Résumé
SUMMARY: The aim of this study was to compare the clinical value of vertebral artery ultrasound (VAU), Magnetic Resonance Angiography (MRA) and Digital Subtraction Angiography (DSA) on vertebral artery stenosis in patients with posterior circulation ischemia. Seventy-three patients with posterior circulation ischemia underwent vertebral artery ultrasound and magnetic resonance angiography as well as digital subtraction angiography, and the diagnosis of vertebral artery stenosis (VAS) and the degree of stenosis (normal, mild stenosis, moderate stenosis, severe stenosis, and occlusion) were recorded and compared between digital subtraction angiogram and vertebral artery ultrasound and magnetic resonance angiography. The vertebral artery stenosis rates on digital subtraction angiography and vertebral artery ultrasound were 87.30 % (55/63) and 49.20 % (31/63), respectively, and the difference was statistically significant. The rates of vertebral artery stenosis on digital subtraction angiography and, magnetic resonance angiography was 90.38 % (47/52) and 88.46 % (46/ 52), respectively, and the differences was not statistically significant. The sensitivity, accuracy, negative predictive value, and positive predictive value of vertebral artery ultrasound in diagnosing vertebral artery stenosis were 51.35 %, 54.76 %, 18.18 %, and 95.00 %, respectively, lower than those of magnetic resonance angiography, which were 91.89 %, 90.48 %, 57.14 %, and 97.14 %, respectively. Of the noninvasive imaging techniques, vertebral artery ultrasound does not accurately characterize vertebral artery stenosis and its degree of stenosis. Magnetic resonance angiography effectively screens for vertebral artery stenosis and its degree of stenosis, and can be used as a reliable tool for vertebral artery stenosis in posterior circulation cerebral infarction, and can be used in conjunction with digital subtraction angiogram in order to improve diagnostic convenience and accuracy.
El objetivo de este estudio fue comparar el valor clínico de la ecografía de la arteria vertebral (VAU), la angiografía por resonancia magnética (ARM) y la angiografía por sustracción digital (DSA) en la estenosis de la arteria vertebral en pacientes con isquemia de la circulación posterior. A 73 pacientes con isquemia de la circulación posterior se les realizó una ecografía de la arteria vertebral y una angiografía por resonancia magnética, así como una angiografía por sustracción digital, y se les diagnosticó estenosis de la arteria vertebral (EVA) y el grado de estenosis (normal, estenosis leve, estenosis moderada, estenosis grave, y oclusión) se registraron y compararon la angiografía por sustracción digital y la ecografía de la arteria vertebral y la angiografía por resonancia magnética. Las tasas de estenosis de la arteria vertebral en la angiografía por sustracción digital y la ecografía de la arteria vertebral fueron del 87,30 % (55/63) y del 49,20 % (31/63), respectivamente, y la diferencia fue estadísticamente significativa. Las tasas de estenosis de la arteria vertebral en la angiografía por sustracción digital y la angiografía por resonancia magnética fueron del 90,38 % (47/52) y del 88,46 % (46/52), respectivamente, y las diferencias no fueron estadísticamente significativas. La sensibilidad, precisión, valor predictivo negativo y valor predictivo positivo de la ecografía de la arteria vertebral en el diagnóstico de estenosis de la arteria vertebral fueron 51,35 %, 54,76 %, 18,18 % y 95,00 %, respectivamente, inferiores a los de la angiografía por resonancia magnética, que fueron 91,89 %, 90,48 %, 57,14 % y 97,14 %, respectivamente. De las técnicas de imagen no invasivas, la ecografía de la arteria vertebral no caracteriza con precisión la estenosis de la arteria vertebral y su grado de estenosis. La angiografía por resonancia magnética detecta eficazmente la estenosis de la arteria vertebral y su grado de estenosis, y puede usarse como una herramienta confiable para la estenosis de la arteria vertebral en el infarto cerebral de circulación posterior, y puede ser utilizada junto con la angiografía por sustracción digital para mejorar el diagnóstico y la exactitud.
