RESUMO
To investigate the effect of long-term indwelling gastric tube on the prevention and treatment of esophageal stenosis after endoscopic submucosal dissection (ESD) for esophageal circumferential superficial cancer, data of patients with esophageal circumferential superficial cancer who underwent ESD in the First Affiliated Hospital of Nanjing Medical University from January 2018 to December 2021 were retrospectively analyzed. There were 15 patients with gastric tube placement (GTP) after ESD (the GTP group ), and 23 patients without GTP (the non-GTP group). The general information, lesion location, pathological stage, postoperative complications, degree of esophageal stenosis (water intake), pain conditions, number of hospitalizations and medical expenses were compared between the two groups. The results showed that there was no significant difference in age, gender, lesion location or postoperative pathological stage between the two groups ( P>0.05). Compared with the non-GTP group, the rate of water intake in the GTP group was significantly higher (11/15 VS 6/23, P<0.05), the frequency of pain was less in the GTP group (7.3±3.1 times VS 10.7±3.6 times, t=3.00, P<0.05), and the number of hospitalizations and the medical expenses after ESD to before and after stent placement were significantly lower in the GTP group than those in the non-GTP group ( P<0.05). There were no significant differences in the incidence of delayed bleeding and perforation, or time of the first stenosis after ESD between the two groups ( P>0.05). The results of the study initially showed that long-term indwelling gastric tube after ESD can reduce the degree of esophageal stenosis with good safety for esophageal circumferential superficial lesions.
RESUMO
Objective:To investigate the differential expressions of AT-rich interacting domain-containing protein 1A (ARID1A) gene and its encoding protein BAF250a and serum carbohydrate antigen 125 (CA125) in different ovarian serous tumor tissues.Methods:The tumor tissues of 97 patients with serous ovarian tumors who were treated by surgery and confirmed by surgical pathological results in Shanxi Provincial Cancer Hospital from August 2015 to September 2018 were collected. Among them, 11 cases were benign lesions (serous cystadenoma, serous fibroadenoma, serous surface papilloma, control group), 21 cases were borderline lesions (atypical proliferative serous tumor, AP group). There were 35 cases in low-grade serous carcinoma (LC) group and 30 cases in high-grade serous carcinoma (HC) group (including 5, 7, 9 and 9 cases in stage Ⅰ-Ⅳ). Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of ARID1A mRNA in tumor tissues of each group, Western blot and immunohistochemistry were used to detect the expression and morphology of BAF250a protein in tumor tissues, and enzyme-linked immunosorbent assay was used to detect the concentration of serum CA125 in each group. The differences of ARID1A gene, BAF250a protein and serum CA125 expressions in each group were compared, and the correlation of their expressions in HC group with the clinical stage of patients was analyzed.Results:The relative expressions of ARID1A mRNA and BAF250a protein in the tumor tissues of the control group, AP group, LC group, and HC group decreased in sequence, and the serum CA125 concentration increased in sequence, the differences were statistically significant [1.37±0.02, 0.68±0.03, 0.42±0.04, and 0.29±0.14, F = 3.753, P = 0.008; 1.33±0.11, 0.81±0.11, 0.51±0.11, and 0.39±0.11, F = 10.753, P = 0.001; (23.72±2.26), (36.83±13.11), (412.55±41.71), and (529.96±61.44) U/ml, F = 10.440, P = 0.003]. Immunohistochemistry showed that the high expression rates of BAF250a protein in the control group, AP group, LC group, and HC group were 90.0% (10/11), 85.7% (18/21), 70.0% (21/35), and 33.3% (10/30). In HC group, the serum CA125 concentration increased with the increase of clinical stage [stage Ⅰ-Ⅳ: (461.33±23.18), (483.51±41.21), (507.78±33.41), and (543.19±47.82) U/ml, r = 0.510, P = 0.015], and the relative expressions of ARID1A mRNA and BAF250a protein decreased with the increase of clinical stage (stage Ⅰ-Ⅳ: 0.33±0.10, 0.28±0.11, 0.21±0.08, and 0.17±0.07, r = -0.329, P = 0.030; 3.83±0.13, 3.08±0.16, 2.61±0.18, and 2.07±0.13, r = -0.651, P = 0.002). Conclusion:The decrease of expressions of ARID1A gene and its encoding protein BAF250a, and the increase of CA125 expression in ovarian serous tumor tissues may indicate the malignant change and invasion of tumors.
