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Brain metastases are the most common intracranial malignancies, and radiotherapy is an effective treatment of controlling the localized lesions. However, conventional radiotherapy techniques have their own shortcomings that limit the effectiveness of radiotherapy. Metastatic brain tumors are highly likely to recur or progress after treatment. Clinical studies have shown that arginine can penetrate the blood-brain barrier and subsequently improve the radiosensitization of metastatic brain tumors. In this article, the mechanisms underlying the effect of arginine on the radiosensitization of metastatic brain tumors by inhibition of tumor glycolytic metabolism, reduction of DNA damage repair and alteration of tumor hemodynamic parameters were reviewed, aiming to provide new ideas for clinical research and treatment of brain metastases.
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【Objective】 To compare the effectiveness of the old mode of blood isolation and batch release (the old mode) and the new mode in Chengdu, so as to provide basis for optimizing working strategy. 【Methods】 1) The blood testing report was released one by one in the old mode but released uniformly in accordance with the blood batches classified by blood storage and supply department in the new mode. 2) In the old mode, apheresis platelet samples were detected by serological testing first and nucleic acid testing(NAT) later, and whole blood samples were reasonably arranged according to blood inventory and detection workload. In the new mode, platelets samples collected within our center headquarters were detected by serological test and NAT simultaneously, while those collected outside the center complied with the old strategy. As for whole blood, the same batch samples classified by blood storage and supply department should be arranged to the detection line with the fewest samples.3) The turnaround time(TAT) in the laboratory (referred to as sample TAT) and the TAT in the blood to-detect stock (referred to as blood TAT) in two phases(year 2016 vs 2018, pre- and post- the new mode), involving 164 748 and 179 488 blood samples, were compared by SPSS25.0 software. The constituent ratio of the TATs were compared with Chi-square test, and the difference of blood TAT between old and new mode were compared with Mann-Whitney U test. 【Results】 1) Significant difference was noticed in constituent ratio of TATs between old and new mode (P<0.05). 2)The blood TATof apheresis platelets using the new mode was 0.95(QR: 0.22)days, with the median 0.20 days shorter than that the old mode.. The blood TAT of whole blood in the new mode was 3.77 (QR: 1.99) days, with the median 0.90 days shorter than that in the old mode, and the difference was statistically significant (P<0.05). 【Conclusion】 Compared with the old mode, the new mode showed the following advantages: 1) It can realize the unified issuing of testing reports of blood with the same batch, contribute to the early discovery of errors that occurred during blood donation process, and located the errors wihin intra-batches for investigation. 2) It can advance the issuing of blood testing reports of the same batch. 3) It can make the flow of samples and blood with the same batch between different departments more standardized and orderly, and optimize the process of blood sorting thus shortening blood TAT. 4) It can realize the counting and checking of samples, within the same batch, at different states, so as to minimize the error issuing of unqualified blood and to-detect blood, and is more conducive to ensure the quality, safety and timely supply of blood.
