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Objective:To analyze the predictive factors of autogenous arteriovenous fistula (AVF) maturation and tentatively discuss the intervention timing of assisted maturation.Methods:It was a retrospective study. The data of patients with newly established AVF and regular follow-up in Haidian Hospital, the Third Hospital of Peking University from August 1, 2018 to March 31, 2022 were analyzed. The patients were divided into mature group and immature group based on whether they met clinical maturity or ultrasonic maturity criteria 3 months after AVF establishment.The general data, preoperative laboratory examination and postoperative ultrasonic examination parameters were compared between the two groups. Logistic regression analysis model was used to analyze the related factors of AVF maturation, and receiver operating characteristic curve (ROC curve) was drawn to evaluate the predictive value of each factor for AVF maturation and intervention timing.Results:A total of 568 patients were included, with age of (56.86±13.82) years old, 339 males (59.68%), and 229 females (40.32%). There were 380 patients in the maturation group and 188 patients in the immature group. The total rate of AVF maturation was 66.90% (380/568). The anastomosis diameter ( t=9.732, P < 0.001), ln(anastomosis artery diameter)( t=10.116, P < 0.001), anastomosis vein diameter ( t=13.961, P < 0.001), ln(brachial artery diameter)( t=9.362, P < 0.001) and brachial artery blood flow ( t=16.542, P < 0.001) of postoperation one month, and anastomosis diameter ( t=7.356, P < 0.001), anastomosis artery diameter ( t=11.117, P < 0.001), anastomosis vein diameter ( t=12.332, P < 0.001), ln(brachial artery diameter) ( t=7.956, P < 0.001) and brachial artery blood flow ( t=13.803, P < 0.001) of postoperation three months in the mature group were significantly higher than those in the immature group. Logistic regression analysis models showed anastomosis vein diameter at 1 month after surgery ( OR=0.577, 95% CI 0.342-0.975, P=0.040), brachial arterial blood flow at 1 month after surgery ( OR=0.988, 95% CI 0.996-1.000, P=0.043) and brachial arterial blood flow at 3 months after surgery ( OR=0.997, 95% CI 0.995-0.999, P=0.002) were the independent relevant factors of AVF maturation. When the anastomosis vein diameter ≥ 3.90 mm at 1 month after AVF surgery ( AUC=0.842, 95% CI 0.809-0.871, P < 0.001), the blood flow of brachial artery ≥ 446.90 ml/min at 1 month after AVF surgery ( AUC=0.880, 95% CI 0.850-0.906, P < 0.001), the critical value of the combined index of anastomotic vein diameter and blood flow of brachial artery at 1 month after fitting ≥ 0.44 ( AUC=0.889, 95% CI 0.860-0.914, P < 0.001) and brachial arterial blood flow ≥ 595.00 ml/min ( AUC=0.857, 95% CI 0.822-0.888, P < 0.001), the unassisted maturation of AVF could be predicted. Conclusions:The anastomosis vein diameter ≥ 3.90 mm at 1 month after AVF surgery, and the blood flow of brachial artery ≥ 446.90 ml/min at 3 months after AVF surgery, or the critical value of combined index of both after fitting ≥ 0.44 can predict the unassisted maturation of AVF, and one month after surgery may be the opportunity for early intervention to promote maturation.
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Objective:To summarize the clinical and imaging presentations of stapical footplate hernia related to inner ear malformation (SFH-Re-IEM).Methods:The clinical and imaging data of 19 patients (24 ears) with SFH-Re-IEM from Shandong Provincial ENT Hospital between June 2014 to June 2022 were retrospectively analyzed. The clinical presentations and headache and the high resolution CT (HRCT) and MRI findings including associated inner ear malformation (IEM) type, internal auditory canal (IAC) malformation, bony defect of the stapical footplate, the extent, margin, density and signal of the herniation cysts, the density and signal of ipsilateral intratympanic, cochlear osseous labyrinthitis were recorded.Results:Among 19 SFH-Re-IEM patients, including 14 males and 5 females, 3 (1, 12) years old. All of the affected ears presented sensorineural or mixed hearing loss, 1 ear for moderate, 7 ears for severe and 16 ears for extremely severe. Besides this, the vertigo in 1 case, otalgia and ear fullness in 2 cases were found, and the others were detected accidentally. Among 24 ears with SFH-Re-IEM, 9 ears (37.5%) consisting with incomplete partition type Ⅰ, 3 ears (12.5%) with common cavity, 7 ears (29.2%) with cochlear aplasia, 3 ears (12.5%) with cochlear dysplasia type Ⅱ, and 2 ears (8.3%) with Mondini deformity were found respectively. Four ears (16.7%) were associated with IAC enlargement and the bony defect of IAC fundus, 19 ears (79.2%) were accompanied with dysplasia in the IAC fundus. In all the 24 ears with SFH-Re-IEM, the focal bony defect of the affected stapical footplate and the hemispherical soft-tissue-density herniating cysts protruding into the tympanium were presented on HRCT, and the herniating cysts presenting the cerebrospinal fluid-like signal with the well-defined margin and the ipsilateral normal tympanium were shown on the MRI hydrographic sequence. Two ears underwent the perilymphaticum gadolinium based on MRI, which demonstrated the hypersignal gadolinium in the perilymphatic space entered into the herniating cysts. Two ears were accompanied with the cochlear osseous labyrinthitis.Conclusion:The ears with IEM-Re-SFH usually present the serious hearing loss. The ipsilateral severe IEM, focal bony defect of the stapical footplate and perilymph herniating are characteristic imaging appearances.