Sujets)
Humains , Mâle , Femelle , Adulte d'âge moyen , Sujet âgé , Insuffisance vertébrobasilaire/imagerie diagnostique , Angiographie de soustraction digitale , Échographie , Angiographie par résonance magnétique , Valeur prédictive des tests , Sensibilité et spécificitéRésumé
Objective@#To investigate the factors affecting cataract among the elderly, so as to provide insights into cataract control.@*Methods@#Based on the major public health monitoring project of Zhejiang Province, residents at ages of 60 years and older were selected from 7 districts (counties) using a multi-stage stratified cluster random sampling method, and were followed up every other year from 2014 to 2020. Demographics, lifestyle, dietary habits and cataract incidence were collected, and factors affecting the incidence of cataract were identified using a multivariable Cox proportional hazard regression model.@*Results@# Totally 9 642 residents were investigated, with a mean age of (68.89±7.39) years, and including 4 635 males (48.07%). There were 828 incident cataract cases, with an incidence rate of 20.946/1 000 person-years. Multivariable Cox proportional hazard regression analysis showed that women (HR=1.695, 95%CI: 1.377-2.088), age of 65 years and older (HR=1.707-5.044, 95%CI: 1.400-7.327), overweight/obesity (HR=1.313, 95%CI: 1.131-1.524), educational level (primary school, HR=1.642, 95%CI: 1.400, 1.926; junior high school, HR=1.553, 95%CI: 1.148-2.102), annual family income (10 000 to 50 000 Yuan, HR=1.353, 95%CI: 1.155-1.585; 50 000 to 100 000 Yuan, HR=0.663, 95%CI: 0.500-0.881; 100 000 to 150 000 Yuan, HR=0.340, 95%CI: 0.204-0.565), smoking (HR=0.649, 95%CI: 0.494-0.853), frequency of vegetable intake of >3 days/week (HR=0.693, 95%CI: 0.527-0.912), frequency of fruit intake of >3 days/ week (HR=0.833, 95%CI: 0.694-0.899), frequency of egg intake of >3 days/week (HR=0.579, 95%CI: 0.450-0.745), frequency of soy products intake of >3 days/week (HR=0.706, 95%CI: 0.588-0.849), frequency of dairy products intake of >3 days/week (HR=1.510, 95%CI: 1.199-1.901) and frequency of nut intake of >3 days/week (HR=1.733, 95%CI: 1.162-2.586) were statistically associated with the development of cataract among the elderly. @*Conclusion @#Gender, age, body mass index, educational level, income, smoking, and frequency of vegetables, fruits, eggs, soy products, dairy products and nuts intake are associated with the development of cataracts.
Résumé
Objective@#To examine the associations of fibroblast growth factor 19 (FGF19), its co-receptor KLB gene and its receptor FGFR4 with susceptibility to sarcopenia, so as to provide insights into elucidation of sarcopenia pathogenesis and formulation of precision interventions for sarcopenia.@*Methods@#A case-control study was conducted. Patients with sarcopenia at ages of 60 years and older included in the Zhejiang Provincial Elderly Health Surveillance Cohorts were selected as the sarcopenia group, and normal residents at ages of 60 years and older were served as controls. Subjects' demographics were collected using questionnaire surveys, and the height, body weight, appendicular skeletal muscle mass and grip strength were measured. Genomic DNA was extracted from blood samples for multiplex PCR targeted capture. The associations between the KLB gene single-nucleotide polymorphisms (SNPs) and susceptibility to sarcopenia were evaluated using multivariable logistic regression models. @*Results@#There were 200 cases in the sarcopenia group, including 91 men and 109 women, and 180 cases in the control group, including 70 men and 110 women. All SNPs satisfied the Hardy-Weinberg equilibrium, and the minor allele frequencies were all > 0.05. There were no significant differences in the distribution of SNPs between the sarcopenia and control groups (all P>0.05). Multivariable logistic regression analysis showed that the SNP rs2687968 locus in the KLB gene was significantly associated with the susceptibility to sarcopenia among the elderly men (superdominant model), and individuals carrying the AC allele had a 2.332-fold higher risk of sarcopenia than those carrying the AA/CC allele (95%CI: 1.882-3.313). @*Conclusions@#KLB gene may correlate with the susceptibility to sarcopenia among the elderly men.
Résumé
Objective@#To investigate the milk drinking behavior and bone mineral density level of pupils in Hainan Province, and to explore the correlation between bone mineral density and milk drinking behavior, in order to provide scientific basis for promoting the healthy development of bones in children and adolescents.@*Methods@#In November 2021, a cross sectional survey including demographic characteristics, milk intake, unhealthy eating behavior, physical activity and sleep was conducted among 696 students from grades 3 to 5 in Sanya and Baisha, Hainan by stratified cluster random sampling, and bone mineral density at the distal 1/3 of the right forearm was measured by dual energy X-ray absorptiometry. t-test was used to compare the differences in bone mineral density among different milk drinking behaviors of pupils, and multiple linear regression was used to analyze the correlation between milk consumption and bone mineral density.@*Results@#About 25.3% students consumed milk daily and 13.9% consumed ≥ 300 g of milk daily. The mean bone mineral density at the distal 1/3 of the right forearm was (0.237±0.041)g/cm 2. The bone mineral density was greater in the group with daily milk intake than in the group without daily milk intake [(0.250± 0.037 )(0.204±0.034) g/cm 2 , t=15.00, P <0.01], and the bone mineral density was greater in the group with daily average milk intake ≥300 g than in the group with daily average milk intake <300 g [(0.284±0.036)(0.229±0.037)g/cm 2, t=13.48, P < 0.01 ]. Multiple linear regression analysis showed that daily average milk intake was positively correlated with bone mineral density, with a correlation coefficient ( β=0.020, t=21.46, P <0.01).@*Conclusion@#Milk consumption among pupils is inadequate, and milk drinking behavior has a positive impact on bone mineral density, so effective milk drinking intervention should be carried out to promote children s bone development.
