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Objective:To investigate the clinical significance of the combined use of fine needle aspiration cytology (FNAC) and BRAF V600E gene mutation detection in the preoperative diagnosis of thyroid nodules. Methods:A retrospective analysis was conducted on 126 cases of thyroid nodules confirmed by routine histopathology after surgery at Wenzhou Central Hospital between January 2022 and January 2023. The results of preoperative FNAC combined with BRAF V600E gene mutation detection were compared with those obtained from FNAC alone. Results:There was no significant difference in specificity for thyroid nodules between FNAC combined with BRAF V600E gene mutation detection and FNAC alone ( P > 0.05). The sensitivity of FNAC combined with BRAF V600E gene mutation detection was significantly higher than that of FNAC alone [97.6% (82/84) vs. 85.5% (65/76), χ2 = 7.82, P < 0.05]. The overall accuracy of FNAC combined with BRAF V600E gene mutation detection was significantly higher than that of FNAC alone [96.8% (122/126) vs. 85.0% (96/113), χ2 = 10.47, P < 0.05]. Conclusion:The combined application of FNAC and BRAF V600E gene mutation detection holds an exceptional diagnostic value in the preoperative diagnosis of thyroid nodules. This approach not only elevates diagnostic sensitivity and accuracy, but also deserves clinical promotion.
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Objective To investigate the expression and clinical significance of microRNA(miR)-539-5p,Caspase activity and apoptosis inhibitory factor 1(CAAP1)in gastric cancer tissue.Methods The gastric cancer tissue specimens and corresponding adjacent tissues of gastric cancer patients(102 cases)who underwent surgery in Xi'an Ninth Hospita from January 2018 to December 2019 were collected,and the expression levels of miR-539-5p and CAAP1 in the tissues were detected and compared.The relationship between the expression of miR-539-5p and CAAP1 and clinicopathological parameters and prognosis was explored.The correlation between miR-539-5p and CAAP1 expression was analyzed by Pearson method.Kaplan-Meier method was used to analyze the survival time of gastric cancer patients.Cox regression model was used to analyze the prognostic factors of patients with gastric cancer.Results The expression level of miR-539-5p in gastric cancer tissue lower than that in adjacent tissue,and the expression level of CAAP1 higher than that in adjacent tissue(P＜0.05).There was a negative correlation between the expression levels of miR-539-5p and CAAP1 in gastric cancer tissue(P=0.000).Further analysis showed that the expression of miR-539-5p and CAAP1 in gastric cancer tissue was greatly correlated with TNM stage,depth of invasion,lymph node metastasis and tumor size(P＜0.05).The 3-year survival rate of miR-539-5p high expression group was higher than that of low expression group(P=0.045).The 3-year survival rate of CAAP1 high expression group which was lower than low expression group(P=0.015).Cox regression showed that TNM stage,depth of invasion,lymph node metastasis and miR-539-5p and CAAP1 expression were prognostic factors in patients with gastric cancer(P＜0.05).Conclusion The decreased expression level of miR-539-5p and increased expression level of CAAP1 in gastric cancer tissues were related to TNM staging,depth of invasion,lymph node metastasis and tumor size,and they are closely related to the prognosis of patients.
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Objective To explore the protective effect and mechanism of endoplasmic reticulum stress(ERS)signaling pathway PERK/eIF2α/ATF4/CHOP on BRL-3A cell injury by serum containing Zhige oral solution.Methods ①Preparation of drug-containing serum:SD male rats were randomly divided into 3 groups:Zhige oral solution group,Metadoxine group and normal group,and were gavaged with Zhige oral solution,Metadoxine and saline respectively,and the drug-containing serum was prepared by blood sampling from the abdominal aorta for 5 consecutive days of intervention.②Normal BRL-3A cells were cultured,and the cell survival rate of each group was determined by CCK-8 after 24h of cell intervention with different concentrations of ethanol(1.0%,1.5%,2.0%,2.5%,3.0%,5.0%,7.0%,10.0%).③Cultured normal BRL-3A cells were divided into normal group,model group,metadoxine group,and Zhige oral solution low,medium and high dose group(later referred to as low dose group,medium dose group and high dose group),After 24 h,the levels of γ-glutamyl transpeptidase(GGT)and lactate dehydrogenase(LDH)in the supernatant of each group were measured,and the survival rate of BRL-3A cells was measured by CCK-8.The expression levels of PERK/eIF2α/ATF4/CHOP pathway-related mRNA and protein in each group were measured by Real-time PCR and Western blot.Results ①After 24 h of cell intervention with the same concentration of ethanol(1.0%,1.5%,2.0%,2.5%,3.0%,5.0%,7.0%,10.0%),the cell survival rate gradually decreased with the increase of ethanol concentration,and when the ethanol concentration was 5%,the cell survival rate decreased significantly(P<0.05),so the ethanol concentrations of 1.0%,1.5%,2.0%,2.5%,3.0%,5.0%were chosen for the subsequent experiments.②Compared with the normal group,the GGT and LDH contents in the supernatant of the model group were significantly higher(P<0.05),and the expression of PERK/eIF2α/ATF4/CHOP pathway-related factors mRNA and protein were significantly higher(P<0.05),showing a significant state of liver injury.③Compared with the model group,the Zhige oral solution group and the metadoxine group showed different degrees of reduction in the above indexes,with the most significant effect in the Zhige oral solution high-dose group(P<0.05).Conclusion Serum containing Zhige oral solution ameliorated ethanol-induced hepatocyte injury in BRL-3A rats,and the mechanism may be related to the inhibition of endoplasmic reticulum stress PERK/eIF2α/ATF4/CHOP signaling pathway.
