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1.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-776768

RESUMO

OBJECTIVE@#To explore the genetic basis of a patient with early-onset Parkinson disease from a consanguineous family.@*METHODS@#Homozygosity mapping and Sanger sequencing of cDNA were used to identify the causative mutation.@*RESULTS@#A homozygous missense variation (c.56C>G, p.Thr19Arg) in the PARK7 gene was identified in the patient. In silico analysis suggested the c.56C>G variation to be pathogenic.@*CONCLUSION@#Homozygous c.56C>G variation of the PARK7 gene was the disease-causing variation in this family.


Assuntos
Consanguinidade , Homozigoto , Humanos , Mutação de Sentido Incorreto , Doença de Parkinson , Genética , Linhagem , Proteína Desglicase DJ-1 , Genética
2.
Chinese Journal of Epidemiology ; (12): 666-669, 2019.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-805450

RESUMO

Objective@#To analyze the prevalence and risk factors of hypertension combined with diabetes in the middle to elder population in the Nan’an district of Chongqing, and to provide evidence for formulating relevant prevention and control strategies.@*Methods@#Middle or elder adults were enrolled by a Stratified multistage cluster sampling method. Questionnaire survey and the related measurements were conducted. The epidemiology of hypertension combined with diabetes was analyzed descriptively, and the risk or protective factors were analyzed by logistic regression method.@*Results@#A total of 24 792 people were surveyed, with 1 547 patients identified as having hypertension combined with diabetes. The overall prevalence rate appeared as 6.2%, of which 6.0% in males and 6.4% in females, respectively. The prevalence of hypertension combined with diabetes in the general population was increasing with age (χ2=343.766, P<0.001). Factors as age, education, smoking, marital status, exercise, BMI, triglyceride, total cholesterol, high density lipoprotein cholesterol and low density lipoprotein cholesterol were related to the prevalence of hypertension and diabetes. High density lipoprotein cholesterol appeared as a protective factor for hypertension combined with diabetes (OR=0.817, 95%CI: 0.715-0.934). Age, education, low density lipoprotein cholesterol and lack of exercise all appeared as risk factors for hypertension combined with diabetes (P<0.05), respectively.@*Conclusions@#The prevalence rate of hypertension combined with diabetes in the middle or elder adults in Nan’an of Chongqing seemed high. Attention should be paid to the health status of people being elderly, overweight or obese, low cultural level, smoking, triglyceride abnormality, total cholesterol abnormality and high low density lipoprotein cholesterol, so as to reduce the risk on hypertension combined with diabetes.

3.
Chinese Journal of Urology ; (12): 650-653, 2019.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-797755

RESUMO

Objective@#To summarize the initial experience of flexible ureteroscopy combined with thulium laser for the treatment of high-risk upper urinary tract urothelial carcinoma (UTUC) in patients with solitary kidney or renal insufficiency.@*Methods@#A retrospective analysis was performed in 5 cases of UTUC with solitary kidney or renal insufficiency treated via flexible ureteroscopy combined with thulium laser from May 2016 to November 2018. Patients consisted of 4 cases of left side tumor, 1 case of right side tumor, with median age of 73 years old(ranging 53-87 years old). Among the 5 cases, 3 were solitary kidney with renal pelvis tumors, 2 cases were renal insufficiency accompanied with proximal ureter or renal pelvis tumor. All the patients had tumors large than 2 cm in diameter. The creatine in 3 cases with solitary kidney was 102, 128, 143μmol/L, respectively. The creatine in 2 cases with renal insufficiency was 281, 179μmol/L, respectively. Variable hydronephrosis was noticed in all paients. The cytological examination could reveal tumor cells in all cases. During the operation, part of tumor tissues were resected for pathological examination and the remaining visible tumor tissue was all ablated and vaporized. As there was no obvious residual tumor tissue, double J stent was retained. Patients were regularly reexamined after surgery.@*Results@#Of the 5 cases, 4 patients were successfully performed, while intraoperative bleeding occurred in 1 case. The operation was suspended after indwelling double J stent. Then, the renal artery interventional embolism was performed after ineffective conservative treatment, and the bleeding was well controlled. One month later, the patient was treated with thulium laser tumor ablation and vaporizaiton under flexible ureteroscopy again. The pathology of all cases was high-grade invasive urinary epithelial carcinoma. Patients were followed up with regular imaging and endoscopic examination. The median follow-up period was 19 (4-26) months, during which 4 cases had local recurrence, one patient died of non-tumor factors. No recurrence of urothelial carcinoma occurred in the bladder during follow-up, the overall recurrence rate was 80%, and the median recurrence time was 6 (1-24) months. Patients with recurrence was treated with thulium laser tumor ablation and vaporizaiton under flexible ureteroscopy again.@*Conclusions@#Flexible ureteroscopy combined with thulium laser is an alternative treatment for high-risk upper urinary tract urothelial carcinoma in patients with solitary kidney or renal insufficiency, while with high tumor recurrence rate. Therefore, a stringent imaging and endoscopic follow-up should carry out postoperatively.