Résumé
Objective: To investigate the effects of dopamine on olfactory function and inflammatory injury of olfactory bulb in mice with allergic rhinitis (AR). Methods: AR mouse model was established by using ovalbumin (OVA), and the mice were divided into two groups: olfactory dysfunction (OD) group and without OD group through buried food pellet test (BFPT). The OD mice were randomly divided into 2 groups, and OVA combined with dopamine (3, 6, 9 and 12 days, respectively) or OVA combined with an equal amount of PBS (the same treatment time) was administered nasally. The olfactory function of mice was evaluated by BFPT. The number of eosinophils and goblet cells in the nasal mucosa were detected by HE and PAS staining. Western blotting, immunohistochemistry or immunofluorescence were used to detect the expression of olfactory marker protein (OMP) in olfactory epithelium, the important rate-limiting enzyme tyrosine hydroxylase (TH) of dopamine, and the marker proteins glial fibrillary acidic protein (GFAP) and CD11b of glial cell in the olfactory bulb. TUNEL staining was used to detect the damage of the olfactory bulb. SPSS 26.0 software was used for statistical analysis. Results: AR mice with OD had AR pathological characteristics. Compared with AR mice without OD, the expression of OMP in olfactory epithelium of AR mice with OD was reduced (F=26.09, P<0.05), the expression of GFAP and CD11b in the olfactory bulb was increased (F value was 38.95 and 71.71, respectively, both P<0.05), and the expression of TH in the olfactory bulb was decreased (F=77.00, P<0.05). Nasal administration of dopamine could shorten the time of food globule detection in mice to a certain extent, down-regulate the expression of GFAP and CD11b in the olfactory bulb (F value was 6.55 and 46.11, respectively, both P<0.05), and reduce the number of apoptotic cells in the olfactory bulb (F=25.64, P<0.05). But dopamine had no significant effect on the number of eosinophils and goblet cells in nasal mucosa (F value was 36.26 and 19.38, respectively, both P>0.05), and had no significant effect on the expression of OMP in the olfactory epithelium (F=55.27, P>0.05). Conclusion: Dopamine can improve olfactory function in mice with AR to a certain extent, possibly because of inhibiting the activation of glial cells in olfactory bulb and reducing the apoptotic injury of olfactory bulb cells.
Sujets)
Animaux , Humains , Souris , Modèles animaux de maladie humaine , Dopamine , Souris de lignée BALB C , Muqueuse nasale/métabolisme , Bulbe olfactif/anatomopathologie , Ovalbumine , Rhinite allergique/métabolismeRésumé
ABSTRACT Background: Predictors of outcomes following endovascular treatment (ET) for aneurysmal subarachnoid hemorrhage (aSAH) are not well-defined. Identifying them would be beneficial in determining which patients might benefit from ET. Objective: To identify the predictive factors for poor outcomes following ET for aSAH. Methods: 120 patients with ruptured cerebral aneurysms underwent endovascular embolization between January 2017 and December 2018. Blood pressure variability was examined using the standard deviation of the 24-hour systolic blood pressure (24hSSD) and 24-hour diastolic blood pressure (24hDSD). Predictors were identified through univariate and multivariate regression analysis. All patients were followed up for three months. Results: At follow-up, 86 patients (71.7%) had good outcomes and 34 (28.3%) had poor outcomes. Patients with poor outcomes had significantly higher 24hSSD than those with good outcomes (19.3 ± 5.5 vs 14.1 ± 4.8 mmHg; P < 0.001). The 24hDSD did not differ significantly between patients with good outcomes and those with poor outcomes (9.5 ± 2.3 vs 9.9 ± 3.5 mmHg; P = 0.464). The following were significant risk factors for poor outcomes after endovascular embolization: age ≥ 65 years (odds ratio [OR] = 23.0; 95% confidence interval [CI]: 3.0-175.9; P = 0.002); Hunt-Hess grade 3-4 (OR = 6.8; 95% CI: 1.1-33.7; P = 0.039); Fisher grade 3-4 (OR = 47.1; 95% CI: 3.8-586.5; P = 0.003); postoperative complications (OR = 6.1; 95% CI: 1.1-34.8; P = 0.042); and 24hSSD ≥ 15 mmHg (OR = 14.9; 95% CI: 4.0-55.2; P < 0.001). Conclusion: Elevated 24hSSD is a possibly treatable predictive factor for poor outcomes after ET for aSAH.
