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ObjectiveTo explore the potential influencing factors and complex pathways affecting rehabilitation effect for children with autism spectrum disorder (ASD) from the perspective of parental efficacy in doctor-patient communication, and to provide evidence for improving the quality of rehabilitation service for children with ASD. MethodsAn anonymous face-to-face questionnaire survey was conducted to collect general demographic information of parents of children with ASD at designated rehabilitation institutions in Gansu province. The data included parental efficacy in doctor-patient communication, parental compliance of treatment and children's rehabilitation outcomes were collected. A structural equation model was used to explore the impact mechanism of parental communication efficacy on the rehabilitation outcomes of children with ASD. ResultsData from 519 parents at 37 rehabilitation institutions across 13 cities/counties in Gansu province were collected. Significant positive correlations were found between parental efficacy in doctor-patient communication, doctor-patient relationships, parental compliance with treatment and rehabilitation outcomes for children with ASD (P < 0.05). Through structural equation model analysis, the standardized direct effect of children with ASD from parents' doctor-patient communication efficacy was 0.151 (P = 0.023). The mediating effect of doctor-patient relationship and parental compliance with treatment were 0.160 (P = 0.001) and 0.111 (P = 0.001), respectively, with a chained mediating effect of 0.035 (P = 0.001). The pathway "parental efficacy in doctor-patient communication → doctor-patient relationship → ASD child's rehabilitation outcome" accounted for the highest proportion of the total mediating effect, at 52.29%. ConclusionParental doctor-patient communication efficacy may positively impact on the rehabilitation outcomes of children with ASD directly, and indirectly through the doctor-patient relationship and parental compliance with treatment. Rehabilitation institutions should focus on fostering parental communication skills and enhancing high-quality and humanized rehabilitation services.
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Objective:To investigate the application value of near-infrared autofluorescence imaging in identifying and protecting parathyroid glands in endoscopic thyroid surgery. Methods:From May 2022 to February 2023, 158 patients who underwent endoscopic thyroid surgery in the Department of Thyroid and Breast Vascular Surgery of Guilin People's Hospital were selected. The endoscopic fluorescence camera system was used to monitor the parathyroid glands under autofluorescence during endoscopic thyroid surgery. A total of 214 pieces were collected, among which the first 15 cases that could not be preserved in situ during the operation needed to be autotransplanted or the tissue clamped parts that could not be clearly identified as parathyroid glands were sent to fast-frozen pathology to determine whether they were parathyroid glands. Results:Among the first 15 patients who could not be preserved in situ during the operation or whose anatomy could not be clearly defined, 23 parathyroid glands were detected by autofluorescence imaging, 21 parathyroid glands were confirmed by pathology, and 2 were adipose tissue, with an accuracy rate of 91.30%; 158 patients underwent surgery Blood calcium decreased 2 hours after operation compared with preoperative blood calcium（P<0.05）, decreased blood calcium 5 days after operation compared with preoperative blood calcium（P<0.01）, and increased slightly 5 days after the operation compared to blood calcium 2 hours after the operation, but the difference was not statistically significant（P>0.05）; while comparing parathyroid hormone（PTH）, PTH at 2 hours after operation decreased significantly compared with PTH before operation（P<0.01）, and PTH at 5 days after operation compared with PTH before operation PTH also decreased（P<0.01）, but increased compared with PTH 2 hours after operation（P=0.001）. Conclusion:In laparoscopic thyroid surgery, the application of near-infrared autofluorescence imaging technology can help surgeons quickly identify and protect parathyroid glands, and reduce the incidence of permanent hypoparathyroidism. Combining autofluorescence imaging, visual anatomy recognition under magnification of laparoscope, and intraoperative frozen pathological examination "trinity" method can improve the success rate of parathyroid gland recognition.
