The clinical study of pelvic sacral acupuncture combined with myofascial manipulation in the treatment of postpartum pelvic pain / 国际中医中药杂志

Objective:To evaluate the efficacy of pelvic sacral tendon regulating acupuncture combined with myofascial manipulation in the treatment of postpartum pelvic pain.Methods:A total of 86 patients with postpartum pelvic pain in our hospital from December 2019 to October 2021 who met the inclusion criteria were divided into control group ( n=44) and observation group ( n=42) by random number table method. The control group was treated with myofascial manipulation, while the observation group was treated with pelvic sacral tendon acupuncture on the basis of the control group. Both groups were treated for 4 weeks. The VAS was used to evaluate the degree of pain, Oswestry Disability Index (ODI) to evaluate the degree of lumbar dysfunction, pelvic floor dysfunction Questionnaire 7 (PFIQ-7) to evaluate the pelvic floor function, and pelvic floor dysfunction Questionnaire (PFDI20) to evaluate the quality of life. Serum levels of insulin-like growth factor-1 (IGF-1) and TGF-β1 were detected by ELISA to evaluate the clinical efficacy. Results:The total effective rate was 95.24% (40/42) in the observation group and 79.55% (35/44) in the control group, and the difference was statistically significant ( χ2=4.74, P=0.030). After treatment, the ODI, VAS, PFIQ-7 and PFIQ-20 scores of the observation group were significantly lower than those in the control group ( t=13.79, 14.05, 10.61, 10.10, all Ps<0.001). The scores of low back pain, limb pain and gait claudication were significantly lower than those in the control group ( t=11.73, 12.16 and 10.89, respectively, all Ps<0.001). The serum levels of TGF-β1 [(163.81±28.05) μg/L vs. (124.56±19.23) μg/L, t=5.76] and IGF-1 [(64.52±9.14) μg/L vs. (49.86±7.62) μg/L, t=5.06] were significantly higher than those in the control group ( P<0.01). Conclusion:The pelvic sacral tendon acupuncture combined with myofascial manipulation can improve the pelvic function of patients with postpartum pelvic pain, relieve the degree of pelvic pain, and improve the curative effect.

Clinical characteristics and prognosis of pregnancy complicated with pheochromocytoma/paraganglioma / 中国综合临床

Pheochromocytoma/paraganglioma is an adrenal tumor that secrets catecholamines and is extremely rare in pregnant women. Its clinical presentation is lack of specificity, and the combination of low prevalence and nonspecific clinical presentation makes diagnosis and treatment difficult. In this study, the clinical data and prognosis of 5 pregnant patients with pheochromocytoma/paraganglioma were analyzed. It was found that hypertension first occurred in 4 patients during pregnancy, and the clinical manifestations of each case were different. Surgical treatment is the first choice in the treatment, patients who cannot operate can choose radionuclide therapy, chemotherapy and targeted therapy. Through follow-up, they all showed recurrence and metastasis at different times. Among them, the patients who continued to be pregnant to the middle and late stages of surgical treatment progressed rapidly, and there were multiple bone metastases throughout the body in a short period of time, and two cases died in a short period of time. Therefore, effective diagnosis, individualized treatment and lifelong follow-up are particularly important.

Helicobacter pylori infection and its correlation with pepsinogen in the elderly aged 60 - 80 years in Jianye District, Nanjing / 公共卫生与预防医学