RESUMO Antecedentes: Fatores preditores de resultados após tratamento endovascular (TE) para hemorragia subaracnóide aneurismática (HSA) não estão bem definidos. Identificá-los seria útil para determinar quais pacientes podem se beneficiar de TE. Objetivo: Identificar os fatores preditivos de resultados ruins após TE para HSA. Métodos: 120 pacientes com aneurismas cerebrais rompidos foram submetidos à embolização endovascular entre janeiro de 2017 e dezembro de 2018. A variabilidade da pressão arterial foi examinada usando-se o desvio padrão da PA sistólica de 24 horas (DPPAS- 24h) e da PA diastólica de 24 horas (DPPAD-24h). Os fatores preditores foram identificados por meio de análises de regressão univariada e multivariada. Todos os pacientes foram acompanhados por três meses. Resultados: No acompanhamento, 86 pacientes (71,7%) tiveram bons resultados e 34 (28,3%) tiveram resultados ruins. Pacientes com resultados ruins apresentaram DPPAS-24h significativamente maior do que aqueles com bons resultados (19,3 ± 5,5 vs 14,1 ± 4,8 mmHg; P <0,001). O DPPAD-24h não diferiu significativamente entre os pacientes com bons resultados e aqueles com resultados ruins (9,5 ± 2,3 vs 9,9 ± 3,5 mmHg; P = 0,464). Os fatores de risco significativos para resultados ruins após embolização endovascular foram os seguintes: idade ≥ 65 anos (razão de probabilidade [OR] = 23,0; intervalo de confiança de 95% [IC]: 3,0-175,9; P = 0,002); escala de Hunt-Hess 3-4 (OR = 6,8; IC 95%: 1,1-33,7; P = 0,039); escala de Fisher 3-4 (OR = 47,1; IC 95%: 3,8-586,5; P = 0,003); complicações pós-operatórias (OR = 6,1; IC 95%: 1,1-34,8; P = 0,042); e DPPAS 24h ≥ 15 mmHg (OR = 14,9; IC 95%: 4,0-55,2; P <0,001). Conclusão: O DPPAS 24h elevado é um fator preditivo possivelmente tratável para resultados ruins após TE para HSA.
Sujets)
Humains , Sujet âgé , Hémorragie meningée/thérapie , Anévrysme intracrânien/complications , Anévrysme intracrânien/thérapie , Pression sanguine , Études rétrospectives , Résultat thérapeutiqueRésumé
@#Currently, cell transplantation in combination with scaffold materials are one of the main strategies in periodontal bone tissue engineering. In periodontal bone tissues, the stiffness and spatial structure of tissues such as alveolar bone and cementum differ, and the difference in mechanical properties of scaffolds also has disparate effects on the proliferation and differentiation of stem cells. Accumulating evidence shows that mechanical stimulating factors such as matrix stiffness and scaffold topography modulate biological behaviors of various seeding cells, including adipose-derived stem cells and periodontal ligament stem cells. A hard matrix can promote cytoskeletal stretching of stem cells, leading to nuclear translocation of Yes-associated protein (YAP) and promoting osteogenic differentiation by upregulating alkaline phosphatase (ALP) and osteocalcin (OCN) via the Wnt/β-catenin pathway. The topologic structure of scaffolds can affect cell adhesion and cytoskeletal remodeling, increase the hardness of cells and promote the osteogenic differentiation of stem cells. In this paper, the effects of mechanical stimulation on the differentiation of stem cells in periodontal bone tissue engineering are reviewed.
Résumé
Coronavirus disease 2019 (COVID-19) has been a pandemic for more than a year.With the expanding second wave of the pandemic in winter,the continuous evolution of SARS-CoV-2 has brought new issues,including the significance of virus mutations in infection and the detection of asymptomatic infection.In this review,we first introduced several major SARS-CoV-2 mutations since the COVID-19 outbreak and then mentioned the widely used molecular detection techniques to diagnose COVID-19,primarily focusing on their strengths and limitations.We further discussed the effects of viral genetic variation and asymptomatic infection on the molecular detection of SARS-CoV-2 infection.The review finally sum-marized useful insights into the molecular diagnosis of COVID-19 under the special situation being challenged by virus mutation and asymptomatic infection.
Résumé
Objective: To compare the expression and difference of melastatin-related transient receptor potential 8(TRPM8) among chronic rhinosinusitis, nasal polyps and normal mucosa tissues. And to explore the significant expression of TRPM8 among CRSwNP. Methods: Fifty-one patients underwent endoscopic sinus surgery in the Department of Otorhinolaryngology Head and Neck Surgery of Renmin Hospital of Wuhan University from February 2019 to January 2020 were recruited, including 33 males and 18 females, aged from 14 to 65 years old (34.55±1.689).Immunohistochemistry was used to detected the expression of TRPM8 protein among CRSsNP(17),CRSwNP (17) and control tissuses(17). In addition, the correlation between the expression of TRPM8 protein in CRSwNP patients and preoperative CT Lund-Mackay scores and preoperative VAS scores and sinonasal outcome test-20 scores was analyzed, respectively. The primary human nasal epithelial cells were cultured in vitro and the expression of TRPM8 was detected by quantitative real-time PCR and western blotting . The tissue in control group, chronic rhinosinusitis without nasal polyps (CRSsNP) group and the CRSwNP group were collected and grinded into tissue homogenized. The expression of TRPM8 protein was detected by western blotting after 24 h stimulation after homogenate was added into the medium of RPMI 2650 and primary nasal epithelial cells. Results: Compared with the control, the expression of TRPM8 was significantly up-regulated in nasal polyps (t=6.852, P<0.05). TRPM8 was mainly expressed in epithelial cells. The expression of TRPM8 in the epithelial cells of CRSsNP had no difference with the control group (t=1.980, P>0.05). In addition, the expression of TRPM8 in CRSwNP patients was positively correlated with the preoperative CT Lund-Mackay scores and VAS scores and SNOT-20 scores (r=0.512, P<0.05;r=0.853, P<0.01;r=0.814, P<0.01). After cultured primary epithelial cells in vitro, the expression level of TRPM8 in epithelial cells derived from nasal polyp was significantly higher than that in control group (t=8.845, P<0.05). By adding the homogenization of control and CRSsNP and CRSwNP tissues, the expression of TRPM8 in RPMI 2650 cells and primary nasal epithelial cells was changed and that was significantly increased after adding the homogenization of the group of CRSwNP. Conclusion: TRPM8 is highly expressed in nasal polyps epithelial cells, suggesting that TRPM8 may be involved in the pathogenesis of nasal polyps regulated by nasal epithelial cells.
