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Objective To explore the efficacy and safety of perforator flap eyelid reconstruction surgery for eyelid repair and reconstruction in patients with eyelid tumors after surgery.Methods Totally 80 patients(80 eyes)who re-ceived eyelid tumor surgery and planned to undergo the perforator flap eyelid reconstruction surgery in our hospital from January 2012 to December 2022 were included.All of them have early-stage and mid-stage eyelid tumors with no orbital or systemic metastasis.A perforator flap eyelid reconstruction surgery was conducted to treat the eyelid defects.The differ-ence in height and length of the palpebral fissure,aesthetic function scores and levels of depression and anxiety of patients before and after repair were compared;the clinical efficacy,adverse reactions and prognosis of patients were evaluated.Results Among the 80 eyes,there were 35 eyes with significant effect,35 eyes with effective impact,and 10 eyes with no effect,with a total effective rate of 87.5％.The height and length of palpebral fissure of patients after repair were(1.49±0.47)mm and(1.43±0.55)mm,respectively,which were significantly lower than those before repair[(2.55± 0.35)mm and(2.38±0.49)mm](both P＜0.01).The aesthetic function score before repair was 0.91±0.23,and that after repair was 1.87±0.19,with a significant difference(P＜0.01).The scores of the Self-rating Anxiety Scale and Self-rating Depression Scale after repair were 40.14±6.54 and 39.45±7.65,respectively,which were significantly lower than those before repair(59.56±8.23 and 57.93±8.19)(both P＜0.01).Among the 80 patients,the total incidence of compli-cations was 27.5％(22/80).All patients were followed up for 6-36 months,with an average follow-up time of(12.39± 6.17)months.No tumor recurrence was found during the follow-up.All composite flaps survived without infection,necro-sis or displacement.Conclusion The perforator flap eyelid reconstruction surgery has a good and safe therapeutic effect on repairing full-layer eyelid defects in patients who underwent eyelid tumor surgery.
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Objective:To investigate the value of three-dimensional reconstruction combined with serum carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) detection in the diagnosis and resectability evaluation of hilar cholangiocarcinoma (HCCA) before resectable lymph node metastasis.Methods:A total of 65 patients with suspected HCCA who were treated at Yiwu Central Hospital from June 2019 to June 2022 were included in the observation group. Thirty healthy people who concurrently underwent physical examinations in the same hospital were included in the control group. All participants underwent a CT three-dimensional reconstruction examination. Simultaneously, the automatic electrochemiluminescence immunoassay analyzer was used to measure serum levels of CA19-9 and CEA. The outcomes of percutaneous transhepatic cholangiography were used as the "gold standard". The consistency between CT three-dimensional reconstruction, CA19-9 detection, and CEA detection, either individually or combined, and the "gold standard" in the diagnosis of HCCA was evaluated.Results:Serum levels of CA19-9 and CEA in the observation group were (62.71 ± 10.63) U/mL and (62.71 ± 10.63) ng/mL, respectively, which were significantly higher than those in the control group [(12.37 ± 7.39) U/mL, (1.31 ± 0.97) ng/mL, t = 23.43, 11.59, both P < 0.05). The levels of CA19-9 [(71.69 ± 12.37) U/mL] and CEA [(8.89 ± 3.51) ng/mL] in patients with HCCA who had lymph node metastasis were significantly higher than those in patients with HCCA who had no lymph node metastasis [CA19-9 (56.78 ± 10.16) U/mL, CEA (6.45 ± 2.11) ng/mL, t = 4.14, 2.76, both P < 0.05].Compared with histopathological examination, the accuracy of CT three-dimensional reconstruction in typing was 85.00%. According to the "gold standard" diagnosis, CT three-dimensional reconstruction, CA19-9 detection, and CEA detection, alone and their combination, successfully detected HCCA in 22 cases (55.00%), 26 cases (65.00%), 31 cases (77.50%), and 38 cases (95.00%), respectively. The detection rate of HCCA was the highest when CT three-dimensional reconstruction, CA19-9 detection, and CEA detection were combined, and the difference was statistically significant ( χ2 = 18.15, P < 0.05). Compared with CT three-dimensional reconstruction (AUC: 0.808), CA19-9 detection (AUC: 0.721), and CEA detection (AUC: 0.703) individually, their combination (AUC: 0.913) had the highest value in the diagnosis of HCCA (all P < 0.05). Conclusion:CT three-dimensional reconstruction, CA19-9 detection, and CEA detection have a certain diagnostic value for HCCA, but the combination of CT three-dimensional reconstruction with the detection of serum levels of CA19-9 and CEA has a higher diagnostic value for HCCA, providing an effective reference for the preoperative evaluation of the resectability of HCCA in the clinic.