Objective To analyze the infection situation of Helicobacter pylori (Hp) and its correlation with pepsinogen (PG) in the 60~80 year old population in Jianye District, Nanjing City. Methods From December 2018 to December 2020, 758 elderly people aged 60 to 80 in the community in Jianye District Nanjing City. were selected. All subjects were tested for Hp by 13C-UBT method, and clinical signs of Hp positive people aged 60 to 80 years were analyzed. Including gender, age, alcohol consumption, family history of stomach cancer, chronic gastritis, and spicy eating habits; Hp positive group was given amoxicillin capsule 1.0g/ time, twice a day, esomeprazole magnesium enteric-coated tablet 20mg/ time, twice a day, clarithromycin tablet 0.5g/ time, twice a day for 8 weeks, and Hp was detected again after the end of treatment. All levels of PGI, PGII and PGI/PGII were determined by ELISA. The serum PG level of the experimental group and the control group and the serum PG level of the Hp positive population before and after Hp eradication were compared, and the correlation between Hp infection and PG level in the elderly population was analyzed by Pearson correlation. Results A total of 161 cases (21.24%) of 758 patients with chronic gastritis had Hp infection. The proportion of Hp infection in males was significantly higher than that in females (χ2=4.128，P2=6.771, P2 =8.305，P2=6.169，P2=5.576 , P2=7.936, P<0.05). The levels of PGI and PGI/PGII in the experimental group were significantly higher than those in the control group (P<0.05). The level of PGII in experimental group was significantly lower than that in control group (P<0.05). After treatment, 76 hP-positive patients turned negative, and PGI and PGI/PGII levels after Hp eradication were significantly lower than those before Hp eradication (P<0.05). PGII after Hp eradication was significantly higher than before (P<0.05). According to Pearson correlation analysis, Hp infection in elderly population was positively correlated with PGI and PGI/PGII levels, with correlation coefficients (r1=0.408,r2=0.412,P<0.05), and negatively correlated with PGII, with correlation coefficients (r=-0.469, P<0.05). Conclusions The Hp infection rate in patients with chronic gastritis is high, mainly in elderly men in Jianye District, Nanjing City.The levels of PGI and PGII in HP-positive patients are high, and the levels of PGI/PGII are low. The serum PG level can be used to evaluate the diagnosis and treatment effect of patients with Hp infection.

Value of radiomics features from adrenal gland and periadrenal fat CT images predicting COVID-19 progression

BackgroundValue of radiomics features from the adrenal gland and periadrenal fat CT images for predicting disease progression in patients with COVID-19 has not been studied. MethodsA total of 1,245 patients (685 moderate and 560 severe patients) were enrolled in a retrospective study. We proposed 3D V-Net to segment adrenal glands in onset CT images automatically, and periadrenal fat was obtained using inflation operation around the adrenal gland. Next, we built a clinical model (CM), three radiomics models (adrenal gland model [AM], periadrenal fat model [PM], and fusion of adrenal gland and periadrenal fat model [FM]), and radiomics nomogram (RN) after radiomics features extracted to predict disease progression in patients with COVID-19. ResultsThe auto-segmentation framework yielded a dice value of 0.79 in the training set. CM, AM, PM, FM, and RN obtained AUCs of 0.712, 0.692, 0.763, 0.791, and 0.806, respectively in the training set. FM and RN had better predictive efficacy than CM (P < 0.0001) in the training set. RN showed that there was no significant difference in the validation set (mean absolute error [MAE] = 0.04) and test set (MAE = 0.075) between predictive and actual results. Decision curve analysis showed that if the threshold probability was more than 0.3 in the validation set or between 0.4 and 0.8 in the test set, it could gain more net benefits using RN than FM and CM. ConclusionRadiomics features extracted from the adrenal gland and periadrenal fat CT images may predict progression in patients with COVID-19. FundingThis study was funded by Science and Technology Foundation of Guizhou Province (QKHZC [2020]4Y002, QKHPTRC [2019]5803), the Guiyang Science and Technology Project (ZKXM [2020]4), Guizhou Science and Technology Department Key Lab. Project (QKF [2017]25), Beijing Medical and Health Foundation (YWJKJJHKYJJ-B20261CS) and the special fund for basic Research Operating Expenses of public welfare research institutes at the central level from Chinese Academy of Medical Sciences (2019PT320003).

7SK truncation at 128-179 nt suppresses embryonic stem cell proliferation / 南方医科大学学报

OBJECTIVE@#To explore the role of small nuclear noncoding RNA 7SK in embryonic stem cell (ESCs) proliferation and the value of 7SK as a target for early diagnosis and treatment for primordial dwarfism (PD).@*METHODS@#ESC line R1 was transfected with the CRISPR/Cas9 system, and sequencing of the PCR product and glycerol gradient analysis were performed to identify novel 7SK deletion mutations. A lentivirus system was used to knock down cyclin-dependent kinase 9 (CDK9) in clones with 7SK deletion mutations, and the effect of CDK9 knockdown on the protein level of cell division cycle 6 (CDC6) was analyzed with Western blotting.@*RESULTS@#We identified a novel deletion mutation of 7SK at 128-179 nt in the ESCs, which resulted in deficiency of cell proliferation. 7SK truncation at 128-179 nt significantly reduced the protein expressions of La-related protein 7 (LARP7) and CDC6.@*CONCLUSIONS@#7SK truncation at 128-179 nt can significantly impair proliferation of ESCs by downregulating CDC6. 7SK is a key regulator of proliferation and mediates the growth of ESCs through a mechanism dependent on CDK9 activity, suggesting the value of 7SK truncation at 128-179 nt as a potential target for early diagnosis and treatment of PD.