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Objective:To observe the effect of Buyang Huanwu Decoction on renal oxidative stress and NF-κB pathway in diabetic nephropathy rats.Methods:Sixty SD rats were randomly divided into normal group, model group, low, medium, and high dose of Buyang Huanwu Decoction groups and metformin group, with 10 rats in each group. The normal group was given ordinary diet every day, and the other groups were given high-fat and high-sugar diet for 6 weeks, then intraperitoneally injected 35 mg/kg STZ to establish diabetic nephropathy model. After successful modeling, the rats were orally injected with 7.42, 14.84 and 29.68 g/kg of low-dose, medium-dose and high-dose Buyang Huanwu Decoction and metformin group was orally given metformin solution 0.2 g/kg. After 6 weeks of feeding, the body weight, 24h urinary protein, serum creatinine and urea nitrogen were detected. The levels of GSH-Px, SOD, CAT and MDA in rats' kidney of each group were detected. The protein expression levels of NF-κBp65, p-NF-κBp65, TNF-α and IL-6 in rats' kidney in each group were detected by Western Blot.Results:Compared with model group, the body weight of the low, medium and high dose of Buyang Huanwu Decoction groups were increased ( P<0.01), the content of 24 h urinary protein, serum creatinine and urea nitrogen were decreased ( P<0.05 or P<0.01),the content of GSH-Px , SOD, CAT were significantly increased ( P<0.05 or P<0.01), the content of MDA was significantly decreased ( P<0.05 or P<0.01), the expression of NF-κB p65 (0.53±0.07, 0.46±0.09, 0.42±0.10 vs. 0.67±0.13), p-NF-κB p65 (0.51±0.12, 0.43±0.06, 0.34±0.17 vs. 0.59±0.07), TNF-α (1.21±0.08, 1.17±0.04, 1.05±0.22 vs. 1.43±0.21), IL-6 (0.92±0.04, 0.89±0.25, 0.73±0.09 vs. 1.06±0.08) were significantly decreased ( P<0.05 or P<0.01). Conclusion:Buyang Huanwu Decoction can improve oxidative stress state and inflammatory damage in renal tissue. The mechanism may be related to the inhibition of NF-κB signaling pathway.
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Objective:To investigate the efficacy of maintenance electroconvulsive therapy (MECT) combined with quetiapine treatment for manic episodes of bipolar disorder.Methods:A total of 103 patients with manic episodes of bipolar disorder received treatment in Kangci Hospital of Jiaxing from January 2019 to August 2020 and were included in this study. They were randomly divided into observation ( n = 46) and control groups ( n = 57). The observation group was given MECT combined with quetiapine treatment and the control group was treated with magnesium valproate sustained-release tablets combined with quetiapine. All patients received 4 weeks of treatment. Clinical efficacy, total hospital cost, drug cost during hospitalization, drug proportion, adverse reactions, and scores of the Bech-Rafaelsdn Mania Rating Scale and the Wisconsin Card Sorting Test pre- and post-treatment were compared between the two groups. Results:After 4 weeks of treatment, total response rate was significantly higher in the observation group than in the control group [76.09% (35/46) vs. 56.14% (32/57), χ2 = 4.45, P < 0.05]. In the observation group, total hospital cost, drug cost during hospitalization, and drug proportion were (16074.52 ± 1019.81) yuan, (1374.52 ± 619.81) yuan, and 8.70% respectively, which were not significantly different from those in the control group [(15618.14 ± 1550.34) yuan, (1261.14 ± 750.34) yuan, 10.53%, t = 1.71, 0.82, χ2 = 0.09, all P > 0.05]. After 4 weeks of treatment, Bech-Rafaelsdn Mania Rating score was significantly lower in the observation group than in the control group [(7.36 ± 3.04) points vs. (10.23 ± 2.37) points, t = 5.38, P < 0.001]. The number of wrong responses and the number of perseverative errors in the Wisconsin Card Sorting Test in the observation group were (40.45 ± 3.61) counts and (9.56 ± 1.39) counts, respectively, which were significantly lower than those in the control group [(48.59 ± 4.51) counts, (12.08 ± 1.25) counts, t = 10.17, 9.56, both P < 0.001]. The number of perseverative errors in the Wisconsin Card Sorting Test was significantly higher in the observation group than in the control group [(33.85 ± 2.50) counts vs. (29.71 ± 2.14) counts, t = 8.90, P < 0.001]. There was no significant difference in total incidence of adverse reactions between observation and control groups (21.74% vs. 22.81%, χ2 = 0.01, P > 0.05). Conclusion:MECT combined with quetiapine treatment is highly effective on the manic episodes of bipolar disorder. The combined therapy is worthy of clinical application.
