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Objective:To explore the predictive value of ultrasound-based radiomics for liver metastasis in pancreatic neuroendocrine tumors (pNEN).Methods:A retrospective analysis was conducted on clinical, pathological, and ultrasound data of 269 pNEN patients confirmed by pathology at Tianjin Medical University Cancer Institute and Hospital from January 2012 to June 2022, including 94 patients with liver metastasis and 175 without liver metastasis. The regions of interest (ROI) were delineated on the maximum diameter section of the tumor using ITKSNAP software, and radiomics features were extracted using Pyradiomics. Radiomics features with an intra-group correlation coefficient greater than 0.90 were retained, and the optimal features were selected using the maximum relevance minimum redundancy (MRMR) algorithm. The dataset was randomly divided into a training set and a validation set in a ratio of 7∶3, and the random forest algorithm (Rfs) was used to predict pNEN liver metastasis. Three models were constructed, including the clinical ultrasound model, the radiomics model, and the comprehensive model that combined clinical ultrasound and radiomics features. The predictive performance of different models for pNEN liver metastasis was analyzed using the ROC curve, and the predictive performance of different models was compared using the Delong test.Results:A total of 874 features were extracted from the ROI, and 12 highly robust radiomics features were retained for model construction based on inter- and intra-observer correlation grading and feature selection. The area under curve(AUC), sensitivity, specificity, and accuracy of the radiomics model, the clinical ultrasound model, and the comprehensive model for predicting liver metastasis in pNEN patients were 0.800, 0.574, 0.789, 0.714; 0.780, 0.596, 0.874, 0.777; and 0.890, 0.694, 0.874, 0.810, respectively. The Delong test showed that the comprehensive model had the best predictive performance, with an AUC superior to that of radiomics model ( Z=3.845, P=0.000 12) and clinical ultrasound model ( Z=3.506, P=0.000 45). Conclusions:The radiomics model based on ultrasound has good performance in predicting liver metastasis in pNEN, and the comprehensive model that combines clinical ultrasound and radiomics features can further improve the predictive performance of the model.
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Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a cystic tumor of the pancreas with some malignant potential. According to the degree of pancreatic duct expansion and the location of the tumor, it can be divided into main-duct type, branch-duct type, and mixed type. According to the degree of atypia, it can be classified as low-grade dysplasia, high-grade dysplasia, or invasive IPMN. According to histological morphology and immunohistochemistry, there are four subtypes: gastric type, intestinal type, pancreaticobiliary type, and eosinophilic type. Ultrasound is commonly used in screening and follow-up, while CT, MRI/MRCP, and EUS can identify IPMN with high-risk and anxiety characteristics, which are valuable in determining the timing of surgery and patient status. Imaging omics is highly accurate in assessing the degree of dysplasia and can be used to identify people at high risk of malignant transformation. In this article, the clinical manifestations, pathology, and imaging features of IPMN are reviewed in the light of the relevant guidelines and literature in recent years, in order to deepen our understanding of IPMN and thus improve the accuracy of imaging diagnosis.
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Objective:To explore the risk factors of posterior circulation ischemic dizziness/vertigo and nursing effects of emotional releasing therapy combined with positive psychological suggestion in patients.Methods:A total of 368 patients with dizziness/vertigo treated in Qinhuangdao First Hospital were selected by Convenience sampling method from January 2018 to August 2020, including 153 cases confirmed with posterior circulation ischemic dizziness/vertigo in posterior circulation group and 215 cases with non-posterior circulation ischemic dizziness/vertigo in non-posterior circulation group. The risk factors were analyzed by Logistic regression analysis. According to random number table method, 153 patients in posterior circulation group were divided into control group (76 cases received routine nursing) and observation group (77 cases received emotional releasing therapy combined with positive psychological suggestion on basis of routine nursing). All patients were intervened until discharge. The onset frequency and duration of dizziness/vertigo before and after intervention, effects of vertigo on patients, anxiety, depression, treatment compliance, and nursing satisfaction after intervention were compared between the two groups.Results:Multivariate analysis showed that male gender ( OR=2.675, 95% CI 1.179-6.070), age not younger than 60 years old ( OR=2.255, 95% CI 1.105-4.602), hypertension ( OR=3.330, 95% CI 1.651-6.717), diabetes ( OR=2.044, 95% CI 1.270-3.291), smoking ( OR=2.333, 95% CI 1.266-4.300), previous history of stroke or transient ischemic attack (TIA) ( OR=2.601, 95% CI 1.333-5.075), and previous history of cardiovascular diseases ( OR=2.143, 95% CI 1.085-4.230) were independent risk factors of posterior circulation ischemic dizziness/vertigo (all P<0.05). After intervention, onset frequency and duration of dizziness/vertigo in observation group were (1.26 ± 0.34) times/month and (4.16 ± 1.02) min, significantly shorter than (3.18 ± 0.95) times/month, (6.43 ± 1.18) min in control group ( t=16.69, 12.74, both P<0.05). The scores of Dizziness Handicap Inventory, Self-rating Depression Scale and Self-rating Anxiety Scale in observation group were (12.27 ± 3.34), (37.35 ± 3.62), (38.13 ± 3.22) points, significantly lower than (18.35 ± 4.61), (44.19 ± 3.14), (43.25 ± 3.08) points in control group ( t=9.35, 12.48, 10.05, all P<0.05). After intervention, Morisky Medic Ationadherence Scale and Newcastle Satisfaction with Nursing Scales scores in observation group were (6.77 ± 0.52), (87.06 ± 3.12) points, significantly higher than (5.34 ± 0.37), (79.14 ± 4.28) points in control group ( t=19.58, 13.09, both P<0.05). Conclusions:Male gender, age not younger than 60 years old, hypertension, diabetes, smoking, previous history of stroke or TIA, and previous history of cardiovascular diseases are independent risk factors of posterior circulation ischemic dizziness/vertigo. The emotional releasing therapy combined with positive psychological suggestion can effectively improve onset of dizziness/vertigo, anxiety, depression and treatment compliance in patients with posterior circulation ischemia, with high nursing satisfaction.