4.
Chinese Journal of Anesthesiology ; (12): 1172-1175, 2019.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-797051

RESUMO

Objective@#To evaluate the effect of dexmedetomidine on cell apoptosis during lung ischemia-reperfusion (I/R) injury in a rat model of cardiopulmonary bypass (CPB).@*Methods@#Ninety-six SPF healthy adult male Sprague-Dawley rats, weighing 350-500 g, were divided into 4 groups (n=24 each) using a random number table method: sham operation group(group S), CPB group(group C), CPB plus left lung I/R group (group IR), and CPB plus left lung I/R plus dexmedetomidine group (group D). The chest was only opened, and the rats underwent no CPB in group S. Only the CPB model was established in group C. The model of left lung I/R injury was established based on the CPB model in group IR.In group D, the model of CPB plus left pulmonary I/R injury was established, dexmedetomidine was intravenously infused in a dose of 3 μg/kg through the tail vein, followed by a continuous infusion of 1.5 μg·kg-1·h-1 until the end of surgery.Eight rats were selected in each group before operation (T0), at 10 min after opening the left hilum (T1), and at the end of operation (T2), the left lung tissues were taken for examination of pathological changes (with a light microscope) which were scored and for determination of cell apoptosis, and immunohistochemistry score (IHS) was assessed.The apoptosis index was calculated.@*Results@#Compared with group S, the pathological changes of lung tissues, IHS and apoptosis index were significantly increased at T1, 2 in the other three groups (P<0.05). Compared with group C, the pathological changes of lung tissues, IHS and apoptosis index were significantly increased at T1, 2 in IR and D groups (P<0.05). Compared with group IR, the pathological changes of lung tissues, IHS and apoptosis index were significantly decreased at T2 in group D (P<0.05).@*Conclusion@#The mechanism by which dexmedetomidine reduces lung I/R injury during CPB is related to inhibiting cell apoptosis in rats.

5.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-796456

RESUMO

Objective@#To explore the genetic basis of a patient with early-onset Parkinson disease from a consanguineous family.@*Methods@#Homozygosity mapping and Sanger sequencing of cDNA were used to identify the causative mutation.@*Results@#A homozygous missense variation (c.56C>G, p. Thr19Arg) in the PARK7 gene was identified in the patient. In silico analysis suggested the c. 56C>G variation to be pathogenic.@*Conclusion@#Homozygous c. 56C>G variation of the PARK7 gene was the disease-causing variation in this family.