RESUMO
Objective To analyze the frequency of interleukin (IL)-22+CD161+CD4+ T cells in the peripheral blood mononuclear cells (PBMCs) in rheumatoid arthritis (RA) patients compared with healthy control subjects and investigate the relationship of IL-22+CD4+CD161+ T lymphocyte frequency changes with RA disease activity.In addition to explore the pathogenesis of RA,and to look for new treatment targets for RA.Methods Twenty-one RA cases were included in the Department of Rheumatology of Tangshan Gongren Hospital from 2017 to 2018.Fourteen patients were female and 7 were male with the age ranged from 36 to 74 years old.The average age of this group of patients was (55±10) years,the average disease course was (60±50) months.All patients fulfilled the classification criteria of American College of Rheumatology [American College of Rheumatology (ACR)].Twenty-one subjects were enrolled as the control group,all of them came to Tangshan Gongren Hospital for regular health check-up.Fifteen subjects in the control group were female and 6 were male.Their age ranged between 40-78 years old with the average age of (55±9) years.IL-22+CD4+CD161+ T cells in PBMCs were detected by flow cytometry.The frequency variation of different CD4+CD161 + T was compared between case and control groups.The correlation was studied between the frequency and RA disease activity score (DAS28),tender joints number,swollen joints number,red blood cell sedimentation rate,high sensitive C reactive protein and white blood cell counts,red blood cell counts,platelet counts,IgG,IgA,IgM,complement C3 level,complement C4 level.T-test or Mann-Whitney U test were used for single-factor analysis,Pearson's test was used for correlation analysis.Results The percentage of RA group secreted CD4+ T cells (0.33± 0.20)％ of INF-γand IL-22,CD4+ T cells (0.51±0.29)％ of IL-22,and CD4+CD161+ T cells of IL-22 simultaneously.The number (0.55 ±0.28)％ was.significantly higher than that of the healtby control group [(0.22±0.14)％,(0.25±0.18)％,(0.36±0.24)％],and the differences were statistically significant [P=0.002,P=-0.0.45,P=0.026].Conclusion The percentage of IL-22+CD4+CD161+ T lymphocytes in the peripheral blood monocytes in RA patients is significantly higher than that in the healthy controls.The results of this study suggest that IL-22+CD4+CD161+ T lymphocytes in RA patients maybe related to RA disease activity and joint lesions.
RESUMO
Objective To evaluate the clinical efficacy and safety of endoscopic submucosal dissection (ESD) guided with endoscopic ultrasonography (EUS) for rectal neuroendocrine neoplasms(NENs).Methods A retrospective analysis was performed on 58 patients with rectal ENEs who underwent ESD from January 2011 to December 2015 in JiangSu Province Hospital.Manifestations of EUS, clinicopathological characteristics, proliferation activity grade, complete resection rate, complications and follow-up results of lesion were studied.Results Those treated by ESD included 58 patients with 64 lesions of rectal NENs.EUS results showed that 3 lesions originated from mucosa, 3 from muscularis mucosa and 58 from submucosa.A total of 34 lesions located within 5 cm from anus, 26 in 6-10 cm from anus and 4 more than 10 cm from anus.All 64 lesions were successfully treated by ESD.The mean maximum diameter of the lesions was 0.8 cm(0.2-3.5 cm), and the mean procedure time was 31 min(10-60 min).The complete resection rate was 93.8% (60/64).There were 4 patients with positive basal surgical margin, and two of them underwent additional surgery and two others were treated with argon plasma coagulation after rejecting surgery and ESD.Histological examination determined that 59 lesions were pathologic grade 1(G1) and 5 were pathologic grade 2(G2).Delayed bleeding occurred in 4 cases after ESD,which was managed by medicine in 1 case and endoscopic treatment in 3 cases.No perforation occurred after ESD.During a mean follow-up period of 22.9 months(3-48 months), no lymph node metastasis or distant metastasis was observed.Conclusion EUS is able to distinguish the origin of rectal NENs and aid determining the range and depth of ESD.ESD appears to be a safe, feasible and effective procedure for providing accurate histopathologica1 evaluations as well as curative treatments for rectal NENs limited to submucosa.
