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Lime sulfur is a common bactericide with strong alkalinity, and is highly corrosive to humans and animals. It is rare for lime sulfur poisoning clinically. This article discusses the clinical manifestations of a patient who was poisoned by oral lime sulfur. After the poisoning, the mucosa of the lips and pharynx broke, fever, and pulmonary inflammation quickly appeared. The pulmonary CT showed slight interstitial changes in both lungs. Through high flow oxygen inhalation, fluid infusion, drainage, maintenance of water and electrolyte balance, protection of important organ functions, and other symptomatic support and treatment, as well as control of blood pressure, blood sugar, maintenance of circulatory function and other targeted measures, the patient's condition gradually improved.
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Compostos de Cálcio , Intoxicação , Animais , Humanos , SulfetosRESUMO
Soil contamination by arsenic (As) is an important environmental issue globally. Intercropping of hyperaccumulators with main crop is typically applied for remediation of As-contaminated soil. Most hyperaccumulators are wild plants with small biomass and slow growth rates. Thus, remediation is slow. Here, we propose an effective intercropping system for remediation of As-contaminated paddy soil. Four treatments-intercropping with water spinach (Ipomoea aquatica Forsk) (T1), water celery (Oenanthe javanica (Blume) DC.) (T2), or Guangdong white arrowhead (Sagittaria sagittifolia L. var) (T3), with rice (Oryza sativa L.) monoculture (control, CK)-were used. Compared with the CK, grain yield per plant of rice under T1 and T2 increased by 58.13% and 10.48%, respectively, but decreased by 46.90% in T3. As concentration, bioaccumulation factor, and translocation factor in brown rice were significantly lower in the intercropping treatments than in CK. As removal by water spinach was 7.04 and 1.47 times that by water celery and arrowhead, respectively. The pH of paddy soil was significantly higher in all treatments than in CK, and iron plaque on rice roots under T1 and T2 decreased significantly but increased significantly under T3 compared with that of CK. Rice intercropped with water spinach had the best remediation effect. Novelty Statement: We believe that the following highlights of this manuscript will make it interesting to general readers of this journal.First, in recent years, many articles about intercropping system for the remediation of soil heavy metal pollution focus on dry land, and few studies have focused on paddy soil. The present study was on arsenic-contaminated paddy soil remediation.Second, water spinach, water celery, and arrowhead have great potential for phytoremediation. Studies have shown that these three aquatic vegetables play a role in the removal of certain pollutants, such as heavy metals. Moreover, when intercropped with rice, they can effectively increase rice yield and reduce rice diseases and insect pests. However, studies on remediation of arsenic-contaminated soil by intercropping aquatic vegetables and rice have not been reported. We propose here a rice-aquatic vegetables (water spinach, water celery and arrowhead) intercropping pattern for remediation of arsenic in soil.Third, according to the arsenic concentration and removal rate, we used a bioaccumulation factor, translocation factor, and arsenic removal per unit area of plants for the quantitative evaluation of the remediation effects of the intercropping systems. We found that the intercropping of rice and water spinach could be used to remediate arsenic-contaminated soil. Moreover, the extraction contents of arsenic using intercropping with water spinach was higher than that achieved in a previous study that applied intercropping with the arsenic hyperaccumulator Pteris vittata over the same growth time. This study provides a reference for realizing both remediation and increased production in arsenic-contaminated soil and for promoting sustainable development of agriculture.
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Arsênio , Oryza , Poluentes do Solo , Arsênio/análise , Biodegradação Ambiental , Solo , Poluentes do Solo/análise , VerdurasRESUMO
It has been suggested that organophosphate pesticides can cause cognitive impairment, most of which are presented as mild cognitive impairment such as decreased attention or vigilance, reduced information processing speed and memory impairment. An early diagnosis and timely intervention in mild cognitive impairment, which may provide a better prognosis. Mild cognitive impairment in clinical work can be easily ignored for a long time. However, it have a particularly impact on patients' life and work, and even progress to irreversible neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease. Therefore, clinicians should raise the cognition of organophosphate pesticides poisoning in patients with cognitive impairment, especially for patients with mild cognitive impairment, and the significance of early detection and diagnosis of the disease is particularly important.