6.
Chinese Journal of Urology ; (12): 650-653, 2019.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-791666

RESUMO

Objective To summarize the initial experience of flexible ureteroscopy combined with thulium laser for the treatment of high-risk upper urinary tract urothelial carcinoma (UTUC) in patients with solitary kidney or renal insufficiency.Methods A retrospective analysis was performed in 5 cases of UTUC with solitary kidney or renal insufficiency treated via flexible ureteroscopy combined with thulium laser from May 2016 to November 2018.Patients consisted of 4 cases of left side tumor,1 case of right side tumor,with median age of 73 years old(ranging 53-87 years old).Among the 5 cases,3 were solitary kidney with renal pelvis tumors,2 cases were renal insufficiency accompanied with proximal ureter or renal pelvis tumor.All the patients had tumors large than 2 cm in diameter.The creatine in 3 cases with solitary kidney was 102,128,143μmol/L,respectively.The creatine in 2 cases with reual insufficiency was 281,179μmol/L,respectively.Variable hydronephrosis was noticed in all paients.The cytological examination could reveal tumor cells in all cases.During the operation,part of tumor tissues were resected for pathological examination and the remaining visible tumor tissue was all ablated and vaporized.As there was no obvious residual tumor tissue,double J stent was retained.Patients were regularly reexamined after surgery.Results Of the 5 cases,4 patients were successfully performed,while intraoperative bleeding occurred in 1 case.The operation was suspended after indwelling double J stent.Then,the renal artery interventional embolism was performed after ineffective conservative treatment,and the bleeding was well controlled.One month later,the patient was treated with thulium laser tumor ablation and vaporizaiton under flexible ureteroscopy again.The pathology of all cases was high-grade invasive urinary epithelial carcinoma.Patients were followed up with regular imaging and endoscopic examination.The median follow-up period was 19 (4-26) months,during which 4 cases had local recurrence,one patient died of non-tumor factors.No recurrence of urothelial carcinoma occurred in the bladder during follow-up,the overall recurrence rate was 80%,and the median recurrence time was 6 (1-24) months.Patients with recurrence was treated with thulium laser tumor ablation and vaporizaiton under flexible ureteroscopy again.Conclusions Flexible ureteroscopy combined with thulium laser is an alternative treatment for high-risk upper urinary tract urothelial carcinoma in patients with solitary kidney or renal insufficiency,while with high tumor recurrence rate.Therefore,a stringent imaging and endoscopic follow-up should carry out postoperatively.

8.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-735127

RESUMO

Mental health is key to public health, as building and developing a mental health service system is legally required in the Mental Health Law of China. The authors probed deep, by means of questionnaire, field survey and group interview, into the characteristics and setbacks of the resources available, organizational framework and operations of the system in China. As found in the study, given a framework in place, this system is plagued by insufficient human resources, weak infrastructure, unreasonable input and compensation mechanism, as well as poor management at community level. These problems are common nationwide. On this basis and with reference to experiences of developed countries, policy proposals are raised in terms of integrated system building, capacity building and assurance mechanism, for framework building and supportive policies of other cities in China.

9.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-756606

RESUMO

Objective To get an understanding of the patient experience in public hospitals nationwide, and to evaluate the implementation of the Action Plan to Improve Health Care. Methods Supported by the mobile technology, from September 6, 2017 to December 15, 2018, the authors conducted an online survey that measured the satisfaction of both inpatients and outpatients at secondary and tertiary hospitals across the country. 15 questions from six dimensions including registration experience, patient-doctor communication, nurse-patient communication, the healthcare signage system, responsiveness of care providers and privacy protection were prepared for outpatients, while 20 questions from nine aspects such as nurse-patient communication, patient-doctor communication, pain management, medication communication, admission and discharge information, responsiveness of care-givers, food service, friendliness to patient family, and the healthcare signage system were directed at inpatients. Descriptive statistical analysis was used to describe the basic features of the data. Results 9.18 million valid responses from outpatients and another 5.38 million from inpatients were obtained. The overall satisfaction rate with outpatient services had reached a score of 90.45 points where nurse-patient communication stands out as the top-rated dimension and privacy protection gets the lowest rating. On the other hand, the inpatient satisfaction stands at a score of 93.01 with friendliness to patient family receiving the top score and patient-doctor communication the lowest. Conclusions Despite the positive feedback Chinese patients give on the outpatient care they receive, we should make efforts to improve the outpatient care environment, the wayfinding system, privacy protection, and responsiveness of care-givers.