Sujets)
Adolescent , Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Maladie chronique , Endoscopie , Protéines membranaires , Polypes du nez , Rhinite , Sinusite , Canaux cationiques TRPMRésumé
SUMMARY: Lumbar disc herniation is considered to be the main pathological factor for the common clinical disease of low back pain. Biomechanical factor is an important cause of lumbar disc herniation, so it is urgent to analyze the stress/strain behavior of intervertebral disc under different loading condition. Slow repetitive loading is considered to be an important factor of spine and disc injuries, and the effect of fatigue load on internal displacement in the intervertebral disc was investigated by applying the optimized digital image correlation technique in this study. The first finding was that fatigue load had a significant effect on the displacement distribution in the intervertebral disc under compression. Superficial AF exhibited the largest axial displacements before fatigue load, while it exhibited the smallest axial displacements after fatigue load. Inner AF exhibited slightly smaller radial displacements than outer AF before fatigue load, while it exhibited significantly greater radial displacements than outer AF displacements after fatigue load. The second finding was that fatigue load had a certain effect on the internal displacement distribution in the flexed intervertebral disc under compression. Middle AF exhibited the smallest axial displacements before fatigue load, while deep AF exhibited the smallest axial displacements after fatigue load. The radial displacement distribution did not change before and after fatigue load, as the radial displacement in outer AF was the smallest, while the radial displacement in inner AF was the largest. The third finding was that with the increase in fatigue time and amplitude, the Young's modulus of the intervertebral disc increased significantly. This study can provide the basis for clinical intervertebral disc disease prevention and treatment? and is important for mechanical function evaluation of artificial intervertebral disc as well.
RESUMEN: La hernia de disco lumbar se considera el principal factor patológico para la enfermedad clínica común del dolor lumbar. El factor biomecánico es una causa importante de hernia de disco lumbar, por lo que es urgente analizar el comportamiento de esfuerzo / tensión del disco intervertebral bajo diferentes condiciones de carga. La carga repetitiva lenta se considera un factor importante de lesiones de columna y disco, y en este estudio el efecto de la carga de fatiga sobre el desplazamiento interno en el disco intervertebral se investigó mediante la aplicación de la técnica de correlación de imagen digital optimizada. El primer hallazgo fue que la carga de fatiga tuvo un efecto significativo en la distribución del desplazamiento en el disco intervertebral bajo compresión. El AF superficial exhibió los desplazamientos axiales más grandes antes de la carga de fatiga, mientras que exhibió los desplazamientos axiales más pequeños después de la carga de fatiga. El AF interno exhibió desplazamientos radiales ligeramente más pequeños que el AF externo antes de la carga de fatiga, mientras que exhibió desplazamientos radiales significativamente mayores que los desplazamientos AF externos después de la carga de fatiga. El segundo hallazgo fue que la carga de fatiga tenía un cierto efecto sobre la distribución del desplazamiento interno en el disco intervertebral flexionado bajo compresión. El AF medio exhibió los desplazamientos axiales más pequeños antes de la carga de fatiga, mientras que el AF profundo exhibió los desplazamientos axiales más pequeños después de la carga de fatiga. La distribución del desplazamiento radial no cambió antes ni después de la carga de fatiga, ya que el desplazamiento radial en la FA externa fue el más pequeño, mientras que el desplazamiento radial en la FA interna fue el más grande. El tercer hallazgo fue que con el aumento del tiempo de fatiga y la amplitud, el módulo de Young del disco intervertebral aumentó significativamente. Este estudio puede proporcionar la base para la prevención y el tratamiento clínico de la enfermedad del disco intervertebral, y también es importante para la evaluación de la función mecánica del disco intervertebral artificial.