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Objective:To analyze the predictive value of enhanced MRI in the outcome of prolapsed and sequestrated lumbar disc herniation through a retrospective analysis.Methods:A retrospective analysis of the data of 64 patients with prolapsed and sequestrated lumbar disc herniation from January 2015 to December 2018, including 38 males and 26 females; age 35.72±12.44 years (range, 22-64 years) ; 43 cases of prolapsed type, 21 cases of sequestrated type. Conservative treatment was the first choice for all patients, in case of surgical indications during the treatment, percutaneous endoscopic lumbar discectomy or fenestration discectomy will be performed. Enhanced MRI was performed at the first and last inspections, the volume of the protrusion, the thickness of rim enhancement (Tr), and the extent of rim enhancement (Er) were measured and calculated at the same time. According to the ring around the protrusion, the size of the rim-enhancement area was divided into type I-III; then compared the relationship between the rim-enhancement signal differentiation and the resorption rate of protrusions, and the correlation between Tr, Er values and the resorption rate of protrusions during the initial inspection.Results:Among the 64 patients, 42 patients completed conservative treatment, and 22 received surgical treatment. According to the rim-enhancement signal differentiation, 23 cases were treated conservatively for type I, 3 cases were treated by surgery; 16 cases were treated for type II conservatively, 7 cases were treated by surgery; 3 cases were treated for type III conservatively, and 12 cases were treated by surgery. All patients were followed up for 12 to 34 months. Among 42 conservatively treated patients, The volume of the protrusion before treatment was 2 645.67±690.86 mm 3, and the volume of the protrusion after treatment was 842.76±573.35 mm 3. The volume of protrusions before and after treatment was statistical significance ( t=11.897, P<0.001), Tr was 1.38±0.83 mm, and Er was 73.08%±34.39%, the resorption rate of protrusions was 65.10%±24.50%, and 39 cases (92.86%, 39/42) reached the standard for protrusion resorption (resorption rate ≥30%); 23 cases of type I , the resorption rate was 76.54%±18.62%; 16 cases of type II had an resorption rate of 56.81%±21.44%; 3 cases of type III had an resorption rate of 21.58%±12.19%. The resorption rate of type III were compared by single factor analysis of variance, and the difference was statistically significant ( F=12.885, P<0.001); 32 cases of both type I and II (82.05%, 32/39) had significant resorption (resorption rate ≥50%), and no case of type Ⅲ had significant resorption, comparing with type I and II, the difference was statistically significant ( P=0.010); Tr was positively correlated with resorption rate ( r=0.569, P<0.001), Er was positively correlated with resorption rate ( r=0.677, P<0.001). Conclusion:Under close clinical observation, parts of the prolapsed or sequestrated lumbar disc herniations can be conservatively treated, and the herniated disc can be resorption in many people and the clinical symptoms were alleviated. Rim-enhancement signal differentiation by enhanced MR has a better predictive value for the outcome of the herniation, type I is more prone to resorption, preferred conservative treatment, type Ⅲ is not easy to resorption, preferred surgery treatment, and the higher thickness of rim enhancement, the greater extend the rim-enhancement, the more prone to resorption phenomenon.
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Objective:To evaluate the association between smoking and the risk of type 2 diabetes (T2DM) incidence among Asian adults based on the prospective studies.Methods:Prospective studies conducted on Asian adults through May, 2019 were retrieved from the following databases: SinoMed, CNKI, VIP, WanFang, PubMed, Web of Science, Embase, and Cochrane Library. Then data were extracted on smoking status, smoking quantity, the number of newly-onset T2DM cases, and effect sizes.Results:A total of 31 studies were included. There were 2 159 787 investigators, 599 340 (27.75%) smokers, and 124 883 (5.78%) T2DM cases identified during the mean follow-up period of 8.3 years. Compared with non-smokers, the combined relativerisk ( RR) and 95% confidence interval ( CI) of current smokers and quitting smokers were 1.52 (1.34- -1.72) ( P<0.001) and 1.22 (1.09- -1.37) ( P=0.047), respectively. The RR and 95% CI of light smokers (<20/day), moderate smokers (20- -29/day), and heavy smokers (≥30/day) were 1.31(1.21- -1.53) ( P=0.001),1.42(1.14- -1.76)( P=0.212), and 2.17(1.50- -3.16) ( P=0.198), respectively. In males and females, the RR and 95% CI were 1.15 (1.08- -1.21) ( P<0.001) and 1.20 (1.11- -1.30) ( P=0.038), respectively. In addition, compared with non-smokers, the RR and 95% CI of current smokers were 1.57 (1.22- -2.03) ( P<0.001) and 1.47 (1.30- -1.66) ( P=0.063) during the follow-up periods of less than and more than 8.0 years, respectively, while the RR and 95% CI of quitters were 1.23 (1.06- -1.43) ( P=0.091)and 1.20 (1.07- -1.34) ( P=0.041), respectively. Conclusions:Prospective studies based on Asian adults have shown that smoking significantly increases the risk of diabetes incidence. That is, as cigarette consumption increases, the risk of diabetes increases accordingly. Moreover, compared to males, the risk for female smokers is greater. In addition, longer durations of smoking cessation are associated with a lower risk of T2DM.