10.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-755927

RESUMO

Objective To explore the correlation between pre-transplantation donor kidney biopsy and short-term renal function after transplantation.Methods This study include 240 kidney transplantation of donation after cardiac death (DCD) from July 2016 to April 2018.Banff's score of donor kidney biopsy was employed for estimating kidney status.Results No significant correlation existed between rate of glomerulosclerosis and delayed graft function (DGF) (P =0.815).The rate of glomerulosclerosis was significantly correlated with 1-week estimated glomerular filtration rate (eGFR) and discharge eGFR (P<0.05).Based upon the glomerulosclerosis rate,the patients were divided into two groups < 20% (n =220) and ≥20% (n =20),there was no significant inter-group difference in DGF,1-week eGFR or discharge eGFR (P>0.05).Arterial fibrosis was significantly positively correlated with DGF and negatively with 1-week eGFR and discharge eGFR (P<0.05).Statistically significant inter-group differences existed in 1-week eGFR and discharge eGFR that arterial fibrosis scores < 2 (n =19) and ≥2 (n =41) (P<0.05).Arteriolar hyalinosis score was negatively correlated with 1-week eGFR and discharge eGFR (P<0.05).Based upon arteriolar hyalinosis scores,they were divided into two groups < 2 (n =193) and ≥2 (n =47).There were significant inter-group differences in DGF,1-week eGFR and discharge eGFR (P<0.05).Remuzzi scores were negatively correlated with 1-week eGFR and discharge eGFR (P<0.05).Interstitial fibrosis was significantly positively correlated with DGF (P<0.05) and negatively with 1-week eGFR and discharge eGFR (P<0.05).Conclusions Donor kidney glomerulosclerosis rate affects short-term renal function of recipients after transplantation.However,using 20% as a threshold value is limited in clinical practice.Arterial intimal fibrosis and arteriolar hyalinosis are important factors affecting short-term eGFR.Recipient kidneys with Remuzzi score > 4 had poor renal function after transplantation.Interstitial fibrosis score may be used as a predictor of postoperative DGF and shortterm renal function recovery.It is expected to be discussed more extensively in literature.

11.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-755137

RESUMO

Objective To investigate the efficacy and safety of preventive anticoagulant therapy at different time windows on formation of portal vein thrombosis after laparoscopic splenectomy and pericardial devascularization.Methods The study was performed as a randomized,prospective trial.83 patients with portal hypertension who underwent laparoscopic splenectomy and pericardial devascularization were divided into four groups:the non preventive anticoagulant group (n =21),the prophylactic anticoagulant group (n =23),the 24 hours of preventive anticoagulant group (n =19) and the 48 hours of preventive anticoagulant group (n =20).The incidences of postoperative portal vein thrombosis,the Yerdel grading,platelet count,APTT,and bleeding complications were studied.Results The incidences of portal vein thrombosis in the four groups were 100%,39.1%,47.3%,55%,respectively,and the difference among the 4 groups was significantly different (P < 0.05).The incidences of portal vein thrombosis between the prophylactic anticoagulant group and the 24 hours of preventive anticoagulant group showed no significant difference (P >0.05),but the incidences of portal vein thrombosis after 48 hours of preventive anticoagulant group was significantly higher than the prophylactic anticoagulant group and the 24 hours of preventive anticoagulant group,respectively (P < 0.05).Postoperative bleeding complications,platelet count and APTT after the operations showed no significant differences (P > 0.05).However,the plasma level of D-dimer in the non preventive anticoagulant group was significantly higher than the preventive anticoagulant group (P < 0.05).Conclusion Preventive anticoagulant therapy effectively reduced the incidence of portal vein thrombosis after laparoscopic splenectomy and pericardial devascularization,but it did not significantly increase the risk of postoperative bleeding complications.