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Doença de Alzheimer , Disfunção Cognitiva , Praguicidas , Disfunção Cognitiva/induzido quimicamente , Humanos , Testes Neuropsicológicos , OrganofosfatosRESUMO
Objective: To analyze the EGFR mutation profile of lung cancer patients in Yunnan, and to provide evidence for clinical personalized treatment. Methods: Demographic and clinical data of 2 967 lung cancer patients undergoing EGFR identification were collected and analyzed from January 2014 to August 2019 in Yunnan Cancer Hospital. Results: The proportion of EGFR mutation in 2 967 patients with lung cancer was 46.2%. Univariate analysis showed that the proportion of EGFR mutation in women was higher than that in men (P<0.001) and displayed a downward trend with age (P=0.03). The mutation rate of ethnic minorities was higher than Han (P=0.012). Mutation rate in patients without smoking history was higher than those with smoking history (P<0.001), and patients without drinking history was higher than patients with drinking history (P<0.001). Mutation rate in patients without family history of lung cancer was higher than those with family history (P=0.008). The mutation rate of adenocarcinoma was higher than other pathological types (P<0.001). The mutation rate was different among stages, and it was higher in early patients than that in advanced patients (P<0.001). The mutation rate of tissue specimens was higher than those of cytology and peripheral blood samples (P<0.001). The mutation rate of Xuanwei area was lower than that in non-Xuanwei area (P<0.001). Multivariate analysis showed that gender (P<0.001), age (P=0.036), smoking history (P<0.001), pathological type (P<0.001), specimen type (P<0.001), and whether or not Xuanwei area (P<0.001) were the independent factors of EGFR mutation.The EGFR mutation was more common in female, non-smokers, adenocarcinoma, non-Xuanwei area, tissue specimen and young lung cancer patients.The mutation types of EGFR in 1 370 cases mainly included 19-Del and L858R. The predominant mutation of EGFR in Xuanwei area was L858R, while in non-Xuanwei area was 19-Del.The mutation rates of G719X, G719X+ L861Q, G719X+ S768I, and S768I in Xuanwei were higher while the mutation rates of 19-Del, L858R, and 20-ins were lower than non-Xuanwei area (P<0.05). The 19-Del mutation rate of ethnic minorities is higher than that of Han (P<0.001). The combined mutation rate of G719X, L861Q in Han was higher than that of ethnic minorities (P=0.005). Conclusions: The EGFR mutation rate in lung cancer patients in Yunnan is similar to Asian and Chinese, and higher in female, non-smokers, adenocarcinomas, young and non-Xuanwei area patients. The most common types of EGFR mutation in Yunnan are 19-Del and L858R. The predominant mutation of EGFR in Xuanwei area is L858R, while in non-Xuanwei area is 19-Del. The mutation rates of G719X, G719X+ L861Q, G719X+ S768I and S768I are higher in Xuanwei patients than those in non-Xuanwei patients. The combined mutation rate of G719X and L861Q in Han nationality is higher than that of ethnic minorities.
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Receptores ErbB , Neoplasias Pulmonares , China , Receptores ErbB/genética , Etnicidade , Feminino , Humanos , Neoplasias Pulmonares/genética , Masculino , Mutação , Inibidores de Proteínas QuinasesRESUMO
Objective: To analyze the expressions of non-small-cell lung cancer (NSCLC) driver genes and their mutation distribution characteristics in the Yunnan-Kweichow plateau, and to provide evidences for personalized molecular targeted therapy of lung cancer in high-incidence areas. Methods: A retrospective analysis was performed on the medical records of patients with NSCLC who underwent combined lung cancer 8 gene detection, including epidermal growth factor receptor (EGFR), rat sarcoma viral oncogene (RAS), anaplastic lymphoma kinase (ALK), RET proto-oncogene (RET), v-Raf murine sarcoma viral oncogene homolog (BRAF), ROS proto-oncogene 1 (ROS1), human epidermal growth factor receptor-2 (HER-2), and cellular-mesenchymal to epithelial transition factor (MET), from January 2016 to August 2019 in Yunnan Cancer Hospital. Besides, we analyzed the expressions of NSCLC driver genes and their mutation distributions. Results: The positive rate of NSCLC driver genes in Yunnan was 67.05%(1 508/2 249). The mutation rates in Xishuangbanna (76.92%), Yuxi (72.38%), Xuanwei (71.88%), Qujing (71.24%), and Honghe (71.79%) were significantly higher than other areas. The mutation rates of Hui (84.38%), Hani (85.00%), Zhuang (75.00%), Buyi (100%), Manchu (100%), Tujia (100%) and Achang (100%) are significantly higher than the minority national average. Driver gene mutations were related to gender (P<0.001), smoking history (P<0.001), age (P<0.001), pathological type (P<0.001), and whether the Xuanwei area (P=0.027), but not related to the nationality (P=0.748) and family history of lung cancer (P=0.676). The mutation rates of EGFR, RAS, BRAF, HER-2 and MET genes were 44.46%, 10.98%, 1.24%, 0.89% and 0.76%, and the rearrangement rates of ALK, RET and ROS1 genes were 4.67%, 1.29% and 0.89%, respectively.The mutation rate of EGFR in females was 56.67%, which was higher than 33.19% in males (P<0.001). The mutation rate of RAS in males was 12.66%, which was higher than 9.17% in females (P=0.010). The mutation rate of RAS in the Han was 11.49%, which was higher than 7.17% in the minority (P=0.032). The rate of RAS mutation in Xuanwei patients was 24.74%, significantly higher than 8.15% in non-Xuanwei area (P<0.001), and the EGFR mutation rate was 40.63%, which was lower than 45.25% in non-Xuanwei area (P=0.045). The rate of ALK rearrangement in Xuanwei patients was 1.56%, which was significantly lower than 5.31% in the non-Xuanwei area (P<0.001), and no HER-2 mutation patients were detected in Xuanwei area. The mutation rate of EGFR in patients with non-smoking history was 51.10%, significantly higher than 29.70% of patients with smoking history (P<0.001). Meanwhile, the rate of ALK rearrangement with non-smoking history patients was 5.35%, which was also higher than 3.16% of patients with smoking history (P<0.001). The rate of RAS mutation in patients with non-smoking history was 9.34%, lower than 14.63% of patients with smoking history (P=0.008). Conclusions: The positive rate of driven gene expression in NSCLC patients from the Yunnan-Kweichow Plateau is slightly lower than the national average. The rates of EGFR and RAS mutations are similar to the domestic average. The rates of ROS1, ALK and RET genes rearrangements and the rates of BRAF, HER2 and MET gene mutations are slightly lower than the national average. EGFR, RAS and ALK genes in the NSCLC patients from Yunnan-Kweichow Plateau have high positive rates, and display different demographic and clinical characteristics, which are of great significance in the selection of targeted therapy populations.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Mutação , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , China , Feminino , Expressão Gênica , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Masculino , Terapia de Alvo Molecular , Proto-Oncogene Mas , Proteínas Proto-Oncogênicas/metabolismo , Proteínas Proto-Oncogênicas p21(ras) , Estudos RetrospectivosRESUMO
Objective: To explore the predictive value of different scoring methods for the prognosis of patients with hyperthermia. Methods: In September 2019, the clinical data of 49 patients with heat radiation disease in the second people's Hospital of Hefei were collected retrospectively. According to the prognosis of patients, they were divided into survival group (32 cases) and death group (17 cases) . The rapid emergency medicine score (REMS) , modified early warning score (modified early warning score) were calculated respectively Score (mews) , logistic organ dysfunction system (LODs) and the differences between the two groups were compared. ROC curve was used to evaluate the accuracy of various scores in the prognosis of patients with heat radiation disease. Results: the fatality of heat stroke was 34.69%, there were significant differences of REMS, MEWS and LODS between the two groups (P<0.05) , the area under ROC curve (AUC) of REMS, MEWS and LODS to predicting prognosis of heat stroke was (0.696±0.076, 95%CI: 0.548 to 0.844, P<0.05, 0.692±0.079, 95%CI: 0.536 to 0.848, P<0.05, 0.787±0.063, 95%CI: 0.663 to 0.911, P<0.05) respectively. Conclusion: There are valuable for predicting prognosis of patients with heat stroke by REMS, MEWS and LODS, especially the LODS, the REMS and MEWS are simple and easy.
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Serviço Hospitalar de Emergência , Golpe de Calor , Golpe de Calor/diagnóstico , Humanos , Prognóstico , Curva ROC , Projetos de Pesquisa , Estudos RetrospectivosRESUMO
In this study, second-harmonic imaging microscopy was used to monitor precancerous colorectal lesions at different stages. It was found that the morphology of glands and lamina propria in mucosa changes with the progression of colorectal diseases from normal to low-grade intraepithelial neoplasia to high-grade intraepithelial neoplasia and this microscopy has the ability of direct visualization of these warning symptoms. Furthermore, two morphologic variables were quantified to determine the changes of glands and collagen in lamina propria during the development of colorectal intraepithelial neoplasia. These results suggest that second-harmonic imaging microscopy has the potential in label-freely and effectively distinguishing between normal and precancerous colorectal tissues, and will be helpful for early diagnosis and treatment of colorectal diseases.