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Objective:To establish the reference for serum metabolomics profiles among healthy Han adults in China, and explore the variation on metabolomics profiles by geographic regions, sex, and age.Methods:Cross-sectional data and serum samples were obtained from the China National Health Survey. A total of 1 039 male and 1 032 female healthy adults(≥30 years) were included in this study. Serum metabolomics analyses were conducted with ultra-performance liquid chromatography-mass spectrometry(UPLC-MS). Orthogonal partial least squares discriminant analysis(OPLS-DA) was performed to compare the differences of metabolomics among different region, sex, and age.Results:Significant differences on metabolomics profiles were identified among region, sex, and age. A total of 114 region-related metabolites were spotted, including 53 metabolites that involved in human metabolic pathways, mainly peptides(20 metabolites) and glycerophospholipid metabolism-related(14 metabolites). Fifty-nine metabolites were pinned down to be sex-related, among which cotinine was significant in all 7 provinces. Age-related metabolites were only found in Shaanxi and Hainan, with 22 metabolites were recognized.Conclusion:Serum metabolomics varies by geographic regions, sex, and age. When metabolomics is applied for diagnosis or biomarker screening in various studies, it shall take into consideration of setting tailored references.
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Objective:To understand the current status of depression in older people aged 65 and over in Henan Province, and to study its influencing factors, with a focus on depression in older adults in grandparent families.Methods:A multi-stage stratified cluster sampling method was used.Baseline data about older people aged 65 and over were collected by self-designed questionnaires, the 15-item Geriatric Depression Scale(GDS-15)was used to assess depression.Results:A total of 7673 valid questionnaires about older adults aged 65 and over were collected, and the rate of depression was 29.52%(2265). Logistic regression analysis showed that 15 factors, such type of parenting, religious belief, region, degree of self-care, affected depression in older people aged 65 and above.Compared with regular parenting, grandparenting alone was a protective factor for depression[ OR(95% CI)=0.613(0.499-0.755), P<0.01]; compared with religious belief, no religious belief was a risk factor for depression[ OR(95% CI)=1.281(1.102-1.488), P<0.01]; compared with income ≥￥4000, incomes between ￥1000-1999[ OR(95% CI)=0.638(0.464-0.877), P<0.01], between ￥2000-2999[ OR(95% CI)=0.567(0.432-0.744), P<0.01]and between￥3000-3999[ OR(95% CI)=0.584(0.448-0.761), P<0.01]were protective factors for depression, with higher income showing stronger protection; compared with retirement, working had a protective effect, but the protective strength decreased in the order of working as urban labor, [ OR(95% CI)=0.332(0.273-0.405), P<0.01], as farmers[ OR(95% CI)=0.391(0.296-0.516), P<0.01], and as professionals or managers[ OR(95% CI)=0.514(0.402-0.656), P<0.01]; living in rural areas[ OR(95% CI)=0.686(0.586-0.804), P<0.01]and female[ OR(95% CI)=0.820(0.734-0.917), P<0.01]were risk factors for depression. Conclusions:There is currently a high rate of depression in older people aged 65 and over in Henan Province.Its influence factors are complicated and variable.Intervention measures taken by institutions need to adapt to specific circumstances.
