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The gynecological malignancy has a high incidence and mortality. More efficient treatment methods still need to be explored to improve the survival benefits. Artificial intelligence (AI) aims to intelligently process the original problems by simulating the thinking way of human brain. It has obtained significant progress in gynecological malignancy, with great potential in the field of cancer diagnosis and treatment. This paper reviews the application of AI in the diagnosis and treatment of gynecological malignancy, and mainly introduces the research progress on AI in the radiotherapy. This paper mainly focuses on the key issues such as automatic delineation, dose prediction, radiotoxicity prediction and efficacy prediction, and discusses the current benefits and limitations of AI in radiotherapy of gynecological malignancy.
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Objective:To summarize the clinical application of multiple flaps in repairing nasal defects.Methods:The clinical data of 32 nasal defect patients underwent flap repair in the Tengzhou Central People′s Hospital from 2017 to 2021 were analyzed retrospectively.Results:The nasal median displacement flap was used in 9 cases, nasofacial groove displacement flap in 10 cases, nasolabial groove flap in 8 cases, nasolabial displacement flap in 2 cases, frontal displacement flap in 2 cases, and free tragus cartilage flap in 1 case. After operation, all flaps survived, blood supply was good, nasal shape and stereoscopic structure returned to normal. There was no tumor recurrence during 6 to 24 months after operation.Conclusions:It is a good choice to use multiple flaps to repair the small defects of nasal parts. And the operation is simple and easy with high success rate.
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Objective:To observe the clinical efficacy and safety of modified Xiao Chengqitang combined with acupoint catgut implantation in treating diet-induced obesity （DIO） syndrome of stomach heat dampness obstruction. Method:One hundred and seventy-two patients were randomly divided into control group（84 cases） and observation group（88 cases）. Both groups of patients received diet and exercise lifestyle adjustments， and acupoint catgut implantation was performed， 10 days for 1 time， 5 days intervals and then catgut implantation again， for a total of 6 times. Patients in observation group took modified Xiao Chengqitang granular powder， 10 g/time， with lukewarm boiled water in morning and evening. Patients in control group took modified Xiao Chengqitang granular powder simulant， 10 g/time， with lukewarm boiled water， 2 times/day. The treatment courses continued 4 months in two groups. Then the body mass index （BMI）， fat percentage （F%）， obesity， waist to hip ratio （WHR） were measured before and after treatment. Color Doppler ultrasonography was used to measure abdominal fat thickness， prehepatic fat thickness （AHF）， perirenal fat thickness （PRF）， and visceral fat index （UVI）. Fasting blood glucose （FBG）， triglyceride （TG）， total cholesterol （TC）， high-density lipoprotein-cholesterol （HDL-C）， low-density lipoprotein-cholesterol （LDL-C）， fasting insulin （FINS）， leptin （LP）， and adiponectin （APN） were detected before and after treatment， and the homeostasis model assessment of insulin resistance （HOMA-IR） index was calculated. In addition， safety evaluation was also conducted. Result:The BMI， F%， obesity degree and WHR in observation group were all lower than those in control group （<italic>P</italic><0.05 or <italic>P</italic><0.01）. Subcutaneous fat thickness， AHF， PRF and UVI in observation group were lower than those in control group （<italic>P</italic><0.01）. The TG， TC， LDL-C and FINS levels in observation group were lower than those in control group （<italic>P</italic><0.01）. The LP and HOMA-IR were also lower than those in control group （<italic>P</italic><0.01）， while the APN was higher than that in control group （<italic>P</italic><0.01）. The total effective rate in clinical application was （71/80） 88.75% in the observation group， higher than （57/75） 76.00% in the control group （<italic>χ</italic><sup>2</sup>=4.374，<italic> P</italic><0.05）. Conclusion:Modified Xiao Chengqitang combined with acupoint catgut implantation in treating DIO syndrome of stomach heat dampness obstruction can adjust LP， APN and other factors， improve energy metabolism such as sugar and fat， and effectively control obesity with high safety， so it is worthy of clinical use.