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Carcinoma in Situ/diagnóstico por imagem , Carcinoma in Situ/diagnóstico , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/diagnóstico , Microscopia/métodos , Detecção Precoce de Câncer/métodos , Humanos , Mucosa/diagnóstico por imagem , Mucosa/patologiaRESUMO
The growth of Ge quantum dots (QDs) using the ion beam sputtering deposition technique has been successfully conducted directly on single-layer graphene supported by SiO2/Si substrate. The results show that the morphology and size of Ge QDs on graphene can be modulated by tuning the Ge coverage. Charge transfer behavior, i.e. doping effect in graphene has been demonstrated at the interface of Ge/graphene. Compared with that of traditional Ge dots grown on Si substrate, the positions of both corresponding photoluminescence (PL) peaks of Ge QDs/graphene hybrid structure undergo a large red-shift, which can probably be attributed to the lack of atomic intermixing and the existence of surface states in this hybrid material. According to first-principles calculations, the Ge growth on the graphene should follow the so-called Volmer-Weber mode instead of the Stranski-Krastanow one which is observed generally in the traditional Ge QDs/Si system. The calculations also suggest that the interaction between Ge and graphene layer can be enhanced with the decrease of the Ge coverage. Our results may supply a prototype for fabricating novel optoelectronic devices based on a QDs/graphene hybrid nanostructure.
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The aim of this study was to investigate the effects of N-acetylcysteine (NAC) on antibiotic susceptibility of bovine mastitis pathogens including Staphylococcus aureus, Streptococcus dysgalactiae, Escherichia coli, and Streptococcus agalactiae. Minimum inhibitory concentrations (MIC) were tested by the agar-based E-test method. The presence of 10mM NAC reduced the MIC of penicillin and ampicillin but enhanced the MIC of erythromycin and ciprofloxacin for all of the strains. In addition, NAC-mediated modulation of MIC of kanamycin, tetracycline, and vancomycin was diverse, depending on the target bacterial pathogen and antibiotic being used. The results suggest that NAC is an important modulator of antibiotic activity against the major bovine mastitis pathogens.
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Mastite Bovina/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Acetilcisteína/farmacologia , Animais , Antibacterianos/farmacologia , Bovinos , Feminino , Testes de Sensibilidade Microbiana , Streptococcus/efeitos dos fármacosRESUMO
The aim of this study was to evaluate the influences of season, parity, lactation, udder area, milk yield, and clinical symptoms on bacterial intramammary infection (IMI) in dairy cows. A total of 2,106 mastitis pathogens in 12 species were isolated from 125 dairy farms distributed in 30 different cities in China, and the information about these factors was recorded at the same time. Mastitis pathogens were isolated from 63.43% of the milk samples, whereas Streptococcus agalactiae accounted for 38.61% of all pathogens, followed by Str. dysgalactiae (28.16%), Staphylococcus aureus (19.10%), Escherichia coli (6.90%), and other pathogens (7.23%). According to our investigation, IMI was more common in spring with the isolation rate of pathogens at 81.04%, and lowest in winter (52.34%). Cows were more likely to be infected by environmental pathogens (E. coli or Str. uberis) in summer, in rear quarters and in cows with higher daily milk yield or lower somatic cell count. In addition, Str. dysgalactiae exhibited a higher prevalence with increased parity. Different clinical symptoms of quarters with bacterial IMI were seen in this study, and mastitis pathogens were isolated from healthy quarters.
