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BACKGROUND:Although the clinical application of Masquelet technology has achieved extensive success,the research on optimizing all aspects of Masquelet technology is still being carried out.The focus of doctors is to speed up bone healing and shorten bone healing time after bone grafting. OBJECTIVE:To observe the effect of calcium phosphate combined with recombinant human bone morphogenetic protein-2 in repairing tibial infectious bone defects. METHODS:Thirty-one patients with tibial infectious bone defects were selected from The People's Hospital of Jianyang City from June 2017 to June 2022.They were treated with the Masquelet membrane induction technique.During the second stage of operation,they were divided into a control group(n=15)and a study group(n=16)according to different bone graft materials.Patients in the control group were implanted with autologous bone/allogeneic bone particles,and those in the study group were implanted with calcium phosphate combined with recombinant human bone morphogenetic protein-2/autologous bone particles.Six months after the second stage operation,peripheral blood inflammatory indexes such as white blood cell count,C-reactive protein,and erythrocyte sedimentation rate were detected.Imaging bone healing time,bone healing X-ray score,bone defect healing classification,and adjacent joint function were recorded.The presence of nail track infection,implant absorption,pain,and infection in the bone extraction area were observed. RESULTS AND CONCLUSION:(1)White blood cell count,erythrocyte sedimentation rate,and C-reactive protein levels of the two groups 6 months after the second stage operation were significantly lower than those before the first stage operation(P<0.05).There was no significant difference in each index between the two groups(P>0.05).(2)Bone healing time in the study group was shorter than that in the control group(P<0.05).(3)The Samantha X-ray score of the study group 6 months after the second stage operation was higher than that of the control group(P<0.05).The excellent and good rate of bone defect healing and adjacent joint function of the study group was higher than that of the control group(P<0.05).There was no significant difference in the recurrence rate and complication rate between the two groups(P>0.05).(4)These findings indicate that the effect of calcium phosphate combined with recombinant human bone morphogenetic protein-2 during the second stage operation of the Masquelet membrane induction technique in the treatment of tibial infectious bone defect is good and safe.
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Objective To observe the value of ultrasound microvascular flow imaging(MV-Flow)combined with maternal serum vascular endothelial growth factor(VEGF)expression level for diagnosis of fetal growth restriction(FGR).Methods Totally 87 pregnant women with FGR(FGR group,including 43 cases of gestational week＜28 weeks[＜28 weeks subgroup]and 44 cases of ≥28 weeks[≥28 weeks subgroup])and 112 normal pregnant women with normal fetuses(normal control group,55 with gestational week＜28 weeks[NC 1 subgroup]and 57 with ≥28 weeks[NC 2 subgroup])were prospectively enrolled.MV-Flow technology was used to measure placental microvascular index(MVI),and the placental microvascular circulation was evaluated.The expression level of maternal serum VEGF was detected simultaneously,also of placental maternal surface immediately after delivery.The receiver operating characteristic curves were drawn to explore the value of placental MVI,maternal serum VEGF and the combination of placental MVI,maternal serum VEGF for diagnosing FGR.Results The levels of placental MVI and maternal serum VEGF in 2 subgroups of FGR group were both lower than those in control group(all P＜0.01).Placental VEGF expression level in FGR group was significantly lower than that in control group(P＜0.01).The area under the curve(AUC)of placental MVI,maternal serum VEGF and their combination for diagnosing FGR＜28 weeks was 0.981,0.870 and 0.997,respectively,while for diagnosing FGR≥28 weeks was 0.991,0.867 and 0.993,respectively.AUC of maternal serum VEGF alone for diagnosing in 2 subgroups of FGR were both lower than that of placental MVI and combination of placental MVI and maternal serum VEGF(all P＜0.05),while no significant difference of AUC was found between placental MVI and combination of maternal serum VEGF and placental MVI(both P＞0.05).Conclusion Both placental MVI and maternal serum VEGF level could be used to screen FGR,and the former was more valuable.
