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Objective:To investigate the curative effect of endoscopic cyclophotocoagulation combined with trabeculectomy for primary open angle glaucoma.Methods:From January 2020 to May 2021, 30 eyes of 30 patients with advanced primary open angle glaucoma with cataract who underwent endoscopic cyclophotocoagulation combined with trabeculectomy in the Municipal Hospital Affiliated to Xuzhou Medical University were retrospectively analyzed. The preoperative best corrected visual acuity, preoperative intraocular pressure (IOP) and numbers of anti-glaucoma medication were recorded. IOP, numbers of anti-glaucoma medication at 1 day, 3 months, 6 months and 1 year after operation, postoperative complications, the numbers of absolute success and qualified success were recorded.Results:All cases were followed up for 1 year. The best corrected visual acuity improved by more than one line in 26 eyes at 1 year after operation. Preoperative visual acuity was maintained in 3 eyes visual acuity decreased in 1 eye. The IOP and numbers of anti-glaucoma medication at 1 day, 3 months, 6 months and 1 year after operation were significantly different from those before operation ( P<0.01). At 1 year after operation, 8 patients were qualified successful and 17 patients were absolutely successful. Early hyphema in 30 eyes, transient ocular hypertension in 3 eyes ciliary body detachment in 0 eyes, corneal edema in 9 eyes, and anterior chamber exudation in 8 eyes. Conclusions:In this small sample size of study with follow-up for 12 months, the results showed that endoscopic cyclophotocoagulation combined with trabeculectomy in the treatment of advanced open angle glaucoma has good preliminary efficacy and safety. However, a large sample of cases is still needed to further study its long-term safety and efficacy.
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OBJECTIVE To evaluate the cost -effectiveness of tislelizumab in the second -line treatment of advanced or metastatic esophageal squamous cell carcinoma （ESCC）in China .METHODS A three -state Markov model was constructed to assess the cost -effectiveness of tislelizumab versus chemotherapy in the second -line treatment of advanced or metastatic ESCC and programmed death receptor 1（PD-L1）positive patients . The cycle length of the model was 1 month，and the time horizon of the model was set as 10 years. The discount rate of cost and utility was 5%. One-way sensitivity analysis ，probability sensitivity analysis and scenario analysis were used to verify the robustness of the base -case analysis results . RESULTS The results of the base-case analysis showed that compared with chemotherapy ，the incremental cost -effectiveness ratio （ICER）of tislelizumab in the second-line treatment of advanced or metastatic ESCC and PD -L1-positive patients were 26 864.01 yuan/QALY and 37 510.07 yuan/QALY，respectively，which was much lower than 1 time per capita gross domestic product （GDP）in 2021（80 976 yuan）. Results of scenario analysis showed that the ICER was less than 1 times per capita GDP ，regardless of the chemotherapy regimens（paclitaxel，docetaxel or irinotecan ）used. With the extension of the simulation time limit ，the ICER of tirelizumab regimen gradually decreased ，and the reduction rate gradually E-mail：lishunping@sdu.edu.cn decreased，but they were all less than 1 time China ’s per capita GDP in 2021. The results of the one -way sensitivity analysis showed that the 3 parameters with the most significant impact on the ICER were progression -free survival of tislelizumab group ，price of tislelizumab ，and the proportion of patients receiving follow-up treatment in the tislelizumab group . The results of the probability sensitivity analysis showed that the probability of tislelizumab with cost -effectiveness in the treatment of advanced or metastatic ESCC patients and PD -L1-positive patients were 99.09% and 99.94%，respectively，when using 3 times per capita GDP as the willingness -to-pay threshold . CONCLUSIONS Tislelizumab has economic advantages over chemotherapy alone in the second -line treatment of advanced or metastatic ESCC patients.