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ObjectiveTo investigate the role of coagulation function parameters and platelet indices in thrombotic events in patients with hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF). MethodsA total of 56 patients with HBV-ACLF who were hospitalized in The First Affiliated Hospital of Soochow University from January 2015 to December 2019 were enrolled and divided into thrombotic complication (TC) group with 24 patients and non-thrombotic complication (NTC) group with 32 patients. A retrospective analysis was performed for their general clinical data on admission, and the patients were observed in terms of the changes in coagulation function, platelet count (PLT), and the platelet function-related index mean platelet volume (MPV) on days 1-7 after admission. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. A repeated measures analysis of variance was used to compare coagulation markers within and between groups at different time points. ResultsOn admission, the TC group had a significantly younger age than the NTC group ［31.5 (29.0-34.0) years vs 48.5 (36.0-50.7) years, Z=-2.637, P=0.008］. On the day of admission, there was no significant difference in MPV between the TC group and the NTC group (P ＞0.05), while on days 2-7 after admission, there was a significant difference in MPV between the two groups (t=-2.696、-2.742、-2.894、-4.174、-3.945、-4.716,all P ＜0.01). In the TC group, MPV reached the peak value on day 5 of admission, with a mean value of 13.90±1.12 fl, which was higher than the range of normal values. On admission, all patients had a mean prothrombin time (PT) of 28.8±7.2 s, a mean activated partial thromboplastin time (APTT) of 50.5±8.7 s, and a mean international normalized ratio (INR) of 2.6±0.7, which were higher than normal values; all patients had a mean fibrinogen (Fb) level of 1.16±0.3 g/L and a mean PLT of (107.7±26.5)×109/L, which were lower than normal values. There were no significant differences in PT, APTT, Fb, INR, and PLT between the TC group and the NTC group (all P ＞0.05). ConclusionCoagulation disorder in patients with liver failure is more of a low-equilibrium state, which is complex and heterogeneous and requires individualized treatment. For patients with HBV-ACLF, the development of thrombotic events may be more associated with platelet function than PLT or conventional coagulation markers.
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ObjectiveTo investigate the association between mean platelet volume (MPV) and prognosis of hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) and the value of MPV in prognostic evaluation. MethodsA retrospective analysis was performed for the clinical data of 37 patients with hepatitis B cirrhosis, 44 patients with HBV-ACLF, and 27 patients with chronic hepatitis B, who were admitted to Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, from January 2015 to December 2019, as well as 24 individuals who underwent physical examination during the same period of time. Related clinical data included sex, age, total bilirubin (TBil), creatinine (Cr), blood urea nitrogen (BUN), albumin (Alb), blood ammonia (NH3), routine blood test results, Model for End-Stage Liver Disease (MELD) score, and blood coagulation parameters. According to prognosis, the patients with HBV-ACLF patients were divided into improvement group with 19 patients and non-improvement group with 25 patients, and the patients were followed up for 3 months. The Kruskal-Wallis H test was used for comparison between multiple groups, and the Wilcoxon rank sum test was used for comparison within each group， the Mann-Whitney U test was used for comparison between two groups； a binary logistic regression analysis was used to investigate the independent influencing factors for prognosis, and the receiver operating characteristic (ROC) curve was used to predict the accuracy of variables. ResultsThere were significant differences in MPV, platelet count, prothrombin time (PT), international normalized ratio (INR), Alb, BUN, TBil, and MELD score between the liver cirrhosis group, the HBV-ACLF group, the chronic hepatitis group, and the healthy group (χ2=39.031， 75.837, 59.894, 56.033, 22.760, 83.353 and 70.299, all P＜0.001). Further comparison of MPV between two groups showed that the HBV-ACLF group had a significantly higher MPV than the healthy group and the chronic hepatitis group (Z=9.076 and 4.435, both corrected P＜0.001), and the liver cirrhosis group had a significantly higher MPV than the healthy group (Z=2.646, corrected P=0.049). For the patients with HBV-ACLF, there were significant differences in MPV, age, PT, INR, and MELD score between the improvement group and the non-improvement group (Z=-3.710， -2.726， -2.678， -2.322 and -2.610, all P＜0.05), and further binary logistic regression analysis showed that MPV (odds ratio ［OR］=1.175, 95% confidence interval ［CI］: 1.067-2.756, P=0.026) and MELD score (OR=1.643, 95% CI: 1.021-2.644, P=0.041) were independent influencing factors for the prognosis of HBV-ACLF. MPV alone, MELD score alone, and MPV combined with MELD score had an area under the ROC curve of 0.742, 0.731, and 0.791, respectively, in predicting the prognosis of HBV-ACLF, and MPV combined with MELD score had relatively high sensitivity (0.72) and specificity (0.895). ConclusionMPV is an independent influencing factor for the prognosis of HBV-ACLF and has a good value in predicting prognosis. MPV combined with MELD score has advantages over MPV or MELD score alone in predicting the prognosis of HBV-ACLF.