12.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-746252

RESUMO

Objective To investigate germline mutation of breast cancer susceptibility genes BRCA1/2,TP53 and PTEN in Chinese breast cancer patients. Methods All of128 female breast cancer patients in Peking University People′s Hospital from January 2016 to August 2018 were selected as objects. Among them,44 cases were sporadic breast cancer and 84 werebreast cancer patients with genetic high risks. Germline mutations of BRCA1,BRCA2,TP53 and PTENwere detected by NGS.χ2 test was used to analyze the difference of pathogenic mutation rates between sporadic breast cancer group and breast cancer with high genetic risks.Groups were divided according to the clinical features of the patients(family history, triple-negative breast cancer,age and bilateral breast cancer).Among them,there were 42 cases with family history of breast cancer,34 cases of triple-negative breast cancer,33 cases of early-onset breast cancer and 7 cases of bilateral breast cancer. Fisher′s exact probability test compared the relationship between pathogenic mutations of BRCA1/2 gene and clinical characteristics of breast cancer patients with hereditary risk factors. Results In 128 cases of breast cancer,30 germline mutations of BRCA1/2 were detected, including 13 pathogenic mutations and 3 newly discovered mutations(BRCA1:c. 4760C>G,BRCA2:c. 44134414del and BRCA2:c. 64826485del). The new mutations may be unique mutations of Chinese population. There were 3 cases of TP53 mutations,including 1 pathogenic mutation. All of the 3 mutations were found in early-onset breast cancer. Germline mutation of T53 has important detection significance for early-onset hereditary breast cancer. There were 5 cases of PTEN mutations,including 3 pathogenic mutations. Among 84 breast cancer patients with genetic high risks,the carry mutation rate was 40.5%(34/84)and the pathogenic mutation rate was 15.4(13/84). Among 44 sporadic cases,the carry mutation rate was 9%(4/44). The pathogenic mutation rate was 6.8%(3/44). Breast cancer susceptibility genes were carried at a higher rate in breast cancer patients with genetic high risks(P<0.001). BRCA1/2 mutations did not show statistical differences among groups of breast cancer patients with hereditary high risk factors . Conclusion Germline mutation detection of breast cancer susceptibility genes by next-generation sequencing is of great significance in breast cancer risk prediction and prognosis evaluation.

13.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-775830

RESUMO

OBJECTIVE@#To explore the genetic basis for a Chinese pedigree where three siblings were affected with Parkinson's disease.@*METHODS@#Multiple ligation-dependent probe amplification (MLPA) and next-generation sequencing (NGS) were employed to detect the causative mutation. Sanger sequencing of cDNA was also used for verify the effect of mutation on the transcription of RNA.@*RESULTS@#Heterozygous deletion of exon 3 of the PARK2 gene was detected by MLPA, while a heterozygous splice site variant c.619-3G>C was detected by NGS. Both mutations were shown to result in aberrant transcripts of the PARK2 gene (loss of exons 3 and 6, respectively) by Sanger sequencing of cDNA. Both mutations have co-segregated with the disease in the pedigree.@*CONCLUSION@#Compound heterozygous mutations of the PARK2 gene probably underlie the disease in this pedigree. Identification of the splice site variant c.619-3G>C has expanded the mutation spectrum of the PARK2 gene.


Assuntos
Grupo com Ancestrais do Continente Asiático , China , Análise Mutacional de DNA , Éxons , Heterozigoto , Humanos , Mutação , Doença de Parkinson , Genética , Linhagem , Ubiquitina-Proteína Ligases , Genética
14.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-815914

RESUMO

To construct a monitoring and risk assessment system of schistosomiasis epidemic focus in marshland, so as to grasp the risk of schistosomiasis transmission, and to provide the technical support for targeted prevention and control measures.The crowd and the risk source of schistosomiasis in Hankou marshland in Wuhan City were monitored to grasp the risk factors of schistosomiasis. The risk level was evaluated by the three-dimensional risk matrix and three-dimensional visualization method.The total numbers of people on holidays and working days were 59 582 and 36 382 persontimes a day respectively in Hankou marshland. Fishing and swimming were the most common ways to contact the river water. The most majority of the people exposed to river water were male (73.9%), retirees (36.1%), local residents (69.7%) and people whose income was 1000 – 3000 yuan per month (52.1%), and the awareness of protection of them was low. In spring, the average density of living Oncomelania hupensis snails was 0.993/0.1 m2, the rat density was 7.72%, and the density of wild feces was 0.78/hm2. In autumn, the average density of living snails was 0.596 /0.1 m2, the rat density was 5.22%, and the density of wild feces was 0.32/hm2. The average density of living snails, the rat density and the density of wild feces were reduced by 39.9%, 32.4% and 59.0% respectively in autumn compared with those in spring. The risk assessment results of three-dimensional matrix showed that part 1 and part 2 were medium risk, part 3 was high risk and part 4 was maximum risk. The risk assessment results of the visualization method showed that the risk level increased from part 1 to part 4, which were basically consistent with the results of the risk matrix.There is a relatively large risk of schistosome infection in Hankou marshland in 2013. The surveillance and risk assessment system of epidemic focus is feasible and scientific.