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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 investigate abnormal spinal curvature among primary and secondary school students in Sichuan Province, so as to provide evidence for scientific prevention.@*Methods@#Using a stratified cluster random sampling method, a total of 210 713 students of grade 4 to grade 12 from 21 cities (prefectures) in Sichuan Province were selected for spinal curvature screening and questionnaire survey from September to November 2022. Chi-square test and multivariate Logistic regression model were used to analyze the influencing factors of abnormal spinal curvature.@*Results@#The detection rate of abnormal spinal curvature was 3.42%, with urban areas (4.54%) higher than that in suburban areas(2.57%), girls (3.86%) higher than that in boys(2.98%), high school students (4.70%) higher than that in middle school students (3.80%) and elementary school students(2.21%), the differences were statistically significant ( χ 2=606.96, 123.81, 645.24, P <0.01). Multivariate Logistic regression analysis showed that urban area, junior and senior high school, girl, carrying backpack on one shoulder, desks and chairs adjusted for student height less than ≤1 time every school year, moderate-to-vigorous physical activity less than 1 h per week, and indoors sedentary time more than 10 h/d were positively associated with abnormal spinal curvature ( OR=1.72, 1.75, 1.87, 1.26, 1.09, 1.07, 1.10, 1.25 , P <0.05).@*Conclusion@#The detection rate of abnormal spinal curvature of primary and secondary school students may be affected by the urbanicity, educational stage as well as gender in Sichuan Province. More attention should be paid to urban high school girls, and targeted strategies should be explored to reduce the incidence of abnormal spinal curvature.
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Objective:To investigate the genetic risk factors and prognosis of 190 patients with myelodysplastic syndrome(MDS). Methods:The clinical data of 190 patients with MDS admitted to the Department of Hematology,The First Affiliated Hospital of Chongqing Medical University from January 2015 to October 2020 were analyzed retrospectively,and the genetic background and survival curve of the patients were also analyzed. Results:MDS patients with higher risk according to International Prognostic Score System(IPSS)stratification at the time of initial diagnosis had more frequent and complex types of gene mutation and chromosomal abnormalities,indicating poor prognosis.The choice of treatment is associated with the prognosis of MDS patients with intermediate risk(IPSS stratification),and the relative risk of the overall survival rate of patients treated with hypomethylating agents is higher than that of patients on concomitant medication. Conclusion:MDS patients with higher-risk(IPSS stratification)have more complex genetic risk factors and lower survival rate than those with lower-risk(IPSS stratification).MDS patients with multiple genetic risk factors have a poor prognosis,and the type of gene mutation is a predictor of prognosis.