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Objective@#The aim of the study was to identify the personality types of middle school students and its association with life satisfaction,and to provide a reference for improving personality and mental health of middle school students.@*Methods@#A total of 1 409 students randomly selected form 4 middle schools of a rural area in Wuhan city by cluster stratified sampling method were taken as the object of the research. Adolescents completed the Chinese version of NEO Five-Factor Inventory (NEO-FFI) and the Satisfaction with Life Scale. Latent profile analysis (LPA) was used to identify personality types. ANOVA analyses were used to explore the associations between personality types and life satisfaction.@*Results@#Three profiles were identified: resilient (5.32%), overcontrolled (32.86%) and undercontrolled (61.82%),the differences were of statistical significance(P<0.05). Resilient adolescents had the highest scores (M=5.10, SD=1.34) whereas undercontrolled had the lowest scores (M=3.66, SD=1.09) on life satisfaction.@*Conclusion@#Schools, families and society should pay attention to the high proportion of overcontrolled and undercontrolled in middle school students and take actions to promote the positive development of personality and mental health.
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Objective To observe the effects of carotid artery stenting (CAS) on ophthalmic artery blood flow in patients with ischemic ophthalmopathy (IOP).Methods A prospective case-control study.Sixty IOP patients (60 eyes) who met inclusive criteria for CAS were enrolled in this study.There was 50％ stenosis of internal carotid artery on one side at least confirmed by color doppler flow imaging (CDFI).Among 60 eyes,there were 3 eyes with central retinal artery occlusion,15 eyes with retinal vein occlusion,37 eyes with ischemic optic neuropathy,5 eyes with ocular ischemia syndrome.The patients were randomly divided into CAS group (32 eyes of 32 patients) and medicine therapy group (28 eyes of 28 patients).The difference of age (t=1.804) and sex (x2=1.975) between two groups was not significant (P＞0.05).The examinations of fundus fluorescein angiography (FFA),CDFI and digital substraction angiography (DSA) were performed before,1 week and 6 months after treatment.The following parameters were recorded:arm-retinal circulation time (A-Rct),peak systolic velocity (PSV),end-diastolic velocity (EDV),and resistance index (RI) in the ophthalmic artery (OA) and central retinal artery (CRA),and the best corrected visual acuity (BCVA).Results There was no significant differences in A-Rct (t=1.354) and BCVA (t=0.376) between the two groups before treatment (P＞0.05).Also,there was no significant differences in PSV (t=-0.294,-2.446),EDV (t=0.141,-0.305),and RI (t=-0.222,-0.694) of OA and CRA between the two groups before treatment before treatment (P＞0.05).Compared with the medicine therapy group,the lower A-Rct was found in the CAS group at different time points after the treatment.The difference was significant on 1 week after treatment (t=-3.205,P＜0.05),but not on 6 months after treatment (t=1.345,P＞0.05).The BCVA of eyes in the two groups were increasing with the extending of time of therapy.Compared with the medicine therapy group,the better BCVA was found in the CAS group at different time points after the treatment (t=0.800,1.527;P＜0.05).Compared with the medicine therapy group,the higher PSV,EDV and lower RI of OA and CRA were found in the CAS group at different time points after the treatment.(P＜0.05).Conclusion Compared with conventional medicine therapy,CAS shows earlier effects in improving ocular hemodynamics for IOP patients with carotid artery stenosis,which benefits visual function improvement of the patients.
