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Objective This study aimed to explore the prognostic value of 18F-FDG PET/CT Metabolic and Heterogeneity Parameters Combined with Clinical Features Before Definitive Chemoradiotherapy(D-CRT)in predicting the prognosis of esophageal squamous cell carcinoma(ESCC)Patients.Methods A retrospective analysis was conducted on clinical data from 106 patients with ESCC who received D-CRT at the first affiliated Hospital of University of Science and Technology of China between January 2017 and December 2021.All patients underwent 18F-FDG PET/CT examination before the treatment.The primary tumor′s metabolic and heterogeneity parameters were obtained through data processing.All patients were followed up for overall survival.The Kaplan-Meier method and Cox proportional hazards models were used to analyze the association between clinical features,tumor metabo-lism and heterogeneity parameters and patient prognosis.Results The 1-and 1.5-year overall survival rates of all patients were 77.4%and 51.9%.The median survival time was 20 months.Univariate analysis showed that N stage,M stage,metabolic tumor volume,total lesion glycolysis,heterogeneity index-2(HI-2),and coefficient of variation with a threshold of 40%maximum standard uptake value(CV40%)were correlated with the prognosis of ESCC(all P<0.05).Multivariate analysis showed that N stage and CV40%were independent predictors of prognosis in patients with ESCC(P = 0.039 and P<0.001,respectively).Conclusion N stage and tumor metabolic heterogeneity parameter CV40%,which offering a degree of predictive value,are closely related to the prognosis of patients with ESCC treated with D-CRT.
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Objective@#To understand campus bullying in colleges and middle schools in Tibet, and to analyze related influencing factors, so as to provide reliable basis and reference for formulating targeted intervention measures.@*Methods@#A stratified cluster sampling method was used to investigate the status and influencing factors of being bullied by questionnaire among 3 875 college and middle school students in Ngari, Qamdo, Lhasa, Nagqu and Xigaze of Tibet, from September to November 2019. Chi-square test and Logistic regression method were used for data analysis.@*Results@#The report rate of campus bullying among college and middle school students in Tibet was 5.50%; 4.35% for girls and 6.76% for boys;8.81% for college students, 1.64% for senior high school students and 5.94% for junior high school students. The results of multivariate Logistic regression analysis showed that smoking ( OR =1.71), Internet addiction ( OR =3.82), depression ( OR =3.84), obesity ( OR =2.02), single parent family ( OR = 1.67 ) and reorganized family ( OR =3.74) were positively correlated with campus bullying ( P <0.05). Girls ( OR =0.66) and senior high school ( OR =0.28) were negatively correlated with campus bullying ( P <0.05).@*Conclusion@#Campus bullying is related to campus environment, family type, behaviors and life styles, etc. Efforts should be committed to build a caring campus culture and a good family moral education environment, in order to reduce the incidence of campus bullying and associated adverse effects.
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Aim To confirm the antidepressant effect of the volatile oil part of the disassembled prescription drugs (Chai Hu, Dang Gui and Bo He, referred to as CDB) from Xiaoyao Powder and investigate its mechanism via Nrf2/H0-1 signaling pathway on OB model rats. Methods GC-MS analysis of the main components of volatile oil part of CDB was performed. The rats were randomly divided into sham operation group, model group, fluoxetine hydrochloride group (FLX, 10 mg • kg
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Objective Electromagnetic navigation was used to observe and measure important anatomical structures through endoscopic endoscopic approach (EEA) to the ventral skull base to provide data for clinical surgery. Methods Using electromagnetic navigation to measure the anatomical structure of the central and paracentral ventral skull base on 10 fresh cadavers, the internal carotid artery (ICA) was the most important. Results Electromagnetic navigation helped to determine the course of important neurovascular. The ICA of the ventral skull base was divided into 5 segments+ 7 major branches, and the length and course of each were measured and recorded. Conclusion The identification and protection of ICA is the key to EEA treatment of ventral skull base lesions, and electromagnetic navigation assistance can improve the efficiency and safety of EEA surgery.