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Objective:To examine the efficacy of haploidentical stem-cell transplantation (haplo-SCT) for patients with refractory relapsed (R/R) non-Hodgkin lymphoma (NHL) by comparing with those contemporaneously undergoing HLA-matched SCT in myeloablative conditioning settings.Methods:Between January 2006 and December 2018, a total of 151 patients undergoing haplo-SCT ( n=81) or HLA-matched SCT ( n=70, sibling or unrelated) were enrolled. Median age of alloSCT was 30(5-59) years. And 150 patients received myeloablative conditioning (MAC) consisting of total body irradiation (12 Gy) plus cyclophosphamide or busulfan plus cyclophosphamide. Only one case had reduced intensity conditioning (RIC) with R-FBA (fludarabine, busulfan & cytarabina). It was followed by an infusion of granulocyte-colony stimulating factor-primed bone marrow (G-BM) and/or peripheral blood stem cells without in vitro T cell depletion. In haplo-SCT and HLA-matched unrelated donor for SCT, GVHD prophylaxis consisted of antithymocyte globulin, cyclosporine A, mycophenolate mofetil and a short course of methotrexate. Clinical efficacy, hematopoietic reconstitution and transplant-related complications were retrospectively analyzed. Results:Among them, 146(96%) patients engrafted with a median time to neutrophil and platelet recovery of 12 and 15 days respectively. During a median follow-up period of 19 months, 66 of them survived (43.7%) and 67 (44.4%) died (39 disease recurrence, 27 transplantation-related mortality). Between haplo-SCT and HLA-matched SCT groups, progression-free survival (PFS) rate was 49.4% and 50.5% ( P=0.577); overall survival (OS) rate 56.7% and 57.4% respectively ( P=0.963). The cumulative incidences of relapse (CIR) were 36.6% and 37.7% ( P=0.836) and those of cumulative incidences of non-relapse mortality (NRM) 22.0% and 24.7% ( P=0.530). And the cumulative incidences of chronic GVHD were 42.3% and 39.6% ( P=0.46) respectively. Conclusions:No inter-group difference exists in each major HSCT endpoint. Multivariate analysis reveals that occurrence of grade Ⅲ-Ⅳ aGVHD has a significantly worse prognosis. And primary chemorefractoriness is a strongest relapsing factor.
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Objective:To investigate the diagnostic value of rapid on-site evaluation (ROSE) technique in the mucosal biopsy under respiratory endoscopy in children with active tuberculosis.Methods:Clinical data of 40 patients with active tuberculosis diagnosed in Department of Respiratory Intervention, Qilu Children′s Hospital, Shandong University from June 2017 to January 2020 were retrospectively analyzed.Results:(1) There were 33 cases of tracheobronchial tuberculosis and 7 cases of tuberculous pleurisy in the 40 cases, among them 9 cases were difficult to diagnose.(2)Among 33 cases of tracheobronchial tuberculosis, 24 cases (72.7%) of caseous necrosis breaking into the lumen, and 9 cases (27.3%) of mucosal swelling and external pressure.Cytological ROSE (C-ROSE) showed granuloma, epithelioid cells and lymphocytic infiltration with all bronchial mucosal biopsies.Different positives results of microbiological ROSE (M-ROSE) in different biopsy parts: positive results were found 6 times at caseous necrosis (13.6%, 6/44 times), 4 times at granulation hyperplasia (12.5%, 4/32 times), 2 times at hyperemia and edema (22.2%, 2/18 times), 0 time at yellow-white necrosis, and 54 times at the junction between lesions and normal mucosa (81.8%, 54/66 times). The mucosal pathology showed granuloma, exudation and necrosis, including 22 cases with tuberculous granuloma, 5 cases with characteristic tuberculous nodules, and 11 cases with positive acid-fast staining.(3)Seven cases of tuberculous pleurisy, serious pleural adhesion, pleural hyperemia and edema were observed under thoracoscopy.After clearing the adhesive tape, scattered caseous miliary nodules were found in pleura in 4 cases with a difficult clinical diagnosis.The C-ROSE of smear on thoracoscopic biopsy were characterized by necrotic and histopathic cell, with multinucleated giant cells, but granuloma was rare.M-ROSE in different parts: 8 times positive for millet nodules (80.0%), 0 time positive for adhesion band, 2 times positive for congestion oedema (14.3%); biopsy pathology showed granuloma and necrosis, with 3 cases characteristic tuberculosis nodules and 2 cases positive for anti-acid staining.(4)Pathogenic microorganisms were detected in 19 children using next generation sequencing (NGS) and Mycobacterium tuberculosis/Rifampicin resistance real-time nucleic acid amplification detection technology (Xpert MTB/RIF), including 7 positive for NGS (36.8%), 8 positive (42.1%) and 5 positive for both NGS and Xpert MTB/RIF (26.3%).Conclusions:Respiratory endoscopy combined with ROSE technique has important clinical significance in early diagnosis of active tuberculosis in children, and it is worth of promotion and applying.
