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Objective:To evaluate the predictive value of 18F-FDG PET-based radiomics models for lymphovascular invasion (LVI) and visceral pleural invasion (VPI) in lung adenocarcinoma (LAC) prior to surgery. Methods:Eighty-seven patients with LAC (42 males, 45 females, age: (64.6±9.0) years; 90 lesions) pathologically confirmed in the Affiliated Taizhou People′s Hospital of Nanjing Medical University between August 2018 and August 2022 were retrospectively included. Based on the radiomics features extracted from PET images, the machine learning models were constructed by using the support vector machine (SVM), logical regression (LR), decision tree (DT), and K-nearest neighbor (KNN) algorithm. Stratified sampling (Python′s StratifiedkFold function) was employed to divide the data into training set and test set at a ratio of 8∶2. The model stability was assessed using the 50% discount cross-validation. The ROC curve was drawn, and the AUC was calculated to evaluate the value of radiomics models in predicting LVI and VPI in LAC. Delong test was used to compare AUCs of different models.Results:The radiomics models (SVM, LR, DT, KNN) based on PET images showed good predictive value for LVI and VPI in patients with LAC. For LVI, the AUCs were 0.91, 0.90, 0.91, 0.91 in the training set, and were 0.85, 0.87, 0.77, 0.78 in the test set; for VPI, the AUCs were 0.86, 0.86, 0.84, 0.81 in the training set, and were 0.82, 0.80, 0.69, 0.78 in the test set. The F1 scores of the SVM model were the best (0.59 and 0.66 for predicting LVI and VPI respectively). The Delong test showed that there were no significant differences in AUCs among the four models ( z values: from -1.46 to 1.71, all P>0.05). Conclusions:The machine learning models based on 18F-FDG PET radiomics features are effective in predicting LVI and VPI in patients with LAC prior to surgery. These models can assist clinicians in stratifying the risk of LAC and making informed clinical decisions. The SVM model has the best performance in predicting LVI and VPI.
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Objective To study the safety and effectiveness of Tiaodu Tongmai Zhengji method in the treatment of cervical cardiac syndrome,and to provide a choice for the clinical treatment of cervical cardiac syndrome.Methods From January 2020 to January 2022,45 patients with cervical cardiac syndrome diagnosed clinically in the outpatient department of geriatrics of our hospital were randomly divided into"Tiaodu Tongmai Zhengji"group,routine massage group and routine acupuncture group,with 15 patients in each group.Three methods were used in the"Tiaodu Tongmai Zhengji"group:acupuncture,massage and chiropractic therapy.The routine massage group adopted the massage treatment scheme of sympathetic cervical spondylosis,while the routine acupuncture group adopted the treatment scheme of cervical spondylosis and palpitation.Three times a week for four weeks.One month later,the treatment effect was evaluated from the main symptoms,secondary symptoms,follow-up symptoms and TCM syndrome score.Results In alleviating the main symptoms of patients with cervical cardiac syndrome,including palpitation,chest tightness and chest pain,the treatment of regulating Du,Tongmai and Zhengji was superior to the conventional massage treatment(P<0.05),while the conventional massage treatment was superior to the conventional acupuncture treatment(P<0.05).Acupuncture,Tuina and Tiaodu Tongmai Zhengji treatment can improve the secondary symptom of cervical heart syndrome,that is,neck and scapular pain.However,in terms of alleviating neck and scapular pain,Tiaodu Tongmai Zhengji treatment is significantly better than conventional acupuncture and Tuina treatment(P<0.01),while there is no difference between acupuncture and Tuina treatment(P>0.05).In improving the anxiety of cervical heart syndrome,acupuncture is better than regulating Du Tongmai Zhengji,while regulating Du Tongmai Zhengji is better than massage(P<0.05).The total effective rate of acupuncture and massage treatment was the same,but the total effective rate of Tiaodu Tongmai Zhengji treatment was better than that of acupuncture and massage treatment(P<0.05).Conclusion Tiaodu Tongmai Zhengji method is a feasible method obtained by summing up experience in clinical practice.It focuses on the manipulation of the spine and its small joints,meridians and acupoints,in order to balance yin and yang,dredge the meridians and dredge the collaterals,regulate the tendons and repair,regulate the qi and blood,restore the muscle mechanical balance,and restore the balance of visceral functions.while Tiaodu Tongmai Zhengji method has obvious advantages in relieving palpitation,chest tightness,chest pain and neck shoulder pain of patients with cervical heart syndrome.The total effective rate is also better than massage method and acupuncture method.Tiaodu Tongmai Zhengji method is a therapeutic method worthy of clinical promotion.