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Objective:To evaluate the effectiveness of single modal and multimodal exercise interventions on sarcopenia in the elderly. Methods:Randomized controlled trials about the effects of single modal and multimodal exercises on the improvement of sarcopenia in the elderly were retrieved from seven databases (PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP and Wanfang data) from the establishment of the databases to July, 2021. Two researchers selected the literatures independently, and evaluated the quality of methodology. The meta-analysis was performed with RevMan 5.3. Results:A total of 15 studies were incorporated, including 816 cases of sarcopenia. Compared to the blank control group, the skeletal muscle mass index improved little with single (MD = -0.05, 95%CI -0.14 to 0.04, P > 0.05) and multiple (MD = 0.15, 95%CI -0.01 to 0.31, P > 0.05) exercises. The maximum grip force improved with both single (MD = 2.06, 95%CI 0.25 to 3.87, P < 0.05) and multiple (MD = 2.36, 95%CI 1.10 to 3.63, P < 0.001) exercises. The knee extensors strength (SMD = 0.49, 95%CI 0.26 to 0.73, P < 0.001) and the walking speed (MD = 0.24, 95% CI 0.19 to 0.29, P < 0.001) improved with multimodal exercises. Conclusion:Single modal exercise may improve maximal grip strength in the elderly with sarcopenia, and multimodal exercise may be effective on maximal grip strength, knee extensors strength and walking speed.
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Objective:To compare the efficacy of bilayer artificial dermis graft plus single layer dermal template and bilayer artificial dermis graft only in repairing lower extremity wounds with large area of exposed bone.Methods:A retrospective case-control study was conducted to analyze the clinical data of 34 patients with 37 wounds of the lower extremity involving large area of exposed bone admitted to Beijing Jishuitan Hospital from November 2009 to November 2020. There were 27 males and 7 females, aged 9-67 years [35.5(29, 45)years]. The exposed bone in the lower leg, ankle and foot was greater than 10 cm 2 in size (the shortest distance from edge to edge of bony exposure was more than 2 cm). At the first stage, the wounds were grafted with bilayer type artificial dermis only for 21 wounds of 20 patients in Group A, and grafted with bilayer type artificial dermis plus single layer dermal template for 16 wounds of 14 patients in Group B. At the second stage, the auto-skin graft was performed in the two groups. The wound healing rate was observed in all patients, and was compared between the two groups at 2 weeks and 2 months after the second stage operation. At the same time, the interval between first stage and second stage surgery was measured. The Vancouver Scar Scale (VSS) was used to evaluate the scar in the skin grafting area in the two groups at 5-6 months after the second stage operation. Results:All patients were followed up for 1 to 24 months [5(2, 7.5)months]. The total excellent and good wound healing rate in all patients was 81%(30/37) at 2 weeks and 97%(36/37) at 2 months. There was no significant difference between the Group A and Group B in the excellent and good wound healing rate at 2 weeks [(76%(16/21) vs. 88%(14/16)] and at 2 months [95%(20/21) vs. 100%(16/16)] ( P>0.05). In Group A, the bilayer artificial dermis was grafted into 4 wounds again to complete exposed bone coverage. However, all wounds in Group B were covered initially without re-grafting. The interval between the two-stage operation was 20(16, 21)days in Group A after the 4 patients who underwent secondary artificial dermal transplantation were excluded, showing no significant difference from 21(21, 23)days in Group B ( P>0.05). At 5-6 months after the second stage operation, the VSS score in Group B [(8.0±1.2)points] was significant less than that in Group A [(9.2±1.1)days] ( P<0.05). In the sub-index of VSS, the score of color and softness of scar in Group B [(2.0±0.6)points, (1.6±0.5)points] were significantly improved compared to those in Group A [(2.5±0.5)points, (2.2±0.7)points] ( P<0.05). Conclusions:The artificial dermis grafting is effective in treatment of lower extremity wounds with large area of exposed bone. However, the bilayer artificial dermis graft plus single layer dermal template can avoid artificial dermal re-graft in repair of large area of exposed bone, and the interval between two-stage operation is not significantly prolonged. Moerover, the color and texture of scar after skin grafting and wound repair efficiency and quality are improved.