Strategies and advances in targeting adaptive immunity to cure chronic hepatitis B / 临床肝胆病杂志

Chronic hepatitis B (CHB) is a major global public health issue, and although direct-acting antiviral agents can control hepatitis B virus (HBV) replication, it is difficult to achieve the cure of CHB. Host adaptive immune response plays a key role in eliminating HBV, and it is expected to achieve the functional cure of CHB by rebuilding the patient’s adaptive immunity. Great progress has been made in therapeutic vaccines, cellular immunotherapy, immune checkpoint blockade, T cell metabolic reprogramming, and strategies of neutralizing antibody targeting adaptive immunity for the treatment of hepatitis B. This article summarizes the above-mentioned therapies for hepatitis B in recent years.

Association Between Occlusion Type and Etiology of Acute Intracranial Large Artery Occlusion.

Objective: To investigate the diagnostic efficiency of truncal-type occlusion and branching-site occlusion in determining the etiology of intracranial large artery occlusion related acute ischemic stroke (AIS). Methods: Patients with intracranial large artery occlusion related AIS who received stent retriever (SR) thrombectomy from November 2014 to June 2019 were included in the study. All patients underwent angiography before SR thrombectomy, which was used to evaluate the occlusion type. Differences in the distribution of occlusion types in intracranial atherosclerosis (ICAS) and embolism were assessed, and the diagnostic indicators, including the area under the ROC curve (AUC), sensitivity, and specificity were calculated. Results: Of the 115 AIS patients with intracranial large artery occlusion, 42 were classified as having ICAS, and 73 having an embolism. In the ICAS group, branching-site occlusion was responsible for 3 (7%) cases and truncal-type occlusion for 39 (93%) cases, while in the embolism group, branching-site occlusion was responsible for 66 (90%) cases and truncal-type occlusion for 7 (10%) cases; the difference was statistically significant (all P < 0.01). The AUC for ICAS predicted by truncal-type occlusion was 0.916, with a sensitivity of 92.86%, and specificity of 90.41%. Conclusion: Truncal-type occlusion showed a high predictability of ICAS. Determine the etiology of intracranial large artery occlusion related AIS before SR thrombectomy may be most helpful in setting up optimal endovascular treatment strategies.

Establishment and clinical performance evaluation of 2019 novel coronavirus antibody colloidal gold detection method / 中华传染病杂志

Objective@#To establish a colloidal gold technique assay for the rapid detection of immunoglobulin(Ig) M and IgG antibodies against 2019 novel coronavirus (2019-nCoV) and to evaluate its clinical performance.@*Methods@#A total of 278 patients who were treated at Wuhan Hankou Hospital and the People's Hospital of Honghu from February 12, 2020 to February 20, 2020 were collected. According to the diagnostic criteria, 89 patients were confirmed with 2019-nCoV nucleic acid positive diagnosis, and 189 were 2019-nCoV nucleic acid-negative suspected patients. A total of 273 medical examiners from Nanfang Hospital, Southern Medical University from 2015 to 2018 were selected as controls. The serum samples of patients were collected. 2019-nCoV nucleic proteins were obtained from prokaryotic expression vectors. Indirect IgM and IgG colloidal gold techniques were established by using recombinant N protein. 2019-nCoV nucleic acid detection by reverse transcription-polymerase chain reaction (RT-PCR) was used as control. Serum specimens were tested for 2019-nCoV IgM and IgG. The specificity and sensitivity of colloidal gold assay were analyzed.@*Results@#The sensitivity and specificity of IgM detection reagents were 78.7% and 98.2%, respectively, those of IgG detection reagents were 73.0% and 99.3%, respectively, and those of IgM combined with IgG detection were 87.6% and 98.2%, respectively. For suspected patients with negative 2019-nCoV nucleic acid, the positive rates of IgM and IgG were 59.8% (113/189) and 52.9% (100/189), respectively, and the positive rate of IgM combined with IgG detection was 66.1% (125/189).@*Conclusion@#This reagent of 2019-nCoV antibodies detection (colloidal gold technique) fulfills the requirement for clinical application with high specificity and sensitivity, which can be served as a supplementary detection method for 2019-nCoV nucleic acid detection by RT-PCR.