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Objective To analyze the clinical efficacy and safety of percutaneous microwave ablation guided by multimode ultrasound in the treatment of benign thyroid nodules.Methods The clinical data of 100 cases of benign thyroid nodules admitted from June 2017 to December 2018 were retrospectively analyzed.50 cases of benign thyroid nodules were treated by traditional open surgery as the control group,and 50 cases of benign thyroid nodules were treated by ultrasound-guided microwave ablation as the observation group.The complete clearance rate of lesion tissue and the incidence of comphcations were compared between the two groups.Results (1) The nodule clearance rate of the observation group was higher than that of the control group,with significant statistically difference (P ＜ 0.05).Compared with the control group (transient thyroid dysfunction 16％,recurrent laryngeal nerve injury 10％),the incidence of complications (transient hypothyroidism 2％,recurrent laryngeal nerve injury 0％) was significantly lower in the observation group (P ＜ 0.05).(2) The quality of life scores of the observation group and the control group were significantly higher than those before the treatment (P ＜ 0.05);The quality of life score of the observation group was significantly higher than that of the control group (P ＜ 0.05).Conclusions Compared with traditional open thyroidectomy,multimodal ultrasound-guided percutaneous microwave ablation has better efficacy and safety,which is worthy of wide application and promotion.
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BACKGROUND: Bone marrow stem cells can be colonized into the mouse endometrium. However, the molecular mechanisms underlying the migration of bone marrow stem cells into the endometrium are still unclear. OBJECTIVE: To investigate the effects of CXCL12 and CXCR4 on the chemotaxis of bone marrow stem cells towards endometrial stromal cells. METHODS: Mouse bone marrow stem cells and human endometrial stromal cells were serum-starved overnight. After 24 hours of estradiol pretreatment, the mRNA expressions of CXCR4 and CXCL12 in the mouse bone marrow stem cells were detected by RT-PCR; the levels of CXCL12 in the mouse bone marrow stem cells and human endometrial stromal cells were detected by ELISA; and the migration of mouse bone marrow stem cells into human endometrial stromal cells was observed by Transwell chamber test. RESULTS AND CONCLUSION: Estradiol pretreatment could upregulate the expression of CXCL12 in the human endometrial stromal cells as well as the expression of CXCR4 in the mouse bone marrow cells, promoting the migration of mouse bone marrow stem cells towards the conditioned medium of human endometrial stromal cells. In conclusion, estradiol can promote the migration of bone marrow stem cells into the endometrium, which may provide new ideas for the treatment of endometrial diseases.
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BACKGROUND: Bone marrow stem cells can be colonized into the mouse endometrium. However, the molecular mechanisms underlying the migration of bone marrow stem cells into the endometrium are still unclear. OBJECTIVE: To investigate the effects of CXCL12 and CXCR4 on the chemotaxis of bone marrow stem cells towards endometrial stromal cells. METHODS: Mouse bone marrow stem cells and human endometrial stromal cells were serum-starved overnight. After 24 hours of estradiol pretreatment, the mRNA expressions of CXCR4 and CXCL12 in the mouse bone marrow stem cells were detected by RT-PCR; the levels of CXCL12 in the mouse bone marrow stem cells and human endometrial stromal cells were detected by ELISA; and the migration of mouse bone marrow stem cells into human endometrial stromal cells was observed by Transwell chamber test. RESULTS AND CONCLUSION: Estradiol pretreatment could upregulate the expression of CXCL12 in the human endometrial stromal cells as well as the expression of CXCR4 in the mouse bone marrow cells, promoting the migration of mouse bone marrow stem cells towards the conditioned medium of human endometrial stromal cells. In conclusion, estradiol can promote the migration of bone marrow stem cells into the endometrium, which may provide new ideas for the treatment of endometrial diseases.
