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Objective To propose a Kaczmarz algorithm-based fast reconstruction method of magnetic particle imaging to solve the problems of magnetic particle tomography in prolonged imaging time and computational complexity.Methods Firstly,the convergence speeds of the classical Kaczmarz algorithm and its variant algorithms were analyzed,and the number of iterations and computational time under arbitrary matrices were calculated.Secondly,the abilities of Euclidean distance and cosine distance in differentiating system data were compared,and the cosine distance-based K-means algorithm was employed to enhance the computational capability of block Kaczmarz algorithm,shorten the system matrix reconstruction time,and ultimately fast reconstruction of magnetic particle imaging was realized.The effectiveness of the proposed algorithm was verified through computer simulation.Results The proposed algorithm reduced greatly the reconstruction time and improved the spatial resolution and quality of the reconstructed images.Conclusion The proposed algorithm enables fast reconstruction of magnetic particle imaging and behaves well in reconstruction of data containing noise.[Chinese Medical Equipment Journal,2024,45(1):9-14]
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Objective:To investigate the mid-and long-term clinical efficacy of modified Colonna arthroplasty in the treatment of unilateral dislocation type developmental dysplasia of hip (DDH) in adolescents.Methods:A total of 28 adolescent DDH patients with unilateral dislocation who underwent modified Colonna capsular arthroplasty from January 2016 to January 2018 in the 920th Hospital of Joint Logistics Support Force of People's Liberation Army were retrospectively analyzed. There were 4 males and 24 females, aged 16.5±5.0 years (range, 10-25 years). The mean body mass index was 21.2±1.1 kg/m 2 (range, 18.7-24.1 kg/m 2). According to DDH classification, 10 cases were Tonnis type III and 18 cases were Tonnis type IV. The postoperative lateral center-edge angle, acetabular coverage, femoral anteversion angle and leg length discrepancy were measured. The operation time, intraoperative blood loss, visual analogue scale (VAS) of hip pain, Harris hip score (HHS) and congenital dislocation of the hip score were recorded. Results:All patients successfully completed the operation and were followed up for 72.1±5.2 months (range, 60-84 months). The operation time was 81.6±4.3 min (range, 70-90 min), the intraoperative blood loss was 177.5±12.6 ml (range, 160-200 ml), and the hospital stay was 6.8±0.7 days (range, 6-9 days). The VAS score of the hip joint was 1.8±0.6 before operation and 2.3±0.6 at the last follow-up, and the difference was not statistically significant ( t=2.845, P=0.224). The preoperative HHS score was 57.1±5.9, and it increased to 87.3±4.0 at the last follow-up, and the difference was statistically significant ( t=-22.141, P=0.001). At the last follow-up, the femoral anteversion angle was 17.0°±1.5°, which was lower than that before operation 41.6°±2.4°, with a statistically significant difference ( t=-44.868, P=0.008). The leg length discrepancy was 10.2±2.3 mm, which was lower than that before operation (26.4±6.1 mm), with a statistically significant difference ( t=-12.892, P<0.001). The lateral center-edge angle was 28° (26°, 30°), and the acetabular coverage rate was 78% (76%, 79%). The curative effect evaluation standard score of congenital dislocation of the hip was 24 (16.7, 25.7) points, including 7 excellent cases, 14 good cases, 4 fair cases, and 3 poor cases. The excellent and good rate was 75% (21/28). Conclusion:The modified Colonna arthroplasty for the treatment of unilateral dislocation DDH in adolescents has good mid-and long-term hip function recovery and radiographic improvement.