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Objective To explore the occurrence of fetal chromosomal abnormalities among pregnant women with an adverse reproductive history using traditional karyotyping and single nucleotide polymorphism microarray(SNP-array)technology.Methods Totally 94 in 2 163(4.35%)cases of singleton pregnant women with an adverse reproductive history were performed amniocentesis in Jinhua Maternal and Child Health Care Hospital from June 2015 to June 2017. Traditional karyotyping and SNP-array were employed simultaneously for prenatal diagnosis,and the detection rates of the two methods were compared. Results All of the 94 specimens were successfully analyzed, 11 cases were found with chromosomal anomaly, the overall detection rate was 11.7%(11/94). Seven (7.4%,7/94) abnormalities cases were detected by karyotyping,and 7(7.4%)by SNP-array.The karyotyping results of trisomy 21,and 45,X and the deletion of chromosome 13 were consistent with SNP-array.Only 3(3.2%,3/94)microdeletion/duplications (the sizes of duplications and deletions were between 422.4-1 708.4 kb)and 1(1/4)loss of heterozygosity were detected by SNP-array,but were missed by karyotyping.Furthermore, 2 cases′copy number variation were found pathogenic gene related, while the other 2 were considered benign or variant of uncertain significance. Four cases(4/7)of abnormalities were detected by karyotyping, while confirmed balanced translocation and inversion by SNP-array.All patients were informed and chosen to continue the pregnancy.Conclusions The rate of abnormal fetal chromosomes in pregnant women with an adverse reproductive history is still high.SNP-array is a new molecular genetic technique,and combined with use of traditional karyotyping,it could improve the detection rate of fetal chromosomal abnormalities and reduce abortion rate, thus providing a basis for genetic counseling and prenatal diagnosis.
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Objective To observe the therapeutic effect of segmental scleral buckling and vitrectomy with/without lensectomy on the retinopathy of prematurity (ROP) stage 4a,4b and 5.Methods One hundred and thirty-four ROP infants (181 eyes) diagnosed as stage 4a,4b and 5,and performed with segmental scleral buckling or vitreous with/without lensectomy were retrospectively analyzed.The operated 4a-,4b-and 5-stage eyes were 40,51 and 90 eyes.The operational method depended on the location and severity of fibrovascular membrane.Of 181 eyes,segmental scleral buckling was referred for 37 eyes which include 23 eyes with 4a stage and 14 eyes with 4b stage;vitrectomy was referred for 50 eyes which include 14 eyes with 4a stage,29 eyes with 4b stage and 7 eyes with 5 stage;vitrectomy with lensectomy was referred for 94 eyes which include 3 eyes with 4a stage,8 eyes with 4b stage and 83 eyes with 5 stage.The effect was classified as success,improved and failure.Failure includes lost eye.Follow-up for 4a,4b and 5 stage patients are 34,31 and 29 months respectively.Results Segmental scleral buckling was referred for 37 eyes,success in 23 eyes (62.16％),improved in 11 eyes (29.73 ％),failure in 3 eyes (8.11 ％).Vitrectomy was referred for 50 eyes,and success in 20 eyes (40.00％),improved in 22 eyes (44.00％),and failure in 8 eyes (16.00％).In the total of 94 eyes underwent vitrectomy with lensectomy,20 eyes was success (21.28％),improved in 17 eyes (18.08％),failure in 57 eyes (60.64％).In 40 stage 4a eyes,33 successes (82.50％),6 improved (15.00％) and 1 failure (2.50％).In 51 stage4b eyes,11 successes (21.57％),30 improved (58.82％) and 10 failures (19.61％).For 90 stage 5 eyes,14 successes (17.50％),19 improved (23.75％) and 57 failures (71.25％).The therapeutic effect of segmental scleral buckling for stage 4a was better than that for stage 5 (x2 =6.707,P=0.035).The difference of therapeutic effect of vitrectomy for different stage was significant (x2=21.010,P =0.000);stage 4a was the best;stage 4b was the second,stage 5 was the worst.The therapeutic effect of vitrectomy with lensectomy for stage 5 was worse than that for stage 4a and 4b (x2=16.066,P=0.003).Conclusion The surgery patterns of ROP was determined based on the disease severity,the surgery effects of stage 4a and 4b were better than stage 5,which had nothing to do with the surgical procedures.