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@#Objective To compare the perioperative efficacy and safety of robot-assisted thoracoscopic surgery (RATS) and uniportal video-assisted thoracoscopic surgery (UVATS) in the lobectomy for early lung adenocarcinoma. Methods Clinical data of 70 early lung adenocarcinoma patients, receiving RATS or UVATS lobectomy by the same surgical team in our hospital from November 2018 to May 2020 were retrospectively analyzed. There were 24 males and 46 females with an average age of 59.3±8.9 years. According to different surgical methods, the patients were divided into a RATS group (31 patients) and a UVATS group (39 patients). The operation time, intraoperative blood loss, postoperative hospital stay, indwelling time, drainage volume, number of lymph node dissected, stations of lymph node dissected and perioperative complications were compared between the two groups. Results There was no conversion to thoracotomy or perioperative death in both groups. There was no significant difference in intraoperative blood loss, postoperative hospital stay, indwelling time of thoracic drainage tube, thoracic drainage volume or stations of lymph node dissected between the two groups (P>0.05). There was no significant difference in the incidence of pulmonary infection, persistent lung leakage, chylothorax, arrhythmia or overall complications between the two groups (P>0.05). The operation time of the RATS group was longer than that of the UVATS group (195.8±52.8 min vs. 154.0±43.1 min, P=0.001). The number of lymph node dissected in the RATS group was more than that of the UVATS group (P=0.016). Conclusion Both RATS and UVATS are safe and feasible in the treatment of lung cancer. The number of lymph nodes removed by RATS is significantly more than that of UVATS.
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OBJECTIVE: To investigate the clinical application of rivaroxaban and analyze the rationality, effectiveness, safety and drug interactions of its clinical application, so as to provide a basis for regulating its clinical application. METHODS: A summary of guidelines or consensus of clinical application experts at home and abroad was made to form a rationality evaluation standard for rivaroxaban. A retrospective survey was conducted on the use of rivaroxaban in all inpatient departments in a hospital in the first quarter of 2018, and the utilization rate of each department was calculated. Through the inclusion criteria, the cases that meet the requirements are analyzed for rationality, efficacy, adverse reactions and drug interactions. RESULTS: In the first quarter of 2018, there were 20 wards and 1 117 cases use of rivaroxaban. The highest utilization rate was the osteological surgery ward, which was mainly used for the prevention of postoperative thrombosis in orthopedics. In the clinical application of rivaroxaban, the prophylaxis or treatment of thromboembolism is mainly performed according to the instructions. The case of irrational rate was 27.14% all 1 028 cases of patients, with insufficient dose, lack of treatment, long course of treatment as the main reason for unreasonable, need to take active intervention measures. The clinical treatment and safety of rivaroxaban were better, with an ineffective rate of 1.17% (12/1 028) and an adverse reaction rate of 9.63% (99/1 028), of which 74.58% (88/118) belonged to hemorrhagic adverse reactions. CONCLUSION: Rivaroxaban is widely used for clinical anticoagulant therapy or prevention, and has good curative effects, but there are irrational usage, especially in terms of dose. During using, it is necessary to pay close attention to hemorrhagic-related adverse reactions. Clinical pharmacists should pay active attention to the update of the clinical application guidelines for drugs and actively communicate with doctors to jointly promote the rational use of rivaroxaban.
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In recent years, as the level of economic life has improved, the incidence of gestational diabetes mellitus has increased year by year. Gestational diabetes mellitus (GDM) has been a serious threat to maternal and newborn health. The pathogenesis of gestational diabetes is not very clear, and may be closely associated with insulin resistance, genetic susceptibility, inflammatory response, metabolic disorders. According to the gestational diabetes diagnostic standard,24-28 weeks pregnant women keep an empty stomach over 8 h, taken 75 g oral glucose directly, and then receive the oral glucose tolerance test. GDM is diagnosed as fasting blood-glucose> 5.1 mmol · L-1,1-hour postprandial blood glucose>10.0 mmol · L-1,and 2-hour postprandial blood glucose>8.5 mmol · L-1. Western medicine treatment is mainly based on diet, exercise, drugs, education, monitoring and insulin therapy according to blood glucose. Meanwhile, GDM is a type of diabetes in traditional Chinese medicine. GDM is prevented and treated with diets and traditional method sports and Chinese herbs. Therefore, integrated Chinese and western medicine therapy can maximize the curative effect, reduce the incidence of gestational diabetes mellitus, and effectively improve the adverse outcome and prognosis of patients with gestational diabetes mellitus from mother to child.