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Humans , Parathyroid Glands/transplantation , Thyroid Gland/surgery , Calcium , Parathyroid Hormone , Optical Imaging/methods , Laparoscopy , Thyroidectomy/methodsABSTRACT
Objective@#To analyze the epidemiological history, clinical manifestations, treatment and the short-term prognosis of 31 cases of 2019 novel coronavirus(2019-nCoV) infection in children from six provinces (autonomous region) in northern China.@*Methods@#A retrospective analysis of the epidemiological history, clinical symptoms, signs, laboratory examinations, chest imaging, treatment and the short-term prognosis of 31 cases of 2019-nCoV was conducted. The patients were diagnosed between January 25th, 2020 and February 21st, 2020 in 21 hospitals in 17 cities of six provinces(autonomous region) of Shaanxi, Gansu, Ningxia, Hebei, Henan and Shandong.@*Results@#The age of the 31 children with 2019-nCoV infection was 7 years and 1 month (6 months -17 years). Nine cases (29%) were imported cases. Other 21 cases (68%) had contact with confirmed infected adults. One case (3%) had contact with asymptomatic returnees from Wuhan. Among the 31 children, 28 patients (90%) were family cluster cases. The clinical types were asymptomatic type in 4 cases (13%), mild type in 13 cases (42%), and common type in 14 cases (45%). No severe or critical type existed. The most common symptom was fever (n=20, 65%), including 1 case of high fever, 9 cases of moderate fever, 10 cases of low fever. Fever lasted from 1 day to 9 days. The fever of fifteen cases lasted for ≤3 d, while in other 5 cases lasted > 3 d. Other symptoms included cough (n=14, 45%), fatigue (n=3, 10%) and diarrhea (n=3, 9%). Pharyngalgia, runny nose, dizziness, headache and vomiting were rare. In the early stage, the total leukocytes count in peripheral blood decreased in 2 cases (6%), the lymphocytes count decreased in 2 cases (6%), and the platelet count increased in 2 cases (6%).Elevation of C-reactive protein (10%, 3/30), erythrocyte sedimentation rate(19%,4/21), procalcitonin(4%,1/28), liver enzyme(22%, 6/27) and muscle enzyme (15%, 4/27) occurred in different proportions. Renal function and blood glucose were normal. There were abnormal chest CT changes in 14 cases, including 9 cases with patchy ground glass opacities and nodules, mostly located in the lower lobe of both lungs near the pleural area. After receiving supportive treatment, the viral nucleic acid turned negative in 25 cases within 7-23 days. Among them, 24 children (77%) recovered and were discharged from hospital. No death occurred.@*Conclusions@#In this case series, 2019-nCoV infections in children from six provinces (autonomous region) in northern China are mainly caused by close family contact. Clinical types are asymptomatic, mild and common types. Clinical manifestations and laboratory examination results are nonspecific. Close contact history of epidemiology, nucleic acid detection and chest imaging are important bases for diagnosis. After general treatment, the short-term prognosis is good.
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The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.
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The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.
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@#The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.
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Objective To explore the application and analysis of E-PASS scoring system for orthopaedic senile hip surgery risk assessment. Methods Retrospectively analyzed the data of 188 cases of elderly hip fracture patients with anesthesia and surgery, postoperative complications. Useing E-PASS scoring system to evaluate the mortality of patients with surgical risk. Results Postoperative complications mainly was respiratory system diseases, the rate of complication was 25.88%(22/85), accounting for total cases rate was 11.70% (22/188). Secondly for cardiovascular diseased and urinary system diseases. E-PASS scoring system showed that the scores of surgery risk assessment in patients with complication was significantly higher than that without complication:(0.27±0.23) scores vs. (0.17±0.16) scores, t=3.728, P<0.05. Ninety-one patients were evaluated to occur complications by E-PASS grading system, 85 patients occurred practically,the rate of actual value/forecast was 0.93.Six patients were evaluated to die, 2 patients occurred practically, the rate of actual value/forecast was 0.33, there were no significant differences ( P=0.056,0.124). Conclusion E-PASS scoring system for orthopaedic senile hip surgery risk assessment can predict the risk of complication and death effectively,it is value of interventing the preoperative risk factors and has great clinical application value.
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Diabetic nephropathy (DN) is the leading cause of end-stage failure of the kidney, but the efficacy of currently available strategies for the prevention of DN remains unsatisfactory. In this study, we investigated the effects of free anthraquinones (FARs) extract, which was extracted from the rhubarb and purified by macroporous resin DM130 with gradient mixtures of ethanol/water as the lelution solvents, in high glucose-cultured glomerular mesangial cells (MCs). The cell proliferation was determined by CCK-8 assay, the levels of TGF-beta1, CTGF, ColIV and FN proteins in the supernatant of MCs were measured by ELISA assays, and the mRNA levels of these four genes were detected by RT-PCR. The results showed that the increased proliferation of MCs, the mRNA levels and protein expression of TGF-beta1, CTGF, ColIV and FN induced by high glucose were inhibited after the treatment with the FARs extract. This indicated that FARs extract could inhibit cell proliferation and the expression of main extracellular matrix induced by high glucose in MCs. The FARs extract exhibited potential values for prophylaxis and therapy of DN.