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Objective@#Positron emission tomography-computed tomography (PET-CT) has been used to quantify inflammatory response in the body. The aim of the present study was to explore the possibility of using this method to evaluate the stability of atherosclerotic plaques and the efficacy of atorvastatin in stabilizing atherosclerotic plaques.@*Methods@#Twenty New Zealand male white rabbits were included and divided into the atorvastatin intervention group and the control group, with 10 rabbits in each group. Rabbits in both groups were fed with a high fat diet for 20 weeks, and treated with thoracoabdominal aortic balloon-pulling to establish atherosclerosis model at the end of the 2nd week. Rabbits in atorvastatin intervention group was given atorvastatin intragastrically once a day. At the 8th week, thoracoabdominal aortic ultrasound was used to detect plaques in all rabbits. Blood was drawn at the 3rd and the 20th week, respectively, to measure blood lipids, high-sensitive C-reactive protein (hs-CRP) and matrix metalloproteinase-9 (MMP-9). At the end of experiment, survival animals were scanned by 18F-FDG PET-CT, and the average and maximum standard uptake values (SUVmean, SUVmax) of aortic segments were measured. Thereafter, the animals were sacrificed and aortic specimens of rabbits were taken and examined by immunohistochemistry. The pathological indexes were measured and compared.@*Results@#At the end of experiment, the total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), hs-CRP [ (4.58±0.51) ng/ml vs.(5.87±0.66) ng/ml, P<0.01], MMP-9[ (43.93±2.16) ng/ml vs. (50.77±2.32) ng/ml, P<0.01], SUVmean (0.59±0.15 vs. 0.68±0.20, P<0.05) , SUVmax (0.68±0.20 vs. 0.81±0.27, P<0.05) , plaque area [ (0.36±0.24) mm2 vs. (0.50±0.34) mm2, P<0.05) ] and density of macrophage[ (4.34±1.54) % vs. (5.65±1.89) %, P<0.01] in the atorvastatin intervention group were significantly lower than those in the control group. In contrast, fiber cap thickness of the plaque[ (4.12±0.66) μm vs. (2.96±0.37) μm, P<0.01] in the atorvastatin intervention group was higher than that of the control group, and the difference was statistically significant. The arterial plaque areas were positively correlated with SUVmean (r=0.27, P<0.05) and SUVmax (r=0.43, P<0.01) . Fiber cap thickness was negatively correlated with SUVmean (r=-0.38, P<0.05) and SUVmax (r=-0.47, P<0.01) . The density of macrophage were positively correlated with SUVmean (r=0.52, P<0.01) and SUVmax (r=0.51, P<0.01) .@*Conclusion@#18F-FDG PET/CT can be used to evaluate the efficacy of atorvastatin by the stability of atherosclerotic plaques.
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Objective: To evaluate the effects of CYP2C19 genetic polymorphism on the plasma concentration of voriconazole in patients with hematological disease and the value of serial monitoring plasma concentrations in the treatment and prevention of invasive fungal disease (IFD). Methods: From January 2016 to December 2016, 65 hematological patients who received voriconazole intravenous administration for the treatment of invasive fungal disease were enrolled in this study. The population CYP2C19 polymorphism of voriconazole were performed using PCR-Pyrosequencing. The trough plasma concentrations of vriconazole (Ctrough) was detected by ultra performance liquid chromatography tandem mass spectrometry. Results: Based on the genotype analysis, 65 subjects were identified as extensive metabolizers' group (30 cases) and poor metabolizers' group (35 cases). The Ctrough of the 65 patients were detected for 169 times totally, and there was a significant difference of Ctrough values between the two groups [0.98(0.38-2.08) mg/L vs 2.19(1.53-4.27) mg/L, z=10.286, P<0.001]. The medium of Ctrough in 65 hematological patients were described. Lack of response to therapy was more frequent in patients with voriconazole levels <1.5 mg/L (50.0%) than in those with voriconazole levels >1.5 mg/L (20.5%) (P=0.052). And the risk of adverse events was more frequent in patients with voriconazole levels >5.5 mg/L (80.0%) than in those with voriconazole levels ≤5.5 mg/L (8.3%) (χ2=11.689, P=0.020). Conclusion: Patients with CYP2C19 wild-type phenotype are extensive metabolizers, their Ctrough of voriconazole are significantly lower than patients with CYP2C19 non-wild-type phenotype (poor metabolizers). Appropriate concentrations of vriconazole can improve the efficacy and safety during treatment.