RESUMO
OBJECTIVE:To observe the efficacy and safety of Shenqi jiangtang granule in the adjuvant treatment of type 2 dia-betes knee arthritis. METHODS:62 patients with type 2 diabetes knee arthritis were randomly divided into control group(31 cas-es) and observation group (31 cases). Control group received hypoglycemic and basic treatment for arthritis,including diet con-trol,exercise therapy and health education,as well as 0.25 g Metformin hydrochloride tablet with a meal,3 times a day + 50 mg Acarbose tablet with a meal,3 times a day,chewing;patients with arthritis pain 100 mg Aspirin enteric-coated tablet after a meal, once a day (chewing or breaking apart was prohibited). Observation group additionally received 3 g Shenqi jiangtang granule half an hour before a meal with 50 ml warm water,3 times a day. The treatment course for both groups was 6 months. Clinical effica-cy,and fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PG),glycated hemoglobin(HbA1c),interleukin-1β(IL-1β),IL-6 before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P0.05). After treatment,FPG,2 h PG,HbA1c,IL-1β and IL-6 in 2 groups were significantly lower than before,and observation group was lower than control group,the differences were statistically significant(P0.05). CONCLUSIONS:Based on conventional treatment,Shenqi jiangtang granule shows obvious efficacy in the adjuvant treatment of type 2 diabetes knee arthritis.,it can reduce blood glucose and inflammation cy-tokine levels,mild symptoms of adverse reactions.
RESUMO
OBJECTIVE:To observe the efficacy and safety of breviscapine combined with double shock in the treatment of lu-pus encephalopathy. METHODS:70 patients with lupus encephalopathy were randomly divided into control group and observation group. Control group was treated with Methylprednisolone sodium succinate for injection 500 mg for continuous 3 d,iv,once a day,Cyclophosphamide for injection 1.0 g in the 4th day,iv,and Methylprednisolone sodium succinate for injection 80 mg was used for maintaining treatment in the 5th day for continuous 15 d,once a day. Observation group was treated with Breviscapine for injection 50 mg for continuous 20 d based on the treatment of control group,iv,once a day. The SLE activity(SLEDAI) score, IL-1β,IL-6,IL-8 and IFN-γ were observed,cases of neurological and psychological symptoms,the fatality rate and incidence of adverse reactions were recorded. RESULTS:After treatment,the SLEDAI,IL-1β,IL-6,IL-8 and IFN-γ in 2 groups were signifi-cantly lower than before,and observation group was lower than control group(P0.05). CONCLU-SIONS:Breviscapine combined with double shock has good efficacy and safety in the treatment of lupus encephalopathy,it can re-duce the SLEDAI score,improve neurological and psychological symptoms.