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Objective To investigate the relationship between the treatment of EGFR-TKI icotinib and the prognosis of advanced lung adenocarcinoma patients with EGFR mutation. Methods Patients with advanced lung adenocarcinoma who had EGFR19 and 21 gene mutations and were treated with EGFR-TKI icotinib were enrolled. The relationships of clinical features, EGFR gene mutation subtypes, and different sites with patients'prognosis were analyzed. Results A total of 101 patients with advanced lung adenocarcinoma were included in this study, including 58 cases (57.4%) of EGFR gene exon 19 deletion mutation (EGFR Del19) and 43 cases (42.6%) of EGFR gene exon 21 point mutation (EGFR L858R). The objective response rate was 63.4%. The mPFS and mOS were 13 months and 27 months, respectively. In addition, the mPFS and mOS of EGFR Del19 and EGFR19 mutation 746-750 were higher than those of EGFR L858R and other EGFR mutations, respectively. Meanwhile, multivariate analysis showed that the number of metastatic sites and pleural metastasis were independent influencing factors of patients'OS (P=0.027; P=0.041). The mOS of patients with the number of metastatic sites ≤3 and without pleural metastasis were 29 and 27 months, respectively. Conclusion There is no significant difference found in overall survival of advanced lung adenocarcinoma patients treated with icotinib among different EGFR mutation subtypes and sites. Herein, the overall survival time is longer in patients with less than three metastatic sites and without pleural metastasis.
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Objective:To explore the clinical characteristics and influencing factors of hematologic disease patients with chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and their effects on the prognosis of patients.Methods:The clinical data of 225 hematologic disease patients who underwent allo-HSCT from January 2014 to February 2021 in the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. The efficacy of allo-HSCT, post-transplantation infection, as well as the incidence of cGVHD and its related factors, and its effect on the overall survival (OS) rate, disease-free survival (DFS) rate, cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) rate of patients according to Seattle diagnostic criteria and National Institutes of Health (NIH) diagnostic criteria were analyzed.Results:All 225 hematologic disease patients had hematopoietic reconstruction after allo-HSCT. Among the 225 patients, 156 patients (69.33%) had early infection (207 times), and 92 patients (40.89%) had late infection (107 times). According to the Seattle diagnostic criteria, 58 patients developed cGVHD (111 times), with a cumulative incidence of 39.5%. The involved organs included skin (33 times), liver (32 times), eyes (19 times), lung (11 times), oral cavity (10 times), intestine (4 times) and hematological system (twice). Multivariate Cox regression analysis showed that acute graft-versus-host disease (aGVHD) was an independent influencing factor for cGVHD ( HR= 3.706, 95% CI 2.025-6.783, P<0.001). Compared to patients without cGVHD, patients with cGVHD had lower 5-year CIR (4.0% vs. 21.8%, P= 0.010) and higher 5-year NRM rate (25.5% vs. 11.8%, P= 0.029), while 5-year OS rate (72.5% vs. 73.6%, P= 0.908) and DFS rate (64.6% vs. 65.9%, P= 0.670) between the two groups had no statistical difference. Compared to patients with limited cGVHD, patients with extensive cGVHD had lower 5-year OS rate (56.0% vs. 83.9%, P= 0.035), lower 5-year DFS rate (52.0% vs. 73.4%, P = 0.038) and higher 5-year NRM rate (43.0% vs. 13.0%, P = 0.018). More erythrocyte suspension infusion during the transplantation was an independent influencing factor for early infection ( P = 0.011). Blood type incompatibility between donor and recipient ( P = 0.017), limited cGVHD ( P = 0.039) and extensive cGVHD ( P = 0.003) were independent influencing factors for late infection. According to the NIH diagnostic criteria, 5 patients (8.62%) who developed cGVHD after 100 days of transplantation were reclassified as aGVHD, and 12 patients (20.69%) were reclassified as overlap syndrome. The cumulative incidence of cGVHD was 36.4%, and aGVHD was the only independent influencing factor for cGVHD ( P<0.001). Compared to patients without cGVHD, patients with cGVHD had lower 5-year CIR (6.7% vs.21.7%, P = 0.006) and higher 5-year NRM rate (26.1% vs. 12.0%, P = 0.035), while 5-year OS rate (73.7% vs. 73.2%, P = 0.845) and DFS rate (64.9% vs. 65.7%, P = 0.522) between the two groups had no statistical difference. Conclusions:The incidence of cGVHD after allo-HSCT in hematologic disease patients is high, and there are many organs involved. cGVHD can reduce the relapse rate of patients, but severe cGVHD increases the mortality of patients. aGVHD is the only independent influencing factor for cGVHD.