الموضوعات
Humans , Antifungal Agents , Cytochrome P-450 CYP2C19/genetics , Genotype , Hematologic Diseases/genetics , Mycoses , Phenotype , Polymorphism, Genetic , Voriconazoleالملخص
Objective To analyze the angiographic and intravascular ultrasound(IVUS) characteristics of 65 coronary artery aneurismal lesions and to evaluate the effects of interventional and medical therapy. Methods 65 in-hosptal patients with coronary artery aneurysmal lesions with both quantitive coronary angiography and IVUS data from 10/2007 to 10/2014 were retrospectively analyzed in our center. Aneurysmal lesions were confi rmed as ture coronary artery aneurysms(CAA) (n=32)or false aneurysms(n=33)by IVUS. The angiography and IVUS characteristics in both groups were analyzed. Patients with aneurysmal lesion were provided with interventional or medical therapy according to the severety of stenosis. The major adverse cardiac events(MACE) were observed in these patients for two years. Results LAD and RCA were the most common sites of true CAA lesions(40.6% and 34.4% respectively).Compared with the false aneurysm group, the ture aneurysm group had longer aneurysm[(11.1±5.8)mm vs.(5.9±2.7)mm,P<0.001], more bifurcation vessels(21 cases vs. 8 cases,P=0.001),bigger luminal external elastic membrane[(25.6 ±10.7)mm2vs.(17.7±6.6)mm2,P=0.001],bigger luminal diameters [(6.2±1.5)mm vs.(5.3±1.0)mm,P=0.005]and bigger cross sectional area[(33.5±12.0)mm2vs. (25.8±7.9)mm2, P=0.003]. The false aneurysms group had bigger plaque burdens than the ture aneurysms[(32.4±10.7)% vs.(23.0±9.8)%,P=0.001].The ratios of receiving percutaneous coronary intervention(PCI) and medical therapy were the same in the two groups (P=0.272). The percentage receiving crossover stenting was higher in the false aneurysms group(33.3% vs. 6.2%, P=0.006). There were no cardiac death and acute myocardial infarction in both groups.One subacute in-stent thrombosis happened in the ture aneurysm group. Conclusions IVUS is a good method for diff erentiation of CAA from false coronary aneurysm. Most aneurysms were adjacent to severe stenosis and vessel bifurcation. It implied that maybe the changes of flow hemodynamics were related to the formation of coronary artery aneurysm. Sufficient and long term anti-thrombotic therapy and provisional interventions to aneurysmal unilateral severe stenosis may be a good choice of treatment for CAA.
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Objective To investigate the expression and clinical implication of miR-494 and its target gene JunD in intervertebral disc herniation (IDH).Methods Six intervertebral disc tissue samples of spinal burst fracture were collected during operation,and then the nucleus pulposus cells were cultured.TNF-α of different concentration (0,10,50 and 100 ng/ml) were added to the cells to induce apoptosis.The apoptosis rate of nucleus pulposus cells and the expression of miR-494 were detected at different time after the stimulation (0,8,16 and 24 h) using qRT-PCR and flow cytometry respectively.Then,AntigomiR-494 was transfected into nucleus pulposus cells after lentivirus packaging,followed by the use of TNF-α (100 ng/ml,16 h) to induce apoptosis.The experiments contained blank control group,AntigomiR-494 + TNF-α group,and negative control + TNF-o group.Flow cytometry was used to detect the apoptosis in each group,and Western blot the expressions of JunD and cytochrome C.The luciferase double report based analysis and bioinformatics methods were used to investigate the relationship between miR-494 and JunD gene.Results The expression of miR-494 and the apoptosis rate of nucleus pulposus cells increased along with the increase of concentration of TNF-α and length of stimulation (P ＜ 0.05).After transfection,the expression of miR-494 and the apoptosis rate in AntigomiR-494 + TNF-α group were significantly lower than those in negative control + TNF-α Group (P ＜ 0.05).The results of Western blot showed that the expression level of JunD protein in AntigomiR-494 + TNF-α group was significantly higher than that of the negative control group (P ＜ 0.05),and the expression level of cytochrome C protein was significantly lower than that of the negative control + TNF-α group (P ＜ 0.05).Luciferase double report gene validation and bioinformatics prediction confirmed that miR-494 directly targeted JunD.Conclusion TNF-α can induce apoptosis of nucleus pulposus cells in a time and dose dependent manner.The expression of miR-494 increases with the increase of TNF-α concentration and length of stimulation.MiR-494 might be the key regulator of the apoptosis of nucleus pulposus cells under the induction of TNF-o.MiR-494 gene knockout can protect the nucleus pulposus cells,through the possible mechanism of upregulating target gene JunD and mediating the cytochrome C apoptosis pathway.MiR-494-JunD-cytochrome C signaling pathway might be one of the potential mechanisms of intervertebral disc degeneration.
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OBJECTIVE To explore the expression of long non-coding RNA (LncRNA) HOTAIR, enhancer of Zeste homolog 2 (EZH2) and vascular endothelial growth factor (VEGF) in nasopharyngeal carcinoma (NPC) and their relationship between HOTAIR and prognosis. METHODS We examined the expression of HOTAIR, EZH2 and VEGF in NPC tissues, and analyzed the clinical significance of HOTAIR expression in patients with NPC. RESULTS We found that the expression of HOTAIR, EZH2 and VEGF in the NPC tissues were significantly higher than those in the chronic nasopharyngitis tissues in the gene and protein levels (U=955,P<0.05). The HOTAIR was positively correlated with VEGF (r=0.599,P<0.001), VEGF was positively correlated with EZH2 (r=0.369, P=0.012), and HOTAIR had no significant correlation with EZH2 (r=0.139,P=0.357). Moreover, HOTAIR expression levels increased with clinical stage progression. CONCLUSION The expression of HOTAIR, EZH2 and VEGF were significantly increased in the NPC tissues, and the expression of HOTAIR was related with the TNM stage, the clinical stage and the short term therapeutic effect of the NPC patients, which indicated that the HOTAIR might be used as a biological indicator to determine the prognosis of the NPC.
