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Objective To observe the relation of phase angle (PA) measured by bioelectrical impedance method with nutritional status of patients with primary liver cancer, and to explore its influence on clinical outcomes. Methods We collected 120 inpatients with primary liver cancer for nutritional risk screening, patient-generated subjective nutrition assessment(PG-SGA), anthropometry, biochemical examination and body composition analysis. According to the phase angle, the patients were divided into low PA group and normal PA group. The correlation between PA and nutrition-related indicators was analyzed. The survival and complications of the two groups were compared after 1-year follow-up. Results There were 56.7% (68/120) of primary liver cancer patients with lower PA. TP, ALB, CHE, HB, AMC, GS, BCM, FFM and ASMI in low PA group were lower while ECW/TBW was higher than those in normal PA group (all P < 0.05). The correlation analysis showed that PA was negatively correlated with ECW/TBW (P < 0.05), but positively correlated with TP, ALB, CHE, HB, AMC, GS, BCM, FFM and ASMI (all P < 0.05). Low PA was significantly associated with nutritional risk, deterioration of liver function, progress of liver cancer staging and severe malnutrition (all P < 0.05). During the follow-up period, the mortality of the low PA group was higher than that of the normal PA group (P < 0.05). The risk of death in the low PA group increased by 2.738 times (OR=3.738, 95%CI: 1.465-9.535). Conclusion Phase angle is an economic and effective index to reflect the nutritional status of patients with primary liver cancer, and closely related to the risk of death. Phase angle measurement is helpful for assessing nutritional status and predicting clinical outcome of patients with primary liver cancer.
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Malnutrition, sarcopenia, and osteoporosis are common nutrition-related complications in patients with liver cirrhosis. Sarcopenia is an important manifestation of malnutrition, while malnutrition and sarcopenia are risk factors for osteoporosis. There is a close relationship among them, and they all have adverse effects on the clinical outcomes and prognosis of patients with liver cirrhosis. Therefore, it is necessary to identify them as early as possible and take active measures for prevention and treatment. Insufficient intake of nutrients, metabolic disorders, abnormal hormone levels, and lack of physical activity all contribute to the development of malnutrition, sarcopenia, and osteoporosis in patients with liver cirrhosis. In addition, medications commonly used in the treatment of liver diseases, such as glucocorticoids and some antiviral drugs, may have potential impact on bone metabolism, which needs to be taken seriously in clinical practice. Reasonable nutritional intervention, appropriate exercise, and treatment of underlying diseases are the basis of the prevention and treatment of malnutrition, sarcopenia, and osteoporosis. Some targeted drugs can improve these nutrition-related complications, which needs to be confirmed by further studies.
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Objective@#To study the occurrence of sarcopenia in patients with liver cirrhosis, and to explore their risk factors and impact on clinical outcomes.@*Methods@#199 hospitalized cases with liver cirrhosis were collected for nutritional risk screening, anthropometric measurement and blood biochemical examination. The body composition analysis was measured based on the skeletal muscle content of the four limbs to calculate the appendicular skeletal muscle mass index (ASMI). Patients were divided into sarcopenia and non-sarcopenia group and the relevant indexes of both groups were compared to screen for factors affecting the occurrence of sarcopenia. During the follow-up of 48 months, the survival and complications of the both groups were compared. Statistical analysis was performed using t-test, χ2 test and logistic regression analysis in terms of different data.@*Results@#The incidence of sarcopenia in cirrhosis was 36.7%, with the highest prevalence in patients with recurrent hepatic encephalopathy (62.5%), followed by patients with abdominal ascites / pleural effusion (37.6%). The incidence of sarcopenia was significantly higher in those with nutritional risk than in those without nutritional risk (P < 0.05). However, even among those without nutritional risk, 14.8% had combined sarcopenia. The body mass index (BMI), upper arm muscle circumference (AMC), and body cell mass (BCM) of the sarcopenia group were lower than those of the non-sarcopenia group (P < 0.05), and the edema index (ECW/TBW) was higher than the latter (P < 0.05). Multivariate analysis showed that age, gender, BMI, and complications of hepatic encephalopathy were the main influencing factors of cirrhosis combined with sarcopenia (P < 0.05). During the follow-up period, the sarcopenia group had a higher mortality rate than non-sarcopenia goup (P < 0.05), and the incidence of recurrent abdominal ascites/pleural effusion, hepatic encephalopathy, and infection was also significantly elevated (P < 0.05).@*Conclusion@#Sarcopenia is one of the manifestations of malnutrition in patients with liver cirrhosis, which increases the risk of mortality and other complications, and has adverse impact on the clinical outcome. Additionally, older age, male sex, low BMI and recurrent hepatic encephalopathy has higher risk for developing sarcopenia.