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Objective To investigate the effect of vasopressin injection technique on ovarian reserve in patients with laparoscopic cystectomy of unilateral ovarian endometrioma .Methods 70 patients with unilateral ovarian endometrioma were randomly allocated into study group (37 cases) and control group(33 cases) according to the digital table .Diluted vasopressin was injected into the space between the normal ovarian cortex and the cyst wall before stripping in the study group , and ordinary laparoscopic cystectomy without injection was adopted in control group.The average contents of anti -mullerian hormone(AMH),follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),antral follicle count(AFC) and peak systolic velocity(PSV) were compared in two groups before and after surgery .Results The operative time of the study group was (37.6 ±8.6) min,which was significantly shorter than (42.8 ±9.1)min of the control group(t=2.46,P<0.05).The blood loss of the study group was (23.2 ±12.1)mL,which was significantly less than (31.4 ±17.3)mL of the control group(t=2.32,P<0.05).In the control group,the E2 levels preoperation and postoperative were (201.46 ±7.51)pmol/L,(153.94 ± 8.72)pmol/L,respectively,the difference was statistically significant between preoperation and postoperation (t =23.72,P<0.05).The AMH levels in the control group preoperation and postoperation were (2.31 ±0.79)ng/mL, (1.67 ±0.75)ng/mL,respectively,there was statistically significant difference between preoperation and postoperation (t=3.38,P<0.05).The FSH levels in the control group preoperation and postoperation were (6.58 ±2.70)U/L, (10.24 ±1.21)U/L,respectively,there was statistically significant difference between preoperation and postoperation (t=7.12,P<0.05).The LH levels in the control group preoperation and postoperation were (5.87 ±1.76)U/L, (6.15 ±2.14) U/L,respectively,there was no significant difference between preoperation and postoperation (t =0.58,P>0.05).The F0 levels in the control group preoperation and postoperation were (8.7 ±2.8),(4.6 ±0.7), respectively,there was significant difference between preoperation and postoperation (P<0.05).The PSV levels in the control group preoperation and postoperation were (13.8 ±5.9)cm/s,(7.5 ±2.4)cm/s,respectively,there was significant difference between preoperation and postoperation (P<0.05).The E2 levels in the study group preopera-tion and postoperation were (199.36 ±8.42)pmol/L,(197.12 ±8.33)pmol/L,respectively,there was no significant difference between preoperation and postoperation (t=1.15,P>0.05).The AMH levels in the study group preopera-tion and postoperation were (2.23 ±0.85) ng/mL,(2.19 ±0.83) ng/mL,respectively,there was no statistically significant difference between preoperation and postoperation (t=0.20,P>0.05).The FSH levels in the study group preoperation and postoperation were (6.27 ±2.35)U/L,(6.73 ±2.23)U/L,respectively,there was no statistically significant difference between preoperation and postoperation (t=0.86,P>0.05).The LH levels in the study group preoperation and postoperation were (5.92 ±2.32) U/L,(5.57 ±2.31) U/L,respectively,there was no statistically significantl difference between preoperation and postoperation (t=0.65,P>0.05).The F0 levels in the study group preoperation and postoperation were (9.2 ±2.4),(8.9 ±2.7),respectively,there was no statistically significant difference between preoperation and postoperation (P>0.05).The PSV levels in the study group preoperation and postoperation were (14.7 ±5.4) cm/s,(14.0 ±4.7) cm/s,respectively,there was no statistically significant difference between preoperation and postoperation (P>0.05).Conclusion Vasopressin injection technique used in unilateral ovarian endometrioma laparoscopic cystectomy is safe and effective ,and it can protect the ovarian reserve .