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<p><b>OBJECTIVE</b>To evaluate the value of a new platelet function test PFA P2Y (PFA-200) in monitoring clopidogrel treatment for cardiovascular disease in elderly patients.</p><p><b>METHODS</b>Fifty-six elderly patients receiving clopidogrel therapy in the Department of Cardiology of General Hospital of PLA from March to August in 2016 and 85 healthy volunteers were recruited for analysis. All the subjects underwent PFA P2Y, LTA (light transmittance aggregometry) and TEG (Thromboelastograph) tests, and Spearman correlation coefficients were used to test the associations between test results. The agreement among the 3 platelet function test methods was assessed using Cohen's kappa coefficient.</p><p><b>RESULTS</b>Correlation coefficient (r) was -0.701 (P<0.001) between PFA P2Y and LTA, and 0.475 (P<0.001) between PFA P2Y and TEG. The agreement was 75% between PFA P2Y and LTA and 67.9% between PFA P2Y and TEG. The κ value was 0.434 (P=0.001) between PFA P2Y and LTA and 0.242 (P=0.046) between PFA P2Y and TEG. With ADP-induced maximum platelet aggregation rate of LTA >50% as the laboratory clopidogrel resistance, the cut-off value of PFA P2Y was 119 s (AUC=0.733) with a sensitivity of 75.6% and a specificity of 73.3%.</p><p><b>CONCLUSION</b>PFA P2Y has a moderate correlation and agreement with LTA, but has a poor correlation and agreement with TEG. PFA P2Y can be useful for assessing the effects of clopidogrel therapy and the association of the cut-off value (119 s) with the long-term clinical ischemic events needs be confirmed in further study.</p>
الموضوعات
Humans , Biological Assay , Blood Coagulation Tests , Blood Platelets , Cardiovascular Diseases , Drug Therapy , Platelet Aggregation , Platelet Aggregation Inhibitors , Therapeutic Uses , Platelet Function Tests , Sensitivity and Specificity , Ticlopidine , Therapeutic Usesالملخص
OBJECTIVETo observe the change of peripheral blood Th17 cells in patients with different kinds of CRSwNPs and the relationship between the frequency of Th17 cells and inflammatory cell density in nasal polyps tissue, and to explore the correlation between levels of peripheral blood Th17 cells and prognosis of patients with CRSwNPs.METHODSEighty one patients with CRSwNPs and 20 controls were recruited in this research. Flow cytometer was used to detect the expression of peripheral blood Th17 cells. The number per 10000μm2 of infiltrated inflammatory cells in nasal polyp tissue (including eosinophils, neutrophils, lymphocytes and plasma cells) was counted at a high-power field. The CT scores were evaluated by Lund-Mackay system and the nasal endoscopy scores were graded according to Lund-Mackay methods. RESULTSThe percentages of Th17 cells in patients with E-CRSwNPs and NE-CRSwNPs were 2.10% (3.75%, 1.40%)和1.10% (1.70%, 0.73%). There was significant difference between the two groups (Mann-WhitneyU=358.0,Z=-2.965, P=0.001). Furthermore, a positive association between the percentage of Th17 cells in peripheral blood and the eosinophil density of nasal polyp (r=0.408,P<0.001) was demonstrated. The percentage of Th17 cell in peripheral blood was significantly correlated with the endoscopic score of CRSwNPs at third month after the operation (r=0.458, P<0.001).CONCLUSIONThl7 might be involved in the pathogenesis and prognosisof eosinophilic CRSwNPs.
