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Objectives@#. Nicotine is an ingredient of tobacco, and exposure to nicotine increases the risks of various cancers, including oral cancer. Previous studies have focused on the addictive properties of nicotine, but its carcinogenic mechanism has rarely been studied. We aimed to explore the key genes in the process through which nicotine promotes the occurrence and development of oral cancer via data mining and experimental verification. @*Methods@#. This study involved three parts. First, key genes related to nicotine-related oral cancer were screened through data mining; second, the expression and clinical significance of a key gene in oral cancer tissues were verified by bioinformatics. Finally, the expression and clinical significance of the key gene in oral cancer were histologically investigated, and the effects of its expression on cell proliferation, invasion, and drug resistance were cytologically assessed. @*Results@#. SERPINE1 was identified as the key gene, which was upregulated in nicotine-treated oral cells and may be an independent prognostic factor for oral cancer. SERPINE1 was enriched in various pathways, such as the tumor necrosis factor and apelin pathways, and was related to the infiltration of macrophages, CD4+T cells, and CD8+T cells. Overexpression of SERPINE1 was associated with N staging and may be involved in hypoxia, angiogenesis, and metastasis. Knockdown of SERPINE1 in oral cancer cells resulted in weakened cell proliferation and invasion ability and increased sensitivity to bleomycin and docetaxel. @*Conclusion@#. This study revealed SERPINE1 as a key gene for nicotine-related oral cancer, indicating that SERPINE1 may be a novel prognostic indicator and therapeutic target for oral carcinoma.
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Systemic lupus erythematosus (SLE) complicated with Aspergillus fumigatus brain abscess is rare and needs to be differentiated from bacterial brain abscess and neuropsychiatric lupus. This article reports 2 cases of surgically diagnosed SLE combined with Aspergillus fumigatus brain abscess. The first patient was a 34-year-old woman. Six months after the diagnosis of SLE, she developed convulsions and unconsciousness. She was diagnosed as neuropsychiatric lupus at the first hospitalization because of negative imaging. After discharge, repeated head magnetic resonance imaging revealed abscess-like signals. The second patient, a 20-year-old male, developed high fever, convulsions, and unconsciousness 3 years after the diagnosis of SLE, and head imaging showed an abscess-like signal. The etiology of the cerebrospinal fluid of the 2 patients was both negative, and the Aspergillus fumigatus brain abscess was diagnosed by pathology through abscess resection or drainage. After treatment with voriconazole, the symptoms were relieved and the lesions were subsided.
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Objective:To explore teaching methods to improve the teaching effect in view of many difficulties in learning medical statistics for clinical medical students.Methods:Taking the clinical medical students of the same grade as the research objects, the students were randomly divided into two groups by cluster sampling in class, i.e. control group and experimental group. The traditional teaching methods and the scenario-based interactive learning software teaching methods were used respectively. The scores of medical statistics courses examinations and the statistical errors in responding to projects of extracurricular research activities were compared between the two groups. SPSS 19.0 was performed for statistical analysis.Results:The results of subject achievements of the students in the experimental group (74.08±11.19) were higher than those in the control group (63.82±10.10) ( t=3.926, P<0.001), especially the comprehensive capabilities of the innovative analysis questions and the multiple-choice questions. The statistical errors of the students in the experimental group was less than those in the control group. There were significant differences between the two groups in the estimation of sample size ( χ2=4.189, P=0.041), statistical design ( χ2=5.558, P=0.018) and data analysis ( χ2=3.971, P=0.046). Conclusion:The results suggest that scenario-based interactive learning software is helpful to improve teaching efficiency, and enhance students' ability to analyze and solve practical problems by using medical statistics knowledge.
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Objective To investigate the correlation between different postoperative serum cortisol cut-off values measured in different periods and the long-term outcomes in patients with Cushing's disease (CD). Methods The clinical data of 102 CD patients undergoing transsphenoidal surgery (TSS) in Peking Union Medical College Hospital from May 1985 to July 2008 were analyzed retrospectively. The differences of long-term outcomes were compared between patients with cortisol levels below 2 μg/dl (2 μg/dl group) and levels between 2 and 5 μg/dl (5 μg/dl group) in the 1postoperative day and 3 and 6 months after surgery. Results The mean follow-up duration was (10.7±1.7) years (range:5-29.1 years). Among these 102 patients,the disease was cured in 74 patients (72.5%) and recurred in 28 patients (27.5%). On the 1postoperative day,there were 63 patients in the 2 μg/dl group,in which 48 patients (76.2%) achieved long-term cure;there were 39 patients in the 5 μg/dl group,in which 26 (66.7%) achieved long-term cure. The difference was not statistically significant (χ=1.097,P=0.295). Three months after TSS,the long-term cure rate was 84.2% (48/57) in the 2 μg/dl group,which was significantly higher than that (65.0%,26/40) in the 5 μg/dl group (χ=4.795,P=0.029). Six months after TSS,the long-term cure rate was 88.7% (47/53) in the 2 μg/dl group,which was significantly higher than that(69.2%,27/39) in the 5 μg/dl group(χ=5.400,P=0.020). Conclusion The serum cortisol level of below 2 μg/dl is more useful than 2-5 μg/dl 3 months and 6 months after surgery in predicting the prognosis of CD patients.