RESUMO
Objective To investigate the neural processing of stimulus salience and behavioral relevance with spatiotemporal patterns of event-related potentials (ERP).Methods The ERP was recorded from 20 subjects while they performed Eriksen task.Each stimulus picture contained 3 symbols:a central target (grey symbol ＜/ ＞ or X) represented pressing the corresponding button or withdrawing response respectively.And the flanking distractors were classified by both behavioral relevance ( ＜/ ＞-facilitory,X-inhibitory,H-irrelevant) and color salience (red,grey).Results Significant interaction effect was found for the reaction time(F(1.85,3521)=13.015,P＜0.001).Significant difference was found between the salient ((411.91 ±40.39) ms) and the non-salient ((420.42±38.58) ms) under the facilitory condition(t (19) =-4.858,P＜0.001).The significant ERP effects were revealed by statistical parametric mapping of F-value.The saliency effects appeared in the right occipital-temporal regions (100-125 ms),the bilateral dorsal attentional network (DAN) (150-300 ms) and the right-lateralized ventral attentional network (VAN) (300-450 ms).The effects of the behavioral relevance occurred in the occipital regions (150-200 ms),the VAN (200-300 ms) and the DAN (300-600 ms).The interaction effects of behavioral relevance between the target and the distractor occurred in the DAN (200-350 ms).Conclusion The information of the distractor salience and behavioral relevance access VAN and DAN in different stages respectively.The ERP effect in the DAN may be the neural correlation of contingent attentional capture.
RESUMO
Objective To measure the level of platelet derived growth factor-BB (PDGF-BB) in maintenance hemodialysis patients and investigate the significance of carotid atherosclerosis.Methods Thirty-six maintenance hemodialysis patients (test group) and 20 healthy controls (normal control group) were enrolled in this study.The level of PDGF-BB was measured by enzyme-linked immunosorbent assay in two groups.Intima-media thickness (IMT) and atherosclerotic plaques of the extracranial common carotid artery were measured by echocardiography.Results The level of IMT and the positive rate of carotid atherosclerosis in test group were significantly higher than those in normal control group [(1991.8 ± 228.6) μ mol/L vs.(71.2± 15.9) μmol/L,(36.78 ±3.40) g/Lvs.(41.96±2.07) g/L,(4.97 ±0.57) mmol/Lvs.(4.48 ±0.84) mmol/L][(1.01 ±0.23) mm vs.(0.72 ±0.15) mm,69.4％(25/36) vs.10.0％(2/20)](P＜ 0.01).The level of plasma creatinine,albumin and total cholesterol in test group were significantly higher than those in normal control group (P ＜ 0.01 or ＜ 0.05).The level of PDGF-BB in test group was significantly higher than that in normal control group[(93.27 ± 31.58) ng/L vs.(31.71 ± 15.78) ng/L,P ＜ 0.01].In test group,age and the level of PDGF-BB and triacylglycerol in carotid atherosclerosis patients were significantly higher than those in non-carotid atherosclerosis patients [(48.04 ± 9.97) years vs.(34.54 ± 10.35) years,(102.60 ± 32.87) ng/L vs.(72.06 ± 13.67) ng/L,(1.51 ± 0.59) mmol/L vs.(1.01 ± 0.27) mmol/L] (P ＜ 0.01).Regression analysis showed that age (β =0.346,P ＜ 0.01) and PDGF-BB (β =0.594,P＜ 0.01) were the important impacting factors for IMT.Conclusion The level of PDGF-BB is increased in maintenance hemodialysis patients,and it may play an important role in carotid atherosclerosis.
RESUMO
Objective To investigate the neural mechanism of the reduction of switch cost induced by short presentation of the task cue.Methods The event-related potentials (ERP) was recorded from 19 subjects while they performed a Chinese Stroop switching task.The factorial design of repeated-measures was adopted with the cue presentation time (100/1000 ms) and the type of succeeding task (repeat/switch).Results For the switch cost of reaction time (the switch subtracts the repeat),the difference between the long cue group (15.0 ± 33.3 ms) and the short group (0.80 -±40.7 ms) had the significantly tendency( t (18) =- 1.77,P=0.09).During the stage of cue processing,the ERP effects of cue reveal in the frontal-occipital areas ( 100 ～ 200 ms),frontoparietal and tempo-occipital regions (200 ～500 ms),frontoparietal network and centro-occipital regions (500 ～900ms).During the stage of task execution,the ERP effects of the cue were observed from the left fronto-occipital areas ( 300 ～ 400 ms) to parieto-occipital areas (400 ～ 900 ms).The ERP effects of the task started from the right hemisphere (500 ～600 ms ) and extended to bilateral prefrontal and centro-parietal area (600 ～900 ms ).Conclusion The short cue presentation can not only start up the preparation of frontoparietal network earlier during cue processing stage but also enhance its retrieval in the left dorsal lateral frontal cortex during task executive stage.