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OBJECTIVE@#To determine the effect of elastic strain rate ratio method and virtual touch tissue quantification (VTQ) on the diagnosis of breast masses. @*METHODS@#Sixty female patients with breast cancer, who received surgical treatment in Daqing Oilfield General Hospital, were enrolled. All patients signed the informed consent paperwork and they were treated by routine ultrasound examination, compression elastography (CE) examination, and VTQ examination in turn. Strain ratio (SR) was checked by CE and shear wave velocity (SWV) value was measured by VTQ. The diagnostic values of different methods were evaluated by receiver operating characteristic (ROC) curves in the diagnosis of benign and malignant breast tumors. @*RESULTS@#The maximum diameter and SWV value of the benign tumors were lower than those of the malignant tumors, and the SR ratio of benign masses was higher than that of malignant tumors (P<0.01). The AUC, sensitivity and specificity for elastic strain rate and VTQ for single or combined use were higher than those of conventional ultrasound (0.904, 97.5%, 69.2%; 0.946, 87.5%, 87.2%; 0.976, 90%, 97.4% vs 0.783, 85%, 61.5%). The AUC and specificity of VTQ were higher than those of the elastic strain rate (0.946, 87.2% vs 0.904, 69.2%), but the sensitivity of VTQ was higher than that of the latter (87.5% vs 97.5%). The AUC and specificity for combination of both methods were higher than those of single method, but the sensitivity was lower than that of the elastic strain rate. @*CONCLUSION@#Combination of elastic strain rate ratio method with VTQ possesses the best diagnostic value and the highest diagnostic accuracy in the diagnosis of breast mass than that used alone.
الموضوعات
Female , Humans , Breast , Breast Neoplasms , Elasticity Imaging Techniques , High-Energy Shock Waves , Microsurgery , ROC Curve , Touchالملخص
It is necessary to refresh our understanding of the academic mission for information retrieval course in the network information era.The correlation between scientific achievements and scientific information and between scientific literacy and information literacy revealed the fact that information retrieval capability is the core of information literacy when the information retrieval course is placed a broader academic background.The connotation of information retrieval was elaborated, which further demonstrates that the academic mission for information retrieval course is to train the information wisdom of undergraduates.
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OBJECTIVE@#To investigate the recurrence rate of nasal inverted papilloma treating by endoscopic and non-endoscopic approach.@*METHOD@#A search on Pubmed, Medline, Springer and Elsevier databases was done to collect the reports (2001-2013) concerning different surgery treating nasal inverted papillomas, and meta-analysis was performed with RevMan 5.0 software.@*RESULT@#Twelve papers (2001-2013) concerning the different surgery approach treating nasal inverted papillomas were retrieved. The heterogeneity test indicated that the 12 studies were consistent statistically (Q = 14.64, df = 11, P = 0.20), the data from these 12 studies could be analyzed by fixed effect model. After combination of these data, those of 1012 subjects accepted endoscopic surgical intervention and 359 subjects treating by non-endoscopic surgical intervention were collected. Test of overall effect by fixed effect model showed that the recurrence rate of inverted papilloma was significantly lower in endoscopic group than in non-endoscopic group (OR = 0.49, 95% CI was 0.35-0.69, P < 0.01). Funnel plot implied that publication bias was not obvious.@*CONCLUSION@#The recurrence rate of inverted papilloma was significantly lower in endoscopic group than in non-endoscopic group.
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Humans , Endoscopy , Nasal Surgical Procedures , Methods , Neoplasm Recurrence, Local , Nose , Nose Neoplasms , General Surgery , Papilloma, Inverted , General Surgery , Retrospective Studiesالملخص
Objective To explore the curative effect of ursodeoxycholic acid in treatment of intrahepatic cholestasis of pregnancy (ICP) and the effect on total bile acid (TBA) in post partum fetal umbilical venous blood .Methods 30 patients with intrahepatic cholestasis of pregnancy who were admitted into the Hospital Affiliated to Sichuan Medical University during January 2014 to December 2014 were selected as the research objects and randomly divided into observation group and control group ,15 cases in each group.The observation group were given ursodeoxycholic acid tablets while control group were injected with ademetionine butanedisulfonate .The curative effect of two kinds of drugs in treatment of intrahepatic cholestasis of pregnancy was observed and the effect on total bile acid in post partum fetal umbilical venous blood was analyzed .ResuIts After treatment , the TBA and ALT of observation group were significantly lower than those pre-treatment and those of control group (P<0.05).There were no significant differences of TBIL and ALP between two groups and within groups.TBA and TBIL in post partum fetal umbilical venous blood of observation group were significantly lower than those of control group (P<0.05).There was no significant difference of ALT level between two groups .There were two cases of abnormal perinatal outcomes in observation group while seven cases in control group (χ2 =3.97, P<0.05).ConcIusion Ursodeoxycholic acid could effectively reduce the total bile acid levels in maternal and fetal umbilical vein blood, reduce the mortality rate of the fetal and improve the perinatal outcomes , with high security.