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Objective:To explore the application effect of problem-based learning (PBL) combined with evidence-based medicine (EBM) teaching in clinical practice of hematology department.Methods:The 68 medical students practicing in the hematology department from July 15 to November 8, 2019 were set as the experimental group, and 65 medical students from December 29, 2018 to June 28, 2019 were set as the control group. Patients with pancytopenia were selected in the first week of admission for PBL combined with EBM teaching practice in the experimental group, but in the control group, these students did not take this practice. Theoretical knowledge, case analysis and assessment, were conducted before the students leaving the department. SPSS 22.0 was used for t test. Results:Compared with the control group, the scores of theoretical knowledge and case analysis of medical students in the experimental group were improved to a certain extent, with statistical significance ( P = 0.001, P < 0.001). And the higher the score of teaching practice, the higher the score of theoretical knowledge and case analysis ( P < 0.001). Conclusion:PBL combined with EBM teaching practice can effectively improve students' learning enthusiasm and initiative, also can enhance their clinical thinking ability, then can help improve the teaching quality of the hematology.
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Objective:To evaluate the diagnostic efficiency and safety of endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA)in lymph node staging of non-small cell lung cancer(NSCLC)in elderly patients.Methods:Thirty-five patients aged ≥70 years and 58 patients aged 60-69 years with NSCLC receiving EBUS-TBNA in our hospital from March 2015 to December 2018 were enrolled.All patients underwent EBUS for all visible mediastinal and hilar lymph nodes, and those with enlarged lymph nodes(short axis ≥6 mm)were further examined with TBNA.The diagnostic efficiency and safety of EBUS-TBNA were analyzed.Results:The sensitivity of EBUS-TBNA was 0.94, the specificity was 1.00, the Yoden index was 0.94, the positive predictive value was 1.00, and the negative predictive value was 0.82.Tumor staging was changed in 20 patients after EBU-TBNA, resulting in changes in assessment on tumor resectability in 5 cases.EBUS-TBNA had excellent agreement with postoperative pathology in evaluating resectability(Kappa=0.95). The sensitivity and specificity were 1.00 and 0.97, respectively.The incidence of complications of EBUS-TNBA was 6.5%.The elderly group had a worse performance status( P<0.05)compared with the control group, but the complication rates(5.7% vs 6.9%, P>0.05)were similar between the two groups. Conclusions:EBUS-TBNA is highly effective and safe in the diagnosis of NSCLC in patients aged 70 and older.
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Objective To analyze the brucellosis epidemic and genotyping characteristics of Brucella strains isolated from Hebei Province,and to provide scientific basis for brucellosis control and prevention.Methods Descriptive epidemiological analysis (including region,population,and time distribution characteristics) was performed using individual data of human brucellosis in Hebei Province from the National Notifiable Infectious Disease Reporting Information System of China Information System for Disease Control and Prevention in 2016,Brucella strains were isolated by phase culture bottles in Brucellosis Lab from Hebei Provincial Center for Disease Control and Prevention.Multiple-locus variable-number tandem-repeat analysis (MLVA) was used to identify the genotyping characteristics of the isolates.Results There were 3 774 reported cases in 2016,and 11 cities in the province had reported the cases.The cases were found mainly in Zhangjiakou,Chengde and Tangshan.And 95.98％ (167/174) of all counties were reported brucellosis cases.Vocational high risk population was farmers and herdsmen engaged in livestock and processing of animal products,accounting for 90.22％ (3 405/3 774).Male had the highest incidence,accounting for 74.38％ (2 807/3 774).The onset time was concentrated in January-August,accounting for 83.67％ (3 161/3 774).Twenty-one strains of Brucella were isolated,twenty isolates were Brucella melitensis biovar 3,and one isolate was Brucella abortus biovar 3.Panel 1 (MLVA-8) identified three genotypes 42,43,and 114,with genotype 42 representing 85.00％ (17/20);Panel 1 + Panel 2A (MLVA-11) identified three genotypes 116,122,291,with genotype 116 representing 85.00％ (17/20),which were identified as belonging to the East Mediterranean group.Panel 1 (MLVA-8) identified the genotype 36,Panel 1 + Panel 2A (MLVA-11) identified the genotype 72 of one Brucella abortus strain.It was identified as belonging to abortus C.Conclusions The brucellosis epidemic in Hebei is relatively severe,the pathogenic bacteria is mainly Brucella melitensis.The MLVA assay is a very practical and important molecular genotyping tool,it provides a basis for tracing the source of brucellosis infection.