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Skeletal muscle plays a paramount role in physical activity, metabolism, and energy balance, while its homeostasis is being challenged by multiple unfavorable factors such as injury, aging, or obesity. Exosomes, a subset of extracellular vesicles, are now recognized as essential mediators of intercellular communication, holding great clinical potential in the treatment of skeletal muscle diseases. Herein, we outline the recent research progress in exosomal isolation, characterization, and mechanism of action, and emphatically discuss current advances in exosomes derived from multiple organs and tissues, and engineered exosomes regarding the regulation of physiological and pathological development of skeletal muscle. These remarkable advances expand our understanding of myogenesis and muscle diseases. Meanwhile, the engineered exosome, as an endogenous nanocarrier combined with advanced design methodologies of biomolecules, will help to open up innovative therapeutic perspectives for the treatment of muscle diseases.
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Exosomes/physiology , Muscle, Skeletal/metabolism , Cell Communication , Homeostasisالملخص
BACKGROUND/OBJECTIVES@#This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959–1961 Chinese Famine. @*SUBJECTS/METHODS@#A total of 3,418 individuals aged 35–74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962–1978), fetal exposed (individuals born in 1959–1961), child exposed (individuals born in 1949–1958), and adolescent/adult exposed (born in 1931–1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates. @*RESULTS@#During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively (P < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29–3.60), 1.53 (0.93– 2.51), and 1.65 (0.75–3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82–42.54) and 2.33 (1.17–4.65), respectively. @*CONCLUSIONS@#These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life.
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Objective:To investigate the clinical value of ultrasound shear wave dispersion (SWD) imaging in assessing the hepatic inflammation activity in patients with chronic hepatitis B.Methods:Fifty-two patients with chronic hepatitis B who underwent liver biopsy in Peking University Third Hospital and Beijing Ditan Hospital Affiliated to Capital Medical University from December 2020 to December 2021 were prospectively enrolled.Liver stiffness (LS) and shear wave dispersion slope (SWDS) were measured by SWD imaging in all participants. Baseline data and laboratory indexes of liver function were collected.Liver inflammation grading(G0-G4) and fibrosis staging (S0-S4) were determined by pathological examination. The relationship between SWDS and various indicators was analyzed by univariate and multivariate linear regression analysis. The participants were grouped according to the pathological grading of hepatic inflammatory activity. The differences of various indexes among three groups were compared, and the correlations between SWDS, LS and laboratory indicators and hepatic inflammatory activity were analyzed. The ROC curve was used to evaluate the diagnostic performances of ultrasound and laboratory indicators for hepatic inflammation activity, and the diagnostic accuracy of different indicators was compared by Delong test.Results:Inflammation and fibrosis were both independent affecting factors of SWDS (all P<0.05); there were significant differences in alanine transaminase(ALT), aspartate aminotransferase(AST), LS and SWDS among groups with different inflammatory activities (all P<0.05). The SWDS and LS of the G3 and G2 groups were statistically higher than those of the G1 group (all P<0.001). ALT was only significantly different between G1 group and G2 group ( P<0.05), and AST was only significantly different between G1 group and G3 group ( P<0.05); The SWDS and LS showed strongly positive correlation ( rs=0.728, P<0.001) and moderately positive correlation ( rs=0.679, P<0.001) with hepatic inflammatory activity, respectively; while the correlations between ALT, AST and hepatic inflammatory activity were weaker( rs=0.376, P<0.05; rs=0.485, P<0.001). The area under the ROC curve, sensitivity and specificity of SWDS for diagnosing hepatic inflammation ≥G2 grade were 0.965, 0.933 and 0.865, respectively. Conclusions:SWDS has certain value in evaluating the hepatic inflammatory activity of ≥G2 grade in patients with chronic hepatitis B.