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Glândulas Mamárias Animais/microbiologia , Mastite Bovina/microbiologia , Leite/microbiologia , Animais , Bovinos , Contagem de Células/veterinária , Escherichia coli/isolamento & purificação , Feminino , Lactação , Paridade , Gravidez , Estações do Ano , Staphylococcus aureus/isolamento & purificaçãoRESUMO
OBJECTIVE: To search for differences in early immune reconstitution after allogenic or autologous hematopoietic stem cell transplantation (HSCT). METHODS: The peripheral blood (PB) from 31 adult patients undergoing allogenic HSCT (allo-HSCT, 15 patients) or autologous HSCT (auto-HSCT, 16 patients) for the treatment of hematological malignancies and from 20 related healthy controls (HC) from December 2011 to August 2014 was used to analyze the kinetic recovery of lymphocyte subsets by means of flow cytometry during 12 months after HSCT. The T cell receptor rearrangement excision circle (TREC) levels among CD3(+) T cells were measured in the patients and HC to evaluate the thymic-dependent T cell reconstitution. RESULTS: The allo- and auto-HSCT recipients did not differ significantly in CD4(+) T cells, CD8 naive T cells, effecter memory T cells (TEM), CD4 central memory T cells (TCM), mid-activated T cells and dendritic cells (DC)during the follow-up (P>0.05). But they both differed significantly from HC (P<0.05). CD8(+) T cells and NK cells reconstructed rapidly. There was no significant difference in the numbers of B cells between the allo- and auto-HSCT groups from M1 to M3 (P>0.05). B cells in both the groups were lower than those in HC (P<0.05). The recovery of B cells in auto-HSCT group was faster than in allo-HSCT group at M6 and M12 (P<0.05). The frequencies of CD4 naive T cells and later activated T cells in allo-HSCT group were significantly higher than in auto-HSCT group at M6 and M12 (P<0.05). The frequencies of CD8 TCM in auto-HSCT group were significantly higher than in allo-HSCT group at M6 and M12 (P<0.05). The TREC levels were significantly lower than in both the groups compared with the age-matched HC during the follow-up (P<0.05). No significant difference was observed between allo-HSCT and auto-HSCT groups (P>0.05). CONCLUSION: The differences of the nature and the speed of lymphocyte reconstitution observed between the two patents groups were minor. This leads us to conclude that in allografted patients, immune reconstitution and subpopulations of peripheral blood lymphocytes are probably not related to the allogenicity of the graft, but due to the impaired thymus functions and slow differentiation of T lymphocytes in thymus.
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Neoplasias Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas , Sistema Imunitário , Adulto , Linfócitos T CD4-Positivos/citologia , Linfócitos T CD8-Positivos/citologia , Estudos de Casos e Controles , Citometria de Fluxo , Humanos , Células Matadoras Naturais/citologia , Timo/citologia , Timo/imunologia , Transplante HomólogoRESUMO
Currently, nucleos(t)ide analogues (NAs) are the major drugs for the antiviral treatment of chronic hepatitis B (CHB), including lamivudine, adefovir dipivoxil, telbivudine, entecavir, and tenofovir disoproxil. Since many patients need to take NAs orally for a long time to inhibit viral replication, the safety of long-term administration is an important factor for selecting drugs in clinical practice. In recent years, some studies have been focusing on the impact of long-term administration of NAs on glomerular filtration function and renal tubular function in such patients. At the same time, more and more biomarkers for evaluating renal impairment have been used in clinical practice, but the applicability of most biomarkers in CHB patients remains uncertain. This review describes the biomarkers that are currently used or have a potential clinical value and investigates the application of such biomarkers in CHB patients in future.
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Antivirais/uso terapêutico , Taxa de Filtração Glomerular/efeitos dos fármacos , Hepatite B Crônica/tratamento farmacológico , Rim/efeitos dos fármacos , Nucleosídeos/uso terapêutico , Nucleotídeos/uso terapêutico , Antivirais/efeitos adversos , Biomarcadores , Taxa de Filtração Glomerular/fisiologia , Hepatite B Crônica/fisiopatologia , Hepatite B Crônica/virologia , Humanos , Rim/fisiopatologia , Nucleosídeos/efeitos adversos , Nucleotídeos/efeitos adversosRESUMO
Titanium alloy and stainless steel (SS) had been widely used as dental implant materials because of their affinity with epithelial tissue and connective tissue, and good physical, chemical, biological, mechanical properties and processability. We compared the effects of titanium alloy and SS on macrophage cytokine expression as well as their biocompatibility. Mouse macrophage RAW264.7 cells were cultured on titanium alloy and SS surfaces. Cells were counted by scanning electron microscopy. A nitride oxide kit was used to detect released nitric oxide by macrophages on the different materials. An enzyme linked immunosorbent assay was used to detect monocyte chemoattractant protein-1 levels. Scanning electron microscopy revealed fewer macrophages on the surface of titanium alloy (48.2 ± 6.4 x 10(3) cells/cm(2)) than on SS (135 ± 7.3 x 10(3) cells/cm(2)). The nitric oxide content stimulated by titanium alloy was 22.5 mM, which was lower than that stimulated by SS (26.8 mM), but the difference was not statistically significant (P = 0.07). The level of monocyte chemoattractant protein-1 released was significantly higher in the SS group (OD value = 0.128) than in the titanium alloy group (OD value = 0.081) (P = 0.024). The transforming growth factor-b1 mRNA expression levels in macrophages after stimulation by titanium alloy for 12 and 36 h were significantly higher than that after stimulation by SS (P = 0.31 and 0.25, respectively). Macrophages participate in the inflammatory response by regulating cytokines such as nitric oxide, monocyte chemoattractant protein-1, and transforming growth factor-b1. There were fewer macrophages and lower inflammation on the titanium alloy surface than on the SS surface. Titanium alloy materials exhibited better biological compatibility than did SS.