Sujets)
Humains , Déplacement de disque intervertébral/étiologie , Déplacement de disque intervertébral/anatomopathologie , Phénomènes biomécaniques , Résistance à la compression , Fatigue , Résistance à la flexion , Disque intervertébral/anatomopathologie , Vertèbres lombales/anatomopathologie , Région lombosacraleRésumé
[Abstract] Objective To analyze the characteristics of lumbar spondylolysis in military patients, and explore the clinical effect of Wiltse approach pedicle screw-laminar hook internal fixation combined with autologous ilium transplantation in repairing single-segment lumbar spondylolysis. Methods Thirty-three military patients with single-segment lumbar spondylolysis were admitted to the 940 Hospital of Joint Service Support Force of Chinese PLA from January 2016 to January 2019. The Wiltse approach pedicle screw-lamina hook internal fixation combined with autogenous ilium transplantation was performed to repair the lumber spondylolysis, the patients were then followed up to evaluate the visual analogue scale (VAS) and Oswestry dysfunction index (ODI) of lumbar pain, and compared with that before surgery. 3-D CT of lumbar spine was used to evaluate the bone graft fusion in the isthmus. Results The army patients accounted for 63.6% (21/33) of all the cases. The injured segments were located at L4 and L5 segment, with the L5 segment (84.8%, 28/33) being the most common. The operation time was 85-150 min, the intraoperative blood loss was 50-150 ml, postoperative drainage volume was 10-30 ml. VAS score of lower back pain decreased from 5.8±0.7 before surgery to 1.4±0.8 three months after surgery, and to 0.4±0.5 at the last follow-up, the difference was statistically significant (P<0.05). ODI decreased from 41.2%±5.8% before surgery to 12%±3.9% 3 months after surgery, and to 9.5%±2.6% at the last follow-up, the difference was statistically significant (P<0.05). At 3 months, 6 months and 12 months follow-up, the bone graft fusion rate was 18.2% (6/33), 48.5% (16/33) and 84.8% (28/33), respectively, and the average bone graft fusion time was 7.0±2.8 months. Conclusion Wiltse approach pedicle screw-laminar hook internal fixation combined with autogenous ilium transplantation is a feasible and effective minimally invasive solution for repairing single-segment lumbar spondylolysis of military patients with shorter bone graft fusion time.
Résumé
OBJECTIVE@#To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province.@*METHODS@#The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017.@*RESULTS@#The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01).@*CONCLUSIONS@#Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.
Sujets)
Humains , Nourrisson , Nouveau-né , Antibactériens , Poids de naissance , Nourrisson de poids extrêmement faible à la naissance , Unités de soins intensifs néonatals , Enquêtes et questionnairesRésumé
OBJECTIVE: Fine-needle aspiration cytology is the risk stratification tool for thyroid nodules, and ultrasound elastography is not routinely used for the differential diagnosis of thyroid cancer. The current study aimed to compare the diagnostic parameters of ultrasound elastography and fine-needle aspiration cytology, using surgical pathology as the reference standard. METHODS: In total, 205 patients with abnormal thyroid function test results underwent ultrasound-guided fine-needle aspiration cytology on the basis of the American College of Radiology Thyroid Imaging-Reporting and Data System classification and strain ultrasound elastography according to the ASTERIA criteria. Histopathological examination of the surgical specimens was performed according to the 2017 World Health Organization classification system. Moreover, a beneficial score analysis for each modality was conducted. RESULTS: Of 265 nodules, 212 measured ≥1 cm. The strain index value increased from benign to malignant nodules, and the presence of autoimmune thyroid diseases did not affect the results (p>0.05 for all categories). The sensitivities of histopathological examination, ultrasound elastography, and fine-needle aspiration cytology for detection of nodules measuring ≥1 cm were 1, 1, and 0.97, respectively. The working area for detecting nodule(s) in a single image was similar between strain ultrasound elastography and fine-needle aspiration cytology for highly and moderately suspicious nodules. However, for mildly suspicious, unsuspicious, and benign nodules, the working area for detecting nodule(s) in a single image was higher in strain ultrasound elastography than in fine-needle aspiration cytology. CONCLUSION: Strain ultrasound elastography for highly and moderately suspicious nodules facilitated the detection of mildly suspicious, unsuspicious, and benign nodules.
Sujets)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Glande thyroide/imagerie diagnostique , Tumeurs de la thyroïde/diagnostic , Nodule thyroïdien/imagerie diagnostique , Cytoponction/méthodes , Imagerie d'élasticité tissulaire/méthodes , Glande thyroide/anatomopathologie , Tumeurs de la thyroïde/anatomopathologie , Thyréostimuline/sang , Valeur prédictive des tests , Études rétrospectives , Sensibilité et spécificité , Nodule thyroïdien/anatomopathologie , Diagnostic différentielRésumé
Objective: This study was aimed to investigate the relationship between the expression of drebrin (DBN1) gene and resistance in colon cancer to reveal the mechanism of tumor drug resistance and provide a basis for the reversal of this drug resistance in tumor cells. Materials and Methods: The human colon carcinoma cell line HCT-8 was used, and vincristine (VCR)-resistant colon cancer cell line HCT-8/V was established by gradually increasing the concentration of VCR. Polymerase chain reaction (PCR) primers were designed for DBN1 gene. The DBN1 differential expression in colon cancer sensitive and resistant cell lines was detected by fluorescence quantitative PCR. Western blot analysis was used to study DBN1 expression in the resistant cells further. Results: VCR resistance of HCT-8/V cell line was established. Quantitative PCR and Western blot results showed that DBN1 expression in the resistant cell line was significantly lower, the difference being statistically significant (P < 0.05). Conclusion: Low DBN1 gene expression may be associated with colon cancer cell resistance to VCR.