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Objective:To analyze the registration characteristics and reporting quality of Taijiquan-related clinical trials.Methods:A database search of the China Clinical Trials Registry (ChiCTR) and ClinicalTrials.gov was performed by computer to collect basic information, study content, interventions, and other registration information of Taijiquan-related clinical trials from inception to June 30, 2022. The WHO TRDS was used to evaluate the registration quality of clinical trials.Results:Totally 381 Taijiquan-related clinical trials were incorporated, of which 241 (63.25%) were prospective registration and 140 (36.75%) were retrospective registration. The quantity of Taijiquan-related clinical trial registrations generally showed an increasing trend, reaching a peak in 2020 (14.70%). The number of clinical trials registered in Shanghai accounted for the most (9.97%). The largest contributor to the registered trials was Fujian University of Traditional Chinese Medicine (4.46%). 55.12% of registered studies were funded by hospitals and universities. The registered studies were most focused on cognitive impairment. 74.54% of the studies adopted randomized parallel controls, and the sample size was mainly between 20 and 200 (80.31%), and the age of the subjects was concentrated above 39 years (53.28%). The average report completion rate of WHO TRDS items was 86.90%.Conclusions:Presently, the development trend of clinical trials related to Taijiquan is relatively promising. However, imbalances exist in some aspects, for instance distribution of registration areas and institutions, funding allocation, and population of subjects. The description of some registration items is missing or not comprehensive, so corresponding measures are required to improve the quality of clinical trial design and to optimize registration details.
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Objective To investigate the therapeutic effect of oral administration of deuterium depleted water on gastroenteritis induced by 131I radiation in thyroid cancer treatment. Methods Fifty patients with papillary thyroid cancer treated with 131I in the Department of Nuclear Medicine of Changshu No.2 People’s Hospital from May 2022 to February 2023 were divided into control group and experimental group (25 patients in each group). Data were continuously collected throughout the study duration. The control group was orally administrated omeprazole enteric-coated capsules and purified water at 660 mL tid for 5 days. The experimental group received the same basic treatment as the control group except that deuterium depleted water was used instead of purified water. The incidence and alleviation of 131I radiation-induced gastroenteritis were observed and compared between the two groups using the Fisher’s exact test and Kaplan-Meier analysis. Results The number of gastroenteritis cases from day 1 to day 5 after 131I administration was 2 (8%), 5 (20%), 2 (8%), 1 (4%), and 0 (0%), respectively, in the experimental group, and 2 (8%), 8 (32%), 4 (16%), 3 (12%), and 1 (4%), respectively, in the control group. The incidence of gastroenteritis was significantly different between the two groups (χ2=4.064, P=0.044). After 5 days of treatment, the overall response rate of patients in the experimental group was 96%, which was significantly higher than 76% in the control group (χ2=9.105, P=0.025). Conclusion Oral administration of deuterium depleted water is effective in the relief of clinical symptoms of 131I radiation-induced gastroenteritis in thyroid cancer treatment. The clinical application of deuterium depleted water should be further investigated.
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Objective:To explore the value of traditional Chinese medicine combined with 131I in the treatment of Graves hyperthyroidism. Methods:From March 2020 to July 2021, 90 patients (39 males, 51 females, age (33.2±7.0) years) with Graves hyperthyroidism who were diagnosed and treated in Changshu No.2 People′s Hospital were retrospectively analyzed. Patients were randomly divided into 3 groups ( n=30 in each group), including group A who received treatment of antithyroid drugs (ATD), group B who received treatment of traditional Chinese medicine, and group C who received treatment of 131I combined with traditional Chinese medicine. Thyroid function indicators and inflammatory indicators before treatment and 1, 3, and 6 months after treatment were determined, including free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid stimulating hormone (TSH) and TSH receptor antibody (TRAb), and C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). One-way analysis of variance and χ2 test were used to analyze data. Results:The levels of FT 3, FT 4, TSH, TRAb, CRP, IL-6 and TNF-α in group A, B and C before treatment and 1, 3, 6 months after treatment were significantly different ( F values: 193.27-906.11, all P<0.05). The total effective rate in group C (100.0%, 30/30) was significantly higher than that in group A (86.7%, 26/30) or group B (83.3%, 25/30; χ2 values: 8.24, 9.83, P values: 0.006, 0.037), while there was no significant difference between group A and group B ( χ2=3.02, P=0.124). The incidence of adverse reactions in group B (46.7%, 14/30) was significantly higher than that in group A (30.0%, 9/30; χ2=6.59, P=0.042). And the incidence of adverse reaction in group C (13.3%, 4/30) was significantly lower than that in group A or group B ( χ2 values: 12.05, 7.20, P values: 0.004, 0.038). Conclusion:The curative effect of 131I combined with traditional Chinese medicine is effective and reliable, suggesting that clinical researches should be carried out together and perfected.