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Anthraquinones , Cell Proliferation , Diabetic Nephropathies , Enzyme-Linked Immunosorbent Assay , Extracellular Matrix , Glucose , Kidney , Mesangial Cells , Rheum , RNA, Messenger , Sincalide , Solvents , Transforming Growth Factor beta1ABSTRACT
Objective To compare the effects of different opportunity internal fixation in treatment of trau-matic flail chest.Methods Clinical data of 53 cases of patients with traumatic flail chest were selected,in which 28 patients were given internal fixation treatment in 72h after injury (early surgery group),25 patients were given sur-gery after 72h(late surgery group),recovery situation(postoperative ventilation time,chest improve time,ICU stay time,extubation time,hospitalization time)of the two groups were observed,respiratory function changes and compli-cations were compared before and after treatment.Results Postoperative ventilation time,chest X -ray improvement time,ICU stay time,extubation time and hospitalization time of the early operation group were (27.4 ±4.8)h, (88.6 ±7.5)h,(3.8 ±0.7)d,(3.2 ±0.8)d,(13.2 ±5.0)d,which were significantly shorter in the late operation group of (40.7 ±5.2)h,(195.3 ±8.0)h,(5.6 ±1.4)d,(5.2 ±1.3)d,(19.8 ±6.4)d,with significant difference (t =7.389,11.204,3.837,3.916,5.261,all P 0.05 ).There was no dead case in the two groups,and the incidence of atelectasis,ARDS and thoracic deformity had no significantly different between two groups (P >0.05 ).Conclusion In treatment of traumatic flail chest,early surgical treatment can rapidly improve the respiratory and circulatory function,it can shorten the postoperative recovery time,and does not increase complica-tions.So,when conditions permit,patients should be given early surgical fixation.
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This study was aimed to find the relationship between lung function injured characteristic of ulcerative colitis (UC) and endoscopic index. It will verify and enrich Chinese medicine theory to guide clinical diagnosis and treatment. UC patients without respiratory system diseases were selected between September 2009 and March 2011 from several triple-A hospitals in China. Furthermore, disease history, lung function, colonoscopy and histopathology were taken. The results showed that among 171 enrolled cases, there were statistical differences in endoscopic index of residual-function and diffusion-function between the abnormal group and the normal group (P< 0.05). The resid-ual-function group was r = 0.003. There were no statistical differences in ventilatory-function and small-airway-function in the abnormal group. It was concluded that there were different types of injured lung function in UC. A-mong them, the abnormalities of residual-function and diffusion-function had strong correlation with the intestinal damage degree. The change on residual-function was more obvious.
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Aim To observe the effects of tetrahydro-biopterin ( BH4 ) on nitric oxide ( NO ) production in the kidney of type 2 diabetic nephropathy ( DN) mice, and to find a new target for the treatment of type 2 DN. Methods The 12 week-old db/db mice developed in-to DN phase were divided into 2 groups:DAHP group, subjected to intraperitoneal injection of 150 mg·kg-1 DAHP (n=8);DN group, subjected to intraperitone-al injection of same dose of normal saline containing 5% DMSO ( n = 6 ) . The age-matched db/m mice ( NS group) were subjected to intraperitoneal injection of same dose of normal saline containing 5% DMSO ( n =6 ) . Three groups of mice were treated for 7 days. Then the fasting blood-glucose, serum creatinine, u-rine protein and activity of iNOS were determined by chemical colorimetry. And the iNOS protein in renal cortex was determined by immunohistochemisty and western blot, respectively. BH4 was measured by HPLC method. NO level was determined by Griess method. Results The levels of fasting blood-glucose, serum creatinine, 24h urine volume, 24h urine pro-tein, BH4 , iNOS and NO in DN group were signifi-cantly higher than those in NS group;The levels of ser-um creatinine, urine volume, urine protein, BH4 , iN-OS and NO in DAHP group were significantly lower than those in DN group. Conclusion In the kidney of type 2 DN mice, the increased BH4 contributes to over-production of NO by the increased iNOS expression, and resultes in the increase of urine volume and urine protein.