RESUMO
BACKGROUND: Presently, the biomaterial used in ligament tissue engineering such as collagen protein, polylactic acid, polyglycolic acid, small intestinal submucosa, glycan and nanomaterial are characterized by rapid degradation, resulting in inflammatory reaction after applying in host.OBJECTIVE: To investigate mechanical strength and in vitro degradation of silk scaffold and explore the reaction to macrophages.DESIGN: Controlled experiment.SETTING: Experiments were performed at the Department of Orthopaedics, Union Hospital, Huazhong University of Science and Technology from September 2004 to January 2005.MATERIALS: White raw Bombyx mori silkworm fibers of size 20/22 (according to the manufacturer) were obtained from the market. Bundles of 30 parallel fibers were prepared for a bundle of scaffold, which was put into fervens 5g/L Na2CO3for degumming. Ratio of Na2CO3 solution (Ml) to raw silk (g) was 1000.METHODS: In vitro degradation: 8cm long silk scaffold was weighed after drying. Subsequently, the silk scaffold was separately dipped into phosphate buffer saline (PBS) and 1.0g/L collagenase prepared with PBS. Twelve weeks later, silk scaffold was weighed to calculate weight loss rate. Simultaneously, tensile test was performed to detect the ultimate tensile strength (UTS) of samples. Culture of monocyte strain RAW264.7:2×108L-1 macrophage suspension (1mL) were separately added in a silk scaffold group, a control group and a lipopolysaccharide (LPS) group. At days 1 and 7, cell supernatant was collected from each group. Tumor necrosis factor-α(TNF-α) levels were measured by enzyme linked immunosorbent assay (ELISA).MAIN OUTCOME MEASURES: ① Changes in weight loss rate and UTS of the silk matrices after incubated with collagenase and the PBS. ②TNF-αlevels in the supernatant of each groups at days 1 and 7.RESULTS: Mass of silk matrices reduced by over 50% after incubated with collagenase for 8 weeks, but no change was found in PBS. UTS decreased by over 50% 8 weeks after incubated with collagenase, but no change was detected in PBS. At days 1 and 7, TNF-α levels in the supernatant was less in the silk scaffold group; TNF-α levels in the supernatant was significantly higher in the LPS group than in the silk scaffold group (P<0.01), but no significant difference in TNF-α levels was measured between the silk scaffold group and the control group (P>0.05).CONCLUSION: After 12-weeks degradation, silk scaffold still has good mechanical properties. Macrophages possess immunological inertia at days 1 and 7 after inoculated with macrophages.
RESUMO
To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months (range 12-30 months). The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation (P < 0. 01), the total excellent and fine rate was 91.86%. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.
RESUMO
To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months (range 12-30 months). The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation (P＜0.01), the total excellent and fine rate was 91.86 %. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.