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Based on the combination of formative evaluation and summative evaluation, the newly-built virtual experimental platform was applied to the functional experimental assessment of clinical students. Its effects were observed by the process evaluation of "daily performance-virtual and real operation + written exam" and feedback from teachers and students. The results showed that daily performance, experimental operation, experimental report and final score of students in the experimental group who received the teaching by virtual experimental platform were significantly better than those in the control group; the students' interests in learning and self-learning ability in the experimental group were also significantly improved. This research showed that the introduction of virtual experimental platform into the teaching evaluation of diversified functional experiment enriches the contents and ways of formative evaluation, so as to improves students' experimental skills, and further enhance the effects of experimental teaching.
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Based on the combination of formative evaluation and summative evaluation,the newlybuilt virtual experimental platform was applied to the functional experimental assessment of clinical students.Its effects were observed by the process evaluation of "daily performance-virtual and real operation + written exam" and feedback from teachers and students.The results showed that daily performance,experimental operation,experimental report and final score of students in the experimental group who received the teaching by virtual experimental platform were significantly better than those in the control group;the students' interests in learning and self-learning ability in the experimental group were also significantly improved.This research showed that the introduction of virtual experimental platform into the teaching evaluation of diversified functional experiment enriches the contents and ways of formative evaluation,so as to improves students' experimental skills,and further enhance the effects of experimental teaching.
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Objective To provide a scientific basis for the formulation of effective incentive measures for rural health workers,by analyzing the factors influencing their work enthusiasm and constructing an incentive mechanism framework.Methods A field questionnaire survey and personal in-depth interview were conducted on 803 health technicians from 45 township health centers in Shandong,Anhui and Shanxi provinces.The study covered economic,management,education and career supports aspects,and the data were analyzed in descriptive,multi-level model and correlation analyses.Results The work enthusiasm scoring of rural health workers was 89.83 + 9.54.Workload,doctor-patient relationship,work competence and income index were the four influencing factors,with the differences showing statistical significance(P ＜0.05).The income index (income expectancy/real income affects work) influences the enthusiasm negatively,while the rest of the factors were positive.Work enthusiasm was positively correlated with three dimensions of job performance.The satisfaction of interpersonal relationship,workload and competence were positively correlated with work enthusiasm.The correlation indexes are respectively 0.35,0.33 and 0.21 (P ＜ 0.01).Conclusions To motivate primary health institutions and their health workers,the authorities should focus on the economic factors,and take into account non-economic ones,while improving the performance-based wage system and creating a fair workplace culture.
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Objective To establish a serological detection method for EA-D-IgA antibody,and to evaluate its diagnostic efficacy for nasopharyngeal carcinoma in different clinical stage.Methods EA-D-IgA antibody serological detection method was established by using the polypropylene microplate with eukaryotic expression product of BMRF1 whole gene fragment of EB virus.Fifteen early stage (stage Ⅰ and Ⅱ) and 48 advanced (stage Ⅲ and Ⅳ) patients with nasopharyngeal carcinoma in Shanxi Provincial Cancer Hospital and Shanxi Dayi Hospital from April 2012 to August 2017,and serum samples from 40 patients with rhinitis who were treated at Shanxi Dayi Hospital from October 2016 to October 2017 were examined respectively by using the constructed EA-D-IgA antibody detection method.The positive detection rate of EA-D-IgA antibodies in different groups was calculated.When the patients with rhinitis were used as the differential control,the diagnostic efficacy of this index for different stages of nasopharyngeal carcinoma was evaluated.Results EA-D-IgA antibody serological method was successfully established.The positive detection rate of EA-D-IgA antibody in early nasopharyngeal carcinoma,advanced nasopharyngeal carcinoma and rhinitis control was 60.0 ％ (10/15),68.3 ％ (33/48) and 5.0 ％ (2/40) respectively.The differences between early stage nasopharyngeal carcinoma and the rhinitis control,advanced nasopharyngeal carcinoma and the rhinitis control were statistically significant (x2 =20.625,P =0.000;x2 =37.017,P =0.000).The difference between early nasopharyngeal carcinoma and advanced nasopharyngeal carcinoma was not statistically significant (x2 =0.394,P =0.530).When compared with the patients with rhinitis,the diagnostic sensitivity,specificity,positive predictive value,negative predictive value was 60.0 ％ and 68.3 ％,95.0 ％ and 95.0 ％,81.8 ％ and 94.3 ％,86.4 ％ and 71.7 ％ respectively in early nasopharyngeal carcinoma and advanced nasopharyngeal carcinoma.Conclusion The method constructed in this study effectively improves the efficacy of EA-D-IgA antibody detection in serological diagnosis of nasopharyngeal carcinoma,which can be used as an adjunct for early diagnosis of nasopharyngeal carcinoma,yet not as a reference for clinical staging.