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Objective:To explore the case characteristics, treatment and prevention measures of cardiac thrombus in children caused by Mycoplasma pneumoniae infection, so as to improve the clinicians′ understanding of the disease.Methods:The clinical data of 10 children with cardiac thrombus caused by Mycoplasma pneumoniae infection treated in Department of Respiratory Intervention, Jinan Children′s Hospital from November 2015 to January 2020 were retrospectively analyzed, including datum of cases, laboratory results, imaging data and follow-up results.Results:A total of 10 children (7 males and 3 females) were included with the median age of 6.5 years old, and all had fever for more than 1 week.The plasma D-dimer (D-D) of 9 children was significantly increased, and the C-reactive protein (CRP) of 6 children was increased.After anti-infection treatment, the absorption of pneumonia with atelectasis was better than before.The embolus disappeared after operation in 1 case, and the remaining 9 cases received anticoagulant therapy, among which 7 cases received Heparin anticoagulant therapy alone: cardiac embolus disappeared during hospitalization in 2 cases, disappeared after 2 weeks of oral administration of Dipyridamole outside the hospital in 1 case, and the other 4 cases received Heparin anticoagulant therapy alone during hospitalization with poor effect, embolus disappeared in 2 cases 4 and 5 months after discharge respectively, and 2 cases were not reexamined due to personal reasons; the embolus disappeared 2 months after discharge in 2 cases who were changed to low-molecular weight Heparin + Warfarin anticoagulant therapy after failing to respond to Heparin anticoagulant therapy.All the 10 cases showed no symptoms of tachypnea or chest pain during telephone follow-up.Conclusions:Children with long fever time and significantly elevated CRP and D-D are more likely to form thrombus.Anticoagulant therapy is effective after thrombosis, and surgical thrombectomy can be performed in children who have failed to respond to anticoagulant therapy or worry about complications caused by dropped embolus.
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Objective:To investigate the protective effect of baicalein on injured PC12 cell induced by Aβ and explore its mechanism.Methods:The method of MTT was used to detect the cell activity of each group and screened the concentration of baicalein. The PC12 cells were randomly divided into the blank group, the Aβ group, the baicalin group and the estradiol group. 24 hours after inoculation, baicalein group was intervened with 1×10 -6 mol/L baicalein solution, and estradiol group was intervened with 1×10 -5 mol/L estradiol solution. Two hours later, except the blank group, the other groups were added with 1.5×10 -4 mol/L Aβ to make the model. MTT assay was used to detect the cell viability of each group after 24 hours of cultivation. Then used oxidation kit to detect the contents of superoxide dismutase (SOD), glutathione peroxidase (GSH-PX) and lactate dehydrogenase (LDH) in each group. And the level of caspase-3 mRNA was detected by Real-time Quantitative PCR (RT-PCR). Then the Western blot method was used to detect the expressions of p-PI3K, p-AKT and caspase-3. Results:Compared with the Aβ group, the PC12 cell viability [(96.348 ± 0.571)%, (97.183 ± 0.714)% vs. (86.922 ± 0.429)%] in the baicalin group and the estradiol group significantly increased( P<0.01). The activities of SOD [(54.31 ± 1.34) U/mgprot, (57.38 ± 2.25) U/mgprot vs. (36.18 ± 2.24) U/mgprot] and GSH-PX [(4.46 ± 0.23) U/mgprot, (4.72 ± 0.31) U/mgprot vs. (2.05 ± 0.37) U/mgprot] significantly increased, and the level of LDH [(85.43 ± 0.92) nmol/ml, (82.46 ± 0.27) nmol/ml vs. (99.17 ± 0.52) nmol/ml] significantly decreased ( P<0.01). The expression of caspase-3 mRNA (2.24 ± 0.64, 2.33 ± 0.75 vs. 3.46 ± 0.46) and p-PI3K (0.46 ± 0.03, 0.44 ± 0.06 vs. 0.66 ± 0.09), p-AKT (0.43 ± 0.05, 0.41 ± 0.02 vs. 0.58 ± 0.03), caspase-3 (0.61 ± 0.03, 0.56 ± 0.53 vs. 0.92 ± 0.07) protein significantly decreased ( P<0.01). Conclusion:Baicalein could slow down cell apoptosis and oxidative reaction, reduce the damage of Aβ to PC12 cells by inhibiting the expression of PI3K/AKT pathway.