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α-Amino acid ester acyltransferase (Aet) catalyzes the L-alanyl-L-glutamine forming reaction from L-alaine methylester hydrochloride and L-glutamine. In this study, the recombinant Escherichia coli saet-QC01 was used to express the α-amino acid acyltransferase, and its expression conditions were optimized. The recombinant protein was separated and purified by Ni-NTA affinity chromatography, and its enzymatic properties and catalytic applications were studied. The induction conditions suitable for enzyme production optimized were as follows: The temperature was 20 ℃, the induction stage (OD₆₀₀=2.0-2.5), IPTG concentration was 0.6 mmol/L, induction time was 12 h. The optimal reaction conditions of α-amino acid acyltransferase were 27 ℃, pH 8.5, it was most stable between pH 7.0 and 8.0 and relatively stable in an acidic environment, and low concentration of Co²⁺ or EDTA could promote the enzyme activity. Under optimal reaction conditions, 600 mmol/L of L-alaine methylester hydrochloride and 480 mmol/L of L-glutamine, the yield of L-alanyl-L-glutamine reached 78.2 g/L and productivity of 1.955 g/L/min, the conversion rate reached 75.0%. α-Amino acid ester acyltransferase has excellent acid-basei resistance, high catalytic efficiency. These characteristics suggest its application prospects in the industrial production.
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Objective To investigate the protective effect of gastrodin (Gas) on the hepatic ischemia-reperfusion injury (HIRI) in mice,and study possible mechanisms.Methods Forty male C57BL/6 mice were randomly divided into sham-operated group (Sham),HIRI group,gastrodin-treated groups with low and high does (Gas-L,Gas-H,respectively),and cobalt protoporphyrin(CoPP) group(n =8).Mice in Gas-L,Gas-H,and CoPP groups were injected intraperitoneally with individual drugs and dose before operation.Except for Sham group,an 70％ volume HIRI model was established by means of 60 minutes ischemia and then 6 hours reperfusion in the other groups.The levels of serum AST and ALT in each group were compared.The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in the liver tissue were measured;The level of TNF-αt,IL-6,IL-10 and heme oxygenase-I (HO-1) mRNA level were detected by real time quantitative PCR.Liver tissue was stained with H&E.The hepatocyte apoptosis was studied by TUNEL.Results Respectively,the serum ALT level in the HIRI,Gas-L,Gas-H and CoPP groups was (5 057.34±290.80)U/L,(3 917.49±198.10) U/L,(3 645.63± 171.10) U/L,(2 977.78± 179.00) U/L,and the ALT level was (5 871.25 ± 819.01) U/L,(4 660.88 ± 505.96) U/L,(4 182.00 ± 507.51) U/L,(3 788.65±462.14)U/L.The serum level of ALT and AST in Gas-L,Gas-H and CoPP groups was lower than HIRI group (P＜ 0.05).The apoptotic index in Gas-L,Gas-H and CoPP groups respectively was (37.89±4.27)％,(32.59±3.78)％,(20.45-±2.49)％,which was lower than group (58.92±3.32)％ (P＜ 0.05).Compared with HIRI group,the TNF-α and IL-6 mRNA level in Gas-L,Gas-H and CoPP groups were decreased,and the levels of IL-10 and HO-1 mRNA were increased.Simultaneously,the activity of SOD was promoted,whereas the levels of MDA was reduced (P＜0.05).Conclusions Gastrodin shows an protective function aganist liver ischemia-reperfusion injury in mice by inhibiting inflammation,oxidative stress and cell apoptosis.The up-regulation of HO-1 by gastrodin may be the possible mechanism.
