate, color recovery rate and responding time of different parts in the two groups were evaluated 2 weeks after treatment.@*RESULTS@#The effective rate in the observation group was 82.59% (166/201), which was higher than 68.16% (137/201) in the control group (<0.01). The effective rate of face-neck, trunk, limbs and hand-foot were 90.32%, 81.63%, 81.48% and 58.62% respectively in the observation group, which were higher than 82.80%, 69.39%, 51.85% and 31.03% in the control group (<0.01, <0.05). The color recovery rate of different parts in the observation group was higher than the control group, and the effect was faster in the observation group (<0.01, <0.05).@*CONCLUSION@#Filiform fire needle as an adjunctive therapy, combined with 308 nm excimer laser are more effective than simple 308 nm excimer laser for vitiligo of different parts. Combination therapy has a shorter responding time, the face-neck has the best effect and hand-foot has poor effect.
Asunto(s)
Humanos , Terapia Combinada , Láseres de Excímeros , Cuello , Resultado del Tratamiento , Vitíligo , TerapéuticaRESUMEN
Objective To determine the diagnosis value of urinary albumin(mAlb)/creatinine(Ucre) ratio in random urine from patients with early diabetic nephropathy.Methods From March 2015 to December 2016,98 case with simple diabetes and early diabetic nephropathy in Ankang Hospital of Traditional Chinese Medicine were selected,including 47 cases with simple diabetes and 51 cases with early diabetic nephropathy.And 60 healthy people were selected as control group.The mAlb and mAlb/Ucre ratios in morning urine,postprandial urine and random urine were detected for three times in three days,and the resluts were calculated and analyzed.Results In early diabetic nephropathy group,the mAlb concentration varied during different time periods,mAlb in morning urine [(60.5 ± 27.1)mg/L] and postprandial urine [(60.7 ± 26.7)mg/L] were significantly increased compared with that in random urine [(40.9 ± 25.1) mg/L] (F =9.551,P =0.000).The MAlb/Ucre ratios were stable in morning urine,postprandial urine and random urine of each period (P ＞ 0.05).The positive rate of mAlb/Ucre ratio was sharply higher than mAlb alone in random urine (90.2％ vs.62.7％).No statistically significant difference showed in positive rates of mAlb/Ucre ratio in subjects from different groups(the positive rate of morning urine specimen was 92.2％;postprandial urine 88.2％;random urine 90.2％,P ＞ 0.05).Conclusion Positive rate of mAlb/Ucre ratio changed slightly during different test periods,and is superior to mAlb alone in clinic application.Additionally,the positive rate of mAlb/Ucre ratio in random urine could serve as an indicator in early screening of early diabetic nephropathy.
RESUMEN
Objective To evaluate the efficacy and safety of Choudongning (CDN) Capsule in children with Tourette’s syndrome of spleen deficiency and phlegm accumulation. Methods A stratified-block randomized, parallel-controlled, double-blind, double- dummy, multi-center trials were designed for clinical study. A total of 240 patients were enrolled and separated randomly into experimental group and positive control group in the rate of 1:1. Patients in the experimental group orally took CDN Capsule and simulated Tiapridal Tablets; The patients in positive control group took Tiapridal Tablets and simulated CDN Capsule. Treatment course lasted for 6 weeks. The clinical efficacy and integrals of YGTSS twitch, the factor scores of motor tics and vocal tics, YGTSS social function damage, traditional Chinese medicine syndrome efficacy were observed to evaluate its security. Results The total effective rate of YGTSS twitch clinical efficacy was 71.19% in the experimental group and 67.50% in the positive control group, respectively. The results of non-inferiority test indicated that the efficacy of experimental group was not worse than that in the positive control group. There was no significant difference between two groups in YGTSS twitch integrals, motor tics and vocal tics’ factor scores, YGTSS social function damage, and traditional Chinese medicine syndrome efficacy. Only two ADRs (1.67%) in the experimental group and six ADRs (5%) in the positive control group were observed during clinical trials. The incidence of ADRs in the experimental group was lower than that in the positive control group with no statistical difference. Conclusion CDN Capsule have similar efficacy on the treatment of Tourette’s syndrome of spleen deficiency and phlegm accumulation contrast to Tiapridal Tablets, with lower adverse reactions and better safety.
RESUMEN
Objective To study the correlation between coronary artery stenosis and endothelial dysfunction in patients with coronary heart disease and subclinical hypothyroidism.Methods According to the results of coronary angiography and thyroid function,the patients were divided into coronary heart disease with subclinical hypothyroidism (group A,n=71),coronary heart disease without subclinical hypothyroidism (group B,n=73), and normal coronary angiography (control group,n=59).The degree of coronary artery stenosis was evaluated by Gensini integral method.Fasting blood was taken to measure nitric oxide (NO),high sensitivity C reactive protein (hs-CRP),and endothelin (ET)to evaluate endothelial dysfunction.Results TC,TG,LDL-c,FT3,TSH,hs-CRP,ET and Gensini score were higher in Group A than in Group B and control group (P＜0.05).The level of NO in Group A and Group B were lower than that in control group (P＜0 .0 5).Multivariate Logistic regression analysis showed that age,TSH,ET and NO were independent risk factors for coronary heart disease.ET and NO levels in patients with coronary heart disease combined with subclinical hypothyroidism were correlated with Gensini scores (r=0.431,r=-0.383,P＜0.001).Conclusion Subclinical hypothyroidism may cause endothelial dysfunction in patients with coronary heart disease,which may increase cardiovascular risk in these patients.