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Objective To investigate the clinical characteristics of 40 patients with ocular toxocariasis (OT) on the first attendance.Methods A total of 40 consecutive patients who were clinically and serologically diagnosed with OT were retrospectively reviewed.Results The mean age of patients was (12.12±10.42) years.There were 29 males and 11 females.29 cases presented with decreased vision,4 children with leukocoria,2 cases with strabismus and 5 cases was found abnormal during regular eye examination.Initially 8 eyes (20％) were misdiagnosed as retinoblastoma (1 eye),Coat' s disease (1 eye),cataract (2 eyes),iridocyclitis (2 eyes) and retinal detachment (2 eyes).23 eyes had retinal detachment,19 eyes had cataract.OT was the initial diagnosis for 15 patients (37.5％).The best corrected visual acuity (BCVA) were NLP to 0.7.Ultrasound biomicroscopy (UBM) were performed in 29 eyes,and identified peripheral granulomas in 23 eyes and adjacent tractional retinal detachment in 12 eyes.We also identified 17 cases (68.0％) with elevated IgE level among 25 patients with positive serological antibody test.Conclusions Tractional retinal detachment,vitreous opacities and cataract are the common clinical findings at the first attendance of OT patients.The adjunctive test of serum total IgE level may be helpful for the diagnosis.The application of UBM and specific IgG detection in serum and intraocular fluid,can also improve the diagnosis.
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Objective To investigate the risk factors of postoperative delirium in elderly patients with intertrochanteric facture.Methods This retrospective analysis was conducted on 256 patients aged over 65 years treated with internal fixation of intertrochanteric facture between January 2012 and December 2013.Incidence and risk factors of postoperative delirium were documented.Results Incidence of postoperative delirium was 14.8％ (38/256).Risk factors of postoperative delirium included body mass index (BMI) less than 20 kg/m2 (P ＜ 0.05),preoperative hemoglobin (Hb) less than 100 g/L (P ＜ 0.05),atrial fibrillation (P ＜ 0.05),low sodium (P ＜ 0.05),preoperative total protein less than 60 g/L (P ＜ 0.05),preoperative waiting time more than 4 days (P ＜ 0.05),preoperative cognitive impairment (P ＜ 0.05),operation time more than 2.5 hours (P ＜ 0.05),perioperation blood loss more than 1,000 ml (P ＜ 0.05),and more than two kinds of medical conditions (P ＜ 0.05).Logistic regression identified three independent factors for postoperative delirium:preoperative waiting time more than 4 days (P ＜ 0.05,OR =2.74),BMI less than 20 kg/m2 (P ＜ 0.05,OR =13.27),preoperative cognitive impairment (P ＜ 0.05,OR =4.47),and operation time more than 2.5 hours (P ＜ 0.05,OR =4.56).Conclusions Risk factors of postoperative delirium in elder patients with femoral intertrochanteric fracture are complicated.Therefore,overall situation should be taken into consideration and comprehensive and effective treatment should be formulated to prevent the occurrence of postoperative delirium.
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Objective To better understand the age related changes of cardiac structure and function and their relationship with gender, body weight and blood pressure. Methods M mode, 2 dimensional, and Doppler echocardiographic studies were performed on 306 healthy intellectuals, including 165 males and 141 females, ranging in age from 30 to 85 years. Results Parameters in both male and female including the ratio of peak E wave to peak A wave velocity(E/A), the ratio of the right ventricular peak E wave to peak A wave velocity(E/Ar), the amplitude of aortic wall (Aao) and the angle between septum and the root of aorta (?) were all decreased with the aging significantly( P
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Objective To evaluate the efficacy and safety of emergency percutaneous coronary intervention(PCI) in patients with non-ST-segment elevation acute coronary syndrome(ACS).Methods A total of 233 patients(emergency group) were treated with emergency PCI within 48 h of heart attack and another 152 patients(delayed group) were treated with PCI after 3-14 days of medical therapy.All culprit lesions were treated.Procedural success rate,the time from admission to angina relief,the length of hospital stay and cardiac events incidence in 30 days were observed.Results The procedural success rates for the emergency group and the delayed group were similar(98.1% vs 95.5%),but cardiac events incidence in 30 days was significantly lower in the emergency group than that of the delayed group(2.9% vs 14.1%,P