15.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-691567

RESUMO

Objective:To investigate the MUC1 specific immune response enhanced by thmosinα1(Tα1)using MUC1-MBP as the specific antigen,and to discuss the feasibility of MUC1-MBP as an adjuvant.Methods:The C57BL/6 mice were randomly divided into normal saline group,MUC1-MBP+BCG group and MUC1-MBP+Tα1 group.The T cellular immune activities,MUC1 special antibody and subclass,anti-tumor effect of Tα1 combined with MUC1-MBP were detected.4-7 d after the 3rd immunization,the spleen indexes of the mice in various groups were measured;the lymphocyte proliferation response was used to detect the stimulate index(SI)of the mice in various groups;the levels of specific cytokines IFN-γ,IL-2,IL-4 and IL-10 in the supernatant of spleen cells of the mice were detected by ELISA;the level of serum MUC1-specific antibody was detected by ELISA.The C57BL/6 mice were inoculated with B16-MUC1 7 d after the last immunization and the survival of the mice was observed.Results:Compared with normal saline group,the spleen index and SI of the mice in MUC1-MBP+Tα1 and MUC1-MBP+BCG groups were significantly increased(P< 0.05 or P<0.01);the specific SI of MUC1 were significantly increased(P< 0.05).Compared with normal saline group,the levels of IFN-γ and IL-2 in the supernatant of spleen cells of the mice in MUC1-MBP+BCG group were obviously increased(P<0.05);the levels of IL-4 and IL-10 were slightly increased,but there were no significant differences(P>0.05);compared with normal saline group,the level of IL-4 in MUC1-MBP+Tα1 group was obviously increased(P< 0.01);the levels of IFN-γ,IL-2 and IL-10 were slightly increased,but there were no significant differences(P>0.05).The titer of MUC1 specific antibody was increased with the increase of concentration of Tα1.The antibody subtype detection results showed that compared with normal saline group,the level of IgG1 in MUC1-MBP+BCG group was significantly increased(P< 0.05 or P< 0.01),and the level of IgG2a had no obvious change.The tumor prevention experiment results showed that compared with normal saline group,the survival rates of the mice in MUC1-MBP+BCG group and MUC1-MBP+Tα1 group had no significant differences.Conclusion:MUC1-MBP combined with Tα1 prefers to Th2 immune responses in the mice.It indicates that Tα1 can be used as an adjuvanted preventive vaccines,but not suitable for therapeutic vaccines.

16.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-710767

RESUMO

Sixty four pregnancy women with mildly raised TSH level (2.5-4.5 mU/L) in the 1st trimester were divided into two groups:only the thyroid function was monitored in study Ⅰ group (n =32),while levothyroxine therapy was given in study Ⅱ group (n =32);45 normal pregnant women with TSH level <2.5 mU/L served as control group.Serum unconjugated estriol(uE3) and placenta growth factor (PlGF) levels in 3rd trimester were measured in all subjects.The incidence of adverse events in control group,study groups Ⅰ and Ⅱ were 22.2%,40.6% and 31.3%,respectively (P >0.05).The serum levels of uE3 (7.34 μg/L) and PlGF (76.3 ng/L) were elevated in study group Ⅱ;and the uE3 level was close to that in the control group (6.61 μg/L),while PlGF level was lower than that in the control group (169.1 ng/L).When TPO antibody was positive,the uE3 level in the study group Ⅰ (logarithmic value 0.37 ±0.31) was lower than those in other two groups (logarithmic value 0.81 ± 0.37,0.56 ± 0.27),while there was no significant difference in PlGF levels among three groups.The results suggest that levothyroxine may improve placental function to some extent and TPO antibody might be one of the regulators in the expression of uE3.