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Objective:To explore the association of miRNA-146a (miR-146a), miRNA-196a2 (miR-196a2), and miRNA-499 (miR-499) single nucleotide polymorphisms with genetic susceptibility in hepatocellular carcinoma.Methods:A case-control study was designed. A total of 175 patients (hepatocellular carcinoma group) in Affiliated Hospital of Yangzhou University from April 2015 to March 2019 and 302 healthy people undergoing physical examination during the same period (the control group) were selected. The genotype distribution of miR-146a, miR-196a2 and miR-499 in the peripheral blood of the two groups were detected by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Logistic regression model was used to analyze the association of 3 genotypes of miRNA, genotypes of hepatitis virus infectors with genetic susceptibility in hepatocellular carcinoma. The relationship between miR-146a gene polymorphism and demography factor as well as the clinical characteristics was also analyzed by using Spearman correlation analysis.Results:In hepatocellular carcinoma group, miR-146a single nucleotide polymorphism of CC, CG, GG site genotypes had 52 (29.7%) cases, 86 (49.1%) cases, 37 (21.1%) cases, respectively; in the control group, the corresponding genotypes had 137 (45.4%) cases, 135 (44.7%) cases and 30 (9.9%) cases, respectively, and the difference in genotype distribution of both groups was statistically significant ( χ2 = 17.23, P < 0.05). There were no statistical differences in genotype distribution of miR-196a2 and miR-499 ( χ2 = 0.51, P = 0.776; χ2 = 0.05, P = 0.976). Single factor logistic regression analysis showed that in the co-dominant model of miR-146a genotype, genotypes of CG ( OR = 1.96, 95% CI 1.13-3.41, P = 0.017) and GG ( OR = 3.30, 95% CI 1.85-5.89, P<0.01) had elevated risk of hepatocellular carcinoma compared with CC genotype. In the dominant model, the risk of hepatocellular carcinoma in CG+GG genotypes was increased compared with that in CC genotype ( OR=1.97, 95% CI 1.33-2.93, P = 0.001); in the recessive model, the risk of hepatocellular carcinoma in GG genotype was increased compared with that in CG+ GG genotype ( OR=2.43, 95% CI 1.44-4.11, P = 0.001). Single factor logistic regression analysis showed that there was no significant difference in the risk of hepatocellular carcinoma in the co-dominant, dominant and recessive models between miR-196a2 and miR-499 genotypes (all P > 0.05). For hepatocellular carcinoma patients with positive hepatitis B virus (HBV), CG genotype had a 2.02-fold (95% CI 1.06-5.07) risk of hepatocellular carcinoma compared with CC genotype, and GG genotype had a 3.12-fold (95% CI 1.66-10.07) risk of hepatocellular carcinoma compared with CC genotype; CG+GG genotype had a 1.91-fold (95% CI 1.85-3.38) compared with CC genotype, GG genotype had a 1.54-fold (95% CI 1.15-6.08) compared with CG+GG genotype. The increasing risk of hepatocellular carcinoma by miR-146a gene polymorphisms was not found in hepatocellular carcinoma patients with hepatitis C virus (HCV) infection or without HBV and HCV infection. Spearman correlation analysis showed that miR-146a gene polymorphisms was not related with age, gender, smoking, drinking, family history of cancer, alanine transaminase and aspartate aminotransferase (all P>0.05). Conclusions:GG and CG genotypes of miR-146a increase the risk of genetic susceptibility in hepatocellular carcinoma, especially for patients with HBV infection. miR-196a2 and miR-499 single nucleotide polymorphisms don't increase the risk of hepatocellular carcinoma.