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Humans , Follow-Up Studies , Hydrocortisone , Blood , Pituitary ACTH Hypersecretion , Blood , General Surgery , Postoperative Period , Prognosis , Recurrence , Retrospective StudiesABSTRACT
Objective To explore the application of video laryngoscope in patients with pituitary adenoma during endotracheal intubation.Methods Fifty-one patients (19 males, 32 females, aged 18-71 years, ASA physical status I or II) scheduled for resection of pituitary adenoma under general anesthesia were enrolled.These patients were randomly divided into two groups: Macintosh laryngoscope Group (group M, n=25) and Video laryngoscope Group (group VL, n=26).When performing endotracheal intubation, Macintosh laryngoscope was used to expose the glottis in group M, and video laryngoscope was used in group VL.Head tilted backward angle, mouth opening, thyromental distance, neck circumference, mandibular ramus length, modified Mallampati classification and the difficulty classification of mask ventilation of the patients in two groups were recorded during peri-operation period.The Cormark-Lehane grade, needed pressing of the cricoids cartilage, the ratio of a second attempt during intubation and the intubation time consumed were recorded.Results Less patients in group VL needed cricoids cartilage press (7.7% vs 48.0%) during the intubation than that in group M (P<0.01).Compared with group M, the Cormack-Lehane grade was significantly lower (P<0.01) and the intubation time consumed was significantly shorter in group VL [(32.4±11.7)s vs (45.8±12.6)s] (P<0.01).Conclusion In patients with pituitary adenoma,video laryngoscope may improve the glottis exposure and the success rate of intubation, as well as shorten the intubation time.
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Objective To explore the clinical effects of integrative nursing for rectal cancer patients with colostomy.Methods A total of 80 cases of rectal cancer patients after colostomy were selected from our hospital from December 4,2009 to May 15,2013.They were assigned to the control group and the observation group according to the admission sequence with 40 patients in each group.The control group had been treated with conventional care,the observation group had been treated with integrative care intervened by ostomy technician.Postoperative anxiety,quality of life and complication rates were analyzed between the two groups.Results Anxiety score from the Self-Rating Anxiety Scale was lower in the treatment group respectively on the day of the operation,one month after operation and one year after operation (58.22 ± 8.23 vs.64.46 ± 9.82,50.55 ± 7.53 vs.59.76 ± 9.83,42.26 ± 2.88 vs.58.46 ± 9.82),P ＜ 0.05.the incidences of complications were significantly rarer than the control group such as the postoperative infection [7.50％ (3/40) vs.25.00％ (10/40)],colostomy hemorrhage [5.00％ (2/40) vs.25.00％ (10/40)],colostomy necrosis [2.50％ (1/40) vs.30.00％ (12/40)],other complications [5.00％ (2/40) vs.15.00％ (6/40)],P ＜0.01 or ＜0.05.Moreover,the defecation function,psychological function,social function and material life (92.55 ± 20.56 vs.84.03 ± 24.60,83.05 ± 23.66 vs.61.86 ± 18.20,79.95 ± 36.02 vs.71.09 ± 27.56,59.08 ± 28.56 vs.50.55 ± 25.96) were improved obviously in the observation group,while the incidences of nausea and vomiting and pain (10.15 ± 3.67 vs.18.99± 7.29,12.05 ± 7.90 vs.22.10 ± 9.56) were lower than the control group,based on QLQ-C30 core questionnaire for the European Quality of Life Evaluation,P ＜ 0.05.Conclusions Integrative nursing may effectively improve rectal cancer patients' quality of life after colostomy,reduce the postoperative complications and relieve anxiety,which may be useful in the clinical application.
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Objective To investigate the therapeutic efficacy of minimally invasive modified transforaminal lumbar interbody fusion (TLIF) combined with unilateral nail holding system in patients with extreme lateral lumbar disc herniation.Methods Thirty-eight patients with extreme lateral lumbar disc herniation were divided into minimally invasive modified TLIF combined with unilateral nail holding system group (observation group) and conventional open TLIF group (control group) with 19 cases each according to random digital table method.The therapeutic efficacy was compared between 2 groups.Results Surgery was completed successfully in 2 groups,and there was no perioperative complications.The amount of bleeding and hospital stay length in observation group were significantly less than those in control group:(152 ± 82) ml vs.(258 ± 104) ml and (6.5 ± 2.3) d vs.(12.7 ± 3.6) d,and the rate of fusion and score of Japan Orthopaedic Association 6 months after surgery in observation group were significantly higher than those in control group:18/19 vs.10/19 and (14.5 ± 2.1) scores vs.(12.6 ± 1.9) scores.There were statistical differences (P ＜ 0.01).There was no statistical difference in complications between 2 groups (P ＞ 0.05).Conclusion Minimally invasive modified TLIF combined with unilateral nail holding system in patients with extreme lateral lumbar disc herniation has less blood loss and shorter hospital stay,and it is effective and safe.
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@#ObjectiveTo observe the effect of language rehabilitation training on stroke patients with complete aphasia.Methods10 stroke patients with complete aphasia were treated with language rehabilitation training.ResultsAfter training, scores of hearing, naming, reciting, reading, and writing of patients were significant higher than that before training (P<0.05—0.01).Conclusion Language rehabilitation training plays an active role in rehabilitation of stroke patients with complete aphasia.
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@#ObjectiveTo study the effect of improving communication methods on decreasing the depression of pstients with stroke dysphasia.Methods16 patients with stroke dysphasia communicated with carton cards,body signal.All the patients were assessed by Hamilton Depression Scale(HAMD) in admission day, one week and two weeks later.ResultsAfter two weeks, the patients' depressive level was decreased from(24.2±8.4) to(13.4±6.7)(P<0.001), the symptom of depression reduced 81.2%.ConclusionsImproving communication methods can decrease the depressive level of the patients with stroke dysphasia.