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OBJECTIVE@#To analyze the results of activated partial thromboplastin time (APTT) mixing test in coagulation factor Ⅷ inhibitor-positive hemophilia patients, so as to increase the value of APTT mixing test in the screen of factor Ⅷ inhibitor.@*METHODS@#Eighty plasmas samples with different titers of coagulation factor Ⅷ inhibitors had been collected and diluted for routine immediate APTT mixing test and at 37 ℃ 2 hours incubation APTT mixing test. Fifteen samples were selected for immediate and normal temperature incubation for 15 min, 30min, 1 hour, 2 hours and 37 ℃ for 30 min, 1 hour, 2 hours APTT mixing test.@*RESULTS@#The results of APTT mixing test were significantly correlated with the titers of coagulation factor Ⅷ inhibitors. The ROC curve result showed that the best diagnostic cut-off value for 2 hours incubation APTT mixing test at 37 ℃ to determine the presence or absence of coagulation factor Ⅷ inhibitors was 43.8 s (sensitivity and specificity was 85.90% and 100%, respectively), while the best diagnostic cut-off value for distinguishing high-titer and low-titer Ⅷ inhibitors was 52.4 s (sensitivity and specificity was 98.18% and 95.65%, respectively). The critical coagulation factor Ⅷ inhibitor titer that could not be corrected by immediate APTT was 5.14 BU/ml, while that could not be corrected by 37 ℃ 2 hours incubation APTT was 1.31 BU/ml. Paired samples t -test was performed on the APTT mixing test results at different times and temperatures, and the differences were statistically significant (P < 0.05).@*CONCLUSIONS@#The APTT mixing test can be used as a screening index for coagulation factor Ⅷ inhibitors. APTT mixing test result shows a significant time-temperature dependence with lower titers of coagulation factor Ⅷ inhibitor. Patients with hemophilia who cannot be corrected by immediate APTT mixing test should be alert to the possibility of high titer of coagulation factor Ⅷ.
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Humanos , Factor VIII , Hemofilia A/diagnóstico , Pruebas de Coagulación Sanguínea/métodos , Tiempo de Tromboplastina Parcial , Factores de Coagulación SanguíneaRESUMEN
Objective: To assess the safety and immunogenicity of freeze-dried rabies vaccine (Vero-cells) for human use on different immunization procedures in healthy people aged 9-65 years. Methods: A randomized, blind, positive-controlled clinical study was conducted in March 2015. The eligible residents aged 9-65 were recruited in Dengfeng city and Biyang County, Henan Province. A total of 1 956 subjects were enrolled. The subjects were randomly (1∶1∶1) assigned to 5-dose control group, 4-dose trial group and 5-dose trial group, with 652 subjects in each group. The subjects of 5-dose control group were immunized with control vaccine on days 0, 3, 7, 14 and 28. The subjects of 4-dose trial group were immunized with trial vaccine on days 0, 7 and 21 (2-1-1 phases) and the subjects of 5-dose trial group were immunized with trial vaccine on days 0, 3, 7, 14 and 28. A combination of regular follow-up and active reporting was used to observe local and systemic adverse reactions till 30 days after the first and full immunization, and the incidence rate of adverse reactions in three groups was analyzed and compared. The venous blood was collected before the first immunization, 7 days after the first immunization, 14 days after the first immunization and 14 days after the full immunization. The neutralizing antibody of rabies virus was detected by rapid fluorescent focus inhibition test (RFFIT), and the seropositive conversion rate and geometric mean concentration (GMC) of antibody were calculated. Results: The adverse reaction rates in 5-dose control group, 4-dose trial group and 5-dose trial group were 41.87% (273/652), 35.43% (231/652) and 34.97% (228/652), respectively. The adverse reaction rates of 4-dose trial group and 5-dose trial group were lower than those of the 5-dose control group (P<0.05). The local reactions were mainly pain, itching, swelling and redness in injection site, while the systemic reactions were mainly fever, fatigue, headache and muscle pain. The severity of adverse reactions was mainly mild (level 1), accounting for 85.33% (518/607), 89.02% (373/419) and 88.96% (427/480) of the total number of adverse reactions in each group. At 14 days after the first immunization and 14 days after the full immunization, the antibody positive conversion rates of three groups were all 100%. At 7 days, 14 days after the first immunization and 14 days after the full immunization, the GMCs of three groups were 0.60, 0.72, 0.59 IU/ml, 20.42, 23.99, 24.38 IU/ml and 22.95, 23.52, 24.72 IU/ml, respectively, with no significant difference (P>0.05). Conclusion: The freeze-dried rabies vaccine (Vero-cells) for human use has good safety and immunogenicity when inoculated according to 5-dose and 4-dose immunization procedures.