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Ligas , Implantação Dentária , Macrófagos/metabolismo , Titânio , Animais , Linhagem Celular , Quimiocina CCL2/biossíntese , Quimiocina CCL2/genética , Citocinas/metabolismo , Expressão Gênica , Mediadores da Inflamação , Camundongos , Óxido Nítrico , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Fator de Crescimento Transformador beta/genética , Fator de Crescimento Transformador beta/metabolismoRESUMO
Systemic lupus erythematosus (SLE) is an autoimmune disease that results in chronic inflammation of different organ systems. Several susceptibility loci for SLE have been suggested in different populations, but the nature of the susceptibility genes has yet to be determined. The programmed cell death 1 gene (PDCD1), the cytotoxic T-lymphocyte-associated protein 4 (CTLA4) gene, and the methyl-CpG-binding protein 2 gene (MECP2) are considered to be the candidate genes associated with SLE. We analyzed the role of PDCD1, CTLA4, and MECP2 gene polymorphisms in Han patients suffering from SLE. Using a case-control study, 263 SLE patients and 263 healthy controls were collected from Chinese Northern Han people. Genomic DNA was prepared from peripheral blood leukocytes and the genotyping was performed using a polymerase chain reaction/ligase detection reaction assay. A statistically significant difference was observed in the rs2239464 and rs2075596 polymorphisms of MECP2 between SLE subjects and controls. The GG genotype in rs2239464 and the GG genotype in rs2075596 might protect against SLE. In contrast, no such association was found in the CTLA4 or PDCD1 polymorphisms. The rs2239464 and rs2075596 polymorphisms of MECP2 might play a significant role in the development of SLE in the Northern Han of China.
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Antígeno CTLA-4/genética , Estudos de Associação Genética , Lúpus Eritematoso Sistêmico/genética , Proteína 2 de Ligação a Metil-CpG/genética , Receptor de Morte Celular Programada 1/genética , Adulto , Feminino , Predisposição Genética para Doença , Genótipo , Humanos , Lúpus Eritematoso Sistêmico/patologia , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo ÚnicoRESUMO
There is no consensus regarding the clinical target volume (CTV) margins which surround the gross tumor volume of metastatic lymph nodes (LN) in radiotherapy of esophageal squamous cell carcinoma (ESCC). This study retrospectively assessed the distance of extracapsular extension (ECE) of metastatic LN in thoracic ESCC and defined nodal CTV margins. Histological sections of metastatic LNs from 217 patients with thoracic ESCC were re-examined. The incidence and maximal distance of ECE of metastatic LNs were assessed. The relationships between ECE and clinicopathologic features were also investigated. The ECE was found in 37.3% of patients (81/217) and 23.1% of metastatic LN (159/689), and the incidences had a significant relationship with N stage and LN size. The median distance of ECE was 1.0 mm (range, 0.2-9.7 mm). The distance of ECE showed a positive correlation with LN size (Spearman's correlation coefficient = 0.419; p<0.001). The ECE distances of LN with <10 mm diameter were significantly smaller than LN with 10-30 mm diameter (p<0.001). The 95th percentiles of ECE distances for these two groups were 3 mm and 5 mm, respectively. For pathologic LN <10 mm in diameter, a 3-mm CTV margin appears to be adequate to encompass 95% of the microscopic ECE, and for LN 10-30 mm, a 5-mm CTV margin is recommended.
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Carcinoma de Células Escamosas/radioterapia , Neoplasias Esofágicas/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/secundário , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/secundário , Carcinoma de Células Escamosas do Esôfago , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Burn induced coagulopathy (BIC) is one of the common complications after burn injury. The types and clinical manifestations of BIC vary dramatically, which frequently leads serious consequences. However, at present BIC does not attract enough attention in clinic. In order to prevent and treat BIC more effectively, the authors suggest that it is necessary to strengthen coagulation surveillance, operation management, infection control, rational application of drugs, prevention and treatment of deep vein thrombosis, relative clinical and basic research, and others.