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In the face of DNA damage caused by various factors, cells have a set of response and repair mechanisms. Cell cycle arrest plays an important role in the DNA damage repair, which provides enough time for repairing damaged DNA. Research on cell cycle regulation focuses on cyclin-dependent protein kinases (CDKs) and cell cycle checkpoints. In the process of DNA damage repair, phosphatidylinositol-3-kinase like kinases (PIKKs) which are recruited to the DNA damage sites can activate cell cycle checkpoint-related proteins to halt cell cycle. In the common DNA damage repair pathways, such as base excision repair (BER), nucleotide excision repair (NER) , mismatch repair (MMR) , and DNA double-strand break repair, the recruitment of repair-related proteins also plays a role in the cell cycle regulation. In this paper, the relationship between the main forms of DNA damage repair and cell cycle arrest and relevant research progress were reviewed.
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Objective:To investigate the effects of micro RNA(miR)-296-3p on cell proliferation, migration and invasion of tongue squamous cell carcinoma and its underlying mechanism.Methods:Normal oral epithelial mucosal keratinocytes HOK was used as the control. Real-time quantitative polymerase chain reaction (PCR) was used to detect the expression of miR-296-3p and nucleoprotein 1(NUPR1) mRNA in tongue squamous cell carcinoma cell lines CAL27, SCC15 and SCC9, and Western blot was used to detect the expression of NUPR1 protein. CAL27 cells were divided into NC group, miR-con group, miR-296-3p group, si-con group, si-NUPR1 group, miR-296-3p+pcDNA group and miR-296-3p+pcDNA-NUPR1 group, then CCK8 method was used to detect the cell activity. Transwell was used to detect the cell migration and invasion. Western blot was used to detect the protein expression levels of proliferating cell nuclear antigen (PCNA), matrixmetallo proteinase-2(MMP-2) and matrixmetallo proteinase-9(MMP-9). Dual-luciferase reporter assay system was implemented to verify the relationship between miR-296-3pand NUPR1.Results:Compared with the HOK cells, the content of miR-296-3p in the tongue squamous cell line CAL27, SCC15 and SCC9 groups was significantly reduced (0.54 ± 0.08, 0.38 ± 0.05, 0.59 ± 0.07 vs. 1.04 ± 0.12, t = 10.401, 15.231 , 9.718, P<0.05), while the expression levels of NUPR1mRNA (5.94 ± 0.40, 4.48 ± 0.45, 5.19 ± 0.48 vs.0.94 ± 0.12, t = 35.918, 22.803, 25.769) and protein (0.79 ± 0.09, 0.54 ± 0.05, 0.62 ± 0.08 vs. 0.28 ± 0.04, t = 15.535, 12.182, 11.404) were significantly increased (all P<0.05). Compared with those in the NC group or miR-con group, CAL27 cell activity, migration number, invasion number and the protein expression of PCNA, MMP-2 and MMP-9 in the miR-296-3p group were decreased (all P<0.05). Compared with those of the NC group or the si-con group, the CAL27 cell activity, migration number, number of invasions and the protein expression of PCNA, MMP-2 and MMP-9 in the si-NUPR1 group were decreased (all P<0.05). miR-296-3p negatively regulatedthe expression of NUPR1 in CAL27 cells. Compared with the miR-296-3p+pcDNA group, CAL27 cell viability (138.34 ± 5.73 vs. 98.54 ± 5.89, t = 14.530), migration number (95.28 ± 7.56 vs. 67.92 ± 5.23, t = 8.929), invasion number (184.53 ± 17.57 to 101.26 ± 10.64, t = 12.162) and the protein expression of PCNA (0.68 ± 0.07 to 0.35 ± 0.06, t = 10.738), MMP-2 (0.43 ± 0.05 to 0.29 ± 0.04, t = 6.559) and MMP-9 (0.58 ± 0.06 vs. 0.33 ± 0.08, t = 7.500) in the miR-296-3p+pcDNA-NUPR1 group were increased (all P<0.05). Conclusions:miR-296-3p may inhibitthe proliferation, migration and invasion of tongue squamous cell carcinoma cells by negatively regulating NUPR1.