Establishment and clinical performance evaluation of 2019 novel coronavirus antibody colloidal gold detection method / 中华传染病杂志

Objective:To establish a colloidal gold technique assay for the rapid detection of immunoglobulin(Ig)M and IgG antibodies against 2019 novel coronavirus (2019-nCoV) and to evaluate its clinical performance.Methods:A total of 278 patients who were respectively treated at Wuhan Hankou Hospital and the People′s Hospital of Honghu from February 12, 2020 to February 20, 2020 were collected. According to the diagnostic criteria, 89 patients were confirmed with positive 2019-nCoV nucleic acid, and 189 were 2019-nCoV nucleic acid-negative suspected patients. A total of 273 medical examiners from Nanfang Hospital, Southern Medical University from 2015 to 2018 were selected as controls. The serum samples of patients were collected. 2019-nCoV nucleic proteins were obtained from prokaryotic expression vectors. Indirect IgM and IgG colloidal gold techniques were established by using recombinant nuclear protein. 2019-nCoV nucleic acid detection by reverse transcription-polymerase chain reaction (RT-PCR) was used as control. Serum specimens were tested for 2019-nCoV IgM and IgG. The specificity and sensitivity of colloidal gold assay were analyzed.Results:The positive rates of IgM and IgG with the colloidal gold detection in confirmed patients with positive 2019-nCoV nucleic acid were 78.7%(70/89) and 73.0%(65/89), respectively. The positive rates of IgM and IgG in medical examiners were 1.8%(5/273) and 0.7%(2/273), respectively. The sensitivity and specificity of IgM detection reagents were 78.7% and 98.2%, respectively, those of IgG detection reagents were 73.0% and 99.3%, respectively, and those of IgM combined with IgG detection were 87.6% and 98.2%, respectively. For suspected patients with negative 2019-nCoV nucleic acid, the positive rates of IgM and IgG were 59.8%(113/189) and 52.9%(100/189), respectively, and the positive rate of IgM combined with IgG detection was 66.1%(125/189).Conclusion:This reagent of 2019-nCoV antibodies detection (colloidal gold technique) fulfills the requirement for clinical application with high specificity and sensitivity, which can be served as a supplementary detection method for 2019-nCoV nucleic acid detection by RT-PCR.

Hepatitis B cured by the activation of intrahepatic innate immunity: Research advances and new strategies / 临床肝胆病杂志

Host innate and adaptive immune responses are essential for the clearance of hepatitis B virus (HBV). Patients with chronic HBV infection have defects in innate and specific immune responses against HBV, which cannot effectively eliminate the virus and may result in persistent virus replication and liver inflammation. In addition to direct inhibition of HBV, treatment strategies targeting host immunity, such as stimulating or restoring antiviral immunity, are also important methods to achieve functional cure in patients with chronic hepatitis B. The liver is the target organ for HBV infection, and therefore, the research on the impact of HBV infection on intrahepatic immune microenvironment has become a hotspot for the research and development of new drugs that regulate the antiviral immune response against HBV in the liver. This article reviews the recent research advances in innate immune response associated with HBV infection and the new strategies to activate intrahepatic innate immune response and achieve the cure of hepatitis B.

The value of third-generation dual-source CT low-pressure voltage combined with ADMIRE in children′s nasopharynx examination / 实用医学杂志