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Humanos , Vacunas Antirrábicas , Anticuerpos Antivirales , Anticuerpos Neutralizantes , Virus de la Rabia , Vacunación , Rabia/prevención & controlRESUMEN
Background and Purpose: Data and high-quality studies of anesthetic methods for children with obstructive sleep apnea hypopnea syndrome (OSAHS) who undergo drug-induced sleep endoscopy (DISE) are limited. Research on pediatric DISE using esketamine has never been reported before. To test the safety and efficacy of esketamine during DISE in children with OSAHS, we compare esketamine (Group K) with dexmedetomidine (Group D) in this study. Methods: 100 children with ASA â â¼â ¡ grade, prepared for an elective adenotonsillectomy under general anesthesia, were enrolled in this study and randomized into two groups. Midazolam 0.1 mg/kg was administered intravenously for both groups. In Group D a 1 µg/kg bolus of dexmedetomidine was given over 10 min followed by the infusion rate 1 µg/kg/hr to the end of DISE. Group K received a 1.0 mg/kg IV bolus of esketamine over 10 s followed by the infusion rate 1 mg/kg/hr to the end of DISE. Results: Group K had a higher percentage of success than Group D (p = 0.008). The onset time of Group K was shorter than that of Group D (p = 0.000). The University of Michigan Sedation Scale (UMSS) score of Group K was higher than that of Group D (p = 0.005). The risk of adverse effects (AEs) was lower in Group K (p = 0.000). In Group D, systolic and diastolic blood pressure (SBP and DBP) and heart rate (HR) all decreased, while in Group K, SBP, DBP, and HR hardly changed. Conclusion: Esketamine in comparison to dexmedetomidine provides more effective and safer depth of anesthesia for OSAHS pediatric DISE by ensuring short onset time, deep sedation, and few AEs. Clinical Trial Registration: ClincalTrials.gov, identifier NCT04877639.
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Aim To investigate the effect of Exendin-4 high glucose and the function of silent information reg- on endothelial progenitor cells ( EPCs) induced by ulator 1 (SIRT1 ).Methods EPCs were isolated and cultured by density gradient centrifugation from peripheral blood of healthy volunteers.Different concentrations of Exendin-4( 12.5, 50, 100, 200 (xmol • L"1) induced EPCs were respectively performed by activity test to select the appropriate concentration.The optimal concentrations of Exendin-4 and high glucose (25 mmol • L 1) were incubated together for 72 h to detect the functional activities of EPCs.The capabilities of migration, adhension and tube formation of EPCs in vitro were detected respectively.The levels of LDH and MDA in EPCs were detected.The mRNA expressions of TNF-a, 1L-1 p and IL-6 in EPCs were measured by real-time fluorescent quantitative PCR ( RT-qPCR ).The protein expression of SIRT1 , P53 and Ac-P53 in EPCs were determined by Western blot.Results Ex- endin-4 could increase the viability of EPCs induced by j J high glucose in a dose-dependent manner, especially for 50 (xmol • L "1 (P <0.05 ).Hie results of Western blot showed that the protein expression of SIRT1 was significantly enhanced by 50 |xmol • L"' Exendin-4 treatment ( P < 0.05 ).Compared with high glucose group, Exenclin-4 significantly increased the migration, adhesion, tube formation of EPCs (P<0.05) and decreased the level of LDH and MDA ( P < 0.05 ).The mRNA expression of TNF-cx, lL-(3 and IL-6 in EPCs also decreased (P < 0.05).However, the protective effects of Exendin-4 could he significantly blocked by SIRT1 inhibitor ( EX-527) (P<0.05).In addition, the S1HT1 agonist ( SHT1720 ) could also improve the dysfunction of EPCs induced by high glucose ( P < 0.05).Conclusions Exendin-4 can improve the viability of human EPCs, restore the EPCs normal function, reduce high glucose-induced oxidative damage, and reduce the releases of inflammatory cvtokines un- j j der high glucose condition, which may be related to the regulation of S1HT1/P53 signaling pathway.
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OBJECTIVE@#To investigate the characteristics of 18F-FDG PET/CT images of multiple myeloma secondary extramedullary infiltration in order to improve recognition.@*METHODS@#Twenty-one patients with multiple myeloma secondary extramedullary infiltration confirmed by pathology or follow-up from January 2012 to October 2020 in the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed. All the patients underwent 18F-FDG PET/CT imaging before treatment, and the PET/CT characteristics of extramedullary infiltration and bone marrow were analyzed.@*RESULTS@#Twenty-one patients included 12 males and 9 females, aged from 41 to 77 years old, with an average of 58.3±10.0; 9 cases of extramedullary infiltration involving lymph nodes; lung, stomach, spleen, and kidney were involved respectively in 2 cases; retroperitoneal, right auricle, subcutaneous nodule, and spinal meninges involvement were reported in each one case respectively. The maximum SUVmax value of extra-medullary lesions was 21.2, the minimum value was 2.1, and mean was 7.7±5.3. The maximum SUVmax value of bone marrow was 33.5, the minimum was 2.4, and mean was 6.6±3.6. There was no statistically significant difference in SUVmax value between extra-medullary lesions and bone marrow (Z=-1.195, P=0.232).@*CONCLUSION@#18F-FDG PET/CT not only has a good diagnostic value for multiple myeloma, but also a good evaluation value for secondary extramedullary infiltration, which provides reference for clinical treatment and prognosis.