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Objective@#To explore the relationship between sleep problems and non-suicidal self-injury behavior in Chinese college students, and to provide scientific basis for the prevention and intervention of non-suicidal self-injury behavior.@*Methods@#A cross-sectional survey of 11 689 college students from three universities in Guangzhou were selected as the research subjects. A questionnaire survey of college students’ mental health was conducted to investigate non-suicidal self-injury behavior, sleep problems, demographic information, lifestyle, and depressive symptoms.@*Results@#In the past year, the prevalence rates of non-suicidal self-injury in college students was 7.8%. Univariate Logistic analysis showed that all sleep problems were associated with non-suicidal self-injury behavior(P<0.05). After controlling for potential confounders,including grade,gender,parents’ education level,health conditon,family income,smoking,drinking and depression,multivariate Logistic regression showed that shorter sleep time at weekend (<7 h/d), insomnia symptoms and frequent nightmares significantly increased the risk of nonsuicidal selfinjury behavior in college students (OR=1.32-3.25, P<0.05), while longer sleep time at weekdays (≥9 h/d) was an important protective factor (OR=0.60, P<0.05).@*Conclusion@#These findings indicate that short sleep time, insomnia and nightmares are important risk factors for college students’ non-suicidal self-injury behavior. Intervention and management on sleep problems can effectively reduce the occurrence of self-injury behaviors.
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Objective@#To evaluate the severity of median nerve damage in patients with carpal tunnel syndrome (CTS) , and to analyze its relationship with body mass index (BMI) and wrist joint index.@*Methods@#From May 2016 to January 2017, 23 patients with mild CTS (mild group) and 35 patients with moderate to severe CTS (moderate to severe group) were enrolled in this study. And 22 healthy volunteers matched for sex and age were selected as control group. The neuroelectrophysiological monitor was used to measure the median nerve movement and sensory nerve conduction in the subjects. The BMI and wrist joint index were calculated. The relationship of neuroelectrophysiological parameters with BMI and wrist joint index was analyzed in the CTS patients.@*Results@#Compared with the control group, the mild group and the moderate to severe group had significantly higher wrist joint index, significantly longer distal motor latency (DML) of the median nerve, and significantly lower sensory nerve conduction velocity (SNCV) and sensory nerve action potential (SNAP) amplitude of the finger 1-wrist and finger 3-wrist (P<0.01) ; the moderate to severe group had significantly higher BMI and significantly lower composite muscle action potential (CMAP) amplitude (P<0.01) . The wrist joint index and BMI were positively correlated with DML of the median nerve and negatively correlated with SCV and SNAP amplitude of the finger 1-wrist and finger 3-wrist (all P<0.05) . The patients with a wrist joint index of >0.73 had a significantly higher risk of CTS than those with a wrist joint index of <0.73 (odd ratio=30.67, 95% confidence interval: 3.79-248.36) .@*Conclusion@#A wrist joint index of >0.73 is an independent risk factor for CTS in manual laborers. CTS should be prevented in the manual laborers with high wrist joint index and BMI.
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BACKGROUND@#Currently, there are many reports on the advantages of three portal video-assisted thoracic surgery (VATS) in the treatment of lung cancer, but there are few reports on the comparison between uniportal and three portal video-assisted thoracic surgery. In this study, we aimed to evaluate the recent curative effect of the postoperative short-term quality of life between uniportal and three portal video-assisted thoracic surgery for non-small cell lung cancer.@*METHODS@#We retrospectively evaluated 266 patients with NSCLC who underwent intended VATS lobectomy by a single surgical team in our ward between January 2016 and August 2017. The general clinical date, perioperative data and short-term life quality were individually compared and analyzed between the two groups.@*RESULTS@#The two groups were similar in terms of clinicopathological features, total number of dissected lymph nodes and nodal stations, postoperative complications and pulmonary complications (P>0.05). Compared with three portal VATS, the intraoperative blood loss, chest tube duration, postoperative thoracic drainage, length of stay and NRS score were significantly decreased in uniportal VATS, with significant differences (P<0.05).@*CONCLUSIONS@#As a more minimally invasive surgery, uniportal VATS can be safely and effectively performed for resectable lung cancer, which would achieve even better operation curative effect than three portal VATS.