17.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-710609

RESUMO

Objective To evaluate the long-term safety of sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue in breast cancer patients.Methods 198 breast cancer patients with clinical negative axillary lymph node received sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue.Patients were followed up and regional lymph node recurrence,disease free survival(DFS) and overall survival(OS) were analyzed.Results After a median follow-up of 70 months,2 patients had ipsilateral lymph node recurrence with a regional lymph node recurrence rate of 1% (2/198).14 patient had recurrence or metastasis and 6 patients died of distant metastasis.The estimated 6 years DFS was 94.4% and OS was 96.5%.The incidence of arm lymphoedema within patients who received axillary lymph node dissection was 4.5% and it was 2.5% in patients who received sentinel lymph node biopsy.Conclusions The sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue was safe and reliable method for further staging axillary lymph node stastus.

18.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-709875

RESUMO

Objective To evaluate the role of PI3K∕Akt signaling pathway in dexmedetomidine-in-duced reduction of lung ischemia-reperfusion ( I∕R ) injury in rats undergoing cardiopulmonary bypass (CPB). Methods Twenty-four healthy adult male Sprague-Dawley rats, weighing 350-450 g, were di-vided into 3 groups (n=8 each) using a random number table method: group I∕R, dexmedetomidine group ( group D) and dexmedetomidine plus wortmannin group (group D+W). Rats were anesthetized with pento-barbital sodium. Lung I∕R was induced by clamping the left hilum of lung for 60 min starting from 10 min of CPB, followed by 120-min reperfusion. Dexmedetomidine was injected via the tail vein in a dose of 3 μg∕kg at 10 min before clamping the left hilum of lung, followed by a continuous infusion of 1. 5 μg·kg-1·h-1 until the end of CPB in group D. Dexmedetomidine was injected via the tail vein in a dose of 3 μg∕kg at 10 min before clamping the left hilum of lung, followed by a continuous infusion of 1. 5 μg·kg-1·h-1until the end of CPB, and wortmannin was simultaneously injected via the tail vein in a dose of 15 μg∕kg, fol-lowed by a continuous infusion of 2. 0 μg·kg-1·min-1until the end of CPB in group D+W. Arterial blood samples were collected immediately before CPB ( T1), immediately after opening the left hilum of lung (T2) and at 1. 5 h after the end of CPB (T3), and oxygenation index (OI) and respiratory index (RI) were calculated. The rats were sacrificed at T3, and the left lung was removed for examination of the patho-logical changes which were scored and for determination of apoptosis rate ( by flow cytometry) and Akt, Bad, activated caspase-3, phosphorylated Akt ( p-Akt) and phosphorylated Bad ( p-Bad) in lung tissues ( by Western blot). Results Compared with the baseline at T1, OI was significantly decreased and RI was increased at T2and T3in the three groups (P<0. 05). OI was significantly decreased and RI was increased at T3than at T2in the three groups ( P<0. 05). Compared with group I∕R, OI was significantly increased and RI was decreased at T3, the pathological damage score and apoptosis rate were decreased, ratios of p-Akt∕Akt and p-Bad∕Bad were increased, and the expression of activated caspase-3 was down-regulated in group D, and OI was significantly decreased and RI was increased at T2in group D+W ( P<0. 05). Com-pared with group D, OI was significantly decreased and RI was increased at T3, the pathological damage score and apoptosis rate were increased, ratios of p-Akt∕Akt and p-Bad∕Bad were decreased, and the ex-pression of activated caspase-3 was up-regulated in group D+W ( P<0. 05). Conclusion Dexmedetomi-dine can reduce dexmedetomidine-induced reduction of lung I∕R injury through activating PI3K∕Akt signa-ling pathway and inhibiting cell apoptosis in rats undergoing CPB.