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Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fluorodesoxiglucosa F18 , Mieloma Múltiple/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Tomografía de Emisión de Positrones , Estudios RetrospectivosRESUMEN
OBJECTIVES@#To study the clinical features of severe meconium aspiration syndrome (MAS) and early predicting factors for the development of severe MAS in neonates with meconium-stained amniotic fluid (MSAF).@*METHODS@#A total of 295 neonates who were hospitalized due to Ⅲ° MSAF from January 2018 to December 2019 were enrolled as subjects. The neonates were classified to a non-MAS group (n=199), a mild/moderate MAS group (n=77), and a severe MAS group (n=19). A retrospective analysis was performed for general clinical data, blood gas parameters, infection indicators, and perinatal clinical data of the mother. The respiratory support regimens after birth were compared among the three groups. The receiver operating characteristic (ROC) curve and multivariate logistic regression analysis were used to investigate predicting factors for the development of severe MAS in neonates with MSAF.@*RESULTS@#Among the 295 neonates with MSAF, 32.5% (96/295) experienced MAS, among whom 20% (19/96) had severe MAS. Compared with the mild/moderate MAS group and the non-MAS group, the severe MAS group had a significantly lower 5-minute Apgar score (P<0.05) and a significantly higher blood lactate level in the umbilical artery (P<0.05). Compared with the non-MAS group, the severe MAS group had a significantly higher level of interleukin-6 (IL-6) in peripheral blood at 1 hour after birth (P<0.017). In the severe MAS group, 79% (15/19) of the neonates were born inactive, among whom 13 underwent meconium suctioning, and 100% of the neonates started to receive mechanical ventilation within 24 hours. Peripheral blood IL-6 >39.02 pg/mL and white blood cell count (WBC) >30.345×109/L at 1 hour after birth were early predicting indicators for severe MAS in neonates with MSAF (P<0.05).@*CONCLUSIONS@#Meconium suctioning cannot completely prevent the onset of severe MAS in neonates with MSAF. The neonates with severe MAS may develop severe respiratory distress and require mechanical ventilation early after birth. Close monitoring of blood lactate in the umbilical artery and peripheral blood IL-6 and WBC at 1 hour after birth may help with early prediction of the development and severity of MAS.
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Femenino , Humanos , Recién Nacido , Embarazo , Líquido Amniótico/química , Interleucina-6 , Lactatos , Meconio , Síndrome de Aspiración de Meconio/diagnóstico , Estudios RetrospectivosRESUMEN
@#Multiple primary lung cancer is a special type of lung cancer. Its detection rate is increasing year by year, and there is no clear diagnosis and treatment strategy, which makes the diagnosis and treatment become a hotspot in clinical work. The molecular genetics is gradually changing the status quo of relying only on imaging and tumor-free interval to distinguish lung metastasis from multiple primary lung cancer, and it is an effective method for differential diagnosis and prediction of biological behavior of lung cancer. Based on our experience and other studies, it is recommended that surgical treatment should be preferred when there is no contraindication. The advantages and disadvantages of bilateral thoracoscopic surgery for bilateral multiple primary lung cancer during the same period are discussed, and its feasibility and safety are confirmed. For the lesions that cannot be completely resected, active surgical local treatment is recommended. The diagnosis and treatment of multiple primary lung cancer is still a clinical difficulty, and we hope that our research can provide theoretical and practical guidance for clinicians.
