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Background@#Neurolytic celiac plexus block (NCPB) is a typical treatment for severe epigastric cancer pain, but the therapeutic effect is often affected by the variation of local anatomical structures induced by the tumor. Greater and lesser splanchnic nerve neurolysis (SNN) had similar effects to the NCPB, and was recently performed with a paravertebral approach under the image guidance, or with the transdiscal approach under the guidance of computed tomography. This study observed the feasibility and safety of SNN via a transdiscal approach under fluoroscopic guidance. @*Methods@#The follow-up records of 34 patients with epigastric cancer pain who underwent the splanchnic nerve block via the T11-12 transdiscal approach under fluoroscopic guidance were investigated retrospectively. The numerical rating scale (NRS), the patient satisfaction scale (PSS) and quality of life (QOL) of the patient, the dose of morphine consumed, and the occurrence and severity of adverse events were recorded preoperatively and 1 day, 1 week, 1 month, and 2 months after surgery. @*Results@#Compared with the preoperative scores, the NRS scores and daily morphine consumption decreased and the QOL and PSS scores increased at each postoperative time point (P < 0.001). No patients experienced serious complications. @*Conclusions@#SNN via the transdiscal approach under flouroscopic guidance was an effective, safe, and easy operation for epigastric cancer pain, with fewer complications.
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Objective To study the Chlamydia trachomatis(CT)and Ureaplasma urealyticum (UU)infection in Guangzhou area, and analyze the consistency of simultaneous amplification and testing (SAT)and conventional methods(CT was detected by latex immunochromatography, UU was detected by liquid culture method).Methods A total of 12 120 samples of urogenital secretions or urine samples were collected from Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University from January 2015 to December 2016.CT-RNA and UU-RNA were detected by the SAT technique, a part of samples were tested by conventional methods at the same time.The positive rates of CT and UU by SAT and the conventional methods between different gender and age groups were analyzed by χ2test, the consistencies between different detection methods were analyzed by Kappa test.Results The positive rate of CT was 4.05%(356/8 781), UU 33.69%(1 125/3 339)in Guangzhou from 2015 to 2016.The positive rate of UU was significantly higher than that of CT(χ2=1 981,P<0.01).Of 145 specimens for CT test,the coincidence rate between SAT and latex immunochromatographic method was 96.55%(140/145), which showed good consistency(Kappa=0.65).Of 186 specimens for UU test,the coincidence rate of the results between the SAT method and liquid culture was 92.47%(172/186),which showed strong consistency(Kappa=0.81). Conclusions The positive rate of UU was significantly higher than that of CT in Guangzhou.The SAT method and conventional methods to detect CT and UU show high consistency, which can provide the evidence for clinical diagnosis of CT and UU infection.
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Objective To investigate the effects of metformin and exaliplatin on proliferation and apoptosis of gastric cancer cell line SGC-7901. The antitumor effects of metformin combined with exaliplatin on gastric cancer cell line SGC-7901 were compared. Methods SGC-7901 cells were cultured in vitro. The proliferation inhibition rate of cancer cell after treatment with various concentrations of metformin(5.0,10.0,15.0 mmol/L)、exaliplatin(2.5,5.0,10.0 μmol/L)or 15.0 mmol/L metformin combined with 10.0 μmol/L exaliplatin was analyzed via MTT colorimetric assay at 24,48,72 h.After 24 h, the SGC-7901 cell apoptosis was detected by flow cytometry, and the relative activity of caspase-3 and bax was detected by western blot. Results The co-administration of metformin and exaliplatin or single agent treatment could increase the proliferation inhibition rates of SGC-7901 cell in a time-and dose-dependent manner, while there was a significant higher proliferation inhibition rate in co-administration versus single-agent treatment (P < 0.05). The apoptosis rate induced by 15.0 mmol/L metformin and 10.0 μmol/L exaliplatin and combined treatment was (16.0 ± 2.1)%, (19.0 ± 2.7)%, (29.0 ± 3.5)%, higher than that in blank control group (10.0 ± 1.1)%, and there was significant difference (P <0.05). Both of metformin and exaliplatin could increase caspase-3 and Bax activity.Caspase-3 and Bax activity in the combination of metformin and exaliplatin was significantly higher than that of metformin group and exaliplatin group (P < 0.05). Conclusions Metformin combined with exaliplatin has synergistic effect in inhibiting the growth and inducing apoptosis of gastric cancer cell line SGC-7901.Enhancing caspase-3 and Bax expression may be the related mechanism