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Objective:To establish an optimized automatic synthesis method of 18F-fallypride, and evaluate its biodistribution and microPET/CT characteristics. Methods:18F-fallypride was automatically prepared by AIO synthesis module and disposable cassette & reagents kit. The crude product was purified by a dedicated coupled column (HLB+ Alumin-N) to obtain the final product. Radiochemical purity and radiolabeling yield were determined. Parkinson′s disease (PD) model mice and rats were established. The radioactive distribution of different organs of PD model mice ( n=24) were monitored. The distribution process of the agent in the SD rat brain (PD model, n=6; normal rat, n=6) were evaluated by microPET/CT imaging. Results:The radiochemical yield of 18F-fallypride synthesized by automatic synthesis module was stable at (10±1)% ( n=5, no decay corrected). The total synthesis time was about 40 min. The radiochemical purity of 18F-fallypride was more than 95%, and the radiochemical purities were also over 95% after being stored in saline and serum for 120 min at room temperature. 18F-fallypride was mainly excreted by the kidneys, and it was less radioactive intake in the liver and spleen in PD mice. MicroPET/CT imaging showed that higher accumulation of 18F-fallypride was noted in corpus striatum and the SUV ratio of PD group was lower than that of control group (5.00±0.93 vs 6.53±1.96). Conclusion:18F-fallypride can be successfully prepared automatically by improved multifunctional module, with the advantages of convenient preparation, stable radiochemical yield, satisfying purity and quality control, so it can be used in the follow-up standardized production of Good Manufacture Practice (GMP) system.
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Objective:To establish a method for detecting pancreatic β-cell dedifferentiation using flow cytometry.Methods:Experimental study. Min6 (mouse β cell line), αTC1-6 (mouse α cell line), HepG2 (human hepatocellular carcinoma cells) and mouse F9 cells (mouse teratocarcinoma cell) were cultured with conventional medium. Min6 cells were treated with interleukin-1β (IL-1β) in combined with tumor necrosis factor α (TNFα), or palmitic acid (PA) overnight and stained with anti-chromogranin A (ChgA), anti-insulin (Ins), anti-glucagon (Gcg), anti-SRY-box transcription factor 9 (Sox9) and anti-octamer binding transcription factor 4 (Oct4) antibodies, respectively. Flow cytometry was applied to detect the pression of ChgA, Ins, Gcg, Sox9, and Oct4 in the cells, respectively. Unpaired Student t test was used for statistical analysis. Results:Flow cytometry analyses showed that Ins and ChgA were highly expressed in Min6 cells, Gcg was highly expressed in αTC1-6, Sox9 was highly expressed in HepG2, and Oct4 was highly expressed in F9 cells, respectively (around 90%). Treatment of Min6 cells with IL-1β+TNFα significantly decreased Ins positive staining cells (92.775%±1.702% vs. 97.125%±0.246%, P=0.045), while increased Sox9 positive staining cells (41.675%±0.390% vs. 25.875%±3.348%, P=0.003). No significant changes in ChgA and Oct4 expression could be viewed (both P>0.05). PA treatment elevated the number of Gcg positive staining cells (54.500%±3.597% vs. 41.160%±3.007%, P=0.022). The levels of mRNA expression by qPCR of the above proteins were in consistent with the levels of protein expression by flow cytometry in Min6 cells. Conclusion:Flow cytometry can be used to detect proteins expressed in dedifferentiated models of β cells, which provides a new method for identify dedifferentiation of pancreatic β cells.