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BACKGROUND: Mounting clinical studies have reported patients with schizophrenia are at high risk of developing sexual dysfunction (SD), but a directly calculated prevalence of SD is currently lacking. AIM: To further quantify the association between schizophrenia and SD. METHODS: MEDLINE (PubMed), Embase (OVID), the Cochrane Library databases, and the PsycINFO were systematically searched for eligible studies reporting the sexual functioning in patients with schizophrenia. This meta-analysis has been registered on PROSPERO (ID: CRD42019121720, http://www.crd.york.ac.uk/PROSPERO). OUTCOMES: The relationship between schizophrenia and SD was detected by calculating the relative risk (RR) with a 95% confidence interval (CI). The GRADE-profiler was employed to rank the quality of the evidence. RESULTS: 10 observational studies (3 case-control studies and 7 cross-sectional studies) were finally included, enrolling a total of 3,570 participants (mean age 28.6-46.2 years), of whom 1,161 had schizophrenia and the remainders were the healthy control subjects. Synthetic results indicated that schizophrenia was significantly associated with an increased risk of SD regardless of gender (3 studies reporting both sexes: RR = 2.24, 95%CI: 1.66-3.03, P < .001, heterogeneity: I2 = 0.0%, P = .431; 7 studies reporting men: RR = 2.63, 95%CI: 1.68-4.13, P < .001, heterogeneity: I2 = 82.7%, P < .001; 5 studies reporting women: RR = 2.07, 95%CI: 1.46-2.94, P < .001; heterogeneity: I2 = 79.7%, P = .001). In accordance with the GRADE-profiler, the quality of the evidence of primary outcomes was LOW, MODERATE, and LOW in studies including both sexes, men, and women, respectively. CLINICAL IMPLICATIONS: Our findings confirmed the potential link between schizophrenia and SD. Clinicians should routinely assess the sexual functioning for those patients with schizophrenia and further recommend the preferred antipsychotics for them. STRENGTHS & LIMITATIONS: This is the first meta-analysis investigating the association between schizophrenia and the risks of SD in both sexes. Nonetheless, substantial heterogeneities were identified across the selected studies. CONCLUSION: Robust data from this meta-analysis showed increased rates of SD in patients with schizophrenia compared with the general populations. Therefore, more specific psychological and pharmaceutical interventions are needed to help patients with schizophrenia gain a better sexual life. Zhao S, Wang X, Qiang X, et al. Is There an Association Between Schizophrenia and Sexual Dysfunction in Both Sexes? A Systematic Review and Meta-Analysis. J Sex Med 2020;17:1476-1488.
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Antipsicóticos , Esquizofrenia , Disfunciones Sexuales Fisiológicas , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esquizofrenia/epidemiología , Conducta Sexual , Disfunciones Sexuales Fisiológicas/epidemiología , Disfunciones Sexuales Fisiológicas/etiologíaRESUMEN
Object:To analyze the effect of muscular tension injury in spasticity of cerebral apoplexy(SCA) rats with spasticity and the expression of γ-aminobutyric acid receptor (GABAα), γ-aminobutyric acid transporter (GAT-1) protein and mRNA expression in cerebral cortex modified Shaoyao Gancaotang, electroacupuncture Quchi, Yanglingquan and acupuncture combined with herb therapies alleviate the effect of SCA. Method:Randomly divided into two groups, divided into blank group, sham operation group, model group, modified Shaoyao Gancaotang group, acupuncture combined with herb group, electroacupuncture group, selected qualified SD rats into the group, 9 rats in each group. The modified Zea-Longa thread embolism method+internal capsule injection of NMDA receptor method was used to prepare a rat model. After the behavioral score confirms the success of the model,dispose of each group separately,electroacupuncture group (electroacupuncture on both sides of Yangling Spring and Quchi,1 time/d for 5 days), modified Shaoyao Gancaotang group (with Shaoyao Gancaotang 1 time/d,10 mL·kg-1 for 5 days),acupuncture combined with herb (modified Shaoyao Gancaotang was given, then electroacupuncture treatment was continued for 5 days). After treatment, the muscle tension was detected by behavioral analysis. Real-time fluorescent quantitative PCR(Real-time PCR) and Western blot were used to detect the expression of GABAα and GAT-1 related mRNA and protein in the cortex. Result:Compared with normal group, the muscle tension of the model group increased (P<0.01), the expression of GABAα mRNA and protein decreased (P<0.01), and the expression of GAT-1 mRNA and protein increased (P<0.01), compared with model group, the muscle tone score of the each treatment group decreased (P<0.05), the expression of GABAα mRNA and protein increased (P<0.05,P<0.01), and the expression of GAT-1 mRNA and protein decreased (P<0.05,P<0.01), of which the corresponding expression in the acupuncture combined with herb group was the most significant. Conclusion:Electroacupuncture Quchi, Yanglingquan,modified Shaoyao Gancaotang and acupuncture combined with three therapies can alleviate the muscle tension of limbs spasm of stroke,and the combination of acupuncture and medicine treatment on the cortical γ-aminobutyric acid receptor the highest expression efficiency suggests that it has the best effect on improving the excitatory spasticity of stroke limbs.