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<p><b>OBJECTIVE</b>To discuss the impacts of moxibustion for regulating spleen and stomach function on the survival quality of the patients of end stage renal disease (ESRD) with maintenance hemodialysis (MHD).</p><p><b>METHODS</b>One hundred and nine cases of uremia with MHD from 3 hemodialysis centers were randomized into an observation group (58 cases) and a control group (51 cases). The regular hemodialysis and conventional medication were used in the two groups. In the observation group, on the basis of the common treatment, moxibustion was applied to Zusanli (ST 36) and Sanyinjiao (SP 6), 2-3 times a day, the treatment of 4 weeks made one session. Totally, 3 sessions were required and the follow-up lasted for 3 months. KDQOL-SF (kidney disease quality of life short form,KDQOL-SFTM 1. 3) was adopted for the questionnaire investigation on survival quality before treatment, after treatment and at the end of follow-up separately in the two groups.</p><p><b>RESULTS</b>After treatment, the survival quality scores in terms of physical functioning (83.62+/-13.27 vs 79.32+/- 22. 17), general health (58. 88+/- 20.24 vs 48.82+/-20.89) and vitality (77.07+/-15.56 vs 70. 59+/-22.61) in the observation group were higher than those in the control group (all P<0. 05). In comparison before and after treatment in the same group, the survival quality scores in terms of physical functioning, general health, vitality and symptoms/problems were all improved in the observation group (all P<0. 05). At the end of follow-up, the survival quality scores in terms of physical functioning, general health, mental health, social functioning, vitality, effects of kidney disease and cognitive function were higher in the observation group as compared with those in the control group (all P<0. 05). In comparison of the results at the end of follow-up with those before treatment, the survival quality scores in terms of vitality, symptoms/problems and cognitive function in the observation group were improved (all P< 0. 05). The differences were not significant in all of the 19 fields of survival quality evaluation before and after treatment, and after follow-up in the control group (all P>0. 05).</p><p><b>CONCLUSION</b>Moxibustion for regulating spleen and stomach function improves the survival quality of the patients with hemodialysis in terms of physical functioning, general health and vitality, which benefits the psychological condition of the patients, resulting in the improvements of the survival quality in the fields of mental health, social functioning, effects of kidney disease and cognitive function.</p>
الموضوعات
Adult , Aged , Female , Humans , Male , Middle Aged , Kidney Failure, Chronic , Therapeutics , Moxibustion , Quality of Life , Renal Dialysis , Spleen , Stomachالملخص
<p><b>OBJECTIVE</b>To investigate the applications of percutaneous screw fixation for the treatment of pelvic fractures and its related surgical considerations.</p><p><b>METHODS</b>From June 2010 to June 2012,19 patients with pelvic fractures were treated with percutaneous hollow screws. There were 13 males and 6 females, with an average age of 41 years (ranged from 22 to 58 years). Fractures were caused by traffic accidents in 11 cases, by falling down from high place in 8 cases. Based on the Tile classification, there were 15 cases of Tile C type and 4 case of Tile B type. The indexes such as screw inserting time, intraoperative blood loss, complications, functional recovery and reduction conditions were observed. Fixation methods included sacroiliac screws, cannulated screw fixation of the pubic ramus and cannulated screw fixation of the pubic symphysis separation.</p><p><b>RESULTS</b>Anatomical reduction achieved in 7 cases, satisfactory reduction 11 cases, and unsatisfactory reduction 1 case. Union time of fracture union ranged from 8 to 12 weeks (mean 10 weeks). Wound infection,ununion of fracture and nerve injuries were not found. According to the Majeed standards, 12 patients obtained an excellent results, 6 good and 1 fair.</p><p><b>CONCLUSION</b>Percutaneous screw fixation for the treatment of pelvic fractures under fluoroscopy has several advantages such as less trauma, less blood loss, fewer rates of complications, reliable fixation and no blood transfusion, which can reconstruct the stability of the pelvic ring, but it needs adequate preoperative preparation and high requirements for the surgeon.</p>
الموضوعات
Adult , Female , Humans , Male , Middle Aged , Young Adult , Bone Screws , Fracture Fixation, Internal , Fractures, Bone , Diagnostic Imaging , General Surgery , Pelvic Bones , Diagnostic Imaging , Wounds and Injuries , General Surgery , Radiographyالملخص
Objective To evaluate and compare the presence of the nerve root sedimentation sign in patients with lumbar spondylolisthesis (LS) and lumbar disc herniation(LDH). Methods One hundred and fifty-one patients with degen?erative lumbar spinal disease treated by surgery from July 2012 to March 2014 were reviewed retrospectively in Tianjin Hos?pital. All the patients were divided into two groups:LS group (48 cases) and LDH group (103 cases). The clinical outcomes were evaluated by Japanese Orthopedic Association (JOA). The probability of positive sedimentation sign was compared be?tween LS group and LDH group. Correlation between the JOA score and nerve root sedimentation sign were analysed in two groups. Results There was no statistical difference in JOA score between LS group and LDH group (15.83±3.57 vs 16.76± 3.10, t=1.624, P=0.107). A positive sedimentation sign was identified in 39 patients in the LS group (81.25%) but in 65 pa?tients in the LDH group (63.11%). The difference between LS group and LDH group was statistically significant(χ2=5.028, P=0.031). In LS group, JOA scores of patients with positive nerve root sedimentation sign were lower than those of patients with negative nerve root sedimentation sign(15.33±3.50 vs 18.00±3.20, t=2.092,P=0.042);but in LDH group, there was no statistical difference in JOA scores of patients between positive nerve root sedimentation sign and negative nerve root sedi?mentation sign (16.40±3.13 vs 17.37±2.99, t=1.539, P=0.127). Conclusion A positive sedimentation sign also occurs in pa?tients with LDH, but positive nerve root sedimentation sign are more likely to appear in patients with lumbar spondylolisthe?sis who have worse clinical symptoms.