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Aged , Female , Humans , Middle Aged , Carcinoma, Non-Small-Cell Lung , Pathology , General Surgery , Lung , Pathology , General Surgery , Lung Neoplasms , Pathology , General Surgery , Operative Time , Postoperative Complications , Quality of Life , Retrospective Studies , Thoracic Surgery, Video-Assisted , Methods , Treatment Outcomeالملخص
BACKGROUND@#Previous studies have shown that the neutrophil-to-lymphocyte ratio (NLR) has a significant impact on the prognosis of many malignant tumors such as gastric cancer, colorectal cancer and pancreatic cancer, but the study on the prognosis of patients with resectable lung adenocarcinoma is less. The aim of this study is to investigate the correlation between the NLR and the clinicopathologic features of adenocarcinoma of lung patients who underwent radical pneumonectomy. Furthermore, this study aimed to clarify the predictive and prognostic significance of NLR in patients who underwent pneumonectomy for lung adenocarcinoma.@*METHODS@#This study reviewed the medical records of 163 patients with lung adenocarcinoma who underwent pneumonectomy. The receiver operating characteristic (ROC) curve and Youden index were used to determine the cut-off value of the NLR. Survival curves were described by Kaplan-Meier method and compared by Log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors.@*RESULTS@#When the NLR value was 2.96, the Youden index was maximal, with a sensitivity of 77.5% and a specificity of 75.9%. The 5-year survival rate in the low NLR group was higher than that in the high NLR group (P<0.05). The univariate and multivariate analyses showed that TNM staging and NLR were independent factors in predicting survival rate.@*CONCLUSIONS@#The NLR value was a simple and useful tool to predict the prognosis of lung adenocarcinoma after radical pneumonectomy.
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Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma , Diagnosis , Allergy and Immunology , Pathology , General Surgery , Adenocarcinoma of Lung , Cell Count , Follow-Up Studies , Kaplan-Meier Estimate , Lung Neoplasms , Diagnosis , Allergy and Immunology , Pathology , General Surgery , Lymphocytes , Cell Biology , Neoplasm Staging , Neutrophils , Cell Biology , Pneumonectomy , Prognosis , ROC Curve , Retrospective Studiesالملخص
Objective To investigate the effect of different extraction methods on anti-inflammatory and analgesic activity of Anemone hupehensis.Methods The different abstracts were prepared from the whole herb of Anemone hupehensis.The analgesic effect was observed by adopting the mouse torsion and electric heating plate method,and the anti-inflammatory activity was comprehensively evaluated by using the mouse ear tumefaction,toe tumefaction and tampon granulation tumefaction exprements.Results Compared with the blank model group,the anti-inflammatory action difference of low dose in the water layer parts of mouse ear tumefaction,toe tumefaction and tampon granulation tumefaction had no statistical significance(P>0.05),and the extracting parts of rest doses all had significant anti-inflammatory and analgesic effect (P<0.05).Ethyl acetate part had strongest activity in the electric heating plate experiment.N-butanol part had strongest activity in the ear tumefaction,toe tumefaction,tampon granulation tumefaction experiments and torsion method.Conclusion The whole herb of Anemone hupehensis has prominent anti-inflammatory and analgesic effect,and the ethyl acetate part E and N-butanol part are main effective parts.
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Objective To investigate the effects of Olaparib on cell proliferation and radiosensitization of human non-small cell lung cancer cells.Methods Non-small cell lung H460 and H1299 cell lines were cultured in vitro and the cells in logarithmic growth phase were selected for experiments.MTT and colony formation assays were used to determine cell proliferation and radiosensitization,respectively.Single cell gel electrophoresis assay (comet assay) was used to detect irradiation-induced DNA damage.Results The results of MTT assay showed that Olaparib inhibited the proliferation of H460 and H1299 cells in a dose-dependent pattern (all P<0.05).H1299 cell line was more sensitive to Olaparib than H460 cells.The results of colony formation assay showed that Olaparib enhanced the radiosensitizition of H460 and H1299 cells (all P<0.05).The results of comet assay showed that Olaparib increased γ ray-induced DNA damage.Conclusions Olapani can enhance the radiosensitization of human non-small cell lung cancer cells,and the radiosensitization effect of Olaparib may be associated with the inhibition of cell proliferation and induction of irradiation-induced DNA damage.