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Sarcopenia is the main constituent of malnutrition and is a frequent complication of chronic liver diseases, which affects up to 70% of patients with advanced liver diseases. It has been associated with adverse clinical outcomes and prognosis, including poor quality of life, development of other complications and reduction in survival rate of non-transplant patients and transplant recipients. Chronic liver disease causes alteration in glucose metabolism, lipid oxidation, ketogenesis and protein catabolism, leading to the loss of adipose and muscle tissue. In addition, inadequate nutrients intake and limited or lack of physical activity perpetuate the reduction of muscle mass. Recently, the roles and mechanisms of muscle growth-related hormones, hyperammonemia-mediated signaling pathways and gut microbiota have been recognized. In view of its impact in chronic liver disease, sarcopenia can be considered as a powerful prognostic factor and a useful additional tool in the global assessment of patients with advanced liver disease. Rational nutritional intervention, appropriate physical exercise, effective ammonia lowering strategies, hormone supplements and targeted molecular therapy (use of myostatin blockers), and liver transplantation, may improve sarcopenia, but still needs more studies for validation.
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Objective ToimprovethediagnosticaccuracybyassessingtheCTfeaturesofganglioneuroblastoma(GNB).Methods 38patientswithGNBconfirmedbypathologicalresultsandunderwentplainandcontrast-enhancedCTscanwereanalyzedretrospectively. Results GNBoftenoccurredinchildren.Allthecasesappearedassolitarylesion,7werelocatedinthemediastinum,12intheadrenal,15inthe retroperitoneal,3inthethoraxcavityand1inthepelviccavity.PlainCTshowed36lesionswithheterogeneouslowdensitywithnecrosisand cysticdegeneration,and28caseswithcalcifications,2withhomogeneouslowdensity.Thesolidlessionofallcasesshowedprogressive enhancement(4casesshowedslightprogressivecontrastenhancement,11casesshowed moderateenhancement,23casesshowed markedlyenhancement).Peripheralvesselsweredisplacedbytumorin19casesandembeddedbytumorin13cases.13casesshowed thepresenceofsmallvesselsin/aroundthetumorarrangedinclumpsorinline.Conclusion ThespecificCTfindingsofheterogeneouslowdensity withnecrosis,calcifications,peripheralvesselsdisplaced,moderatetomarkedlyprogressiveenhancement,mightbeusefulforthediagnosisofGNB.
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Objective@#To investigate the effect of dietary control combined with different exercise modes on plasma vaspin, irisin, and metabolic parameters in patients with non-alcoholic fatty liver disease (NAFLD) through a randomized open parallel-controlled study.@*Methods@#The patients aged 30-65 years who visited Tianjin Third Central Hospital from January 2013 to December 2014 and were diagnosed with NAFLD by liver ultrasound and fat content determination were screening, and 474 patients were enrolled in this randomized controlled trial and divided into aerobic exercise group, resistance exercise group, and control group. All patients received dietary intervention. The three groups were compared in terms of biochemical parameters, fat content, NFS score, energy metabolic parameters, body composition index, and levels of vaspin and irisin at baseline and after 6 months of intervention. SPSS 19.0 was used for statistical analysis. The t-test, the Mann-Whitney U test, the chi-square test, and an analysis of variance were used for comparison between groups. The multiple imputation method was used for missing data, and the results were included in the intention-to-treat analysis.@*Results@#There were no significant differences in age, sex, anthropometrical parameters, and biochemical parameters between the three groups at baseline. Compared with dietary control alone, aerobic exercise and resistance exercise helped to achieve significant reductions in waist circumference, diastolic pressure, percentage of body fat, volatile fatty acid, fasting blood glucose, homeostasis model assessment of insulin resistance, triglyceride, low-density lipoprotein cholesterol, free fatty acid, uric acid, alanine aminotransferase, and liver fat content after 6 months of intervention (P < 0.05). The aerobic exercise group had a significant increase in non-protein respiratory quotient and significant reductions in body mass index and aspartate aminotransferase after intervention, as well as a significant increase in resting energy expenditure and significant reductions in abdominal fat ratio and total cholesterol after 6 months of resistance exercise (P < 0.05). The aerobic exercise group and the resistance exercise group had a significant reduction in vaspin and a significant increase in irisin after intervention (P < 0.05), and the resistance exercise group had significantly greater changes in these two adipokines than the aerobic exercise group (P < 0.05).@*Conclusion@#Exercise therapy is an effective method for the treatment of metabolism-associated diseases, and a combination of resistance and aerobic exercises is more reasonable and effective in clinical practice. As a relatively safe exercise mode, resistance exercise can also effectively improve the metabolic state of NAFLD patients.