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To explore the changes of serum miR-375 and its target genes in patients with allergic rhinitis (AR) before and after treatment and its significance. Methods: A total of 120 AR patients treated in Wuhan Fourth Hospital were selected as an observation group (AR group), and 120 healthy volunteers served as a control group. Real-time quantitative polymerase chain reaction was used to detect the expression changes of miR-375 and its predicted target genes, such as 3-phosphoinositide-dependent protein kinase-1 (PDK1), protein kinase B (AKT1), Janus kinase 2 (JAK2), and signal transducer and activator of transcription 3 (STAT3), as well as inflammatory factors, such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), and interleukin-13 (IL-13) in the AR group before and after treatment. According to the relative expression levels of miR-375 and target genes, the AR patients were also subdivided into a high expression group and a low expression group for comparative analysis. Results: Before treatment, the level of miR-375 in the serum in the AR group was higher than that in the control group (P<0.01); the expressions of PDK1, AKT1, JAK2 and STAT3 in the plasma in the AR group were lower than those in the control group (all P<0.01); the plasma levels of TNF-α, IL-6, IL-10, and IL-13 in the AR group were higher than those in the control group (all P<0.05). After treatment, compared with the control group, the level of miR-375 in the serum was down-regulated (P<0.01), while the levels of target genes (PDK1, AKT1, JAK2 and STAT3) were up-regulated (all P<0.05), and the levels of TNF-α, IL-6, IL-10, and IL-13 were down-regulated in the AR group (all P<0.05). The total effective rate, total nasal symptom score (TNSS), symptom improvement time, and incidence of adverse reactions in the AR groups with high expression of miR-375 and low expression of target genes before treatment were better than those in the correspending groups with low expression of miR-375 and high expression of target genes (all P<0.05). Conclusion: MiR-375 might be a potential predictor of treatment response for AR patient, which might be related to the plasma levels of its target genes and inflammatory factors.
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Humanos , Interleucina-6 , MicroARNs , Rinitis Alérgica , Factor de Transcripción STAT3 , Factor de Necrosis Tumoral alfaRESUMEN
OBJECTIVE: To explore the feasibility and safety of axillary reverse lymphatic mapping(ARM) afterneoadjuvant chemotherapy(NAC) for breast cancer.METHODS: The clinical data of 45 breast cancer patients whomreached yc N0 after being treated with NAC in the First Affiliated Hospital of Bengbu Medical College between January 2015 and July 2018 were analyzed retrospectively. Double tracer SLNB,directly ALND,or ALND followed by SLNBfailure/SLN + were performed according to the indication of the disease. All the patients were performed ARM usingmethylene blue dye during operation. The success rate of ARM mapping,tumor invasion rate and the safety of ARMlymph node retention were analyzed statistically.RESULTS: There were 13 patients in the ARM lymph node retentiongroup and 32 patients in the ARM lymph node resection group. Follow-up was up to June 2019,the median follow-uptime was 37.5(12-48)months. Discovery rate of ARM in ALND and SLNB group was 93.1%(27/29) and 40%(8/20)respectively. ARM lymph node and SLN overlap was 3 cases. ARM lymph node tumor metastasis was 1 case. Incidencerate of upper limb edema after surgery was lower in ARM reserved group than excision group(P=0.010). The differencesof local recurrence rate between ARM reserved group and excision group was not significant(P=1.000).CONCLUSION: For breast cancer patients with yc N0 after neoadjuvant therapy,reverse axillary lymph node mapping has a high successrate and a low tumor metastasis rate,which is safe and feasible.