RESUMO
BACKGROUND: In China, diabetic patients suffer from various chronic complications with a higher prevalence, which is nearly close to that in developed countries. Especially in Xinjiang, the prevalence is much higher than the average level, and the level of disease control is very poor as a whole.OBJECTIVE: To study the actuality of controlling type 2 diabetes mellitus in Xinjiang so as to analyze its relationship with disease courses.DESIGN: Cluster sampling and stratified analysis.SETTING: Department of Endocrinology, Xinjiang General Hospital of Chinese People's Armed Police Forces.PARTICIPANTS: The survey was conducted at ten treatment centers of Xinjiang(the First Affiliated Hospital of Xinjiang MedicalUniversity, People's Hospital of Xinjiang Uigur Autonomous Region, Urumchi Hospital of Air Force of Chinese PLA, Railway Hospital of Xinjing Uigur Autonomous Region, Military Unit Hospital of Xinjiang, Kuitun Central Hospital of Yili Region of Xinjiang, Kelamay People's Hospital of Xinjiang, Kuler People's Hospital of Xinjiang, the First Division Hospital of Xinjiang Military Unit for Produce and Building, Xinjiang Hospital of Traditional Chinese Medicine). Totally 646 type 2 diabetic patients who had received treatment for diabetes mellitus for 12 months, at any of the centers were randomly recruited with cluster sampling method including 337 males and 309 females. According to different courses of disease, the subjects were divided into 6 groups: 202 cases in group of ＜ 3 years, 89 in group of 3-4 years,89 in group of 5-6 years, 77 in group of 7-9 years, 108 in group of 10-14years, and 81 in group of ≥ 15 years. All the subjects agreed to participate in the survey.METHODS: Patients detected their blood sugar level and urine sugar level themselves with portable diabetograph and test paper. For them, there were at least four days per week to take diabetic diet which was considered as common diet control, and there were at least three days per week to participate in leisure activity and at least half an hour per day to spend in proper exercise which was considered as frequent exercise. Complications of diabetes mellitus were diagnosed with clinical manifestation, disease history and objective examination. The survey was performed through letter,telephone counseling, and patient's reexamination. Enumeration data was analyzed with chi-square test.MAIN OUTCOME MEASURES: Differences in blood sugar, urine sugar, management of living style, prevalence of complications in all the diabetic patients with different courses of disease.RESULTS: There were 645, 645, 643, 646 patients with complete data of blood sugar and urine sugar determined periodically at home, participated in the observation of the management of living style, prevalence of diabetic complications and treatment for diabetes mellitus, respectively. ①There was no significant difference in blood sugar and urine sugar level deter mined at home every month among patients of different courses (P ＞ 0.05). ② There was no difference in diet control and exercise among patients of different courses (P ＞ 0.05). ③In patients with disease course of ＜ 15 years, prevalence of the complication in large vessels and extremity,retinopathy, and positive expression of proteinuria presented an increased tendency; whereas, a decreased tendency was found in patients with the disease course of ≥ 15 years(χ2=34.16,60.64,49.18,P=0.00). ④The proportion of applied therapies, such as diet control and exercise, oral antidiabetic drug, insulin, and insulin plus oral anti-diabetic drug, was different in patients with different disease courses (χ2=97.88 ,P=0.00). In patients with short disease courses, diet control or oral anti-diabetic drug was administrated more usually; in those with long disease courses, insulin treatment or insulin plus oral anti-diabetic drug was applied more frequently.CONCLUSION: ①Whether patients determine their blood sugar and urine sugar levels by themselves is not correlated with patients' disease courses. ②Diet control and exercise are not in correlation with disease courses. ③ For patients with the disease course of less than 15 years, the proportion of prevalence of various diabetic complications is increased with the increase of disease courses; for those with the disease course of more than 15 years, however, it is decreased significantly. ④Simple diet control or oral anti-diabetic drug is often applied in patients with short disease courses while insulin or insulin plus oral anti-diabetic drug are administrated in most patients with long disease courses.
RESUMO
Objective To observe the protective effects of le g negative pressure (NP) treatment on free radical injury from chronic ischemia of lower legs in canines. Methods By cutting off the branches of the femoral artery a nd inserting two pieces of spiral wires into the artery of canine posterior limb , we succeeded in duplicating the animal model of arterial occlusive disease in the lower extremity within two weeks. After treatment with LNP for 8 to 10 days, the blood samples of the ischemic legs were collected and the lipid peroxide (L PO) content as well as superoxide dismutase (SOD) activity were measured and ana lyzed, respectively. Results When the ischemic model was set up, PLO content inc reased while SOD activity decreased apparently, compared with those of normal [(35.594?10.753)vs. (24.800?9.011)?mol?L -1, P