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Objective:To observe the clinical characteristics of esophageal reflux after total gastrectomy (ERATG), and to explore the mechanism of occurrence.Methods:Fourteen gastric cancer patients who underwent total gastrectomy were prospectively enrolled in this study. The postoperative symptoms were observed and recorded and 24 h MII-pH with pH monitoring was performed to investigate the characteristics of postoperative reflux.Results:After total gastrectomy patients were with different degrees of ERATG as heartburn, appetite loss, chest tightness and belching. The overall nature of ERATG is mainly weak acid, with a pH between 4 and 7. ERATG involved esophageal-jejunal anastomosis and a length of esophagus 7 cm above the anastomosis. Patients with typical reflux symptoms had a lower pH minimum in the upright position than those without typical symptoms[(4.76±0.71) vs.(5.68±0.37), t=2.866, P<0.05]. Patients with typical reflux symptoms had a higher frequency of reflux of mixed liquid and liquid-air reflux than those without typical symptoms[liquid(31.25±29.76) vs.(4.50±9.14), t=0.011, P<0.05; liquid-air(19.50±12.99) vs.(2.00±2.61), t=0.004, P<0.05]. Conclusion:ERATG is mainly a upward reflux of weakly acidic gas, with typical symptoms of heartburn, appetite loss, chest tightness and belching. Patients with typical symptoms usually have lower pH in the upright position.
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Objective:To evaluate the effect of lifestyle interventions on cardiovascular risk factors in overweight/obese individuals.Methods:A total of 148 overweight/obese subjects who had annual physical exam in the Health Management Center, the First Affiliated Hospital Zhejiang University School of Medicine from Dec 2017 to Dec 2020 were included. They were divided into the self-management group ( n=74) and the intervention group ( n=74). The intervention group was given a 6-month lifestyle intervention, while the self-management group received regular nutrition and physical activity education. Anthropometric and laboratory data was collected at baseline and after intervention in both groups. Effect of the intervention was evaluated. Results:The age of subjects in the intervention and self-management group was (42.5±7.5) and (40.1±9.6) years, respectively. After the intervention, weight, body mass index, waist/hip ratio, visceral fat area, systolic blood pressure, diastolic blood pressure, uric acid, homocystein, triglyceride, alanine aminotransferase andγ-glutamyl transferase of the intervention group [(75.6±12.7) kg, (26.72±3.04) kg/m 2, 0.92±0.05, (104.4±28.5) cm 2, (124.2±13.7) mmHg (1 mmHg=0.133 kPa), (77.8±10.1) mmHg, (353.6±84.8) μmol/L, 9.11(7.73, 10.00) μmol/L, 1.23(0.83, 1.91) mmol/L, 19.5(13.0, 29.5) U/L, 19.0(13.0, 30.5) U/L, respectively] were significantly lower than that of the baseline data [(81.1±12.5) kg, (28.64±2.82) kg/m 2, 0.95±0.04, (127.2±26.6) cm 2, (132.4±14.7) mmHg, (83.2±10.2) mmHg, (387.2±91.2) μmol/L, 10.25(8.30, 11.70) μmol/L, 1.78(1.40, 2.37) mmol/L, 28.0(18.0, 58.0) U/L, 36.0(23.0, 54.3) U/L, respectively] (all P<0.05); compared with the self-management group [(80.1±9.2) kg, 31.7% (28.5%, 38.4%), (119.5±32.6) cm 2, (133.5±15.9) mmHg, (82.6±12.2) mmHg, (4.93±0.86) mmol/L, 1.78(1.26, 2.97) mmol/L, respectively], the intervention group had decreased weight, body fat percent, visceral fat area, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride [(75.6±12.7) kg, 30.0%(26.3%, 34.3%), (104.4±28.5) cm 2, (124.2±13.7) mmHg, (77.8±10.1) mmHg, (4.53±0.83) mmol/L, 1.23(0.83, 1.91) mmol/L, respectively], and increased high-density lipoprotein cholesterol [(1.09±0.24) vs (1.18±0.28) mmol/L] (all P<0.05). Conclusion:An intensive lifestyle intervention has a beneficial effect on cardiovascular risk factors in overweight/obese individuals.