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Objective:To investigate the difference of accuracy between magnetic induction Freehand-3D ultrasound and two-dimensional ultrasound in measuring the volume of thyroid model.Methods:Forty thyroid models were established using porcine liver, and the Archimedes procedure was set as gold standard in the measurement of the volume of each model. The accuracy of measurement of the porcine thyroid model volume between two-dimensional ultrasound and magnetic induction Freehand-3D ultrasound were compared.Results:There were no significant differences in the accuracy of measurements of thyroid model volume among two-dimensional ultrasound, magnetic induction Freehand-3D ultrasound and Archimedes procedure (all P>0.05). Compared with the Archimedes procedure, magnetic induction Freehand-3D ultrasonic method showed higher correlation coefficient of the measurement of thyroid model volume ( r=0.998). Bland-Altman analysis showed the lower measure error with a relative error of 3.42% and range of -9.57% to 12.07%. And the limits of agreement were (-1.253, 0.999) in the magnetic induction Freehand-3D ultrasonic measurement. Conclusions:Compared with two-dimensional ultrasound, the magnetic induction Freehand-3D ultrasound show higher accuracy in the measurement of the volume of the thyroid model.
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Objective:A retrospective analysis was performed on clinical characteristics and deoxyguanosine kinase DGUOK gene mutations in a family with hepatocerebral mitochondrial DNA depletion syndrome (MTDPS). Methods:The clinical data, treatment process and gene detection results of a child with MTDPS in the second hospital of Hebei Medical University in April 2019 were analyzed and summarized.Results:Proband was a girl.From the first week of infantile, she suffered from recurrent hypoglycemia, hyperlactic acid, progressive cholestatic liver dysfunction, coagulopathy, difficult feeding, slow growth of body mass, microcephaly, hypotonia, and gradul intermittent binocular tremors, and eventually failed to thrive.Gene testing identified two compound heterozygous mutations c. 42-c.43insTTCA(p.F15fs129X)/c.808-1(IVS6)G>A in DGUOK gene.The former was a frame-shift mutation resulted in truncated protein and the later was a splicing mutation resulted in abnormal splicing.Each parent was a heterozygous carrier, and there were no mutations in the two sites with her elder sister. Conclusions:Both mutations were first reported worldwide. DGUOK gene mutations with MTDPS are important causes of infant liver failure.When hypoglycemia, hyperlactic acidemia and liver dysfunction occur in newborn and infant, MTDPS related gene DGUOK gene sequencing screening should be considered for early definitive diagnosis, or, when acute liver failure happen in infant and childhood, neuromuscular involvement is insufficient.
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China has a heavy burden of hepatocellular carcinoma, which is a serious threat to people′s life and health. However, the available drugs for advanced hepatocellular carcinoma in the past are limited and the efficacy is not satisfactory. In recent years, immunotherapy has a significant effects in some tumors. The authors introduce the efficacy of restart immunotherapy on an advanced hepatocellular carcinoma patient undergoing interruption of treatment due to corona virus disease 2019, in order to provide references for the diagnosis and treatment of this kind of patients.
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Objective:To explore the relationship of risk factors and clinical features to assessments of children with cerebral palsy (CP ) using a magnetic resonance imaging classification system (MRICS).Methods:Medical records of CP patients under 18 years old were reviewed retrospectively. Data including high-risk factors, cranial MRI results and clinical characteristics were collected. The cranial MRI results were classified according to the MRICS.Results:Of 1357 patients studied, 1112 (82%) had received cranial MRI scans. Among them, 962 (86.5%) showed MRI-identified brain abnormalities, 489 in the periventricular white matter. Subjects with different weeks of gestation, birth weights, delivery times, neonatal hypoxic-ischemic encephalopathy, and neonatal cerebral hemorrhage had significantly different MRI classifications according to the system. Premature birth, low birth weight and multiple births correlated with the incidence of white matter brain injury. Only 4 of the subjects with neonatal cerebral hemorrhage were classified as having normal brain structures using the MRICS. However, gender, birth method, and pathological jaundice had no significant relationship with MRICS ratings. Significant differences in MRICS classifications were observed between patients with different CP subtypes, gross motor function scores, as well as with or without epilepsy, speech or language impairment. But degrees of mental retardation were not significantly related with MRICS classifications.Conclusion:MRICS classifications relate closely with risk factors and the clinical characteristics of CP patients. The system can play an important role in finding pathogenesis and predicting clinical outcomes. It is worthy of applying and promoting in the clinic.