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Objective To investigate the effect of paclitaxel combined with platinum on neoadjuvant chemotherapy in patients with locally advanced cervical cancer (LACC).Methods A total of 58 cases with LACC were treated with neoadjuvant chemotherapy in our hospital were selected,of which 29 patients (group A) were treated with paclitaxel plus lobaplatin and 29 patients (group B) were treated with paclitaxel plus cisplatin.Both groups received Radical cervical cancer surgery.The short-term efficacy,serum tumor markers,incidence of toxic side effects and long-term prognosis were compared between the two groups.Results The remission rate in group A was 82.75 ％ and the total effective rate was 100.00％;the remission rate in group B was 68.97％ and the total effective rate was 96.55％;there was no significant difference between the two groups (P＞0.05).After chemotherapy,serum CYFRA21-1 and SCCAg levels in patients of group A and B were significantly lower than those before chemotherapy (P＜0.05).During chemotherapy,the incidence of nausea,vomiting and diarrhea in group A was 17.24％ and 6.90 ％,respectively.The incidence of nausea,vomiting and diarrhea in group B was 48.28％ and 31.03 ％,respectively,the difference between the two groups was statistically significant (P＜0.05).After 36 months of follow-up,the overall survival rate in group A was 68.97 ％,and the overall survival rate in group B was 62.07 ％,there was no significant difference between the two groups (x2 =0.305,P =0.581);there was no significant difference in survival time between the two groups (Z=0.381,P=0.537).Conclusion The effect of Paclitaxel combined with lobaplatin in the preoperative neoadjuvant chemotherapy of LACC patients is equivalent to paclitaxel and cisplatin.
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Purpose To explore the difference of expression and prognostic significance of SP1,KLF4 and p21 in low grade ovarian serous carcinoma (LGSC) and high grade ovarian serous carcinoma (HGSC).Methods The expression of SP1,KLF4 and p21 protein was examined with immunohistochemistry EliVision method in cases with LGSC and HGSC.Kaplan-Meier analysis and Cox multivariate survival analysis were used to assess the impact of SP1,KLF4 and p21 expression on prognosis of LGSC and HGSC.Results SP1,KLF4 and p21 expression were detected respectively in 74.5％,17.0％ and 11.7％ HG-SC cases,and in 65.2％,34.8％ and 26.1％ LGSC cases.Compared to control group,the expression level of SP1 was significantly higher (P ＜ 0.05),but the expression level of KLF4 and p21 were significantly lower (P ＜0.05).There was no significant difference of SP1,KLF4 and p21 expression between HGSC and LGSC (P ＞ 0.05).The expression of SP1,KLF4 and p21 were associated with FIGO stage,meanwhile SP1 associated with residual tumor size in HGSC (P ＜ 0.05).There was a significant negative correlation between SP1 and KLF4,p21 proteins in HGSC (P ＜ 0.05).Kaplan-Meier analysis revealed that there were significantly poor overall survival (OS) of 5 years for patients with HGSC displaying high expression of SP1,or low expression of KLF4 and p21 (P ＜0.05),but no significantly improved OS for patients with LGSC (P ＞ 0.05).Cox analysis showed that SP1 overexpression is an independent prognosis factor for HGSC.Conclusion Overexpression of SP1 and low expresion of KLF4 and p21 contribute to carcinogenesis of HGSC and LGSC.They are associated with a poor prognosis of HGSC,but not LGSC,meanwhile SP1 is an independant prognosis factor for HGSC.