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Objective To investigate the possibility of establishing a Modic changes (MCs) animal model,and explore the pathogenesis of MCs through imaging,histology and molecular biology experiments.Methods Fifty four New Zealand rabbits (weight 2.5-3.0 kg,half male and half female) were randomly divided into 3 groups:sham group (n=l8),muscle embedment group (n=18) and NP embedment group (n=18).In NP embedment group,the L4-5 and L5-6 discs were exposed by the lumbar anterolateral surgical approach.A 16 G needle was used to puncture the L5-6 vertebral body close to the epiphyseal plate.The depth of the drilling was approximately 3 mm.A 5 ml syringe was then put into the L4-5 intervertebral disc and extracted the NP,which was injected into the drilled hole of the vertebral body.The muscle embedment group and sham group shared the same operating procedures and drilling methods with the NP embedment group.Some pieces of muscle acquired from paraspinal muscles were put into the drilled hole in muscle embedment group,while nothing was put into the drilled hole in sham group.After that,the bleeding stopping,tissue washing and suture were done in all groups.12 weeks,16 weeks and 20 weeks after the surgery,MRI scan was applied to each group.All the specimens were tested by HE staining,real-time fluorescence quantitative PCR and Western blot to observe the expression of inflammatory cytokines.Results After modeling for 12 weeks,16 weeks and 20 weeks,MRI showed low signal changes on T1WI and mixed high signal in the context of low signal changes on T2WI in the NP embedment group.However,the muscle embedment and sham group showed no significant signal changes.Gross observation and HE staining confirmed that there was abnormal tissue proliferation in the imbed site of the NP embedment group.RT-PCR and Western blot showed high expression of IL-4,IL-17 and IFN-γin the NP embedment group,which were positively correlated with the length of the postoperative period.There was no significant difference between the muscle embedment group and sham group.Conclusion The puncturing of vertebral body close to endplate and putting nucleus into it can create an animal model of MCs.Autoimmune factors may play an important role in MCs.
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This study was aimed to explore whether multiple common gene mutations of leukemia synergistically involved in acute promyelocytic leukemia (APL) pathogenesis, and to investigate their relevance to clinical features, cytogenetics and molecular risk stratification. 84 specimens of admitted de novo APL patients from February 2005 to October 2010 were collected, the gene mutations of bone marrow mononuclear cells and clinical features of mutation-positive patients were analyzed by genomic DNA-PCR. The results indicated that the prevalence of mutations was 60.7% (51/84), in which the mutations with the highest incidence were found as FLT3-ITD, reaching 27.4% (23/84). Next, there were 12 cases WT1 mutation, 9 for FLT3-TKD, 7 for TET2, 5 for N-RAS, 4 for ASXL1, 2 for EZH2 mutation and 1 positive case in MLL-PTD, IDH1 and CBL mutation respectively. No mutation was found in other JAK1, DNMT3, c-Kit, NPM1, IDH2, RUNX1 and JAK2 (V617F) common leukemia-related genes. Combined analysis with clinical data demonstrated that the patients with FLT3-ITD mutation displayed higher white blood cell counts, while the patients with N-RAS mutation showed lower platelet counts. Overall survival of these patients was obviously shorten as compared with patients with wild-type. This difference between mutant and wild-type of all above mentioned cases was statistically significant (P < 0.05). The difference between APL with simple t (15;17) and additional abnormal karyotype was not statistically significant. It is concluded that the FLT3-ITD mutation is recurrent genetic change in APL, and together with N-RAS mutation indicates poor prognosis. Additional abnormal karyotype does not associate with prognosis of APL.