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Objective To evaluate the short-term and long-term outcomes of laparoscopic splenectomy combined with eradication of Helicobacter pylori (HP) in patients with idiopathic thrombocytopenic purpura (ITP).Methods 72 patients with ITP were divided into three groups:the eradication of Hp group (group A),the untreated or failure group (group B),and the Hp-negative group (group C).Results Hppositive Patients (group A and group B) were significantly shorter in the course of disease before splenectomy (26.7± 13.8 months vs.45.2±22.1 months,P＜0.05),and lower in platelet counts peak within 7 days after splenectomy (134.9±53.9) × 109/L vs.(250.9± 160.5) × 109/L,P＜0.05) than Hp-negative patients.After discharge from hospital,in 28 patients who received infection therapy against Hp by taking amoxicillin,CLA,omeprazole for one month,21 (75.0％) patients had the Hp eradicated,but in 7 patients the eradication failed.The PLT between these 2 groups of patients were (189.6± 114.8)× 109/L vs.(124.0±45.7) × 109/L,(P＜0.05).The long-term outcomes in platelet counts and remission rates after spleuectomy of the three groups of patients were (149.7±90.6) × 109/L,76.1％ (group A);(98.5±64.1) × 109/L,66.6％(group B);(172.4± 102.0)× 109/L,80.0％ (group C).The platelet count in group B was significantly lower than group C (P＜0.05).There was no statistical significance between group A and group C (P＞0.05).There was no significant difference in the remission rates in the three groups.Conclusions Eradication of Hp improved the short-term and long-term outcomes of Hp-positive ITP patients after splenectomy.
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Objective To study the role of capsaicin on improving the sensitivity of cholangiocarcinoma (CCA) cells to 5 fluorouracil(5-FU)and to investigate its molecular mechanism.Methods The MTT and animal experiment were performed to study the effect of capsaicin on the sensitivity of CCA cells to 5-FU,and the q-PCR and Western blot were performed to study its molecular mechanism.Results The effect of 5-FU inhibiting the growth of CCA cells and in vivo was significantly enhanced by capsaicin (60 μmol/L),as well as the apoptosis induced by 5-FU (P ＜ 0.01).In molecular mechanism study,capsaicin down-regulated the expression of beclinl and atg5,but inhibited the 5-FU-induced autophagy of CCA cells.In addition,capsaicin effectively increased the phosphorylation levels of S6 (S235/236) and AKT (S473).Conclusions Capsaicin can promote cell apopto sis and inhibit cell autophagy to improve the sensitivity of CCA cells to 5-FU significantly,which maybe associated with the activation of PI3K/AKT/mTOR pathway in CCA cells.
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Objective To retrospectively analyze the influence factors during autologous peripheral blood stem cell (PBSC) mobilization and collection process in the patients with non-Hodgkin′s lymphoma (NHL).Methods Forty-eight patients with NHL in our hospital from January 2014 to August 2016 underwent PBPC mobilization and collection.The factors of age,sex,disease stage,bone marrow involvement at diagnosis,chemotherapy frequency,relapse and so on were analyzed retrospectively.Results PBSC mobilization and collection was successful in 37 cases (77.10%).The success rate was affected by the time from diagnosis to mobilization (P=0.038),chemotherapy courses (P=0.016),prior chemotherapy including fludarabine (P=0.049),relapse(P=0.033),and the levels of white blood cell (P=0.014) and platelet (P<0.01) before stem cells collection.Conclusion For the patients planning to receive autologous peripheral blood stem cell transplantation,many times of prior chemotherapy are unfavorable,mobilization and collection should be taken as early as possible,chemotherapeutic agents which possibly injure stem cells should be avoided,it is needed to simultaneously pay attention to peripheral blood WBC and platelet level for determining the collection timing.