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Objective To investigate the influences of culture conditions on the in vitro induction and maturation of dendritic cells by using different combinations of cytokines. -ethods Mouse bone mar-row cells were isolated and cultured in media containing varying combinations of cytokines, including granu-locyte-macrophage colony stimulating factor (GM-CSF), interleukin-4 (IL-4) and fms-like tyrosine kinase 3 ligand (Flt3L). After cultured at 37℃ for seven days, the attached bone marrow cells were collected and stained by fluorescence-labeled monoclonal antibodies (McAb) against CD11c, MHCⅡ and CD86 for flow cytometry analysis. In the parallel group, LPS was added on day 5 to a final concentration of 1μg/ml for DC maturation analysis by flow cytometry. Results In group Flt3L (20 ng/ml)/GM-CSF (20 ng/ml)/IL-4 (10 ng/ml), 90％ of bone marrow cells were CD11c-positive. Flt3L (100 ng/ml) could induce 88％ of bone marrow cells to express CD11c. Bone marrow cells positive for MHCⅡ accounted for 35. 4％ and 36. 1％ in group Flt3L/GM-CSF/IL-4 and group Flt3L/GM-CSF, where both Flt3L and GM-CSF were used at a concentration of 20 ng/ml. After LPS stimulation, the positive rates of MHCⅡ in group Flt3L/GM-CSF/IL-4 and group Flt3L/GM-CSF were 58. 1％ and 59. 6％, which increased by 22. 7％ and 23. 5％, re-spectively. The percentages of CD86-positive bone marrow cells were 7. 1％ and 5. 5％ in group Flt3L/GM-CSF/IL-4 and group Flt3L/GM-CSF. Bone marrow cells positive for CD86 grew by 7. 1％ and 6. 2％ in group Flt3L (20 ng/ml) and group GM-CSF/IL-4 after LPS stimulation. Conclusions Flt3L and GM-CSF probably dominated the differentiation and maturation of bone marrow-derived dendritic cells with a synergis-tic effect. Combined usage of Flt3L and GM-CSF at the concentration of 20 ng/ml would be an optimal proto-col for DC research.
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Photodynamic therapy (PDT) has emerged as a more effective and promising treatment towards cancer therapy. PDT is a minimally invasive and spatially selective medical technique to destroy cancer cells without drug resistance, which has been increasingly applied in the clinical praxis alongside surgery, chemotherapy and radiotherapy. However, traditional PDTs use a high energy one-photon laser beam, which is far from the efficient optical window of mammalian tissue (650−950 nm). Moreover, it has great limitations in the depth of penetration, and induces the undesired light toxicity. The development of photosensitizers has always been a bottleneck to the effective application of PDT in clinical practice. From the first generation of hematoporphyrin derivatives to the third-generation photosensitizers with tumor targeting ability, they meet the urgent clinical needs to some extent, but they still can not satisfy the requirements of two-photon PDT. Therefore, the development of photosensitizers, which are capable of two-photon activated PDT, has become a promising approach. Among the various two-photon absorption photosensitizers, ruthenium (Ⅱ) polypyridyl complexes have been recognized as excellent candidates due to their attractive photophysical properties. This review is prepared to summarize the recent achievements in the application of ruthenium (Ⅱ) polypyridyl complexes as photosensitizers for two-photon PDT, as well as to provide guidance for the design of two-photon activated photosensitizers in future research.
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Objective To understand the distribution and drug resistance of pathogenic bacteria from diabetic foot patients of different grades of Wagner classification,and provide basis for the rational use of antimicrobial agents in clinical practice.Methods Clinical data,pathogens isolated from wound secretion,and antimicrobial susceptibility testing result of diabetic foot patients who were admitted in the department of endocrinology in a hospital between January 2014 and December 2016 were analyzed retrospectively,patients were divided into gram-positive (G+) bacteria infection group,gram-negative (G) infection group,and mixed infection group according to the isolation of bacterial species,relationship between patients' clinical characteristics and Wagner grades was analyzed.Results There were 103 patients with diabetic foot,39 with G+ bacterial infection,50 with G-bacterial infection,and 14 with mixed infection.The age and disease course of patients with mixed infection was significantly elder and longer than the other two groups of patients(both P＜0.05);glycosylated hemoglobin (HbA1c) and procalciton in mixed infection group were both lower than the other two groups(both P＜0.05);the percentage of neutrophils in G+ infection group was higher than the other two groups(P＜0.01).A total of 132 specimens were detected,103 strains were isolated,the positive rate was 78.03％,isolation rates of G+ and G-bacteria were 33.33％ (44/132) and 44.70％ (59/132) respectively.The major G+ strains were Staphylococcus aureus (n =19) and Staphylococcus epidermidis(n=11),the major G bacteria were Citrobacterbraakii(n=12),Escherichia coli(n=11),and Pseudo monas aeruginosa (n =11).As the Wagner grade increased,the proportion of mixed infection continued to rise.The main multidrug-resistant organisms were methicillin-resistant Staphylococcus aureus and extended-spectrum betalactamase-producing G-strains.Conclusion For diabetic foot patients,especially those with higher Wagner grades,etiological examination and antimicrobal susceptibility testing of ulcer secretion should be timely performed,so as to provide reference for rational use of antimicrobial agents in clinic.