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ABSTRACT:Objective To observe whether N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP)can inhibit rat silicotic fibrosis by regulating stimulatory G proteinα(Gαs)/inhibitory G proteinα(Gαi)signal.Methods Male Wistar rats were randomly divided into three groups (n=1 0 ):control 1 6-w group,silicosis 1 6-w group,and Ac-SDKP pre-treatment group.The pathological changes of the lung tissue was observed by HE staining;the expressions ofα-smooth muscle actin (α-SMA),Collagen Ⅰ,fibronectin (Fn),Gαs,Gαi2 ,Gαi3 and cAMP were detected by Western blot.Immunofluorescence was performed on lung tissue sections to detect the coexpression ofα-SMA/Gαi3 . Results Within silicosis 16-w group,HE staining showed that the silicotic nodule volume increased,nodule fusion and the formation of interstitial fibrosis could be seen,and cell fibrous nodules were visible.Immunofluorescence staining showed the enhanced coexpression ofα-SMA/Gαi3 in fibrosis area.Compared with those in control group, the expressions ofα-SMA,Collagen Ⅰ,Fn,Gαi2 and Gαi3 significantly increased in silicosis 1 6-w group,but the expressions of Gαs and cAMP decreased.Compared with silicosis 1 6-w group,Ac-SDKP pre-treatment group had alleviated lung injury and decreased coexpression ofα-SMA/Gαi3 .The expressions ofα-SMA,Collagen Ⅰ,Fn,Gαi2 and Gαi3 protein significantly decreased in Ac-SDKP pre-treatment group,while the expressions of Gαs and cAMP increased obviously.Conclusion Ac-SDKP can regulate the expressions of Gαs and Gαi and promote the formation of cAMP,thus playing an effective role against silicotic fibrosis.
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With increasing use of carbapenem antibiotics , carbapenems-resistant gram-negative bacteria are spreading, and carbapenemase-producing is the main mechanism of carbapenems resistance . Rapid and accurate identification of carbapenemase and its type is of great importance to timely and effective treatment and control of infections .Chromogenic /Fluorogenic culture media, modified Hodge test and double disk synergy test are traditional methods for carbapenemase detection , but all are time-consuming. Biochemical method is more time efficient and with high sensitivity and specificity , but cannot be used to identify subtypes.Now matrix-assisted laser desorption ionization -time-of-flight mass spectrometry (MALDI-TOF MS) has been successfully applied in the identification of species , subtypes and detection of drug -resistant genes.And among various carbapenemase gene detection techniques , next generation sequencing (NGS) can also be used for the detection of integrons , transposons and plasmids, which is important in both epidemiology and resistant mechanism studies .This article reviews the advantages and disadvantages of various methods for phenotype and gene detection of carbapenemase .
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Objective To provide reference for clinical application of combined antoxidants , by evaluating the com-bined and individual antioxidant activities of three commonly used antioxidants :edaravone,glutathion(GSH) and vitamin C ( VC) .Methods The multiple and individual antioxidant activities of the three antioxidants were compared by determining total antioxidant activity assay , reductive activity assay , superoxide anion scavenging assay and hydroxyl radical scavenging assay.Results and Conclusion Results showed that the combined antioxidants acted synergistically in scavenging free radicals and increased remarkably antioxidant activity at the same molar concentration .The rationality of different antioxi-dant combination should be taken into consideration in subsequent clinical application .