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Objective:To explore the expression of vasohibin-1 (VASH1) and vascular endothelial growth factor A (VEGF-A) and clinical significance of VASH1 in gastric carcinoma.Methods:The expression of VASH1 and VEGF-A were detected by immunohistochemistry in formalin-fixed and paraffin-embedded sections in 56 pairs of gastric cancer and corresponding paraneoplastic tissue specimens. The correlation between the expression of VASH1, VEGF-A, clinicopathological parameters and prognosis were analyzed.Results:VASH1 and VEGF-A expression was significantly higher in gastric cancer tissues than normal paraneoplastic tissues. VASH1 and VEGF-A protein were expressed in 79% and 82% of gastric cancer tissues, respectively. A positive correlation was found between Vasohibin-1 and VEGF-A expression in gastric cancer tissues. VASH1 expression has significant positive correlation with TNM stage, tumor stromal invasion, tumor gross types and distant metastasis. Patients with high VASH1 expression had significantly worse overall survival (OS) and progression-free survival (PFS) than those with low VASH1 expression.Conclusion:VASH1 might be a clinically relevant predictor of patients in gastric cancer.
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In the past few years, continuous manufacturing(CM) has been put forward by the FDA. Pharmaceutical enterprises are encouraged to promote the implementation of CM, which has become a hot research direction of pharmaceutical technology. In February 2019, the FDA issued a draft guideline for the implementation of CM, which greatly promoted the development of CM and provided reference for continuous manufacturing of traditional Chinese medicine(TCM). The production process of TCM is a complex system. With the innovation of production equipment and the promotion of automation and informatization of TCM production, the exis-ting policies, regulations and traditional production control capacity are difficult to meet the market demand for high-quality TCM pro-ducts. In this paper, we reviewed the new technologies and methods of quality control in accordance with the characteristics of TCM production by referring to modern manufacturing technology, information technology and quality control technology. Based on the "QbD" theory and "PAT" technology, process knowledge system(PKS), an advanced control strategy, was proposed to provide a reference for the implementation of CM in TCM production.
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Commerce , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Quality Control , Technology, Pharmaceuticalالملخص
Reactive nitrogen species (RNS) affects intracellular redox balance and induces post-translational modification of proteins. Moreover, RNS, as the signal molecule, participates in the transduction of cellular signals under physiological conditions. However, excessive RNS can induce nitrosative stress and then damage cells, and thereby may play a role in the tumor initiation and progression. Thus, we discussed the role of RNS under physiological conditions and the tumor microenvironment, which may provide some novel ideas for the development of new drugs and the treatment of diseases.
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Objective:To investigate the expression of CD157 and its significance in colorectal cancer.Methods:The expression of CD157 was detected in 50 cases of colorectal cancer tissues and corresponding adjacent normal colorectal tissues by immunohistochemistry. The correlation between the expression of CD157 and clinicopathological parameters and prognosis was analyzed statistically.Results:Higher expression of CD157 protein was observed in colorectal cancer than that in normal colorectal tissues (72% vs. 20%, χ 2=25.09, P<0.01). Moreover, High expression of CD157 was correlated with the tumor size (χ 2=7.368, P=0.007), TNM stage (χ 2=9.223, P=0.002), the depth of tumor infiltration (χ 2=4.158, P=0.041), distant metastasis (χ 2=5.521, P=0.019), vascular invasion (χ 2=6.307, P=0.012) and microsatellite instability (χ 2=4.778, P=0.029), but not with gender, age, histology type, location, differentiation grade, lymph node metastasis, nerve infiltration or Kras mutation (all P>0.05 respectively). Patients with low expression of CD157 had longer survival (45±4 )months than those with high expression (30±3)months (χ 2=5.234, P=0.022). Conclusions:High expression of CD157 in colorectal cancer tissue is related to poor survival of postoperative patients.