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Objective To evaluate the diagnostic value of MSCT in the differentiation of thymic epithelial tumours (TET)with the maximum diameter equal or less than 3 cm.Methods A retrospective analysis of pathological and imaging data of 56 patients with pathologically confirmed TET with the maximum diameter equal or less than 3 cm was performed.According to the 2004 WHO classification,56 TETs were classified as low-risk thymomas(types A/AB/B1),high-risk thymomas (types B2/B3)and thymic carcinomas (type C).The CT manifestations of TET in each group,including shape of tumor,tumor edge (smooth or spiculate protuberance), presence of small nodule around tumor,enhancement degree,pleura invasion and fat space around tumor,were analyzed retrospectively.The differences in the CT manifestations among three types were compared using chi-square test.If the sample number was too small, Fisher 's exact test was used.Results Compared with high-risk thymomas (23 cases)and thymic carcinomas (6 cases),regular round shape was more often observed in low-risk thymomas (27 cases)(χ2 =73,P <0.001;χ2 =116,P <0.001)and the mediastinum-lung interface was more likely to bulge (χ2 = 3.41,P =0.046;χ2 =7.39,P =0.01).Blurred edge,spiculate protuberance and pleural invasion and so on were significantly more common in high-risk thymomas and thymic carcinomas (P <0.001)and they were the most common in thymic carcinomas (χ2 =11.5,P =0.009).There was a significant difference between type B2 thymomas and thymic carcinomas (χ2 =31.52, P <0.001),however there was no significant difference between type B3 thymomas and thymic carcinomas (χ2 =6.96,P =0.07). Conclusion MSCT can accurately show the shape of tumor,tumor edge,presence of small nodule around tumor,enhancement degree,pleura invasion,which can predict the histologic type of thymomas and also can provide information for preoperative diagnosis and prognosis evaluation.
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Objective To evaluate the diagnostic value of MSCT in the differentiation of thymic epithelial tumours (TET)with the maximum diameter equal or less than 3 cm.Methods A retrospective analysis of pathological and imaging data of 56 patients with pathologically confirmed TET with the maximum diameter equal or less than 3 cm was performed.According to the 2004 WHO classification,56 TETs were classified as low-risk thymomas(types A/AB/B1),high-risk thymomas (types B2/B3)and thymic carcinomas (type C).The CT manifestations of TET in each group,including shape of tumor,tumor edge (smooth or spiculate protuberance), presence of small nodule around tumor,enhancement degree,pleura invasion and fat space around tumor,were analyzed retrospectively.The differences in the CT manifestations among three types were compared using chi-square test.If the sample number was too small, Fisher 's exact test was used.Results Compared with high-risk thymomas (23 cases)and thymic carcinomas (6 cases),regular round shape was more often observed in low-risk thymomas (27 cases)(χ2 =73,P <0.001;χ2 =116,P <0.001)and the mediastinum-lung interface was more likely to bulge (χ2 = 3.41,P =0.046;χ2 =7.39,P =0.01).Blurred edge,spiculate protuberance and pleural invasion and so on were significantly more common in high-risk thymomas and thymic carcinomas (P <0.001)and they were the most common in thymic carcinomas (χ2 =11.5,P =0.009).There was a significant difference between type B2 thymomas and thymic carcinomas (χ2 =31.52, P <0.001),however there was no significant difference between type B3 thymomas and thymic carcinomas (χ2 =6.96,P =0.07). Conclusion MSCT can accurately show the shape of tumor,tumor edge,presence of small nodule around tumor,enhancement degree,pleura invasion,which can predict the histologic type of thymomas and also can provide information for preoperative diagnosis and prognosis evaluation.