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Objective To investigate the diagnostic value of cell wax block combined with immunohistochemistry in the diagnosis of malignant pleural effusion in lung adenocarcinoma and to analyze the expression and clinical significance of EGFR in pleural effusion.Methods From March 2013 to June 2017,50 lung cancer patients with pleural effusion specimens and corresponding histological specimens of lung adenocarcinoma in the Central Hospital of Wenzhou were selected.The intensity of EGFR expression in pleural effusion lung adenocarcinoma cells was detected.The difference of EGFR expression between pleural effusion cells and paraffin blocks was compared by ARMS method.Results The EGFR negative,weak positive,moderate positive and strong positive expression rates were 1 case (2.0％),8 cases(16.0％),20 cases(40.0％) and 21 cases(42.0％),respectively.There were no statistically significant differences in the sensitivity and specificity between the ARMS method and the immunohistochemical staining of lung cancer tissues (x2 =0.000,0.006,all P ＞ 0.05).The consistency of detection was excellent (Kappa value =0.93,P ＜ 0.001).There was no statistically significant differences in sensitivity and specificity between ARMS and pleural effusion wax immunohistochemical staining(x2 =0.014,0.027,all P ＞0.05),and the consistency was better (Kappa value =0.72,P ＜ 0.05).Conclusion Pleural effusion cells have the advantages of easy access,low cost,simple operation and good specificity,which is an easy and effective method to assess the expression of EGFR gene mutation in lung adenocarcinoma,which provides a reference for individualized treatment and prognosis of advanced lung adenocarcinoma.
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Objective To explore the value of microvascular angiography in evaluating the neovascularization of internal carotid artery plaque and the prediction of cerebral infarction.Methods A total of 100 patients with suspected cerebral infarction received from March 19th,2016 to December 1 st,2017 in our hospital were enrolled in this study.All patients underwent microvascular imaging and then analyzed the importance of this technique in evaluating cerebral infarction,plaque neovascularization.Results 100 lesions were recorded in 100 patients,among which there were 22 cases with no superb microvascular ultrasound imaging (SMI) and blood flow signal (ie,score 0) in the plaque.SMI imaging could better show neovascularization (ie score 1 or 2 points).In 78 cases,they all grew from the arterial wall to the plaque.There were 61 cases of cerebral infarction in the blood flow group (78.2％),8 cases (36.3％) of cerebral infarction in the group without blood flow,with statistical significance(P =0.023).SMI imaging was highly sensitive to the prediction of cerebral infarction incidence,reaching 88.4％.Conclusions Ultra-microvascular imaging can improve the sensitivity of cerebral infarction prediction and promptly detect neovascularization of internal carotid artery plaque,thus providing a basis for clinical treatment.
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High mobility group protein B1 (high mobility group box 1,HMGB1) is a nuclear protein that is highly conserved,constitutively expressed in various tissues and cells in the nucleus.It participates in gene transcription and replication,which is released into the nucleus mainly as a late cytokine mediated inflammatory immune response.As a result of cell stress,HMGB1 and pathogens including viruses infection are closely related.Recent studies have shown that HMGB1 is involved in the occurrence and development of many kinds of virus related diseases.This paper makes a review of the research progresses.
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Objective To investigate the changes and clinical significance of peripheral blood T lymphocyte subsets and cytokines in influenza A (H7N9) virus infection patients.Methods Twenty-three patients with H7N9 virus infection who received treatment at the First Affiliated Hospital of Soochow University from April 2013 to April 2015 were enrolled as case group.Twenty healthy subjects in the outpatient clinic during the same period were selected as control group.The percentages of T lymphocyte subsets in the peripheral blood including CD3+CD4+ T cells, CD3+CD8+ T cells, regulatory T lymphocytes (Treg), Th17, CD3+CD8-interferon (IFN)-γ+ (Th1) cells and CD3+CD8-IL-4+ (Th2) cells were detected by flow cytometry.The changes of plasma cytokines including interleukin (IL)-8, IL-18, interferon-inducible protein (IP)-10, macrophage inflammatory protein (MIP)-1b were quantified by Bio-Plex Pro human cytokine Group Ⅰ 27-plex panel and Group Ⅱ 21-plex panel.The normality test was performed by Kolmogorov-Smirnov test.Two independent samples t test were used to compare the two groups.Results The percentages of CD3+CD4+ and CD3+CD8+ T cells before treatment in case group were significantly lower than control group ([27.90±10.19]% vs [38.75±6.78]%, t=-2.726, P=0.012;[14.82±7.72]% vs [22.79±6.12]%, t=-2.556, P=0.018), while the percentages of Th17 and Th2 before treatment in case group were significantly higher than control group ([2.64±1.40]% vs [0.29±0.21]%, t=4.668, P0.05).Before treatment, levels of IL-8, IL-18, IP-10 and MIP-1b of case group were significantly higher than those in control group (IL-8: [23.19±14.35] vs [12.78±6.76] ng/L, t=2.277, P=0.035;IL-18:[230.55±230.18] vs [72.80±27.91] ng/L, t=2.348, P=0.036;IP-10:[28 870.55±41 815.22] vs [1 356.13±1 093.10] ng/L, t=2.371, P=0.035;MIP-1b: [197.74±119.87] vs [118.51±41.86] ng/L, t=2.198, P=0.043).Conclusions Patients with H7N9 virus infection exhibit an imbalance of T lymphocyte subsets.It is very important to monitor the changes of T lymphocyte subsets in those patients for clinical prognosis.A storm of cytokines could exist during H7N9 virus infection, which may be the main reason for multiple organ failure.