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Objective:To observe the effect of Saposhnikoviae Radix-Mume Fructus containing-serum in regulating the phenotypic transformation of airway smooth muscle cells (ASMCs) proliferation model, in order to explore the mechanism of combined administration of "Saposhnikoviae Radix, Mume Fructus" in inhibiting airway remodeling, and reveal the compatibility mechanism of traditional Chinese medicine. Method:The proliferation model of ASMCs was established by platelet derived growth factor (PDGF) induction. The rats were given normal saline, Saposhnikoviae Radix-Mume Fructus, Saposhnikoviae Radix-Mume Fructus(15.425, 15.425, 30.85 g·kg-1·d-1) to prepare drug serum respectively. Four generations of logarithmic phase human bronchial smooth muscle cells (HBSMC) were collected and divided into blank control group, cell model group, normal rat serum group and normal rat serum cell model group, hormone intervention group, Saposhnikoviae Radix serum group, Mume Fructus serum group, Saposhnikoviae Radix-Mume Fructus serum group. The cells were given corresponding treatment. Immunofluorescence staining and Western blot were adopted to detect ASMCs deflating marks protein α-actin and osteopontin (OPN) expressions, and phenotypic transformation was observed; the levels of vascular endothelial growth factor(VEGF), transforming growth factor-β(TGF-β) and interleukin-6(IL-6) secreted by ASMCs were detected by enzyme linked immunosorbent assay (ELISA). Result:Compared with blank group and normal rat serum group, the fluorescence intensity and protein expression of α-actin in model group and normal rat serum cell model group were low, whereas the fluorescence intensity and protein expression of OPN were high, and the concentrations of VEGF, TGF-β and IL-6 increased significantly (Pβ and IL-6 (PConclusion:The combined administration of "Saposhnikoviae Radix-Mume Fructus" has an inhibitory effect on airway remodeling, which may be related to the inhibition of the transformation of ASMCs from contractile phenotype to synthetic phenotype, so as to reduce the release of active substances, such as VEGF, TGF-β and IL-6.
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Objective@#To investigate the correlation between CXC chemokine receptor 6 (CXCR6) and prognosis of renal clear cell carcinoma.@*Methods@#A total of 100 patients with renal clear cell carcinoma who underwent surgery in the First People's Hospital of Ziyang from January 2013 to October 2014 were selected. Immunohistochemistry was used to detect the expression of CXCR6 in 100 cases of renal clear cell carcinoma and adjacent normal tissues. The patients were followed up to observe the positive rate of CXCR6 expression and the factors affecting overall survival (OS) and progression-free survival (PFS) of renal clear cell carcinoma and adjacent normal tissues.@*Results@#The positive rate of CXCR6 expression in renal clear cell carcinoma tissues was higher than that in adjacent tissues, and the difference was statistically significant [46.0% (46/100) vs. 20.0% (20/100), χ2 = 15.287, P < 0.01]. The positive expression rate of CXCR6 in patients with clinical stage Ⅲ-Ⅳ, lymph node metastasis and pathological grade Ⅲ-Ⅳ was higher than that in patients with clinical stage Ⅰ- Ⅱ, pathological grade Ⅰ- Ⅱ and without lymph node metastasis, and the difference was statistically significant (all P < 0.05). A total of 92 patients were followed up and 40 died. The follow-up time reached to (35-60) months and the median follow-up time was 48.9 months. Kaplan-Meier and log-rank test showed that patients with positive CXCR6 expression had lower 3-year OS and PFS rate compared with patients with negative CXCR6 expression, and the difference was statistically significant (3-year OS rate: 52.1% vs. 78.6%, χ2 = 10.027, P = 0.001; 3-year PFS rate: 48.3% vs. 67.8%, χ2 = 4.344, P = 0.037). Cox regression multivariate analysis showed pathological grade (OS: OR = 2.154, 95% CI 1.547-9.517, P = 0.023; PFS: OR = 1.235, 95% CI 1.109-5.917, P = 0.042), lymph node metastasis (OS: OR = 1.412, 95% CI 1.109-5.917, P = 0.041; PFS: OR = 1.841, 95% CI 1.354-8.994, P = 0.010), CXCR6 expression (OS: OR = 1.864, 95% CI 1.358-6.813, P = 0.031; PFS: OR = 1.457, 95% CI 1.127-6.884,P = 0.025) were independent risk factors of OS and PFS for renal clear cell carcinoma patients treated by the surgery.@*Conclusions@#The positive expression of CXCR6 is an independent risk factor for OS and PFS of renal clear cell carcinoma. The prognosis of patients with positive CXCR6 expression is poor.