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Objective To investigate the clinical efficacy of microsurgical repair of soft tissue necrosis after beak-type calcaneal fracture.Methods From January,2012 to March,2017,surgically flaps were used to repair wounds in 8 patients with soft tissue necrosis after calcaneal beak fracture.Five patients underwent sural neurovascular flap in the first stage of repair,2 patients were treated with peroneal perforator propeller flap,and 1 patient was treated with posterior tibial artery perforator propeller flap.The donor sites of 3 flaps were directly closed,and donor areas of the remaining 5 were covered with medium-thickness skin grafts without being sutured directly.The size of flap was 5.0 cm× 3.0 cm-7.0 cm × 5.0 cm.Through postoperative outpatient and WeChat follow-up.The patient's flap survival,infection,flap shape,sensation and ankle function were evaluated.Results All flaps and skin grafts survived post-operatively.All patients were followed-up for 6-12 (mean,8.4) months.All patients had good flap survival and no complications such as soft tissue and calcaneal infection.The flaps were good in texture,shape and function of ankle.At the last follow-up,according to the British Medical Research Institute (BMRI),the sensory function was divided into 6 levels.The flap sensory function recovered to S2 in 3 cases,and the remaining 5 cases was S1.According to the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-hindfoot Scale (AHS),the results were excellent in 5 cases,and good in 3 cases.All patients had good clinical results and satisfaction at the last followedup.Conclusion The treatment of soft tissue necrosis after calcaneus beak fractures can be completed in one stage by using flaps,which avoided the occurrence of calcaneal osteomyelitis.It is easy to perform early rehabilitation exercise and the ankle function is well restored.
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Objective To assess the efficacy and clinical value of immunoglobulin combined with interferon ( IFN) α-2b in treatment of patients with glucocorticoid refractory subacute thyroiditis. Methods Thirty-five cases of subacute thyroiditis (12 males, 23 females, age (58.1±12.0) years) from January 2016 to May 2017 were retrospectively analyzed. Patients were resistant to the treatment of glucocorticoid and as-pirin, or were not suitable for that treatment because of accompany diseases. Thirty-four healthy controls (16 males,18 females, age (57.0±10.0) years) were included. Thyroid hormone, C-reactive protein (CRP), erythrocyte sedimentation rate ( ESR) and 24 h iodine uptake rate tests, as well as 99 Tcm O-4 thyroid imaging and thyroid ultrasonography were performed before and after co-administration of immunoglobulin and IFNα-2b. Paired t test or Wilcoxon signed rank test, two-sample t test or Wilcoxon rank test were used for data anal-ysis. Results The levels of free triiodothyronine ( FT3 ) , free thyroxine ( FT4 ) and thyroid stimulating hor-mone ( TSH) 4 weeks after immunology intervention were restored compared with the levels before treatment ( t:4.81, 7.76, z=4.60, all P<0.01) and were not significantly different compared with those in the con-trol group ( t:0.02, 0.33, z=0.37, all P>0.05) . CRP and ESR were sharply decreased compared to those before treatment (t:9.59, 13.78, both P<0.01). The 24 h iodine uptake rate was restored 4 weeks after treatment (t=13.92, P<0.01). The positive result was found in 1 patient (2.9%, 1/35) by 24 h iodine uptake rate test, and 5.7%(2/35) of patients were positive in 99TcmO-4 static imaging and 1 patient(2.9%, 1/35) had positive ultrasonography result. The 3-month follow-up showed that 32 cases were cured and the treatment was effective in all 35 patients. Only 1 case recurred after 12-month follow-up, and the effective rate was 96.9%(31/32, 3 cases were lost to follow-up). Conclusion Immunology intervention is an effective way to treat glucocorticoid refractory subacute thyroiditis and should be applied extensively in clinical treatment.
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Objective To evaluate the safety,feasibility of the application of "four-quadrant" tumor target-artery positioning in "zero-ischemia" retroperitoneal laparoscopic partial nephrectomy.Methods A retrospective study was conducted on 25 patients who underwent retroperitoneal laparoscopic partial nephrectomy from November 2016 to March 2017 by single surgeon.There were 15 males and 10 females with a mean age of (52.6 ± 11.9) years old.The mean diameter of the tumor was (3.8 ± 0.5) cm.The mean R.E.N.A.L.score was (9.0±1.3).The mean GFR of the operation side was (49.2±11.4) ml/(min · 1.73 m2) before the operation.All 25 patients underwent 3 Dimentional CT for the reconstruction of their renal models.The tumor target-artery was located in "four-quadrant" system,which based on the boundary between tumor and renal parenchyma.Perioperative outcomes including the estimated blood loss (EBL),operation time,complications and oncological outcomes were carefully collected and analyzed.Results Of all the 25 patients,21 patients underwent "zero-ischemia" retroperitoneal laparoscopic partial nephrectomy,the mean operation time was (106.1 ± 18.8) min,the mean EBL was (162.2 ±68.0) ml with no transfusion case.4 patients converted to conventional retroperitoneal laparoscopic partial nephrectomy,the operation time was 110-140 min,the EBL was 350-500 ml and the warm-ischemia time was 12-20 min respectively.The pathological outcome shows renal cell carcinoma in 24 patients and papillary renal cell carcinoma in 1 patient with all negative margins.The mean GFR of the operation side was (45.1 ± 10.2) ml/(min · 1.73 m2) after three months of the surgery and shows no statistical difference (P =0.268).Conclusion The application of the "four-quadrant" tumor target-artery positioning in " zeroischemia" retroperitoneal laparoscopic partial nephrectomy is a safety and feasible method in terms of accurate location of the target-artery,better postoperative renal function,low EBL and reasonable oncological outcomes.