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Objective To observe the impact of minimally invasive Sweet esophagectomy on short term quality of life for patients with Siewert typeⅡesophagogastric junction adenocarcinoma.Methods From January 2015 to September 2017, 60 patients underwent minimally invasive Sweet esophagectomy(MISE group) and 60 patients underwent open sweet esophagecto-my(OSE group).The questionnaires(EORTC QLQ-C30 and QLQ-OES18) were applied to assess the quality of life of the pa-tients before and 1,2,4,8 weeks after operation.The clinicopathologic factors, operational factors and postoperative complica-tions of the two groups were compared by t test and χ2test.The Mann-Whitney test was used to test for statistical significance because the responses were not normally distributed.Results The two groups were similar in terms of clinical characteristics and preoperative QOL scores(P >0.05).The MISE group was associated with a significant decrease in surgical blood loss [(88.1 ±32.2)ml vs.(119.5 ±34.1)ml, t=5.052, P=0.001], chest tube duration[(8.1 ±4.4)d vs.(10.5 ±4.0)d, t=3.110, P=0.002] and postoperative stay[(9.1 ±4.6)d vs.(11.6 ±3.8)d, t=3.167, P=0.002] relative to the OSE group.The postoperative in-hospital mortality and total morbidity did not differ between the two groups (P>0.05).The MISE group was associated with significantly fewer respiratory complications than the OSE group (8.5%vs.22.7%, t=4.063, P= 0.044).The MISE group was associated with a significant increase in hospitalization costs [(54 106 ±4 352) yuan vs. (51 143 ±5 315)yuan, P=0.001] relative to the OSE group.MISE group gained higher scores in physical function, role func-tion, emotional function, Global QOL and lower scores in pain, fatigue, acid reflux than OSE group after surgery.Conclusion Our minimally invasive technique for Siewert typeⅡesophagogastric junction adenocarcinoma can be safely and effectively performed with favorable early outcomes.Compared to conventional open Sweet approach, MISE impoved the short term quality of life after surgery.
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Objective To investigate the correlation between the prognostic nutritional index(PNI) and the clinicopathologic features of patients with non-small cell lung cancer(NSCLC),and to compare postoperative complications and survival between patients with High-PNI(H-PNI) and Low-PNI(L-PNI) after operation.Methods This study retrospectively reviewed and analyzed the medical records of 216 patients underwent surgery between July 2010 and December 2011 who were pathologically dignosed with NSCLC.Among these,127 patients with H-PNI,and 89 patients with L-PNI.The clinicopathologic features,median survival time and 5-year survival rates between two groups were analyzed.Results Patients in the L-PNI group had greater pathologic TNM stage,larger tumors,lower Serum albumin levels,and greater percentage of chemotherapy than those in the H-PNI group(P < 0.05).The H-PNI group was associated with significantly fewer postoperative complications than the L-PNI group (P < 0.05).For the patients with H-PNI,the MST was 61.6 months an the 1-,3-,and 5-year OS were 91.3 %,80.1%,and 74.1%,respectively.For the patients with L-PNI,the MST was 49.9 months and the 1-,3-,and 5-year OS were 82.0%,63.5%,and 53.5%,respectively.There was significant difference in survival between the two groups(P < 0.05).TNM staging and PNI were showed to be independent prognostic factors.Conclusion Different PNI of NSCLC has certain heterogeneity.Patients with H-PNI show better survival and lower postoperative complications rate than those with L-PNI.
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Objective To discuss the curative effect of double targets percutaneous radiotfrequency thermocoagulation (PRT) on primary trigeminal neuralgia (PTN) and its safety.Methods Sixty patients with PTN were randomly divided into single target treatment group and double targets treatment group.CT guided stereotactic location was used to navigate PRT;patients in the single target treatment group only accepted one target damage and those in the double targets treatment group accepted target damage with 3 mm of deep and shallow interval.The curative effects and complications were compared one week,3 months,one and 2 years after the surgery.Results The percentage of patients with good curative effect in double targets treatment group was significantly higher than that in single target treatment group one and 2 years after surgery,with statistically significant difference (86.7% vs.60%,70% vs.45%,P<0.05).Recurrence rates of double targets treatment group 3 months,one and 2 years after surgery were 0%,3.3% and 6.7%,which were lower than those in single target treatment group (3.3%,10% and 16.7%),without significant difference (P>0.05).Ipsilateralfacial hypaesthesia of different degrees appeared in both groups,but complications as keratohelcosis,diplopia,chewing weakness or difficulty in opening mouth did not appear.And the degree of facial numbness in double targets treatment group was a little higher than that in single target treatment group without statistical significance (P>0.05).Conclusion Double targets PRT used in PTN treatment can obviously improve the postoperative pain relief and do not apparently increase the degree of postoperative facial numbness as compared with single target PRT.