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Objective To explore the detection trend of vaginal intraepithelial neoplasia(VaIN)of lower genital tract from 2013 to 2015. Methods A retrospective analysis was undertaken of colposcopy-directed biopsy of cervical, vaginal and vulvar intraepithelial neoplasia lesions include cervical intraepithelial neoplasia (CIN), VaIN and vulvar intraepithelial neoplasia (VIN) in Obstetrics and Gynecology Hospital of Fudan University from January 2013 to December 2015. Results (1) Overall data of CIN, VaIN and VIN:a total of 16732 cases were diagnosed of lower genital intraepithelial neoplasia in 3 years, accounting for 23.20% (16732/72128) of total colposcopy-directed biopsy cases. Among them, CIN, VaIN and VIN accounted for 19.48%(14053/72128), 2.67%(1923/72128), 1.05%(756/72128) of total colposcopy-directed biopsy cases of the lower genital tract, 83.99%(14053/16732), 11.49%(1923/16732), 4.52%(756/16732) of total lower genital intraepithelial neoplasia, respectively. (2) Annual data of CIN, VaIN and VIN from 2013 to 2015. The annual proportion of CIN in all intraepithelial neoplasia of lower gential tract was basically stable, consisting of 86.02%(3955/4598),83.25%(4795/5760) and 83.20%(5303/6374), respectively. The annual proportion of VaIN was gradually increasing, consisting of 8.09% (372/4598), 12.45%(717/5760) and 13.08%(834/6374), respectively. The annual proportion of VIN was gradually decreasing, consisting of 5.89% (271/4598), 4.31% (248/5760) and 3.72% (237/6374), respectively. Conclusion The increasing detection of VaIN from 2013 to 2015 might correlate with the increasing attention to inspection of the entire vaginal wall.
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Objective The double antiplatelet therapy with aspirin and clopidogrel is widely used in the progressive stroke patients.However, this therapeutic regimen is still lack of guideline confirmation .In this study, we aimed to observe the effects of cere-bral hemodynamics and platelet parameters of combined antiplatelet treatment with aspirin and clopidogrel on progressive stroke patients . Methods This retrospective study enrolled 82 patients with progres-sive stroke within 24 hours in the Nanjing Brain Hospital Affiliated to Nanjing Medical University from January 2014 to January 2016.All the patients were divided into two groups ( single antiplatelet group and combined antiplatelet group ) according to the antiplatelet therapy .Forty patients were included in the single antiplatelet group oral-ly took aspirin 0.1g once a day while in the combined antiplatelet group forty-two patients were included to take clopidogrel 75 mg once a day besides aspirin for 21 days and then kept aspirin only .All the patients were observed for 3 months.On the 1st and 7th day of ad-mission and 3 months after admission , the patients were examined for the terms of the grades of National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI), as well as the platelet parameters including plaletet count (PLT), thrombocytocrit (PCT), mean platelet volume ( MPV) and platelet distribution width ( PDW) .The thrombelastogram was done to test the plate inhibition rate . Meanwhile , the transcranial doppler examination was done to realize the cerebral hemodynamics . Results After 7 days'and 3 months'treatment, the grades of NIHSS of combined antiplatelet group were significantly decreased versus single antiplatelet group , while BI of the combined antiplatelet group was significantly increased ( P<0.05 ) .The inhibition rate induced through adenosine diphosphate pathway was higher in the combined antiplatelet group versus the single antiplatelet group (P=0.003) on the 7th day.PLT ( P=0.006) level in the combined antiplatelet group was higher than that in the single antiplatelet group , while MPV ( P=0.023) and PDW (P=0.017) were actually lower in the combined antiplatelet group than the single antiplatelet group after 7 days'treatment.After 3 months, PDW in the combined antiplatelet group was still lower than the single antiplatelet group (P=0.041).On the 7th day, Vs (P=0.046), Vm (P=0.039) in bilateral middle cerebral artery in the combined antiplatelet group were lower than the single anti -platelet group.After 3 months, the Vs (P=0.030), PI (P=0.041) in the combined antiplatelet group was further improved versus the single antiplatelet group . Conclusion The improved effects of combined antiplatelet treatment with aspirin and clopidogrel on the clinical symptoms, cerebral hemodynamics and platelet parameters were better than single antiplatelet treatment with aspirin .