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Objective To evaluate different methods in detecting intraperitontal free cancer cells (IFCCs) in patients with gastric cancer and to clarify the relationship between positive IFCCs and short-term prognosis.Methods A total of 119 gastric cancer patients who underwent surgical treatment were enrolled.Peritoneal lavage was performed with 300-400 ml saline respectively at three points of time:immediately after abdominal cavity entry;when surgical operation was completed;when extensive intraoperative peritoneal lavage was done.The IFCCs were detected with methods of traditional centrifugal cytology,membrane cytology,ICC and RT-PCR.The survival curve of patients with gastric cancer was drawn using Kaplan-Meier method.Results The positive rate of PLC was 16.8%,20.7% and 11.2% respectively at 3 timepoints (P < 0.05).The positive rates of ICC were 28.6%,38.8% and 20.7% respectively at 3 timepoints.The positive rates of RT-PCR were 39.3%,69.5% and 50.8% respectively at 3 time points.The positive rate of IFCCs detected through RT-PCR was higher than that of PLC and ICC (P < 0.05).The short-term prognosis of patients with positive IFCCs was worse than those with negative results detected with any three method at the timg point immediately after opening the abdomen (P < 0.05).At the timg point immediately after removing the tumors,the short-term prognosis of patients with positive IFCCs detected with PLC was worse (P < 0.05).Conclusion The short-term prognosis was poor in patients with positive IFCCs.It is the best time to detect IFCCs before radical resection.Surgical procedures increase the risk of shedding of IFCCs.
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Background@#Ongoing efforts have been made to identify new neuroimaging markers to track amyotrophic lateral sclerosis (ALS) progression. This study aimed to explore the monitoring value of multimodal magnetic resonance imaging (MRI) in the disease progression of ALS.@*Methods@#From September 2015 to March 2017, ten patients diagnosed with ALS in Peking Union Medical College Hospital completed head MRI scans at baseline and during follow-up. Multimodal MRI analyses, including gray matter (GM) volume measured by voxel-based morphometry; cerebral blood flow (CBF) evaluated by arterial spin labeling; functional connectivity, including low-frequency fluctuation (fALFF) and regional homogeneity (ReHo), measured by resting-state functional MRI; and integrity of white-matter (WM) fiber tracts evaluated by diffusion tensor imaging, were performed in these patients. Comparisons of imaging metrics were made between baseline and follow-up using paired t-test.@*Results@#In the longitudinal comparisons, the brain structure (GM volume of the right precentral gyri, left postcentral gyri, and right thalami) and perfusion (CBF of the bilateral temporal poles, left precentral gyri, postcentral gyri, and right middle temporal gyri) in both motor and extramotor areas at follow-up were impaired to different extents when compared with those at baseline (all P < 0.05, false discovery rate adjusted). Functional connectivity was increased in the motor areas (fALFF of the right precentral gyri and superior frontal gyri, and ReHo of right precentral gyri) and decreased in the extramotor areas (fALFF of the bilateral middle frontal gyri and ReHo of the right precuneus and cingulate gyri) (all P < 0.001, unadjusted). No significant changes were detected in terms of brain WM measures.@*Conclusion@#Multimodal MRI could be used to monitor short-term brain changes in ALS patients.