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Calcium polyphosphate (CPP) is a new type of degradable material for bone repair, yet it is fragile and is not so controllable in regard to degradation. For increasing biological activity and close proximity to natural bone structure, in this experiment, we chose chitosan (CS) and its derivative carboxymethyl chitosan (CMC) as the extracellular matrix structure for the organic phase. Aldehyde sodium alginate (ADA) was used as natural cross-linker. The binary (CPP/CMC) and ternary (CPP/CMC/CS) composite scaffolds were prepared by the "multiple composite-cross-linking method". The degradation laws of the two materials were investigated through the weight loss of scaffolds, the pH value of degradation solution, the compressive strength and the surface morphology characterization. The results showed that the composite scaffolds had good interface and the compressive strength increased greatly, but the organic phase of dual-phase composite scaffolds degraded quickly, while degradation controllability and mechanical properties of ternary composite scaffold were significantly improved. All the above findings show that the method of ternary complex scaffold preparation is useful for the design and preparation of bone tissue engineering materials.
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Humans , Absorbable Implants , Biocompatible Materials , Chemistry , Bone Cements , Chemistry , Calcium Phosphates , Chemistry , Chitosan , Chemistry , Tissue Engineering , Tissue Scaffolds , ChemistryABSTRACT
Tissue engineered meniscus provides a novel approach for the treatment of severe meniscus injury. The researches on scaffold for tissue engineered meniscus is an essential element. The researches on scaffolds for tissue engineered meniscus, including natural biomaterials and synthetic polymer, have made great advances in recent years. At present, collagen meniscus implants have been used in clinical practice. As hydrogel is characterized by having high water content and good biocompatibility, being similar to extracellular matrix in structure, and being able to provide access to microsurgery, it has become the hotspot field in recent years. Meanwhile, the combinatorial scaffold material advantages of biological composite tissue engineered scaffolds also illuminate the key point of research on meniscal scaffolds. This paper reviews the recent progress in betterment of the scaffolds so as to provide a theoretical and practical basis for further researches of tissue engineered meniscus.
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Animals , Humans , Biocompatible Materials , Cells, Cultured , Chondrocytes , Cell Biology , Hydrogels , Menisci, Tibial , Cell Biology , General Surgery , Regeneration , Physiology , Tibial Meniscus Injuries , Tissue Engineering , Tissue ScaffoldsABSTRACT
<p><b>OBJECTIVE</b>To look for an ideal substance to repair large gap of nerve defect after injury by culture of Schwann cells (Scs) and preparation of acellular allogenous nerve grafts (ANG) with chemical extraction.</p><p><b>METHODS</b>The double adhesion culture and Arab-c to prohibit the fibroblast growth were used to achieve high-purified Scs. Triton-x-100 and sodium deoxycholate were used to achieve ANG. Finally the Scs were microinjected into the acellural nerve grafts and cultured in vitro. The consequence was analysed.</p><p><b>RESULTS</b>High purified Scs and ANG were acquired, which could integrate each other well. Scs could survive and transfer to aline in vitro.</p><p><b>CONCLUSIONS</b>Populating Scs into chemical extracted ANG may be an ideal substance to repair the large gap of nerve defect after injury.</p>
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Animals , Male , Rats , Cell Transplantation , Cells, Cultured , Graft Survival , Immunohistochemistry , In Vitro Techniques , Models, Animal , Nerve Regeneration , Physiology , Peripheral Nerves , General Surgery , Rats, Inbred F344 , Schwann Cells , Transplantation , Sciatic Nerve , Transplantation , Sensitivity and Specificity , Tissue Transplantation , Transplantation, HomologousABSTRACT
Purpose:To explore the problems in the treatment of elderly patients suffering from lung cancer. Methods:58 cases of elderly patients aged over 70 who received operation for lung cancer during Oct. 1997 to Aug. 2002 were analyzed retrospectively.Results:56 cases underwent resections (resection rate 96.6%), of which 48 cases (82.8%) had radical resection and 8 cases (13.8%) palliative resection.2 cases (3.4%) had exploratory surgery. Postoperative complications were found in 50 cases (86.2%), of which 2 cases died during perioperation period(mortality rate 3.4%). Conclusions:Old age is not the major determining factor when considering surgical operation as the treatment for lung cancer patients. In order to enhance resection rates especially radical resection rate and survival rate, to diminish postoperative complications and mortality, and thus to improve the quality of life for the elderly lung cancer patients, a series of measures must be taken. First, diagnosis and treatment of the associated condition must be emphasized. Second, full preoperative preparations with appropriate choice of the time and procedure for operation. Finally, intensive monitoring during the preoperative period and prevention and treatment of postoperative complications are also important factors to be considered.