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Transtornos da Coagulação Sanguínea , Queimaduras , Humanos , Transtornos da Coagulação Sanguínea/etiologia , Transtornos da Coagulação Sanguínea/terapia , Queimaduras/complicações , Queimaduras/terapiaRESUMO
Venous thromboembolism (VTE) has become a serious medical problem faced by medical personnel all over the world, due to its high incidence, high fatality, and easily missed and misdiagnosed. Patients with severe burns are at high risk for VTE due to the presence of blood hypercoagulability, central venous catheterization, repeatedly received surgical procedures, and prolonged bed rest. Identifying the risk factors of VTE in burn patients and taking targeted preventive measures are the key to reduce the incidence of VTE. However, there are no risk assessment tools or prevention guidelines for VTE in burn patients at home and abroad, and scholars from various countries are actively exploring the occurrence, influencing factors, and prevention of VTE in burn patients. This paper reviews the research progress of the occurrence situation, related risk factors, risk assessment, and prevention of VTE in burn patients in recent years, and discusses the existing problems and future research directions in this field.
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Queimaduras , Cateterismo Venoso Central , Tromboembolia Venosa , Humanos , Tromboembolia Venosa/etiologia , Tromboembolia Venosa/prevenção & controle , Tromboembolia Venosa/epidemiologia , Fatores de Risco , Cateterismo Venoso Central/efeitos adversos , Queimaduras/complicações , Queimaduras/terapia , AnticoagulantesRESUMO
OBJECTIVE: To evaluate the effects of different warm-up methods on the acute effect of lower limb explosive strength with the help of a reticulated meta-analysis system and to track the optimal method. METHODS: R software combined with Stata software, version 13.0, was used to analyse the outcome metrics of the 35 included papers. Mean differences (MD) were pooled using a random effects model. RESULTS: 1) Static combined with dynamic stretching [MD = 1.80, 95% CI: (0.43, 3.20)] and dynamic stretching [MD = 1.60, 95% CI: (0.67, 2.60)] were significantly better than controls in terms of improving countermovement jump height (cm), and the effect of dynamic stretching was influenced by the duration of stretching (I2 = 80.4%), study population (I2 = 77.2%) and age (I2 = 75.6%) as moderating variables, with the most significant effect size for dynamic stretching time of 7-10min. 2) Only dynamic stretching [MD = -0.08, 95% CI: (-0.15, -0.008)] was significantly better than the control group in terms of improving sprint time (s), while static stretching [MD = 0.07, 95% CI: (0.002, 0.13)] showed a significant, negative effect. 3) No results were available to demonstrate a significant difference between other methods, such as foam axis rolling, and the control group. CONCLUSION: The results of this review indicate that static stretching reduced explosive performance, while the 2 warm-up methods, namely dynamic stretching and static combined with dynamic stretching, were able to significantly improve explosive performance, with dynamic stretching being the most stable and moderated by multiple variables and dynamic stretching for 7-10min producing the best explosive performance. In the future, high-quality studies should be added based on strict adherence to test specifications.
RESUMO
Objective: To explore the effects of low position lateral supramalleolar flap carrying periosteum and proximal leg propeller flap in relay repair of electric burn wounds of forefoot. Methods: A retrospective observational study was conducted. From January 2019 to January 2022, 12 patients with electric burn wounds of forefoot meeting the inclusion criteria were admitted to the Sixth Hospital of Shanxi Medical University, including 10 males and 2 females, aged 23-65 years. After debridement, the wound with an area of 6.0 cm×3.0 cm to 15.0 cm×7.0 cm was repaired with the lateral supramalleolar flap carrying part of the periosteum of the distal tibia and fibula with the rotation point moved down to the front of the ankle joint. The area of the cutted flap was 6.5 cm×3.5 cm-15.5 cm×7.5 cm. At the same stage, the donor site wound of lateral supramalleolar flap was repaired with peroneal artery or superficial peroneal artery perforator propeller flap in relay, with the relay flap area of 3.0 cm×1.5 cm-15.0 cm×4.0 cm. After operation, the survival of the lateral supramalleolar flap and relay flap, and the wound healing of the relay flap donor site were observed. During follow-up, the shapes of the lateral supramalleolar flap and its donor site were observed. Results: After operation, one patient developed secondary blisters in the superficial skin distal to the lateral supramalleolar flap, which healed after dressing change, and the lateral supramalleolar flap and relay flaps survived well in the other patients; the donor site wound of the relay flap healed well. During follow-up of 12-18 months, the lateral supramalleolar flaps were in good shape and not bloated, with only linear scar left in the donor site of the flap. Conclusions: The low position lateral supramalleolar flap carrying periosteum can repair electric burn wounds of forefoot with advantages including reliable blood supply, low rotation point, and better repair effects. The use of relay flap to repair the donor site of lateral supramalleolar flap can reduce the damage to the appearance and function of the donor site.
