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Objective:To investigate the correlation between circulating tumor cell (CTC) detection, RAS/RAF gene mutation and clinicopathological characteristics in patients with colorectal cancer (CRC).Methods:The Amplification Refractory Mutation System (ARMS)-polymerase chain reaction (PCR) were used to detect the gene mutation in the tumor tissues of 138 CRC patients in the Third Affiliated Hospital of Sun Yat-sen University from May 2017 to May 2020. At the same time, the venous blood of 138 patients was collected and enriched for CTC genotyping by mRNA in situ hybridization. The correlation between CTC, RAS/RAF gene mutation and clinicopathological features of CRC patients was analyzed.Results:The mutation rates of KRAS, NRAS and BRAF genes were 48.6%(67/138), 5.1%(7/138) and 1.4%(2/138), respectively; The overall positive rate of CTC was 84.1%(116/138). The positive rates of different CTC types were: 23.1%(32/138) in epithelial type, 71.7%(99/138) in mixed type and 12.3%(17/138) in interstitial type respectively. The positive rate of CTC in CRC patients with clinical stage Ⅲ-Ⅳ, lymph node metastasis (N1-N3) and distant metastasis (M1) was significantly higher than that in CRC patients with stage Ⅰ-Ⅱ, no lymph node metastasis (N0) and no distant metastasis (M0) (all P<0.05). The total number of CTC, mixed CTC and interstitial CTC were positively correlated with clinical stage, lymph node metastasis and distant metastasis (all P<0.05). RAS/RAF gene mutation, gender, age, tumor location and tumor differentiation did not affect the positive rate of CTC (all P>0.05). Conclusions:The results of CTC typing are of great research significance for comprehensive treatment, prognosis assessment and stratified management of CRC, among which the interstitial type of CTC may be a high risk factor for the recurrence and metastasis of CRC.
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Hereditary hemochromatosis(HH) is relatively rare in the Chinese population, and the disease can involve multiple systems. It is easy to be missed and misdiagnosed due to nonspecific clinical manifestations. We report on a case with diabetes as the first diagnosis and being confirmed HH later. In addition to abnormal liver function, this patient also developed a variety of endocrine and metabolic diseases such as hypogonadism and osteoporosis. Included with this case report is a literature based discussion of clinical features, management of HH along with its relationship with endocrine dysfunction to improve disease understanding.
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Objective To explore the clinical characteristics in patients with histiocytic necrotizing lymphadenitis (also called Kikuchi-Fujimoto' s disease,KD) and meningitis.Methods We reported a patient who developed meningitis preceding the other presentations of KD with abnormal serum autoimmune phenomena,and systematically reviewed 19 cases of KD with meningitis that had been reported worldwide,and analyzed the clinical parameters and treatments.Results The present case was a 25-year-old female subject with serum antinuclear factor antibody and anti-ribonucleoprotein antibody positive.The patient recovered after treatment with steroid and no recurrence was appeared.Among the 19 patients,the average age was 20.2 years,sex ratio was 10:9 (10 female:9 male),7 patients had abnormal serum autoimmune phenomena,7 patients'initial symptom was meningitis and 5 patients were administrated with steroid.Conclusions The onset age in KD with meningitis is earlier than the common KD,and sex ratio in KD with meningitis is close to 1∶ 1.A definitive diagnosis of the disease is determined by a lymph node biopsy at present.
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@#ObjectiveTo compare the health-related quality of life (HRQOL) of patients with or without coronary artery disease (CAD) and also to determine the factors affecting their quality of life.MethodsOne hundred patients with CAD and 100 patients without CAD were included in this cross-sectional study. The patients with CAD and the patients without CAD were matched by age, sex, marital status, and income. HRQOL was measured with the generic HRQOL instrument.ResultsHRQOL scores of the patients with CAD differed significantly from the patients without CAD. Compared to the patients without CAD, the HRQOL of the patients with CAD was lower in the dimensions of mobility, hearing, breathing, elimination, usual activities, mental function, discomfort and symptoms, vitality, and sexual activity. The patients with CAD had lower HRQOLscores than the patients without CAD. In the patients with CAD, age and sex independently affected the HRQOL. Older patients and women had worse HRQOL.ConclusionCoronary artery disease negatively affects HRQOL. It is thought that interventions to increase quality of life the patients with CAD may improve their HRQOL.
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@#Objective To explore influence of out-hospital health education on life quality of senile patient with acute myocardial infarction (AMI) after underwent stenting therapy of coronary artery.Methods A total of 100 cases of AMI patients undergoing stenting therapy of coronary artery were selected and randomly divided into the follow-up group and control group with 50 cases in each group. Patients of the follow-up group accepted out-hospital health education. While patients of the control group were only carried out conventional in-hospital health education. The quality of life of two groups was compared.Results At the end of study, the follow-up group had a better life quality than the control group ( P<0.01). The satisfactory degrees of nurse-patient relationship in the follow-up group were better than that of control group ( P<0.05).Conclusion Out-hospital health education can improve life quality of senile patient with AMI after underwent stenting therapy of coronary artery.
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@#Objective To investigate the effect of health education on compliance of the senile non-rheumatic atrial fibrillation patients receiving anticoagulative drug treatment.Methods 188 senile inpatients with on-rheumatic atrial fibrillation and receiving anticoagulative drug treatment were given the health education in three different manners:group instruction,individual instruction and self-study in the hospital for three to four weeks by a team consisted of nurses and doctors.Results After education,the average test scores were higher than before education(P33<0.05).The self-care skill and knowledge such as self-monitor of bleeding were improved.Conclusion Health education is an important method for the senile patients to learn anticoagulative knowledge and improve the ability of self-management.