Objective Exploration of the application value of the third-generation dual source CT low tube voltage (70 kVp) scanning combined with advanced modeling iterative reconstruction (ADMIRE) technique in children with adenoid examination. Methods CT scans were performed in patients with clinically suspected adenoid hypertrophy. They were divided into two groups according to the time of treatment. Group A (40 cases) : low tube voltage (70 kVp) scan, reference tube current 163 mAs, reconstruction with ADMIER, Intensity 3; Group B (40 cases) : conventional 100 kVp, reference tube current 163 mAs, conventional (filtered back-projection, FBP) reconstruction;rest of the scanning parameters remained unchanged. The subjective scores and objective quality indicators of the images (CT value, image noise, signal noise ratio (SNR) , contrast noise ratio (CNR)) and radiation dose of the two groups were compared. Results The difference of radiation dose between group A and group B was statistically significant (P < 0.05). The radiation dose of group A was lower than that of group B by 77.58％.Compared with group B, the image noise of group A increased by 0.002％; the SNR decreased by 0.01％; CNR increased by 0.03％; there was no significant difference in objective quality evaluation index and subjective score between two groups in the image quality (P> 0.05). Conclusion The third-generation dual-source CT low-tube voltage (70 kVp) combined with ADMIRE reconstruction technique for children with adenoid scan can effectively reduce the radiation dose while ensuring image quality.

Efficacy of percutaneous pedicle screw fixation of ankylosing spondylitis combined with thoracolumbar fractures / 中华创伤杂志

Objective To investigate the feasibility and clinical effect of percutaneous pedicle screw fixation in the treatment of ankylosing spondylitis (AS) with thoracolumbar fractures.Methods A retrospective case-series study was performed on 12 AS patients with thoracolumbar fractures admitted from January 2013 to January 2016.There were 9 males and 3 females,aged (42.7 ± 13.0) years (range,24-63 years).All patients received percutaneous minimally invasive pedicle screw fixation.The operation duration,intraoperative blood loss,length of incision,ambulation time,and time to basic life were recorded.Visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated before and after operation.Postoperative complications and bone fracture union were observed during the followup period.Results All patients were followed up for average 22 months (range,14-36 months).All patients underwent successful surgery,with operation duration and intraoperative blood loss of (178.0 ± 60.2) min and (116.7 ± 44.2) ml respectively.No serious complications such as blood vessel or nerve injury occurred during the operation.The incision length was 1.2-1.5 cm.All the patients were able to do exercise with the help of brace 2-3 days after the operation and returned to basic life after (23.4 ± 7.3)days postoperatively.At 1,3,6 and 12 months after operation,VAS and ODI differed significantly from the preoperative detections (P ＜ 0.05).During the follow-up,bone fracture union was observed in all patients,with no nail breakage or nail loosening occurred after operation.Conclusion For AS combined with thoracolumbar fractures,minimally invasive fixation can attain satisfactory curative effect,with advantages of minor lesion,little bleeding,fast recovery and sound bone union.

Preliminary application of optimized temporal parallel acquisition technique real-time cine sequence in cardiac MRI in arrhythmia patients / 中国医学影像技术

Objective To observe the value of optimized temporal parallel acquisition technique (TPAT) sequence in evaluating cardiac structure and function in arrhythmia patients.Methods Totally 33 arrhythmia patients (arrhythmia group) and 48 normal rhythm subjects (normal group) underwent cardiac MRI with conventional cine (balanced steadystate free-precession [bSSFP]) sequence and optimized TPAT sequence.Myocardial thickness,cardiac function,myocardial strain parameters of left ventricle and image quality of 2 sequences were compared in the two groups,respectively.Results In arrhythmia group,there was statistical difference of myocardial thickness in 12 myocardial segments between the 2 sequences (all P ＜ 0.05),as well as peak and average values of myocardial radial and circumferential strain (all P＜0.05).In normal group,there was no statistical difference of myocardial thickness and stain parameters between the 2 sequences (all P＞0.05).Additionally,no statistical difference of cardiac function was found between the 2 sequences in two groups (all P＞0.05).In arrhythmia group,the image quality of optimized TPAT sequence was better than that of bSSFP sequence (P＜0.05).Conclusion For arrhythmia patients,optimized TPAT cine sequence could improve image quality of cardiac MRI.