19.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-709727

RESUMO

Objective To evaluate the effects of pretreatment with exogenous insulin-like growth factor-1 (IGF-1) on lung injury in rats undergoing cardiopulmonary bypass (CPB).Methods Seventy-two SPF healthy male Sprague-Dawley rats,weighing 350-500 g,were divided into 4 groups (n =18 each) using a random number table:sham operation group (group S),CPB group,CPB plus left lung ischemia-reperfusion group (group LI) and IGF-1 group.The chest was only opened,and the rats underwent no CPB in group S.Only the CPB model was established in group CPB.The model of left lung ischemia-reperfusion injury was established based on the CPB model in group LI.The model of CPB and left lung ischemia-reperfusion injury was established,and IGF-1 30 μg/kg was intravenously injected at 10 min before clamping the hilum of lung and immediately after opening the hilum of lung in group IGF-1.Six rats were selected before operation (T1),10 min after opening the left hilum (T2) and at the end of operation (T3),and blood samples were collected from the femoral artery for blood gas analysis.The oxygenation index (OI) and respiratory index (RI) were calculated.Serum was obtained from blood,and the concentrations of interleukin-6 (IL-6),IL-1β and tumor necrosis factor-alpha (TNF-α) in serum were measured using enzyme-linked immunosorbent assay.The left upper lung tissues were removed for examination of the pathological changes which were scored with a light microscope.Results Compared with the baseline at T1,OI was significantly decreased,and RI,concentrations of IL-6,IL-1β and TNF-α in serum and pathological scores of lung tissues were increased at T3 in CPB,LI and IGF-1 groups (P<0.05).Compared with group S,OI was significantly decreased,and RI,concentrations of IL-6,IL-1β and TNF-α in serum and pathological scores of lung tissues were increased at T3 in CPB,LI and IGF-1 groups (P<0.05).Compared with group CPB,OI was significantly decreased,and RI,concentrations of IL-6,IL-1β and TNF-α in serum and pathological scores of lung tissues were increased at T3 in group LI (P<0.05).Compared with group LI,OI was significantly increased,RI,concentrations of IL-6 and IL-1β in serum and pathological scores of lung tissues were decreased at T3,and the concentration of serum TNF-α was increased at T3 in group IGF-1 (P<0.05).Conclusion IGF-1 pretreatment can reduce lung injury in rats undergoing CPB,and the mechanism is related to inhibiting inflammatory responses.

20.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-687782

RESUMO

<p><b>OBJECTIVE</b>To evaluate the application of various obstructive sleep apnea (OSA) screening scales in patients with acute ischemic stroke.</p><p><b>METHODS</b>One hundred and two patients with acute ischemic stroke were enrolled continuously during July 2016 and March 2017 from Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. All patients were assessed by the same physician with various OSA screening scales, including Epworth scale, Berlin questionnaire, STOP-Bang questionnaire, SOS scale, four-variable scale and its modified version. Polysomnography was performed in Sleeping Disorder Center on each patient. According to the apnea-hypopnea index (AHI) acquired from polysomnography, patients were divided into moderate-severe OSA group (AHI ≥ 15, =58) and normal-mild OSA group (AHI<15, =44). The efficiencies of the scales in identification of patients with moderate or severe OSA were analyzed and compared.</p><p><b>RESULTS</b>The ROC curves showed that the four-variable scale and its modified version had higher area under curve (0.806 and 0.807, both <0.01) for diagnosis of moderate-severe OSA, and the cut-off values for Epworth scale, Berlin questionnaire, STOP-Bang questionnaire, SOS scale, four-variable scale and its modified version were 9, 2, 4, 15, 11, 10, respectively. The sensitivities, specificities, positive and negative predictive values of four-variable scale and its modified version in diagnosis of moderate-severe OSA were higher than those of other scales.</p><p><b>CONCLUSIONS</b>Compared with Epworth scale, Berlin questionnaire, STOP-Bang questionnaire and SOS scale, the four-variable scale and its modified version are more effective in screening of OSA for patients with acute ischemic stroke.</p>


Assuntos
Isquemia Encefálica , Humanos , Programas de Rastreamento , Polissonografia , Curva ROC , Apneia Obstrutiva do Sono , Acidente Vascular Cerebral , Inquéritos e Questionários
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