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As a nuclear transcription factor , nuclear factor E2-related factor 2 (Nrf2) protein plays an important role in regulating intracellular redox balance and cellular resistance to various stresses. Oxidative stress and ionization stress can cause Nrf2 to translocate from cytoplasm to nucleus. Then the Nrf2 binds to antioxidant response elements to regulate the transcription of antioxidant genes such as NQO1 and HO-1 and play the anti-oxidant protective effect. In recent years, the results show that many cancer cells, including lung cancer, involve Nrf2 overexpression, and there is a connection between Nrf2 protein levels and the occurrence, development, chemoradiotherapy resistance as well as the patient prognosis of lung cancer. The excessive Nrf2 protein levels in lung cancer cells, caused by the mutation of Nrf2 or its inhibitory protein Keap1, can promote the proliferation and migration of lung cancer cells, leading to chemoradiotherapy resistance and poor prognosis. The structure, function and regulation of Nrf2 were summarized, and the research progress on the mechanism of Nrf2 in the occurrence, development and treatment of lung cancer were reviewed.
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Objective To use nerve conduction study (NCS) to evaluate the function of large fibers,skin sympathetic response (SSR) and contact heat evoked potential (CHEP) to evaluate the function of small fibers in patients with impaired glucose regulation (IGR),and to analyze the occurrence of peripheral neuropathy and damage characteristics.Methods According to the classification criteria of glucose metabolism proposed by WHO in 2006,we selected 120 patients with IGR from January 2015 to December 2016 in our hospital,including 37 impaired fasting glucose (IFG) patients,83 impaired glucose tolerance (IGT) patients,and 60 normal subjects served as control group.All subjects received median,ulnar,tibial,peroneal,sural NCS,SSR and CHEP using the Keypoint.net (Medoc Ltd) electromyogram device.IGR patients were evaluated using the Michigan Neuropathy Screening Instrument (MNSI).Results The abnormal rate of MNSI score in IGR patients was 18.3% (22/120);the abnormal rate of NCS was 22.5% (27/120),and the abnormal rate of SSR was 39.2% (47/120).In IFG group,the abovementioned abnormal rates were 8.1% (3/37),13.5% (5/37),29.7% (11/37) respectively,and 22.9% (19/83),26.5% (22/83),43.4% (36/83) in IGT group.Compared with control group,the tibial,sural nerve sensory nerve action potential amplitude decreased in IGT group (1.3 (0.1,1.9) μV vs 1.4(1.1,3.2) μV,Z=-3.05,P=0.002;(10.5±2.0)μV vs (7.6 ± 1.9)μV,t=0.60,P=0.001);and there was no significant difference between IFG patients and control group.Compared with control group,IFG patients' SSR amplitude reduced in lower limbs (0.7 (0.4,0.8) mV vs 0.8 (0.6,1.0) mV,Z =-2.95,P =0.003),CHEP amplitude decreased in dorsum hand and peroneal area stimuli ((63.0 ±10.0)μV vs(52.4 ±15.3)μV,t=0.61,P=0.003;(44.7 ±12.5)μV vs (28.2 ± 10.6)μV,t=0.31,P =0.000);and in IGR group,SSR amplitude reduced in upper and lower limbs (1.1 (0.5,2.2) mV vs 1.3(0.7,2.6)mV,Z=-2.12,P=0.030;0.4(0.2,0.8)mV vs 0.8(0.6,1.0) mV,Z=-5.96,P=0.000),CHEP amplitude decreased in dorsum hand and peroneal area stimuli ((63.0 ± 10.0) μV vs (38.7± 13.5)μV,t =0.37,P=0.000;(44.7 ±12.5)μV vs(21.9 ± 13.6)μV,t =0.35,P=0.000).Conclusions There is peripheral neuropathy in IGR patients,and the incidence of neuropathy in patients with IGT is higher than those with IFG.Neurophysiological methods are earlier than clinical scores to detect neuropathy.There are only small fiber damages in IFG patients,and IGT patients present by large and small fibrous lesions,mainly in small fibers and lower sensory nerve fibers,characterized by axonal damage and length dependence.