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Objective To investigate the serum γ-glutamyl transferase(γ-GT)level and its clinical significances in hepatitis B virus(HBV)-liver failure(LF)patients.Methods γ-GT levels were detected in 89 LF patients,30 cases with cirrhosis and 30 healthy controls.Difference of serum γ-GT between survival group and death group in LF patients and dynamics of γ-GT after hospitalization were studied. Survival rate between γ-GT increase group and decrease group were compared.The associations of γ-GT with model for end stage live disease(MELD)and prealbumin were calculated.Results At baseline,the γ-GT levels in LF,cirrhosis and healthy control groups were(149.61 ± 69.86),(123.96 ± 59.52)and (48.28 ± 10.25)U/L,respectively,the difference among groups was significant(F= 178.150,P<0.05).The survival group in LF patients showed significant increase of γ-GT one week after hospitalization compared with death group([75.27 ± 10.34]vs[29.47 ± 5.05],t=5.40,P<0.05). The γ-GT increase group showed higher survival rate than γ-GT decrease group[76.19%(48/63)vs 23.08%[6/26],χ2=21.76,P<0.05].Serum γ-GT level in LF patients was positively correlated with both MELD score and prealbumin(r=0.709 and -0.627,respectively,both P<0.05).Conclusions The rise of γ-GT may indicate a better prognosis in LF patients.Serum γ-GT positively correlates with prealbumin and both could reflect the regeneration of hepatocytes.
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Objective To investigate the clinical effects and the degree of satisfaction of areola margin small incision and conventional incision in the treatment of patients with benign tumor of mammary glands. Methods 338 patients were selected and randomly divided into the observation group and the control group according to the digital table,169 patients in each group. The clinical effects and the degree of satisfaction of the patients were compared. Results Compared with the control group, the operation time was slightly longer in the observation group[(26. 2 ± 4. 8) min vs. (24. 5 ± 3. 7) min,t =13. 178,P =0. 000];The incidence rate of postoperative complications was significantly reduced (2. 37% vs. 34. 55%,χ2 =57. 911,P=0. 000);The scar score wassignificantlylower[(1.11±0.47)pointsvs.(4.14±0.45)points,t= -60.387,P=0.000];Thepostoperative satisfaction rate was significantly higher (98. 82% vs. 62. 13%,χ2 =72. 379,P =0. 000). Conclusion Areola margin small incision has high degree of satisfaction and small scar,provides safe and reliable effect in treatment of benign tumor of mammary glands. This method can be suitable for popularization and application in clinic.
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Objective To investigate the clinical effects and the degree of satisfaction of areola margin small incision and conventional incision in the treatment of patients with benign tumor of mammary glands. Methods 338 patients were selected and randomly divided into the observation group and the control group according to the digital table,169 patients in each group. The clinical effects and the degree of satisfaction of the patients were compared. Results Compared with the control group, the operation time was slightly longer in the observation group[(26. 2 ± 4. 8) min vs. (24. 5 ± 3. 7) min,t =13. 178,P =0. 000];The incidence rate of postoperative complications was significantly reduced (2. 37% vs. 34. 55%,χ2 =57. 911,P=0. 000);The scar score wassignificantlylower[(1.11±0.47)pointsvs.(4.14±0.45)points,t= -60.387,P=0.000];Thepostoperative satisfaction rate was significantly higher (98. 82% vs. 62. 13%,χ2 =72. 379,P =0. 000). Conclusion Areola margin small incision has high degree of satisfaction and small scar,provides safe and reliable effect in treatment of benign tumor of mammary glands. This method can be suitable for popularization and application in clinic.