Therapeutic Efficacy of Active Immunization Combined with Dydrogesterone in the Treatment of Recurrent Abortion and Its Effects on Serum Levels of LP and ADPN / 中国药房

OBJECTIVE:To observe the therapeutic efficacy of active immunization combined with dydrogesterone in the treatment of recurrent abortion,and its effects on serum levels of leptin(LP)and adiponectin(ADPN). METHODS:Totally 103 patients with recurrent abortion from department of gyhecology,Jinan Third People's Hospital during Nov. 2015 to Nov. 2016 were selected as trial group,and then divided into trial group one(n＝51)and trial group two(n＝52)according to admission order. Other 100 normal pregnant women were taken as control group. Trial group one was given active immunization combined with dydrogesterone,including that lymphocytes from the patients'spouse were injected subcutaneously into the patient,every half a month,3 times of active immunization as a course of treatment,and was given Dydrogesterone tablet 10 mg after pregnancy,bid, until 3 months after the pregnancy. Trial group two was given Dydrogesterone tablet 10 mg,bid,until 3 months after the pregnancy. The serum levels of β-HCG,LP and ADPN were compared between trial group and control group at admission,the serum levels of β-HCG,LP,ADPN and pregnancy outcome(recurrent abortion,full-term pregnancy and successful delivery rate) was compared between 2 trial groups after treatment. RESULTS:At admission,the serum levels of β-HCG,LP and ADPN in trial group were significantly lower than control group. After treatment,the levels of β-HCG,LP and ADPN,successful delivery rate and full-term pregnancy rate in trial group one were significantly higher than trial group two, recurrent abortion rate was significantly lower than trial group two,with statistical significance(P＜0.05). No adverse reactions were observed in the study. CONCLUSIONS:The use of active immunization combined with dydrogesterone can significantly improve the serum levels of LP and ADPN as well as pregnancy outcome,with good safety.

Interferon-α modulates HBV specific T-cell response to inhibit viral gene expression in chronic HBV infection mouse model / 中国感染与化疗杂志

Objective To explore the antiviral effect and mechanism of interferon-α (IFN-α) in chronic HBV infection mouse model by hydrodynamic tail vein injection. Methods Chronic HBV infection mouse model was constructed with C57BL/6j mice by hydrodynamic tail vein injection of pAAV-HBV1.2 plasmid. Serum IFN-α was determined by ELISA after injection of IFNα- expressing plasmid (i.e., plasmid pKCMvint.IFN-α-2a) or control plasmid pKCMvint. HBsAg and HBeAg levels were assayed on Abbot ARCHITECT i2000SR. Total lymphocytes in liver or spleen were counted and the frequency and function of CD8+T cells and HBV-specific CD8+T cells were analyzed by flow cytometry. Results Serum IFN-α expression level was significantly higher in the animals injected with pKCMvint.IFN-α-2a plasmid than in control group (P＜0.01). Serum HBsAg decreased quickly 12 days after injection and significantly lower than control group. Serum HBeAg was undetectable after IFN-α expression. Interestingly, the frequency of CD8+T cells in the liver of animals injected with pKCMvint.IFN-α-2a plasmid was significant higher than control group (P＜0.05), while total liver lymphocytes and HBV-specific CD8+T cells had a similar trend. Consistently, the HBV-specific CD8+T cells in IFN-α-expressing animals showed higher level of producing IFN-γ, TNF-α and IL-2 than control group. IFN-γ production was significantly different between IFN-α- expressing group and control group (P＜0.05). Conclusions IFN-α can increase the frequency and function of liver CD8+T cells to inhibit HBV gene expression in chronic HBV infection mouse model.

The value of ultrasound transient elastography in the estimation of intraocular pressure / 中华超声影像学杂志

Objective To explore the feasibility and the value of ultrasound transient elastography in the estimation of intraocular pressure.Methods Thirty-two cases of glancomatous patients' and twenty-eight healthy subjects'eyeball were examined by using ultrasound transient elastography,meanwhile using Photoshop image analysis software to quantitative analysis of blue gradation ratio of the front wall tissue of eyeball,then intraocular pressure were examined by NCT.The difference of quantitative data of blue gradation ratio of the front wall tissue of eyeball between glancomatous patients and healthy subjects were compared.The relationship of quantitative value of blue gradation ratio and intraocular pressure were established.Results The blue gradation ratio of the front wall tissue of eyeball in glancomatous patients were 0.37± 0.03,while in healthy subjects were 0.33 ± 0.02,there was a significant difference between glancomatous patients and healthy subjects (P < 0.01),and there was a linear relation between blue gradation ratio and intraocular pressure(r = 0.424,P < 0.05).Conclusions The ultrasound transient elastography can be used in estimation of intra-ocular pressure in glancomatous patients,and there is a linear relation in quantitative data between blue gradation ratio and intraocular pressure.