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Objective The double antiplatelet therapy with aspirin and clopidogrel is widely used in the progressive stroke patients.However, this therapeutic regimen is still lack of guideline confirmation .In this study, we aimed to observe the effects of cere-bral hemodynamics and platelet parameters of combined antiplatelet treatment with aspirin and clopidogrel on progressive stroke patients . Methods This retrospective study enrolled 82 patients with progres-sive stroke within 24 hours in the Nanjing Brain Hospital Affiliated to Nanjing Medical University from January 2014 to January 2016.All the patients were divided into two groups ( single antiplatelet group and combined antiplatelet group ) according to the antiplatelet therapy .Forty patients were included in the single antiplatelet group oral-ly took aspirin 0.1g once a day while in the combined antiplatelet group forty-two patients were included to take clopidogrel 75 mg once a day besides aspirin for 21 days and then kept aspirin only .All the patients were observed for 3 months.On the 1st and 7th day of ad-mission and 3 months after admission , the patients were examined for the terms of the grades of National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI), as well as the platelet parameters including plaletet count (PLT), thrombocytocrit (PCT), mean platelet volume ( MPV) and platelet distribution width ( PDW) .The thrombelastogram was done to test the plate inhibition rate . Meanwhile , the transcranial doppler examination was done to realize the cerebral hemodynamics . Results After 7 days'and 3 months'treatment, the grades of NIHSS of combined antiplatelet group were significantly decreased versus single antiplatelet group , while BI of the combined antiplatelet group was significantly increased ( P<0.05 ) .The inhibition rate induced through adenosine diphosphate pathway was higher in the combined antiplatelet group versus the single antiplatelet group (P=0.003) on the 7th day.PLT ( P=0.006) level in the combined antiplatelet group was higher than that in the single antiplatelet group , while MPV ( P=0.023) and PDW (P=0.017) were actually lower in the combined antiplatelet group than the single antiplatelet group after 7 days'treatment.After 3 months, PDW in the combined antiplatelet group was still lower than the single antiplatelet group (P=0.041).On the 7th day, Vs (P=0.046), Vm (P=0.039) in bilateral middle cerebral artery in the combined antiplatelet group were lower than the single anti -platelet group.After 3 months, the Vs (P=0.030), PI (P=0.041) in the combined antiplatelet group was further improved versus the single antiplatelet group . Conclusion The improved effects of combined antiplatelet treatment with aspirin and clopidogrel on the clinical symptoms, cerebral hemodynamics and platelet parameters were better than single antiplatelet treatment with aspirin .
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Objective To observe the clinical effects of painting therapy on nausea,vomiting and anxiety induced by chemotherapy in breast cancer patients.Methods This study used convenience sampling and before-and-after self-controlled design,and enrolled 200 patients with breast cancer undergoing EC (Epirubicin+Cyclophosphamide)chemotherapy regimen.All patients were given painting therapy on the first day of the second chemotherapy.Functional living index-emesis(FLIE) and self-rating anxiety scale(SAS) were used to compare the effects before and after intervention,and measured after the first chemotherapy and after implementation of painting therapy.Results The scores of FLIE were significantly different before and after implementation of painting therapy(P＜0.05);scores in SAS for patients' subjective feelings(nervous,panic,headache,upset),and objective symptoms(hands trembling,numbness,indigestion)were significantly lower after intervention than those before intervention,and the differences were statistically significant(P＜0.05).Conclusion Painting therapy can alleviate chemotherapy induced nausea and vomiting in breast cancer patients effectively.