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Objective:To explore the relationship between high sensitivity C-reactive protein (hs-CRP) and vascular access failure in hemodialysis patients.Methods:From July 2017 to June 2018, 105 patients with regular hemodialysis were selected from the blood purification center of Beijing Haidian hospital.According to the presence or absence of VAF, the patients were divided into two groups: VAF+ group and VAF - group.The difference of hs CRP level between the two groups was compared.Results:During the 12-month follow-up, 17 patients had more than one event of vascular failure.The total protein level of VAF+ group was significantly lower than that of VAF-Group((65.61±4.01) g/L and( 68.98±5.66) g/L, P=0.021). The male proportion of VAF+ group was lower than that of VAF-group (29.41% vs 53.41%, P=0.07), but the difference was not statistically significant.There was no significant difference in the annual change level of hs CRP between VAF + group and VAF Group((0.33±5.49) mg/L and(0.57±4.45) mg/L, P=0.840). The level of total protein was the independent protective factor of VAF( OR=0.889, 95% CI 0.797-0.991, P=0.034). The level of hs CRP was not significantly correlated with vascular access events( OR=1.018, 95% CI 0.926-1.119, P=0.713). Conclusion:There is no correlation between hs CRP and VAF.The exact mechanism of inflammation in intimal hyperplasia needs further study.
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Objective@#To explore the relationship between high sensitivity C-reactive protein (hs-CRP) and vascular access failure in hemodialysis patients.@*Methods@#From July 2017 to June 2018, 105 patients with regular hemodialysis were selected from the blood purification center of Beijing Haidian hospital.According to the presence or absence of VAF, the patients were divided into two groups: VAF+ group and VAF - group.The difference of hs CRP level between the two groups was compared.@*Results@#During the 12-month follow-up, 17 patients had more than one event of vascular failure.The total protein level of VAF+ group was significantly lower than that of VAF-Group((65.61±4.01) g/L and( 68.98±5.66) g/L, P=0.021). The male proportion of VAF+ group was lower than that of VAF-group (29.41% vs 53.41%, P=0.07), but the difference was not statistically significant.There was no significant difference in the annual change level of hs CRP between VAF + group and VAF Group((0.33±5.49) mg/L and(0.57±4.45) mg/L, P=0.840). The level of total protein was the independent protective factor of VAF(OR=0.889, 95%CI 0.797-0.991, P=0.034). The level of hs CRP was not significantly correlated with vascular access events(OR=1.018, 95%CI 0.926-1.119, P=0.713).@*Conclusion@#There is no correlation between hs CRP and VAF.The exact mechanism of inflammation in intimal hyperplasia needs further study.
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Objective To analyse the relationship between pre-stroke sleep quality and post-stroke insomnia. Method One hundred nineteen hospitalized patients with cerebral infarction within 2 weeks from onset were recruited during April 2018 and August 2018. Sleep quality of pre- and post-stroke evaluated by Pittsburgh sleep quality index (PSQI) were collected. According to the post-stroke PSQI＞5,119patients were divided into insomnia group and non-insomnia group. Multivariate logistic regression model was used to explore the independent risk factors for insomnia after stroke. Result Among the 119 patients, the prevalence of post-stroke insomnia was 55.5% and pre-stroke sleep quality was significantly relative to post-stroke insomnia (OR=1.405,95%CI 1.196～1.650,P＜0.05). Conclusion Pre-stroke sleep quality is correlated to post-stroke insomnia.
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Objective To explore the mechanism of transforming growth factor-beta/p38 mitogen-activated protein kinases (TGF-β/P38MAPK) signaling pathway that transformed corallin into a transforming growth factor-beta/p38 mitogen activated protein kinases (TGF-β/P38MAPK).Methods The hair follicle stem cells (HFSCs) were divided into blank group,positive group and 10-10,10-9,10-8,10-7,10-6,10-5,10-4,10-3 mol/L mycoralin solution groups according to the random number table method.After 24 h,the cell proliferation rate was determined by MTT assay.The HFSCs were divided into blank group,positive group and low,medium and high dose groups according to the random number table method.The positive group was added with 5 mol/L of alkaline fibroblast growth factor solution,while the low,medium and high dose groups were added with 10-7,10-6 and 10-5 mol/L of mycoralin solution for intervention.The cell proliferation rate was determined by MTT assay.The protein expressions ofTGF-β,phosphorylated P38(p-p38),P38,Bax and bcl-2 in cells were detected by Western blot,and mRNA expressions of Bax and bcl-2 in cells of each group were detected by real-time quantitative PCR.Results Compared with the blank group,the productivity of the cells (0.418 ± 0.031,0.412 ± 0.014,0.468 ± 0.024 vs.0.353 ± 0.006) in the 10-7,10-6 and 10-5 mol/L aucubin groups significantly increased (P＜0.01).Compared with the blank group,the protein expression of TGF-β (0.377 ± 0.027,0.338 ± 0.021,0.322 ± 0.017 vs.0.557 ± 0.017),p-p38 (0.270 ± 0.020,0.228 ± 0.013,0.216 ± 0.012 vs.0.461 ± 0.012),Bax (0.450 ± 0.017,0.365 ± 0.011,0.279 ± 0.006 vs.0.551 ± 0.015) in the low,medium and high dose groups significantly down-regulated,while the Bcl-2 (0.450 ± 0.017,0.365 ± 0.011,0.279 ± 0.006 vs.0.358 ± 0.011) protein expression significantly increased.Compared with the blank group,the expression of Bcl-2 (1.714 ± 0.028,2.514 ± 0.054,3.382 ± 0.084 vs.1.000 ± 0) mRNA increased,Bax (0.415 ± 0.020,0.353 ± 0.090,0.235 ± 0.114 vs.1.000 ± 0) mRNA in the low,medium and high dose groups significantly down-regulated (P＜0.01).Conclusions By regulating the TGF-β/p38MAPK signaling pathway,mycoralin can reduce the expression of downstream apoptotic factors,and promote the repair of damaged skin.