Résumé
OBJECTIVE: To investigate the metabolic characteristics of bakuchiol mediated by cytochrome P450 enzyme (CYP) and UDP-glucuronosyltransferase (UGT) in rat liver microsomes (RLMs) or human liver microsomes (HLMs), and to compare the metabolic gender differences. METHODS: Bakuchiol was incubated at 37? with male and female RLMs or HLMs in the presence of nicotinamide adenine dinucleotide phosphate (NADPH) or uridine 5′-diphosphoglucuronic acid (UDPGA). The residual concentrations of bakuchiol were measured in each incubation system using high performance liquid chromatography (HPLC). The metabolic stability and metabolic gender differences of bakuchiol were evaluated by the remaining percentage of bakuchiol after incubation.RESULTS: When bakuchiol was metabolized by CYP in RLMs, the intrinsic clearance (Clint) value in male RLMs ?(326.6±15.4) mL·min-1·kg-1?was significantly higher than that of female RLMs ?(77.2±4.8) mL·min-1·kg-1? (P<0.01). When bakuchiol was metabolized by UGT in RLMs, female RLMs had a significantly higher Clint value ?(419.1±24.1) mL·min-1·kg-1? than male RLMs ?(164.5±8.4) mL·min-1·kg-1? (P<0.01). When bakuchiol was metabolized by both CYP and UGT in RLMs, male RLMs had a significantly higher Clint value ?(1063.1±27.2) mL·min-1·kg-1? than female RLMs ?(781.2±16.5) mL·min-1·kg-1?(P<0.01). When bakuchiol was metabolized by CYP in HLMs, male HLMs had a significantly higher Clint value ?(24.8±2.1) mL·min-1·kg-1? than female HLMs ?(17.6±1.0) mL·min-1·kg-1? (P<0.01). There were no significant gender differences in the metabolism of bakuchiol when it was metabolized by UGT in HLMs. The Clint values were 176.4±26.5 and (165.9±8.6) mL·min-1·kg-1, respectively. The metabolic parameters of bakuchiol mediated by CYP and UGT in HLMs had no significant gender differences. The Clint values were 262.5±20.9 and (236.2±10.5) mL·min-1·kg-1, respectively. CONCLUSION Bakuchiol can be metabolized by CYP and UGT in RLMs or HLMs, and the metabolic parameters exhibit species differences and gender differences.
Résumé
Objective To explore the efficacy and complications of small insicion surgical treatment and the routine microscopic surgical treatment for children with tight filum terminale type of tethered cord syndrome.Methods According to the clinical manifestations and imaging findings,a total of 43 children with tethered cord syndrome were classified into two groups.Namely the control group (30 cases) who underwent the routine microscopic surgery and the observation group (13 cases) who underwent the small insicion surgical treatment.The difference including prognosis,complications,hospital stays,size of the wound between the two groups were analyzed.Results The 43 children were followed up for 3 to 24 months with an average of 9 months.The results indicated that the postoperative effective rate of the control group was 93.3%,while it was 100% in the observation group.The difference between the two groups was not statistically significant(P > 0.05).The rate of complications of the control group was 6.67% whlie it was 0.00% in the observation group,and the difference of the two groups was statistically significant(P < 0.05).The difference of hospital stays and the size of the wound between the two groups were statistically significant (P < 0.05).Conclusion The small insicion surgical treatment could guarantee the surgical effect for children with tight filum terminale type of tethered cord syndrome,and it can reduce the surgical trauma,post operation hospitalization duration,incidence of complications and intraoperative scar tissues.
Résumé
BACKGROUND: Phosphoinositide-3-kinase, regulatory subunit 1 (PIK3R1) could regulate cancer cell proliferation important for cancer cell proliferation; however, its role in Hepatocellular carcinoma (HCC) remains largely unknown. Here, we investigated the role of PIK3R1 in HCC and examined the underlying molecular mechanisms. METHODS: The expression of PIK3R1 was evaluated by immunohistochemistry and qRT-PCR in a series of HCC tissues. The mRNA and protein expression of PIK3R1 was used by qRT-PCR and western blot assays in a series of human HCC cell lines, and then we choose MHCC97H and HCCLM3 cells as a model to investigate the effect of PIK3R1 on HCC progression. The effects of PIK3R1 knowdown on cell proliferation, migration, apoptosis of HCC were assessed by the MTT assay, clonogenic assays, wound healing assay and flow cytometry in vitro. Western blot assay was performed to assess the expression changes of PI3K/AKT/mTOR signaling pathway. RESULTS: Our results found that PIK3R1 was highly expressed in HCC tissues compared with adjacent normal tissues. Knockdown of PIK3R1 inhibited the proliferation, migration and promoted apoptosis of HCC cell lines. In addition, we proved that knockdown of PIK3R1 downregulated p-PI3K, p-AKT, and p-mTOR expressions in MHCC97H and HCCLM3 cells. CONCLUSIONS: In conclusion, PIK3R1 providing potential novel targets for the treatment of HCC.