The curative effect and prognostic analysis of transcatheter arterial chemoembolization combined with radiofrequency ablation in treatment of liver cancer / 中国基层医药

Objective To investigate the clinical efficacy and prognosis of transcatheter arterial chemoembo-lization(TACE)combined with radiofrequency ablation(RFA)in treatment of liver cancer.Methods 64 patients of liver cancer were selected as the research subjects,and they were divided into two groups by randomized single blind method.32 cases in the control group adopted the TACE treatment,while 32 cases in the observation group were given TACE combined with RFA.The tumor shrinkage,complete necrosis rate,local recurrence rate,AFP levels and adverse reactions of the two groups were compared.The patients were followed up for 3 years to record survival.Results After treatment,the tumor shrinkage rate and complete necrosis rate of the observation group were 90.63% and 75.00%, which were significantly higher than 68.75% and 50.00% of the control group,the differences were statistically significant (χ2 =8.453,8.203,all P 0.05 ).Conclusion TACE combined with RFA in treatment of liver cancer can significantly improve the effect of tumor necrosis rate,reduce the local recurrence rate and prolong the survival time of the patients, and it had less adverse reaction,higher safety,and which should be applied in clinical.

A one-stage, high-load capacity separation actuator using anti-friction rollers and redundant shape memory alloy wires.

This paper proposes a SMA (shape memory alloy) wire-based separation actuator with high-load capacity and simple structure. The novel actuator is based on a one-stage locking mechanism, which means that the separation is directly driven by the SMA wire. To release a large preload, a group of anti-friction rollers are adopted to reduce the force for triggering. In addition, two SMA wires are used redundantly to ensure a high reliability. After separation, the actuator can be reset automatically without any auxiliary tool or manual operation. Three prototypes of the separation actuator are fabricated and tested. According to the performance test results, the actuator can release a maximum preload of 40 kN. The separation time tends to decrease as the operation current increases and it can be as short as 0.5 s under a 7.5 A (the voltage is 5.8 V) current. Lifetime test indicates that the actuator has a lifetime of more than 50 cycles. The environmental tests demonstrate that the actuator can endure the typical thermal and vibration environment tests without unexpected separation or structure damage, and separate normally after these environment tests.

Clinical Research on Reducing Vagal Reflex during RFCA / 昆明医科大学学报

Objective To discusse the mechanism and clinical significance of bradycardia -hypotension phenomenon which is caused by vagal reflex during and after the RFCA and present the experience of using appropriate measures to decrease the incidence of this situation. Methods The patients who were suffering from tachyarrhythmias and treated by RFCA were divided into two groups. The groups were as follows:148 patients who were not taken special measures in the early stage were selected in control group;1 540 patients who were taken measures to prevent vasovagal reflex were selected in observation group. Result During the RFCA, the incidence of bradycardia -hypotension phenomenon in control group was 13.5% (20/148), the incidence of bradycardia-hypotension phenomenon in observation group was 5.0%(77/1540) (<0.01) .Conclusions The incidence of bradycardia-hypotension phenomenon caused by vagal reflex during the RFCA is related to catheter irritation to the heart,pressure on the vessels and hypovolemia. The incidence of this phenomenon can be decreased obviously by some measures,such as non-restricted diet before RFCA,discretion rehydration during and after the RFCA and hemostasis with appropriate force after extubation. The key to rescue patients successfully are early detection and timely processing.

Three-Points Approach Ablation for Treatment of Typical Atrial Flutter Guided by CARTO / 昆明医科大学学报

Objective To evaluate the feasibility and effect of three-points ablation approach in in treatment of typical atrial flutter guided by CARTO. Methods Twenty-six patients with typical atrial flutter diagnosed by ECG and electrophysiological study (EPS) were enrolled in this study. Activation sequence mapping and linear ablation were performed in 11 patients (conventional group) . Three-points guided linear ablation with CARTO system was performed in another15 patients (three-points group) . Results There was no significant difference in the success rate between the two groups. Both the procedure and fluoroscopic time in three-points group were significantly shorter than that in conventional group [(72.66±29.82) vs (102.52±32.61) min;(4.26±2.76) vs (7.32±3.16) min] . Conclusions The three-points ablations approach is as safe and effective as conventional ablation approach in treatment of typical atrial flutter;however,the former can significantly shorten the procedure time and fluoroscopy time.