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Objective To explore the effect of latissimus dorsi musculocutaneous flap for repairing severe soft tissue defect of the elbow.Methods Seventeen patients with severe soft tissue defect of the elbow were repaired by latissimus dorsi musculocutaneous flap.Ten patients were performed transfer of skin flap for functional reconstruction,9 patients reconstructed elbow flexion,and 1 patient reconstructed elbow extension.Seven patients' tissue defect were repaired by cover type musculocutaneous flap,and the areas of these flaps ranged from 6 cm × 10 cm-12 cm × 27 cm.Results All the musculocutaneous flaps kept alive.After an average postoperative follow-up for 12-40(22.0 ± 9.6) months,the color and luster of the flaps were satisfying.There were no scar contracture of the flap and no bulkiness of the elbow.Ten patients performed transfer of skin flap for functional reconstruction,and the range of motion was 100°-140° of flexion and-20°-0° of extension.Muscle power was M3-M5.Hand function was near normal.Conclusion Latissimus dorsi musculocutaneous flap is an ideal surgical method to repair the severe soft tissue defect of the elbow.
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The connection between male infertility and abnormal methylation of imprinted genes has attracted much attention. Some imprinted genes, e.g., H19, MEG3, MEST and SNRPN, are known to be related with male infertility. Abnormal imprinted information may influence sperm concentration, motility and morphology, but the mechanism is still unclear. Sperm genomic imprinting reconstruction and erase respectively occur at the time of spermatogenesis and before embryo transfer. Many studies have shown that the probability of imprinting disorder syndrome of offspring born through assisted reproductive technology (ART) was significantly higher, leading to the worry about the safety of ART and speculation that the operation and in vitro environment may affect sperm imprinted information, which in turn may lead to imprinting diseases in the offspring. However, above connection still lacks convincing evidence. This paper has conducted a literature review of recent literature and explored the impact of abnormal methylation of imprinted genes on male fertility and the offspring.
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Humanos , Masculino , Impressão Genômica , Infertilidade Masculina , Genética , Proteínas , Genética , RNA Longo não Codificante , Genética , Técnicas de Reprodução AssistidaRESUMO
Objective To develop a precise and reliable method to determine mammalian cell survival using the triphe-nyltetrazolium chloride (TTC) solution.Methods Different amounts of TTC solution were added to the cultured cells in order to find the optimal concentration .The correlation between the cell number and the measured optic density value was analyzed.In addition, the TTC method was compared with traditional MTT assay .Results The TTC assay could precisely reveal the viability of cultured cells as well as the MTT method , but the non-specific reaction of the MTT reagent by other antioxidants could result in unreliable overestimation of the cell number .Conclusion The TTC assay can be used to deter-mine the survival of cultured cells more precisely .
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Objective To provide reference on the difference in blood glucose metabolism between different mouse strains by comparing blood glucose changes under food and /or water deprivation.Methods C57BL/6J mice, BALB/c mice,and ICR mice used in this study were divided into four groups:control group, food deprivation group, water depriva-tion group and food &water deprivation group .Their blood glucose was measured within 12 hours under various stresses . Results and Conclusion There are different blood glucose regulation patterns in different mice strains .The blood glucose level of C57BL/6J mice is usually higher than that of the BALB/c and ICR mice, while the of blood glucose level BALB/c mice stays relatively stable , and the ICR mice have the widest range of blood glucose levels upon these stresses .Accord-ing to our data, the difference in blood glucose metabolism between different mouse strains should be taken into considera -tion in blood glucose related studies for proper interpretation and design of experiments .