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Objective To observe the effects of different compatibility ratios of Astragali Radix and Angelicae Sinensis Radix on vascular intimal hyperplasia; To ascertain the effective compatibility of Astragali Radix and Angelicae Sinensis Radix for antagonizing vascular intimal hyperplasia. Methods SD rats were divided into different groups by baseline geometric design method: Astragali Radix and Angelicae Sinensis Radix different compatibility ratios groups, Astragali Radix group, Angelicae Sinensis Radixgroup, positive medicinegroup and sham-operation group. A model of intimal hyperplasia of thoracoabdominal aorta was established by balloon catheter injury in vascular endothelium of rats. Then the thoracoabdominal aorta was taken out after gavage of Astragali Radix and Angelicae Sinensis Radix with different compatibility ratios for 14 days. Bloodletting was used to take thoracoabdominal aorta. Masson staining and Morphometric methods were used to analyze the intimal hyperplasia. Results IA, IT, HRIA and HRIT increased 14 day after intimal injury. Compared with the model group, IA, IT, HRIA and HRIT in Angelicae Sinensis Radix group, Astragali Radix and Angelicae Sinensis Radix 1:2 group, Astragali Radix and Angelicae Sinensis Radix 1:5 group, Astragali Radix and Angelicae Sinensis Radix 1:1 group and Astragali Radix and Angelicae Sinensis Radix 5:1 group were lower, and the effects of Astragali Radix and Angelicae Sinensis Radix 1:1 ratio were strongest. The effects on intimal hyperplasia in Astragali Radix group and Astragali Radix and Angelicae Sinensis 2:1 group had no significant differences compared with model group. Conclusion Astragali Radix and Angelicae Sinensis can inhibit vascular intimal hyperplasia in a certain compatibility ratios, and the effects of Astragali Radix and Angelicae Sinensis Radix 1:1 on intimal hyperplasia are the best.
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Objective To explore the pathogenesis of irritable bowel syndrome (IBS) by detecting serum levels and the colonic mucosa expression of inflammatory cytokines,peptide YY (PYY),and claudin-1,and to analyze their correlation.Methods From April 2013 to April 2015,50 outpatients with IBS and 20 healthy controls were selected.Serum levels of PYY,interleukin (IL)-10,tumor necrosis factor (TNF)-α and claudin-1 were detected by enzyme-linked immunosorbent assay (ELISA).The expression of IL-10,TNF-α,PYY and claudin-1 in colonic mucosa was determined by immunohistochemistry.Single factor analysis of variance,least significant difference (LSD) method,chi-square test,and Pearson correlation analysis were performed for statistical analysis.Results Among the 50 patients with IBS,27 cases were diarrhea-type irritable bowel syndrome (D-IBS),and 23 cases were constipated-type irritable bowel syndrome (C-IBS).The serum level and the positive expression rate of PYY in colonic mucosa of D-IBS group were significantly higher than those of healthy control group ((16.28± 2.75) ng/L vs (10.12± 1.55) ng/L;66.7 ％ (18/27) vs 30.0 ％ (6/20)),and the differences were statistically significant (LSD-t=10.19,x2 =6.182,both P＜0.05).The serum level and the positive expression rate of IL-10 in colonic mucosa of D-IBS group were both significantly lower than those of healthy control group ((2.95 ±0.24) ng/L vs (3.58±0.35) ng/L;22.2％(6/27) vs 50.0％ (10/20)),and the differences were statistically significant (LSD-t =4.52,x2=3.948,both P＜0.05).The serum level and the positive expression rate of TNF-α in colonic mucosa of D-IBS group were both significantly higher than those of healthy control group ((8.73±0.41) ng/L vs (7.73±0.51) ng/L;66.7％(18/27) vs 30.0％(6/20)),and the differences were statistically significant (LSD-t=8.43,x2 =6.182,both P＜0.05).There was no statistically significant difference between C-IBS group and healthy control group in the serum levels of PYY ((10.24±1.34) ng/L vs (10.12± 1.55) ng/L),IL-10 ((3.43 ± 0.71) ng/L vs (3.58 ± 0.35) ng/L),TNF-α ((7.81±0.26) ng/L vs (7.73 ±0.51) ng/L),and thus the positive expression rate in colonic mucosa (39.1％(9/23) vs 30.0％(6/20),56.5％(13/23) vs 50.0％(10/20),34.8％ (8/23) vs 30.0％(6/20);all P＞0.05).The serum level of claudin-1 and its positive expression rate of PYY,IL-10,TNF-α in colonic mucosa in D-IBS group were both lower than those of healthy control group ((94.44 ± 6.61) ng/Lvs (103.64 ± 5.47) ng/L;11.1％ (3/27) vs 40.0％ (8/20)),and the differences were statistically significant (LSD-t=5.76,x2 =5.349;both P＜0.05).However,the serum level of claudin-1 and its positive expression rate in colonic mucosa in C-IBS group were both higher than those of healthy control group ((115.54±3.42) ng/L vs (103.64±5.47) ng/L;73.9％ (17/23) vs 40.0％(8/20)),and the differences were statistically significant (LSD-t=5.56,x2 =5.055;both P＜0.05).The serum levels of IL-10 and PYY,TNF-α and claudin-1 were negatively correlated in the D-IBS group (r=-0.874 and -0.863,both P＜0.05).While the serum levels of TNF-α and PYY,IL-10 and claudin-1 were positively correlated (r =0.865 and 0.876,both P＜ 0.05).Conclusions There may be the imbalance of proinflammatory factors and anti-inflammatory factors in IBS patients.PYY may decrease the expression of claudin-1 by promoting IL-10 and inhibiting TNF-α,and thus ameliorate the inflammation reaction of IBS patients.