Assuntos
Queimaduras por Corrente Elétrica , Retalho Perfurante , Procedimentos de Cirurgia Plástica , Lesões dos Tecidos Moles , Feminino , Humanos , Masculino , Queimaduras por Corrente Elétrica/cirurgia , Perna (Membro)/cirurgia , Periósteo/cirurgia , Transplante de Pele , Lesões dos Tecidos Moles/cirurgia , Resultado do Tratamento , Adulto Jovem , Adulto , Pessoa de Meia-Idade , IdosoRESUMO
Objective: To explore the application effects of mind mapping combined with scenario simulation training on the ability training of junior nurses in hospital transfer of patients with critical burns and trauma. Methods: A prospective randomized controlled study was conducted. From December 2019 to December 2020, 55 female junior nurses from the Institute of Burn Research of the First Affiliated Hospital of Army Medical University (the Third Military Medical University) who met the inclusion criteria were enrolled in this study and divided into routine group (27 nurses, aged (24.0±0.9) years) and combined group (28 nurses, aged (24.2±0.8) years), according to the random number table. The nurses in routine group were trained with hospital transfer of patients with critical burns and trauma by theory combined with operational skill, and the nurses in combined group were trained with hospital transfer of patients with critical burns and trauma by mind mapping combined with scenario simulation training. Before and after the training, the self-made theoretical examination papers and skill assessment items were used for the examination and assessment to nurses, and their scores were calculated and compared. The self-made emergency ability scoring system was used to evaluate the emergency disposal ability of nurses from five dimensions, including team cooperation ability, emergency response ability, operative technique ability, specialized business ability, and nurse-patient communication ability, and their scores were calculated and compared. The non-standard implementation rates of transfer nursing measures, such as incomplete preparation of goods, poor communication effect of patients, inadequate pipeline nursing, unclear handover, and inadequate final treatment, were calculated and compared in the process of transporting highly simulated human (hereinafter referred to as simulated human) by nurses before and after training; and the rate of disease change and successful rate of transport of simulated human were calculated and compared after training. After assessment, self-made satisfaction questionnaire was used to compare nurses' satisfaction with the training mode, content, and effects. Data were statistically analyzed with independent sample t test, Pearson chi-square test, or Yates corrected chi-square test. Results: Fifty-five enrolled nurses were fully involved in the training, examination, assessment, and questionnaire filling. Before training, there were no statistically significant differences in theoretical examination and skill assessment scores between the 2 groups (P>0.05); After training, the theoretical examination and skill assessment scores of nurses in combined group were significantly higher than those in routine group (with t values of -3.89 and -4.24, respectively, P<0.05). Before training, there were no statistically significant differences in the scores of each item of emergency disposal ability between the 2 groups (P>0.05); after training, the scores in terms of team cooperation ability, emergency response ability, operative technique ability, specialized business ability, and nurse-patient communication ability of nurses in combined group were significantly higher than those in routine group (with t values of -6.49, -6.44, -2.21, -2.85, and -2.34, respectively, P<0.05). Before training, there were no statistically significant differences in the non-standard implementation rates of transfer nursing measures of nurses between the 2 groups (P>0.05); after training, the non-standard rates of incomplete preparation of goods, unclear handover, and inadequate final treatment of nurses in combined group were significantly lower than those in routine group (with t values of 3.87, 5.89, and 5.28, respectively, P<0.05). After training, the rate of disease change of simulated human of nurses in combined group was 7.14% (2/28), which was significantly lower than 33.33% (9/27) in routine group (χ2=5.89, P<0.05); the successful rate of transport was 96.43% (27/28), which was significantly higher than 74.07% (20/27) in routine group (χ2=3.87, P<0.05). After assessment, the total score of training satisfaction and scores of satisfaction with training mode and training effect of nurses in combined group were significantly higher than those in routine group (with t values of 5.22, 4.67, and 10.71, respectively, P<0.05). There was no statistically significant difference in the satisfaction score on training content between the two groups (P>0.05). Conclusions: Evidence-based mind mapping combined with scenario simulation training significantly improves the nursing skills and emergency handling capabilities of junior nurses in transferring patients with critical burns and trauma.