RESUMEN
Objective This study aimed to assess the risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in patients with multiple myeloma (MM) by systematic analysis.Methods The literature was retrieved in 4 English databases (PubMed,Web of science,OVID,Cochrane Library)and 3 Chinese databases (CNKI,VIP,and Wanfang) as of september 2016.The key word in English/Chinese database retrieval is " MM or multiple myeloma and infection".Newcastle Ottawa Scale (NOS) was used to evaluate the article quality.The overall odds ratio (OR) and 95％ confidence intervals (95％ Cls)were estimated by fixed (heterogeneity test at/2 ＜ 25％) or random (heterogeneity test atI2 ≥25％) effects model.Results A total of 9 studies were included in the Meta analysis.The study found that multiple myeloma patients had an increased risk of HBV and HCV infection,3.17 and 4.16 times higher than the control group.HBV (OR =3.17,95％ CI:1.17-1.96,I2 =27％,P =0.002) and HCV infection (OR =4.16,95％ CI:1.33-2.22,I2 =0％,P ＜0.001) in the multiple myeloma group were significantly different from those of the control group (P ＜ 0.05).Conclusions HBV and HCV infection are risk factors for multiple myeloma and should be highly regarded and controlled before and after treatment.
RESUMEN
Objective To discuss the value of early prediction and evaluation using ultrasound-guided diffuse optical tomography (US-guided DOT) of neoadjuvant chemotherapy (NCT) for breast cancer.Methods Sixty-two primary breast cancer patients were included.Before every neoadjuvant chemotherapy and surgery,the total hemoglobin concentration(Hb) was measured by US-guided DOT.According to the RECIST 1.1 standard,62 patients were divided into partial response (PR) group,complete response (CR) group,progressive disease(PD) group and stable disease(SD) group.According to the Miller and Payne (MP) grading system,the patients were divided into poor efficacy group(MP grade 1-3) and the effect of excellent group (MP grade 4-5).According to the postoperative pathological results,patients were divided into pathologic complete response(pCR) group and non pCR group.Hb with imaging and postoperative pathological results were analyzed.Results All of the 62 patients finished the NCT.After first cycle of chemotherapy and all chemotherapy,the value of Hb in the above groups had different degrees of decline,and the difference among the groups was statistically significant(P ＜0.001).When the descending value of Hb was 44.5 as the threshold for early prediction of NCT efficiency,the area under the curve of ROC (Az) was 0.745,and the sensitivity was 75.0％,specificity was 73.1％,positive predictive value was 79.4％,negative predictive value was 67.9％,and accuracy was 74.2％,respectively.Conclusions In the process of neoadjuvant chemotherapy of breast cancer,the decrease of Hb value is positively related to the therapeutic effect of chemotherapy.The change of Hb value can predict and evaluate the efficacy of neoadjuvant chemotherapy in the early time.
RESUMEN
AIM To investigate the therapeutic action and mechanism of Shuwei Decoction (Bupleuri Radix,Cyperi Rhizoma,Atractylodis macrocephalae Rhizoma,etc.) on functional dyspepsia (FD) from the perspectives of autophagy and intercellular gap junction pathway through its impact on the expressions of Beclin-1,mTOR,Cx43 protein and mRNA in gastric antrum pyloric smooth muscle cells of FD model rats.METHODS Sixty Wistar rats were randomly divided into control (blank) group,model group,mosapride group (1.37 mg/kg),low,medium and high dose Shuwei Decoction groups (7.67 g/kg,15.34 g/kg,30.68 g/kg,respectively).FD model rats were prepared according to compound etiological modeling method for 21 days.On the first day after modeling,the rats in each group were given the corresponding medicine for intragastric administration once a day for 14 days.Two hours after the last administration,we procured gastric antrum and pyloric tissues from the sacrificed rats.The expressions of Beclin-1,mTOR and Cx43 protein were detected by Western blot,and so were the expressions of Beclin-1,mTOR and Cx43 mRNA by quantitative real-time PCR (RT-qPCR).RESULTS We observed decreased expression of Beclin-1 protein in low,medium and high dose Shuwei Decoction groups (P ＜ 0.01),and an increased expression of Cx43 protein in high dose Shuwei Decoction group (P ＜ 0.05).In medium and high dose Shuwei Decoction groups,decreased expression of Beclin-1 mRNA (P ＜ 0.01),and increased expression of mTOR and Cx43 mRNA (P ＜ 0.01) were detected as well.CONCLUSION Shuwei Decoction can improve FD by suppressing cell autophagy and enhancing the function of gap junction through up-regulating the expression of mTOR mRNA and Cx43 protein and mRNA,and down-regulating the expression of Beclin-1 protein and mRNA.