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Wide range of disorders ranging from genetic disorders to coital difficulties can influence male fertility. In this regard, genetic factors are highlighted as the most frequent, contributed to 10-15%, of male infertility causes. To investigate the influence of genetic abnormalities on semen quality and reproductive hormone levels of infertile men from Northeast China. 2034 infertile men including 691 patients with abnormal sperm parameters were investigated retrospectively. Semen analysis was performed according to the World Health Organization guidelines. Y chromosome micro deletions were detected by polymerase chain reaction assays. Chromosome analysis was performed using G-banding. The incidence of abnormal chromosomal karyotype in the patients with abnormal sperm parameters was 12.01% [83/691]. The most frequent cause was Klinefelter's syndrome 37.35% [31/83]. As the same as chromosomal abnormalities group, the volumes of testes [p=0.000 and 0.000, respectively] and the levels of testosterone [T] [p=0.000], and testosterone/ luteinizing hormone [T/LH] [p=0.000] of patients with Y chromosome micro deletions were significantly lower than those of fertile group. In addition, the levels of follicle-stimulating hormone [FSH] [p=0.000], and luteinizing hormone [LH] [p=0.000] were significantly higher in patients with Y chromosome micro deletions than those in the fertile group. Translocation abnormalities displayed slight effect on sperm motility. Y chromosome micro deletions and sex chromosome disorders particularly Klinefelter's [47, XXY], have severe adverse influence on normal hormone levels, testicular volume and sperm count, whereas translocation abnormalities may inversely correlate with sperm motility
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Objective To investigate the effect of free transplantation of fibula composite tissue flap to the repair of forearm bone and soft tissue serious defect.Methods Eleven cases of reparing forearm bone and soft tissue serious defect through transplantation of free fibula composite tissue petal were applied from March 2004 to February 2011.The length of transplanted fibula composite tissue flap was 8-14 cm ; the flap area was 5 cm ×8 cm-20 cm ×20 cm.The curing situation on bone fracture was observed in 3,6 and 12 months after the surgical opration and the function of defected arm was evaluated in 1 year after surgical operation.Results All of 11 cases of fibula composite tissue flap were survived.The observation was undertaken for more than 12 months after the operation and the fracture section occured the characteristics of healing up in 3 months and fibula and arm bone occured well healed up in half a year; It scored 22.9 according to Enneking system after 1 year of the operation.The function of forearm rotation were classed as this:3 good cases,6 medium cases and 2 poor cases.In the 2 sural nerve bridging transplantation cases,one case was repaired of radial nerve inside static's two-point discrimination (s2PD) to 9 mm,another case was repaired of ulnar nerve distal volar little finger s2PD to 15 mm.All the cases could achieve making a fist with thumb and a thumb could be oppoiste to other 4 fingers,and the ankle joint movement was normal.Conclusion Transplantion of free fibula composite tissue flap to the repair of forearm bone and soft tissue serious defect is an ideal surgical operation method.
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Objective To study the prevalence and genotypes of rotavirus (RV) among children,< 5 years old hospitalized with viral diarrhea in Tianjin. Methods Stool specimens were collected from hospitalized diarrhea children in Tianjin children's hospital between May 2008 and April 2009. Detection of rotavirus was employed by Colloidal Gold Device. The detected positives were inoculated to MA-104 cells. The total RNA of virus was extracted after CPE which was caused by rotavirus were observed, The VP7 serotypes were determined by using RT-PCR to amplify the VP7 gene and sequencing the RT-PCR products.The clinical data for each patient were also collected. Results Among 837 specimens, the RV antigen positive rate was 26. 3% (220/837). Among all the children with rotavirus diarrhea, 90. 5% (199/220)were < 2 years old. The prevalence of rotavirus diarrhea in children peaked during Oct. 2008 through Apr.2009. Of the 208 rotavirus positive specimens, 95 were successfully identified by RT-PCR Thirty-five positive strains of RV were sequenced, and the sequencing results showed that 32 positive strains were belonged to rotavirus G1 type, 2 positive strains were belonged to rotavirus G3 type and 1 positive strain were belonged to rotavirus C9 type. Conclusion RV was the dominant etiological agent for infantile diarrhea infection in Tianjin, and the predominant serotype was G1.
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Objective To study the relation between function of sperm membrane and seminal parameters.Methods Five hundred and three semen samples were collected from 149 normal men and 354 infertile men.Sperm concentration,motility,viability,semen WBC concentration,morphology and sperm tail hypo-osmotic swelling(HOS) were analyzed according to WHO criteria. Results Sperm HOS score in infertile group was lower than that in control group(P