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Fish oil is an important nutrient component in rainbow trout bone, and the optimization of extraction by enzymatic hydrolytic method is of great significance.This study selected the alkaline protease as the hydrolytic enzyme, and optimized the process conditions of enzymatic hydrolysis of rainbow trout fish using single factor analysis method.Effects of several factors on the extraction of fish oil were studied, including the ratio of material to liquid, pH, enzymatic hydrolysis time, enzymatic hydrolysis temperature and amount of enzyme.Fatty acids were identified by gas chromatography-mass spectrometry (GC-MS).Results showed that the optimum extraction parameters of enzymatic hydrolysis were as follows: 2000 U/g alkaline protease, ratio of material to liquid of 1∶1 (w/w), pH 7.5, and extraction at 55℃ for 3h.It was found that the main composition of rainbow trout bone oil was unsaturated fatty acid with the content of 80.4% (w/w).The relative content of monounsaturated fatty acid and polyunsaturated fatty acid was about 76.9% (w/w) and 23.1% (w/w), respectively.The total content of EPA and DHA was 3.4% (w/w).This study optimized the extraction method of rainbow trout fish oil, analyzed and identified the main volatile compounds, and identified the main substances contributing to fish oil flavor.The method thus was of significance for the analysis and identification of fish oil products.
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According to the national residency training regulations in the teaching of clinical and scientific research, the department of thoracic surgery of First Affiliated Hospital of Chongqing Medical University has used seminar teaching , and has collected random sampling survey questionnaire of 110 students participating in seminar from September 2014 to March 2016. The investigation shows that through seminar teaching training, doctors will cultivate their clinical and research ability, and enhance their self-confidence. Therefore, the application of seminar teaching in department of thoracic surgery is helpful to improving the quality of clinical teaching and is worthy of further improvement and promotion.
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The aim of the present study was to accurately evaluate the association of Sox2 expression with the survival of patients with digestive tract cancers. Relevant literatures were identified by comprehensively searching databases including the Pubmed, Embase, CBMdisc, and Wanfang (up to October 2014). A meta-analysis was performed to clarify the association between Sox2 expression and overall survival or clinicopathological parameters of patients with digestive tract cancers (esophageal, gastric, and colorectal cancers). The results showed a significant association between high Sox2 expression and poor overall survival in patients with digestive tract carcinomas (HR=1.55, 95% CI=1.04-2.31), especially for patients with esophageal cancer (HR=2.04, 95%CI=1.30-3.22), colorectal cancer (HR=1.40, 95% CI=1.04-1.89), and digestive tract adenocarcinoma (HR=1.80, 95% CI=1.12-2.89), for Europeans (HR=1.98, 95% CI=1.44-2.71) or patients who did not receive neoadjuvant treatment (HR=1.73, 95% CI=1.10-2.72). Furthermore, Sox2 over-expression was highly correlated with vascular invasion (OR=1.86, 95% CI=1.25-2.77) and poor differentiation (OR=1.88, 95% CI=1.14-3.08), especially in esophageal and colorectal cancers. In conclusion, Sox2 expression may serve as a novel prognostic factor for patients with digestive tract cancers. Over-expression of Sox2 that is correlated with vascular invasion and poor differentiation suggests poor outcomes of patients with digestive tract cancers.
Sujets)
Humains , Antinéoplasiques , Utilisations thérapeutiques , Marqueurs biologiques tumoraux , Génétique , Métabolisme , Tumeurs colorectales , Diagnostic , Traitement médicamenteux , Mortalité , Anatomopathologie , Tumeurs de l'oesophage , Diagnostic , Traitement médicamenteux , Mortalité , Anatomopathologie , Tube digestif , Métabolisme , Anatomopathologie , Expression des gènes , Traitement néoadjuvant , Méthodes , Grading des tumeurs , Tumeurs du tissu vasculaire , Diagnostic , Traitement médicamenteux , Mortalité , Pronostic , Facteurs de transcription SOX-B1 , Génétique , Métabolisme , Tumeurs de l'estomac , Diagnostic , Traitement médicamenteux , Mortalité , Anatomopathologie , Analyse de survieRésumé
OBJECTIVE: To understand the application of warfarin hospitalized patients with non-valvular atrial fibrillation, summarize the clinical experience and provide reference for clinical medication, and explore the significance of clinical pharmaceutical care for warfarin. METHODS: The information of 726 cases with non-valvular atrial fibrillation hospitalized in the first cardiovascular ward from January 2012 to December 2013 were retrospectively collected and analyzed in the aspect of types of anticoagulant solution, warfarin dosage and INR monitoring. RESULTS: The anticoagulation solution commonly used in our patients with atrial fibrillation included dual antiplatelet therapy, aspirin antithrombotic therapy and warfarin anticoagulant therapy. 13.8% of the cases had initial INR of 2.0-3.0, and 43.4% of the cases attained INR target after dosage adjustment. CONCLUSION: At present the clinical application of warfarin still exists deficiencies. It is necessary to continue to raise people's awareness of warfarin and atrial fibrillation anticoagulant. Active clinical pharmaceutical care for warfarin is of great significance.