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Objective To explore the composition and drug resistance characteristics of pathogenic isolates from cerebrospinal fluid (CSF) cultures to facilitate empirical therapy of pediatric patients with meningitis in Guangzhou district.Methods During 2011 Jan 1st to 2015 Dec 31st,cerebrospinal fluids were collected from pediatric patients with suspected meningitis for regular culture,identification and drug susceptibility test of pathogenic isolates according to the national clinical laborato ry standard operation procedure,followed by analysis of their composition and drug resistance characteristics.Results There were 132 pathogenic isolates from CSF cultures,including Gram-positive strains (39.40%,52/132),Gram-negative strains (757.58%,6/132),fungi (3.03 %,4/132),respectively.The main isolates were Escherichia coli (E.coli) (23.48%,31/132),Streptococcus pneumonia (S.pneumonia) (22.73%,30/132),Staphylococcus aureus (S.aureus) (12.12%,16/132)and Streptococcus agalactiae (S.agalactiae) (9.85%,13/132),respectively.E.coli had no resistance to piperacillin/tazobactam,furantoin,cefepime,amikacin,tobramycin,imipenem,ertapenem and meropenem.3.22 % resistance rate to cefotetan,9.38% to ceftazidime,12.90 % to aztreonam,approximately 30 % to ampicillin/sulbactam,ofloxacin,ciprofloxacin,ceftriaxone,gentamycin,cefazolin,over 60 % to both sulfamethoxazole and ampicillin,31.25 % strains were ESBL positive.S.pneumonia had no re sis tance to ertapenem,5.88 % resistance rate to telithromycin,14.71% to chloromycetin,17.76 % to ceftriaxone,23.53 % to amoxicillin,32.30 % to meropenem,35.29 % to cefotaxime,over 70 % to tetracycline,erythromycin,penicillin,and sulfamethoxazole.S.a ureus had no resistance to rifampicin,tigecycline,quinuprin/dupletin,linezolid and vancomycin,6.25% resistance to ciprofloxacin,6.25% to gentamicin,12.50% to sulfamethoxazole,18.75% resistance to clindamycin,31.25 % to tetracycline,62.50 % to erythromycin,over 90 % to cephalosporins and nearly 100 % to penicillin,the rate of MRSA strain was 56.25 %.S.agalactiae had no resistance to penicillin,23.08 % resistance rate to ofloxacin,7.69 % to ciprofloxacin,over 60% to tetracycline,erythromycin and clindamycin.Conclusion The main pathogenic isolates from CSF cultures were E.coli,S.pneumonia,S.aureus,S.agalactiae,different species of isolates have different drug resistance characteristics.This will provide instructions for the prevention,pathogenic diagnosis and treatment of meningitis in pediatric patients.
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BACKGROUND: Plating ankle arthrodesis includes anterior and lateral plating methods, but there is some lack of knowledge about their differences in biomechanics. OBJECTIVE: To establish the three-dimensional models of anterior and lateral plating ankle arthrodesis through three-dimensional finite element technique, simulate human gait, and to analyze its biomechanical stability and safety. METHODS: The geometrical morphology of ankle joint was reconstructed based on the normal human ankle CT data. The models of anterior and lateral plating ankle arthrodesis were established using finite element analysis software Abaqus 2016, and the biomechanical changes after exerting stress at the positions of intorsion,extorsion, dorsiflexion, and neutral were analyzed. RESULTS AND CONCLUSION: (1) The maximal displacement and stress distribution under different stress were compared between two models by three-dimensional element analysis, and there was no significant difference in the stability between two models. (2) The abilities of resistance to intorsion and dorsiflexion stresses of the lateral plating model were slightly better than those of the anterior plating model, but the resistance to extorsion stress of the lateral plating model was lower than that of the anterior plating model; the stress peak both concentrated on the plate-screw connections. (3) The plate, screw and bone mass of the anterior plating model showed the maximum stress peak under intorsion stress, and broken plates and nails usually occur. (4) The lateral plating presented with peak stress under extorsion stress.
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Objective To investigate the bacterial resistance profile of clinical isolates collected in the hospitals across Chuzhou in 2016. Methods Antimicrobial susceptibility testing was carried out by Kirby-Bauer method. The data were analyzed using WHONET 5.6 software according to CLSI 2015 breakpoints. Results A total of 5 465 clinical isolates were collected during 2016, of which gram positive organisms and gram negative organisms accounted for 25.9% (1 416/5 465) and 74.1% (4 049/5 465), respectively. Prevalence of MRSA was 37.6% among S. aureus and the prevalence of MRCNS was 78.1% in CNS. All Staphylococcus, E. faecalis and E. faecium isolates were sensitive to vancomycin and linezolid. The prevalence of extended spectrum-lactamases (ESBLs) positive strains was 51.2% in E. coli, 23.4% in Klebsiella spp. (K. pneumoniae and K. oxytoca), and 23.6% in P. mirabilis isolates, respectively. The Enterobacteriaceae strains were highly sensitive to carbapenems. The percentage of the P. aeruginosa isolates resistant to the antimicrobials tested was lower than 30%. The percentage of the Acinetobacter strains resistant to meropenem and imipenem was 65.6% and 67.4%, respectively. Conclusions The situation of antibiotic resistance is still very serious, especially multi-drug or pan-drug resistant strains, which is of great concern.