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BACKGROUND: Anterior cervical decompression and fusion has been widely used in the treatment of multi-level cervical spondylotic myelopathy, but accompanied with lots of complications.OBJECTIVE: To investigate the efficacy of zero-profile interboby fixation system for multi-level cervical spondylotic myelopathy.METHODS: Seventy-one patients with multi-level cervical spondylotic myelopathy were randomly divided into two groups, and the patients in group A accepted zero-profile interboby fixation system, and group B accepted cage interboby fixation system. The Japanese Orthopaedic Association score, fusion rate, as well as the incidence of dysphagia and esophageal fistula were detected to compare the efficacy between two groups.RESULTS AND CONCLUSION: (1) All cases were followed-up for 3-34 months, average of 17.5 months. The excellent and good rate at the last follow-up showed no significant difference between two groups. (2) The final fusion rate did not differ significantly between two groups, but the fusion rate in the group A was significantly higher than that in the group B at 6 and 9 months postoperatively (P < 0.05). (3) There was one patient with mild dysphagia in the group A (3%), three mild, five medium, and two severe dysphagia in the group B (29%), which showed significant difference between two groups (P < 0.05). No internal fixation loosening occurred in the group A, but three cases in the group B. The blood loss, operation time and radiology times in the group A were significantly lower than those in the group B (P < 0.05). (4) These results suggest that the effect of these two surgical methods in promoting functional recovery of spinal cord and final fusion rate show no significant differences; however, the zero-profile interboby fixation system exhibits better postoperative stability and interim fusion rate, with lower incidence of dysphagia.
الملخص
Objective To explore the efficacy of sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy and the factors associated with the prognosis.Methods 106 cases with esophageal varices in control group was treated with drugs alone;study group had 113 cases, was given endoscopic therapy add drugs, The study group randomly divided into two groups, one was treated with endoscopic variceal ligation all the time (EVL group), another was treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy (sequential group). After the treatment, the rate of removal of varicose veins, the rate of rebleeding, the number of total treatment,mortality and intra-operative complications and postoperative complications were compared. And compared rebleeding rate and mortality with the control group and study groups with different CTP and MELD, analyze the factors of prognosis, and evaluate their prognostic value.Results Rebleeding, rate in control group, EVL group and sequential group were 41.51%,10.53% and 10.64%,sequential group was significantly better than control group (P = 0.000); mortality in control group, EVL group and sequential group were 15.09%, 5.26% and 2.13%, sequential group was also significantly better than control group (P = 0.001); rate of recurrence in EVL group and sequential group within half a year were 73.68% and 44.68%, sequential group was significantly better than EVL group (P = 0.021). In all control group and EVL group and the sequential group, rebleeding rate and mortality of the liver function Child-Turcotte-Pugh (CTP) class C was significantly higher than that of calss A; In MELD model, AUC area under the ROC curve of rebleeding rate in control group and sequential group were 0.944 and 0.851, mortality of the two groups were 0.881 and 0.984, while the rate of recurrence in the EVL group and sequential group were respectively 0.914 and 0.765, the MELD score has the important value to the prediction of rebleeding and death.Conclusion The rebleeding rate and mortality in cirrhotic patients with esophageal varices treated with sequential endoscopic variceal ligation plus endoscopic variceal sclerotheropy were significantly decreased and the recurrence rate was lower than that of the patients with endoscopic variceal ligation all the time. Liver function Child-Turcotte-Pugh (CTP) score and the MELD score have important value in prediction of rebleeding and death, ligation and sclerosing sequential therapy can significantly reduced rebleeding and mortality in CTP class B and C, and improve the MELD threshold of rebleeding and death.