Sujets)
Humains , Régulation de l'expression des gènes tumoraux/génétique , Carcinome hépatocellulaire/génétique , Phosphatidylinositol 3-kinases/génétique , Tumeurs du foie/génétique , Immunohistochimie , Technique de Western , Apoptose , Carcinome hépatocellulaire/anatomopathologie , Évolution de la maladie , Lignée cellulaire tumorale , Prolifération cellulaire , Phosphatidylinositol 3-kinase de classe Ia , Réaction de polymérisation en chaine en temps réel , Tumeurs du foie/anatomopathologieRésumé
OBJECTIVES: The aim of this study was to compare the expression levels of serum miRNAs in diabetic retinopathy and type 2 diabetes mellitus. METHODS: Serum miRNA expression profiles from diabetic retinopathy cases (type 2 diabetes mellitus patients with diabetic retinopathy) and type 2 diabetes mellitus controls (type 2 diabetes mellitus patients without diabetic retinopathy) were examined by miRNA-specific microarray analysis. Quantitative real-time polymerase chain reaction was used to validate the significantly differentially expressed serum miRNAs from the microarray analysis of 45 diabetic retinopathy cases and 45 age-, sex-, body mass index- and duration-of-diabetes-matched type 2 diabetes mellitus controls. The relative changes in serum miRNA expression levels were analyzed using the 2-ΔΔCt method. RESULTS: A total of 5 diabetic retinopathy cases and 5 type 2 diabetes mellitus controls were included in the miRNA-specific microarray analysis. The serum levels of miR-3939 and miR-1910-3p differed significantly between the two groups in the screening stage; however, quantitative real-time polymerase chain reaction did not reveal significant differences in miRNA expression for 45 diabetic retinopathy cases and their matched type 2 diabetes mellitus controls. CONCLUSION: Our findings indicate that miR-3939 and miR-1910-3p may not play important roles in the development of diabetic retinopathy; however, studies with a larger sample size are needed to confirm our findings.
Sujets)
Humains , Animaux , Sujet âgé , Diabète de type 2/génétique , Rétinopathie diabétique/génétique , microARN/sang , Diabète de type 2/sang , Rétinopathie diabétique/sang , Analyse de profil d'expression de gènes , Réaction de polymérisation en chaine en temps réelRésumé
Objective:To investigate the prognosis of cervical and posterior to level V (PLV) lymph node metastasis and discuss further updates on neck levels and N stages for nasopharyngeal carcinoma (NPC). Methods:A total of 406 pathologically diagnosed NPC cases from December 2011 to June 2016 were retrospectively analyzed. SPSS 20.0 was used to analyze the prognosis of patients with cervi-cal and PLV lymph node metastasis. Results:In the 406 cases, the 5-year overall survival (OS), progression-free survival (PFS), local re-lapse-free survival (LRFS), and distant metastasis-free survival (DMFS) were 75.0%, 63.4%, 87.2%, and 81.8%, respectively. The 3-year OS, PFS, LRFS, and DMFS of patients with node involvement of PLV were 51.5%, 22.7%, 90.0%, and 41.3%, respectively. For the N3 stage, the 3-year OS, PFS, LRFS, and DMFS with or without PLV involvement were 43.9%and 84.7%(P=0.002), 12.9%and 55.4%(P=0.006), 88.9%and 80.3%(P=0.649), and 33.0%and 85.9%(P<0.001), respectively. Univariate analysis showed that N stage was a prog-nostic factor for OS, PFS, and DMFS (P<0.05). Multivariate analysis demonstrated that PLV was an independent prognostic factor for DMFS (P<0.05). Conclusion:Patients with NPC with PLV node involvement exhibited poor prognosis and an increased risk of distant metastasis. Thus, PLV should be a new neck node level for head and neck tumors.
Résumé
OBJECTIVES: Behcet’s disease is a form of systematic vasculitis that affects vessels of various sizes. Aortic pseudoaneurysm is one of the most important causes of death among patients with Behcet’s disease due to its high risk of rupture and associated mortality. Our study aimed to investigate the outcomes of Behcet’s disease patients with aortic pseudoaneurysms undergoing open surgery and endovascular aortic repair. METHODS: From January 2003 to September 2014, ten consecutive patients undergoing surgery for aortic pseudoaneurysm met the diagnostic criteria for Behcet’s disease. Endovascular repair was the preferred modality and open surgery was performed as an alternative. Systemic immunosuppressive medication was administered after Behcet’s disease was definitively diagnosed. RESULTS: Eight patients initially underwent endovascular repair and two patients initially underwent open surgery. The overall success rate was 90% and the only failed case involved the use of the chimney technique to reach a suprarenal location. The median follow-up duration was 23 months. There were 7 recurrences in 5 patients. The median interval between operation and recurrence was 13 months. No significant risk factors for recurrence were identified, but a difference in recurrence between treatment and non-treatment with preoperative immunosuppressive medication preoperatively was notable. Four aneurysm-related deaths occurred within the follow-up period. The overall 1-year, 3-year and 5-year survival rates were 80%, 64% and 48%, respectively. CONCLUSIONS: Both open surgery and endovascular repair are safe and effective for treating aortic pseudoaneurysm in Behcet’s disease patients. The results from our retrospective study indicated that immunosuppressive medication was essential to defer the occurrence and development of recurrent aneurysms.