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Adult , Female , Humans , Male , Middle Aged , Amyotrophic Lateral Sclerosis , Diagnostic Imaging , Brain , Diagnostic Imaging , Cerebrovascular Circulation , Disease Progression , Magnetic Resonance Imaging , Methods , Multimodal Imaging , Methods , Prospective Studiesالملخص
Objective To report a new self-designed locking plate assembly suitable for treatment of displaced calcaneal fractures of Sanders types Ⅱ &Ⅲ via sinus tarsi approach.Methods We designed a new locking plate assembly suitable for treatment of displaced calcaneal fractures of Sanders types Ⅱ & Ⅲ via sinus tarsi approach.Its biomechanical performance was tested by standard electronic and mechanical devices.From March 2014 to October 2015,18 patients with displaced calcaneal fracture were treated with our self-designed new locking plate assembly.They were 14 men and 4 women,aged from 32 to 66 years (average,50.4 years).All the fractures were unilateral closed ones,with 7 cases of the left side and 11 ones of the right side.By the Sanders classification,14 cases belonged to type Ⅱ (8 to type Ⅱa,4 to type Ⅱb and 2 to type Ⅱc) and 4 to type Ⅲ (2 to type Ⅲab,one to type Ⅲac and one to type Ⅲbc).The B(o)hler angle,Gissane angle,and height,width and length of the calcaneus were measured and compared at preoperation,postoperative 3 months and final follow-ups.The clinical outcomes were evaluated using Maryland foot score system atfinal follow-ups.Results This new locking plate assembly could tolerate a maximum vertical load of 1,396.03 N and a maximum horizontal anti-bending load of 427.15 N.It broke after it had been subjected to 93,003 loadings in a repeated 500 N stress test.All the 18 patients were followed-up for an average of 9.3 months (from 6.0 to 13.5 months).Follow-ups at 3 months postoperation showed significant improvements in B(o)hler and Gissane angles and calcaneal height,width and length compared with pre-operative parameters (P < 0.05),but no significant differences were observed in the above parameters between 3 and final follow-ups postoperation (P > 0.05).Maryland foot scores demonstrated 12 excellent cases,3 good ones and 3 fair ones.No incision infection,implant failure,nonunion or malunion happened in this series.Conclusions This new locking plate assembly suitable for sinus tarsi approach can be used in clinic because it has advantages of easy placement,rigid fixation,satisfactory functional recovery of the foot and limited complications.
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Objective To discuss the cause of relapse after the first surgery of varicose veins of lower limb,and corresponding prevention and treatment methods.Methods The data of 81 cases of recurrence varicose veins of lower limb in Department of Vascular Surgery,Yanzhou First People's Hospital from September 2010 to October 2016 were analyzed retrospectively,all patients receded ascending phlebography for deep veins Postoperative follow-up of 6 to 48 months was followed by the combination of outpatient and telephone follow-up,with the symptoms,signs and blood vessels of the lower extremities as the follow-up.Results Remnant of the main trunk or tributaries of great saphenous vein in 19 cases,31 limbs of deep venous incompetent,incompetent perforator veins 25 limbs,the residual of small saphenous vein were 3 cases,crockett's syndrome 10 cases,sequelae of deep venous thrombosis belongs to the residual 5 limbs,Klippel-Trenaunay syndrome 1 limbs.There were some patients who suffered from 2 reasons or more than two reasons simultaneously.After surgery again,the cure vate was 100% and no serious complications such as deep vein throm-bosis.During the follow-up,12 patients showed different degrees of subcutaneous stasis,oral drug observation,and later regression.Local subcutaneous hematoma was 5 cases,2 cases of pure syringe were treated with pressure after suction,3 routine local incision was removed to remove stitches,drainage change and delayed healing.Six patients showed the sensory impairment of skin numbness in the leg boot area,and oral related neurotrophic drugs improved within 1 to 6 months after surgery.The remaining patients recovered well after operation.Conclusions Various causes can lead to the varicose vein of lower limb,a varicose vein of lower limb is a common clinical symptoms of many different diseases.Preoperative comprehensive examination to clarify the cause,this will help to reduce the probability of recurrence of lower extremity varicose veins.