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OBJECTIVE:To observe clinical efficacy and safety of Tobramycin dexamethasone ointment in Nd∶YAG laser lac-rimal duct plasty. METHODS:Medical records of 1000 patients(1250 eyes)with obstructive lacrimal duct disease receiving To-bramycin dexamethasone ointment in Nd∶YAG laser lacrimal duct plasty were selected from our hospital during Jan. 2013-Jan. 2017. They were divided into chronic dacryocystitis group(380 eyes),small tears(total)tube obstruction group(360 eyes),naso-lacrimal duct obstruction group (342 eyes),punctal occlusion group (86 eyes) and traumatic canalicular laceration group (82 eyes)according to the lacrimal duct obstruction. In 5 groups,heated Tobramycin and dexamethasone ophthalmic ointment would be loaded in 1 mL syringe and injected into the lacrimal duct via probe,dropping the probe while pushing the ointment. They received lacrimal duct flushing regularly and were followed up for 3 months. Therapeutic efficacies and safty were compared among 5 groups. RESULTS:Cure rate and response rate of patients with chronic dacryocystitis were 85.00％ and 87.63％;those of patients with lacrimal small (total) obstruction were 87.78％ and 94.45％;those of patients with nasolacrimal duct obstruction were 89.18％ and 95.03％;those of patients with punctal occlusion were 84.88％ and 94.18％. All of above were significantly higher than 42.68％and 64.63％of patients with traumatic canalicular laceration,with statistical significance(P<0.05). There was no sta-tistical significance in the incidence of ADR among 5 groups(P>0.05). CONCLUSIONS:In the treatment of chronic dacryocysti-tis,small tears(total)tube obstruction,nasolacrimal duct obstruction and punctal occlusion,application of Tobramycin dexametha-sone eye ointment in Nd∶YAG laser lacrimal duct plasty shows good therapeutic efficacy and has less ADR.
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Objective To compare the therapeutic effect of combined fascia sheath suspension and frontal muscle flap suspension in the treatment of congenital severe congenital ptosis.Methods 46 cases (58 eyes) with congenital severe upper eyelid prolapse who were treated from March 2015 to March 2016 in Eye Hospital of Hebei Province were selected.The patients were divided into two groups:combined fascial sheath suspension group and frontalis muscle flap suspension.Comparisons of postoperative patients with eyelid height,eyelid radian,corneal exposure with eyes closed,eyelid activity,complication of the situation were carried out.And patient satisfaction survey was conducted.Results The effective rate of combined fascial sheath suspension group was 93.10％,the complication rate was 6.9％,and the patient satisfaction rate was 91.22±0.37,significantly better than the frontal muscle flap suspension group of patients (75.86 ％,24.14 ％ and 75.05 ± 0.28,respectively).The time of closure of the eyelid was shortened,the complications were less,and the eyelid had better activity.The difference between the two groups was statistically significant (P＜0.05).Conclusions Combined fascia sheath for congenital severe upper eyelid droop is significant,with fewer complications and a higher rate of satisfaction,which is worth clinical promotion.
ABSTRACT
Foreign Language Department of Kunming Medical University has developed medical English self-access learning platform based on campus network, created medical English online courses and network resource library , established major oriented learning evaluation mechanism . It provides an online teaching, learning, practice, testing and evaluation environment for college teachers and students. The architecture of the platform takes medical specialty into consideration, which focuses on the training of students' English skills. The detailed design of the platform is presented. The platform was launched in September 2014. Performance testing is used to measure the ability of the system. Three methods including students' interview, the interaction between the teaching management staff and quantitative analysis are adopted to evaluate the application results . Finally this paper has preliminarily explored self-access learning modes available for students. According to the related information, the platform runs smoothly after it was put into use and improves students' learning ability of medical English to a certain extent.