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Objective:To investigate the effect of GRP94 gene expression down-regulation on the proliferation in human lung carcinoma A549 cells and possible mechanism.Methods:Expression of GRP94 was examined in 4 lung carcinoma cells and two lung bronchial epithelial cells by qRT-PCR and Western blot.Chemically synthesized siRNA targeting GRP94 gene and transfected into A549 cells used by Lipofectamine2000.The mRNA and protein expression levels of GRP94,c-myc and cyclinD1 were detected by qRT-PCR and Western blot.CCK8 assay and Colony formation assay were used to detect the effect of specific GRP94 siRNA on cell proliferation.Results:The levels of GRP94 expression in the four lung carcinoma cells were significantly higher than that in two lung bronchial epithelial cells (P<0.05).GRP94 siRNA significantly downregulated the levels of GRP94 mRNA and protein in A549 cells, and the downregulation evidently suppressed cell proliferation.However, The c-myc and cyclinD1 expression levels in A549 cells in siRNA-GRP94 group was significantly lower than that in siRNA-NC group (P<0.05).Conclusion:The levels of GRP94 expression in lung carcinoma cells were significantly higher than that in normal lung epithelial cells.Knockdown GRP94 expression significantly inhibit the level of lung carcinoma A549 cells proliferation,which may act via influencing the expression of c-myc,cyclinD1.
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Objective To observe the effect of the Chinese medicine on the patients’ thyroid autoantibodies TPOAb and TGAb of Hashimoto's thyroiditis. Methods 100 cases of Hashimoto's thyroiditis were randomly divided into group A and group B, with 50 cases in each group. Group A was given levothyroxine sodium(L-T4) to maintain thyroid function(FT3,FT4,TSH)in the normal range, at the same time Chinese medicines of soothing liver and strengthening spleen, nourishing the liver and kidney, activating blood and removing blood stasis were additionally added;while group B was taken L-T4 to maintain the thyroid function in the normal range. The levels of TPOAb, TGAb were determined before and after treatment in both groups. Results After the treatment, the level of TGAb and TPOAb[respectively(106.3±29.5)IU/ml,(871.5± 209.3)IU/ml] in group A were decreased compared with their previous level [respectively(385.5±76.6)IU/ml, (1621.5±399.2)IU/ml], the difference was statistically significant(t were 48.2、10.6,P<0.01). The level of TGAb and TPOAb [respectively(437.6±135.4)IU/ml,(1798.6±434.6)IU/ml] in group B were slightly increase than their previous level[respectively(383.9±105.8)IU/ml,(1633.2±396.5)IU/ml], with no significant difference. The levels of TPOAb and TGAb in group A had significant difference than those in group B after the treatment(t were 22.3、19.6,P<0.01). Conclusion TCM combined with L-T4 can reduce the level of thyroid autoantibodies of TPOAb and TGAb-in patients.
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Objective:This study was aimed to investigate the safety and feasibility of applying duodenal feeding tube in thoracoscopy-and laparcoscopy-guided esophagectomy for esophageal carcinoma. Methods:Clinical data of 73 esophageal carcinoma patients who underwent esophagectomy and received a duodenal feeding tube by thoracoscopy and laparoscopy from March 2011 to September 2012 were analyzed retrospectively. Modes of operation included the separation of the esophagus by thoracoscopy, separation of the stomach by laparoscopy, reconstruction of the digestive tract, and so on. Results:A duodenal feeding tube was carefully placed at the site of esopha-gectomy of the patient. Operation time lasted from 180 min to 410 min, with an average of 273 min. The duodenal feeding tube was placed at 27 min into the operation. Intra-operative blood loss ranged from 50 mL to 450 mL, with an average of 120 mL. No post-operative death was encountered among the cases. After surgery, anastomotic fistula and gastrointestinal discomfort occurred in 2 and 5 of the 73 cases, respectively. Conclusion:Placement of a duodenal feeding tube at the site of esophagectomy through thoracoscopy and laparoscopy is completely safe and feasible.