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Objective To study the effect of sand therapy on the hemodynamics of flexural femoral artery, and further reveal the therapeutic mechanism of sand therapy from the perspective of hemodynamics. Methods The three-dimensional finite element model of the curved femoral artery was established based on CT images of human aorta, and the data of heart rate, peak blood flow velocity and inner diameter of femoral artery measured by the experiment were used as initial conditions and boundary conditions to carry out finite element numerical simulation. The blood flow velocity, pressure and wall shear stress before and after sand therapy were analyzed and compared under fluid-solid coupling condition. Results Compared with treatment before sand therapy, the longitudinal velocity of the flexural segment of blood vessel increased significantly, with an increase of 22.76%. The secondary reflux velocity decreased significantly, with a relative decrease of 18.26%. The wall shear stress decreased by 2.01% after sand therapy. Conclusions Sand therapy had a significant effect on blood fluidity, by improving blood flow of femoral arteries, and preventing deposition of arterial platelets. The transverse flow phenomenon was obviously weakened after sand therapy, which could avoid the deposition of substances in blood and had a positive effect on the prevention of atherosclerosis, thrombosis and other vascular diseases.
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Objective To study the effect of sand therapy on the hemodynamics of flexural femoral artery, and further reveal the therapeutic mechanism of sand therapy from the perspective of hemodynamics. Methods The three-dimensional finite element model of the curved femoral artery was established based on CT images of human aorta, and the data of heart rate, peak blood flow velocity and inner diameter of femoral artery measured by the experiment were used as initial conditions and boundary conditions to carry out finite element numerical simulation. The blood flow velocity, pressure and wall shear stress before and after sand therapy were analyzed and compared under fluid-solid coupling condition. Results Compared with treatment before sand therapy, the longitudinal velocity of the flexural segment of blood vessel increased significantly, with an increase of 22.76%. The secondary reflux velocity decreased significantly, with a relative decrease of 18.26%. The wall shear stress decreased by 2.01% after sand therapy. Conclusions Sand therapy had a significant effect on blood fluidity, by improving blood flow of femoral arteries, and preventing deposition of arterial platelets. The transverse flow phenomenon was obviously weakened after sand therapy, which could avoid the deposition of substances in blood and had a positive effect on the prevention of atherosclerosis, thrombosis and other vascular diseases.
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Objective@#To establish a New Zealand rabbit animal model of laryngopharyngeal reflux disease (LPRD) using esophageal balloon together with metal internal stent dilation and to investigate the changes of mucosa.@*Methods@#20 New Zealand rabbits were randomly divided into experimental group and control group, with 10 in each group. Balloon dilatation and metal internal stent dilation were carried out in experimental group to reproduce the animal model of LPRD.The middle of balloon was placed at the lower esophageal sphincter (LES) while the stent was placed at the upper esophageal sphincter (UES). The guide wire was placed in the control group, but the balloon was not expanded and the stent was not placed. The general condition, pH value of hypopharynx, laryngeal histopathology and changes of pepsin content of New Zealand rabbits were observed regularly. The difference between experimental group and control group was compared.@*Results@#The 24-hour Dx-pH monitoring results showed that the number of reflux episodes(20.0[9.5, 35.0], 13.0[6.5, 22.0]), and the percent time below pH 5.5 (1.36%[0.60%, 4.57%], 1.36%[0.43%, 2.77%]) in the experimental group at the 2nd and 4th week were significantly different from those in the control group (0[0,3.0], 1.0[0.5, 3.8]; 0[0, 0.01%], 0[0, 0], respectively, all P<0.01), suggesting that the experimental group New Zealand rabbits developed LPRD. Compared with the control group under microscope, lymphocytes infiltration and submucosal gland hyperplasia increased in the mucosa of the throat of the experimental group. The results of pepsin immunohistochemical staining between the two groups were statistically significant (P=0.014).@*Conclusion@#The use of balloon dilatation of the LES combined with metal stent dilatation of the UES can successfully establish a laryngopharyngeal reflux model, and lesions in the throat tissue can be observed.