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Objective To explore the feasibility of MR lymphography (MR-LG) in detecting internal mammary sentinel lymph node (SLN) for rabbit models of VX2 breast cancer.Methods Totally 75 New Zealand white rabbits were randomly divided into 2 groups to establish VX2 breast cancer (tumor group) and inflammation models (inflammation group),respectively.MR-LG examinations and lymph node dissection were performed in all the rabbits.The results of internal mammary SLN and lymphatic vessels mapping were recorded,and the influence factors were analyzed.Results The success rate of model establishment was 97.33％ (73/75).The detection rate of internal mammary SLN and lymphatic vessels was 15.94％ (11/69) and 75.36％ (52/69),respectively,there was no statistical difference between the two groups (both P＞0.05).The rabbit's weight,time of tumor growth,tumor size,number,size and status of axillary SLN,as well as presence or not of internal mammary lymph vessels detection showed no statistical difference between detection and non-detection of internal mammary SLN (all P＞0.05),while the tumor size and axillary lymph node number showed statistically significant differences between detection and not detection of internal lymphatic vessels (both P＜0.05).The accuracy,sensitivity,specificity,false negative and false positive rate of internal mammary SLN detection with MR-LG was 76.81％ (53/69),39.13％(9/23),95.65％(44/46),60.86％(14/23) and 4.35％(2/46),respectively.Conclusion MR-LG can effectively detect internal mammary SLN and lymphatic vessels for rabbit models of VX2 breast cancer.
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Objective@#To evaluate the effect of platelet-rich fibrin extract (PRFe) on the adhesion, proliferation and differentiation of MC3T3-E1 cells cultured on the titanium discs.@*Methods@#Samples were divided into experimental group (P) and control group (D). Group P used the α-minimal essential medium (α-MEM) containing PRFe (0.5%), while group D used only the α-MEM. Cell adhesion and cytoskeleton were observed using scanning electron microscopy (SEM) and laser scanning confocal microscopy (LSCM). Methyl thiazolyl tetrazolium (MTT) assay to detect the number of the osteoblasts at 1, 3, 5, 7 d; the activity of alkaline phosphatase (ALP) to detect the differentiation of osteoblast at 1, 3, 5, 7 d; the level of osteogenetic biomarkers core-binding factorα1 (cbfα1) and osteocalcin (OCN) were quantified by quantitative real-time PCR (qRT-PCR) at 3 and 7 d.@*Results@#SEM and LSCM showed that the adhesion and filaments of group P were higher than those of group D at each time point. MTT assay showed that the absorbance were significantly increased in group P (1 d: 0.299±0.002, 3 d: 0.517±0.004, 5 d: 0.810±0.002, 7 d: 1.203±0.011) compared with group D (1 d: 0.198±0.003, 3 d: 0.399±0.002, 5 d: 0.588±0.002, 7 d: 0.897±0.005) at each time points (P<0.05). Furthermore, the ALP activity of group P (1 d: 0.162±0.004, 3 d: 0.289±0.001, 5 d: 0.491±0.006, 7 d: 0.647±0.005) was significantly higher than that of group D (1 d: 0.121±0.003, 3 d: 0.191± 0.006, 5 d: 0.252±0.004, 7 d: 0.365±0.012), (P<0.05). Moreover, the qRT-PCR showed that the Cbfα1 and OCN gene expression in group P (Cfbα1, 3 d: 1.50±0.04, 7 d: 1.94±0.06; OCN, 3 d: 3.37±0.17, 7 d: 3.92± 0.04) were significantly higher than that in group D(Cfbα1, 3 d: 1, 7 d: 1.18±0.13; OCN, 3 d: 1, 7 d: 2.34± 0.09) (P<0.05).@*Conclusions@#PRFe promoted the adhension, proliferation and differentiation of MC3T3-E1 cells on the titanium discs.