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Background and Purpose:dPET/CT is very expensive,so although the accuracy of hPET/CT is less than dPET/CT,it is better than CT,and is useful for guiding the tumor staging before operation.This paper is evaluate the role of ~(18)F-fluorodeoxyglucose(FDG) hPET/CT in primary carcinoma of gastric cardia detection.Methods:26 patients with histologically proven primary carcinoma of gastric cardia underwent whole body hPET/CT imaging.Visual and semiquantitative analysis and standardized uptake value(SUV) were used to analyze the images.The results of hPET/CT study were compared with those of CT.Results:1.The sensitivity of hPET/CT in primary carcinoma of gastric cardia detection was 92.3%(24/26);two cases of signet ring cell carcinoma gave false negative results,and the primary lesions were small(
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Objective To look for an ideal substance to repair large gap of nerve defect after injuries by culture,population of Schwann cells(Scs)and preparation of acellular allogenous nerve grafts with chemical extraction. Method The double adhesion culture and Arab c to prohibit the fibroblast growth were used to achieve high purified Scs;detergents:Triton X 100 and sodium deoxycholate were used to achieve acellural nerve grafts (ANG);and finally the Scs were micro injected into the acellural nerve grafts and the consequence studied Result By the way above,high purified Scs and the ANG was acquired,which can integrated each other well Scs can survived and transformed to aline in vitro Conclusion ANG populated isogenous Scs may be an ideal substance to repair the large gap of nerve defect after injuries
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Objective To search for a more efficient method to induce bone marrow stromal cells (BMSCs) into Schwann-liked cells (SLCs) in vitro. Methods On the base of the method which was used by Dezawa (it was looked as the traditional inducing method),some steps were modified,namely,to use all the reagents in half dose in the same time and two times intervally,this method was looked as the modified inducing method.After induced by the two methods,the cells morphologic characteristic,the positive ratio of immunocytochemical dye with anti-S-100 and anti-GFAP,the cells activity measured by MTT method and the DNA percentage in S period measured by flow cytometry were compared with each other respectively to evaluate the methods'effects. Results Compared with the traditional method,the cells induced by the modified method were more similar to the primary Schwann cells in morphology,more positive proportion in immunocytochemic dye with anti-S-100 and anti-GFAP,less damage in the activity and more percentage in S period. Conclusion The modified method had more advantages such as less damage on cells and more efficiency in inducing BMSCs into SLCs.
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Diabetic nephropathy is one of the leading causes of the end-stage renal failure, and its major pathologic feature is the renal fibrosis. Transforming growth factor-?_1 is a key factor in the progression of the disease. Two signal pathways, Smads and MAPK following the factor, are closely connected with extracellular matrix accumulation which leads to renal fibrosis. Smads and MAPK also have a cross talk in extracellular matrix accumulation. The relationship between the two signal pathway and ECM accumulation offers us a new therapeutic strategy for renal fibrosis of diabetes.
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Purpose:To study the reasons for operative death and complications in cases of thoracic tumors,it was important for avoiding the operation risks and raising the survival rate. Methods:Analyzing the 3490 cases of thoracic tumors treated by surgery during 20 years in our hospital. Results:Among these cases,90 patients died and the operation death rate was 2.58%(90.3 400).In the 90 cases,there were lobectomy of lung cancer in 67,and the death rate was 1.72%(67/2 896);carcinoma of esophagus and gastric cardia in 19,the rate 3.91%(16/486);mediastinal tumors in 2,the rate 1.85%(2/108).The chief complications were cardiopulmonary diseases,stress ulcer,postoperative hemorrhage,stump fistula,anastomatic fistula,chylothorax and diaphragmatic hernia.Conclusions:The pulmonary,cardiavescular complications and anastomatic fistula were the major reasons for the operative death,but the first was pulmonary complication.