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Objective To explore the efficacy of circular wound edge protector(CWEP)in preventing surgical site infection (SSI)following open abdominal surgery,analyze the related risk factors for postoperative SSI,and provide scientific basis for preventing SSI following open abdominal surgery.Methods 162 patients who underwent open abdominal surgery in a hospital from March 2014 to December 2015 were randomly divided into intervention group (used CWEP during surgery)and control group (used sterile gauze pad to protect incision).Length of hospital stay,cost of dressing change,and SSI between two groups were compared,risk factors for postoperative SSI were analyzed.Results Incidence of SSI in intervention group was lower than control group (14.81%[12/81]vs 34.57%[28/81],P <0.05);grade-A incision healing rate of intervention group was higher than control group(86.42% vs 66.67%,P <0.05).The cost of dressing change in intervention group was lower than control group([305.5 ± 176.7]yuan vs [431.6 ± 381.4 ]yuan,P = 0.008 ). Multivariate logistic regression analysis indicated that hypoproteinemia(OR,2.88[95%CI ,1.21-6.87]),body mass index ≥24(OR,3.11[95%CI ,1.12-8.66]),and blood loss≥400 mL(OR,3.98[95%CI ,1.36- 11.64])were independent risk factors for postoperative SSI,while CWEP use was the protective factor(OR,0.24[95%CI ,0.09-0.59]).Conclusion CWEP can effectively reduce the incidence of SSI following open abdominal surgery.
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Objective To observe the expression level of macrophage stimulating protein (MSP) in acute on-chronic liver.failure (ACLF) patients,and to explore the clinical significance and correlation with different immune regulatory factors.Methods The double antigen sandwich enzyme-linked immunosorbent assay method was used to detect MSP in the peripheral blood of 45 patients who were diagnosed with ACLF and 32 cases of chronic hepatitis B (CHB).The MSP levels were compared among ACLF patients with different outcomes,and the MSP level of healthy person was used as control.Meanwhile,liver function and hepatitis B virus (HBV) load were detected,and the expressions of peripheral blood CD4+ interferon (IFN)γ+ (helper T cell 1 Th1),CD4+ interleukin (IL)-4+ (helper T cell 2,Th2),CD4+IL-17+ (helper T cell 17,Th17) and CD4+ CD25+ Foxp3+ (regular T cell,Treg) were measured by flow cytometry.The comparison of means between two samples was done by t test,and oneway ANOVA and linear correlation analysis were also used.Results The serum MSP levels in ACLF patients,CHB group and healthy control were (1.65±0.46) ng/mL,(1.43±0.32) ng/mL and (1.23±0.21) ng/mL,respectively.The serum MSP level in ACLF patients was significantly higher than both CHB patients (t=2.163,P=0.035) and healthy control (t=4.032,P=0.01).The MSP level in ACLF survival group was statistically higher compared with ACLF death group ([2.29 ± 0.42] ng/mL vs [1.42±0.17] ng/mL,t=1.973,P=0.042).Th2,Th17 cells in ACLF group,CHB group and healthy control group were (1.51±0.27) ％ and (1.94±1.02)％,(0.42±0.08)％ and (0.55±0.36)％,(0.23±0.19) ％ and (0.26±0.19) ％,respectively,which were all significantly different (F=7.759 and 37.229,respectively;both P＜0.01).The MSP level was positively associated with the number of Th2 (r=0.386,P=0.032) and Th17 (r=0.644,P=0.000),and the ratio of Th17/Treg (r =0.605,P=0.000);while it was negatively associated with the number of Th1 (r=-0.212),Treg (r=-0.262) and the ratio of Th1/Th2 (r=-0.394) (all P＞0.05).Conclusion MSP is involved in the progress of ACLF,and it may be associated with clinical outcomes and cellular immune imbalance of ACLF patients.