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Objective To study the value of CT lymphography (CT-LG) in evaluating axillary sentinel lymph nodes (SLN) of rabbit with breast cancer using 3D and curved planar reformation (CPR).Methods CT-LG examinations were completed on the VX2 rabbit models bearing breast cancer established by tumor tissue mass suspension injection.All raw data were transferred to a postprocessing workstation, then the 3D and CPR were used to show lymphatic vessel and lymph nodes.On the CT-LG images, one or several lymph nodes displayed firstly in the lymphatic drainage pathway was defined as the SLN which was then confirmed by the biopsy.Results (1) 20 rabbits bearing tumor underwnet CT-LG examinations, and both SLNs and draining lymphatic vessels were detected using 3D and CPR techniques.70% (14/20) of experimental rabbits had fine images, and 16 SLNs and 7 non-SLNs were demonstrated on 14 rabbits on CT-LG images with good quality.(2) 8 continuous lymphatic vessels displayed well, exhibiting a homogeneous and continuous tube with uniform contrast-medium filling on CPR images.Most lymphatic vessels demonstrated well, and the 14 vessels with local interrupt or fuzzy on 3D images showed continuous tubular contrast-filling with heterogeneous high-density on the CPR images from the injection sites to axillary SLN.Among 6 rabbits with poor images, 3 rabbits showed the SLN but without lymphatic vessels on 3D images, 2 showed only initial segment of lymphatic vessel,and 1 had no lymphatic vessel and SLN.(3) A total 24 SLNs were obtained by SLNB,including 18 metastatic SLNs and 6 negative ones.On CT-LG images, there were statistical differences between the metastatic and negative SLNs in the maximum diameter and filling defect (P=0.041 and P=0.001, respectively).However, the short diameter, shape and margin of SLNs had no statistical differences between the two groups (all P>0.05).Conclusion On CT-LG examinations, 3D and CPR images may show axillary SLNs and lymphatic vessels effectively,and CPR can demonstrate more details than 3D.The maximum diameter and fillingdefect of SLN are helpful for distinguishing metastatic and negative SLNs.
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A patient was treated by multiple dental implants,the implanted 6 was adjucent to impacted 8 .Immediately after implanta-tion,4 month and 3 year after implantation the distace between 8 and 6 implant central line was 4.4,3.2 and 2.5 mm,the angle between 8 long axis and 6 implant central line was 42.3°,45.5°and 50.3°.Then 8 was extracted.
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Objective To observe the value of one-step spectral imaging and perfusion imaging in diagnosis of solitary pulmonary nodule(SPN).Methods Forty-seven patients with SPN proved by pathology underwent perfusion scan with gemstone spectral ima-ging mode,who were divided into malignant group in 28 patients and benign one in 1 9.The parameters of CT perfusion including blood volume (BV),blood flow (BF),mean transit time (MTT)and permeability surface (PS)were analyzed.Iodine concentration (IC),normalized iodine concentration (NIC)and slope rate of spectral curve in both arterial phase and venous phase were measured and calculated.The independent sample t test was performed to compare quantitative parameters between malignant and benign SPN.Results BF,BV and PS of malignant SPN were higher than those of benign ones (P 0.05).IC,NIC and slope rate of spectral curve in malignant SPN were higher than those in benign ones in both phases (P <0.05).Conclusion One-step spectral imaging and perfusion imaging can provide more parameters,which is helpful for the diagnosis of SPN.
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Objective:To study the osseointegration of implant in fresh extraction socket with or without bone grafting.Methods:In the mandibular premolar region of 6 beagle dogs,bone defect in the size of (3~4)mm ×(3~4)mm ×(5 ~6)mm on the mesial wall of the mesial root socket was made.On control side implants were installed immediately into the extraction sockets(group A).On an-other side Bio-Oss grafts and membrane(GBR)were placed following implantation(group B).All animals were sacrificed 3 months af-ter implantation,specimens were examined for histo-morphometric analysis of bone to implant contact and new bone formation.Results:No implant was loosening in the 2 groups.New bone was filled in the bone defect areas in 2 groups.No statistical difference of the per-centage of new bone formation and bone-to-implant contact ration(BIC)was observed between 2 groups.Conclusion:With the defect in a certain size on the root socket wall osseointegration may occur between the new bone and implant without bone transplantation.
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<p><b>OBJECTIVE</b>To investigate the possible effects of long-term exposure to dust containing thorium and thoron progeny on dust-exposed miners.</p><p><b>METHODS</b>A negative, high voltage, exhaled thoron progeny measurement system was used to estimate the miners' thorium lung burden.</p><p><b>RESULTS</b>The highest thorium lung burden of 638 miners was 11.11 Bq. The incidence of stage 0(+) pneumoconiosis was higher among dust-exposed miners. Lung cancer mortality of the dust-exposed miners was significantly higher than that of controls (P < 0.005).</p><p><b>CONCLUSION</b>There is a difference in cancer rates between those who have long-term exposure to dust containing thorium (in which carcinogenic ThO(2) and SiO(2) exist) and thoron progeny and those who have not.</p>