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Objective:To explore the clinical value of "hydration therapy" in the treatment of severe acute paraquat poisoning (APP).Methods:A prospective historical control observation was conducted. Fifty-eight patients with severe APP admitted to Shouguang People's Hospital Affiliated to Weifang Medical College from February 2014 to June 2019 were enrolled. Twenty-six patients admitted before May 10th, 2016 were enrolled in the standard treatment group. After being admitted to intensive care unit (ICU) from the department of emergency, patients in the standard treatment group were immediately given standard treatment such as repeated gastric lavage, catharsis, adsorption of poison by activated carbon or montmorillonite powder, drug treatment and blood purification. From May 10th, 2016, 32 patients were enrolled in the intensive treatment group. On the basis of standard treatment, "hydration therapy" was carried out, that was, 0.9% NaCl and/or 5% glucose injection were used for continuous intravenous infusion throughout the day, so as to ensure that the total amount of fluid infusion per day reached 200 mL/kg within 48-72 hours after ICU admission. At the same time, furosemide was used to strengthen diuresis to ensure the balance of water and electrolyte. If heart failure or acute pulmonary interstitial edema occurred during the treatment, "hydration therapy" should be stopped immediately. Six months after treatment, all patients were followed up. The patients with normal activity, no complaints of discomfort and no damage of heart, lung, liver, kidney and other organs were regarded as cured. The therapeutic effect of "hydration therapy" was evaluated.Results:There was no significant difference in gender, age, dosage or time from taking poison to ICU between the two groups. In the intensive treatment group, 32 patients did not appear heart failure during continuous rehydration treatment. Follow-up after 6 months showed that the overall cure rate in the intensive treatment group was significantly higher than that in the standard treatment group [59.4% (19/32) vs. 19.2% (5/26), P < 0.05]. In the 6-month follow-up, there was no significant difference in age or time from taking poison to ICU between the two groups, but the dosage in the intensive treatment group was significantly higher than that in the standard treatment group (mL: 54.06±26.03 vs. 23.00±4.47, P < 0.05). After 6 months of follow-up, chest CT showed that the lesions of pulmonary fibrosis of cured patients in both group gradually reduced with time, not completely progressive and irreversible. Conclusion:"Hydration therapy" with intensive diuresis can significantly improve the rescue success rate of patients with severe APP.
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Objective:To evaluate the effect of job-transfer training for psychiatrists in Henan province in 2018 and to compare them with the results of 2016.Methods:Data of the trainees were collected through questionnaires in 2017 and 2019 respectively. The influencing factors of knowledge and skills were determined by Multiple linear regression analysis; baseline data, training intention, training feedback and the proficiency of knowledge and skills were compared by independent sample t test and chi-square test. Results:The overall satisfaction rate for training was 98.3%, and the overall mastery rate of training knowledge and skills was 59.2% in year 2018. Compared with 2016, the willingness to participate in training, the satisfaction rate, the recognition degree of " 1+ 10+ 1" training mode, the degree of mastery and practical application of training knowledge and skills increased( P<0.05). There were statistically significant differences in the distribution of the primary reasons for participating in the training, factors hindering their participation in the training, and the causes for their failure to fully apply their learning to practice( P<0.01). The results showed that scope of practice, title, intention, and interest in psychiatry was related to the mastery of training knowledge and skills( P<0.05). Conclusions:The effect of training in 2018 is better than 2016, and the degree of mastery and practical application of training knowledge and skills should be increased.
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Objective@#To investigate the correlation between cervical lymph node skip metastasis with ultrasonographic characteristics of papillary thyroid micro- carcinoma (PTMC).@*Methods@#We reviewed ultrasonographic features of 385 primary PTMC and cervical lymph node metastasis, confirmed by pathology in Tianjin Medical University Cancer Institute and Hospital, to evaluate the efficacy of ultrasonography in the diagnosis of cervical lymph node metastasis of PTMC patients. The relationship between ultrasonographic features of primary lesions and skip metastasis of cervical lymph nodes was analyzed by χ2 test and multiple factor Cox regression.@*Results@#Among the 385 cases of PTMC patients with cervical lymph node metastasis, 231 cases were central lymph node metastasis alone, 31 cases were lateral cervical lymph node metastasis alone, 123 cases were both central and lateral cervical lymph node metastasis. Among the 354 cases without skip metastasis of cervical lymph nodes, 48 cases were level Ⅱ, 92 cases were level Ⅲ, 83 cases were level Ⅳ, 9 cases were level Ⅴ, 354 cases were level Ⅵ. Among the 31 cases with skipping metastasis of cervical lymph nodes, 12 cases were level Ⅱ, 14 cases were level Ⅲ, 14 cases were level Ⅳ, 1 case was level Ⅴ. The sensitivity and specificity of preoperative ultrasonography in the diagnosis of central cervical lymph node metastasis were 46.3% and 66.7%, respectively, and those of lateral cervical lymph node were 91.0% and 87.8%, respectively. Univariate analysis showed that the abutment/perimeter, diameter and location of PTMC were significantly associated with skip metastasis (P<0.05), multivariate analysis showed that abutment/perimeter and location of PTMC were significantly associated with skip metastasis (P<0.05).@*Conclusions@#The sensitivity and specificity of preoperative ultrasound diagnosis for lateral cervical lymph node metastasis of PTMC is higher than that of central metastasis. PTMC with abutment/perimeter ≥1/4 and upper portion location are prone to skip metastasis.
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Paraquat (PQ) poisoning has become one of the common pesticide poisoning in China. PQ is extremely toxic to human beings. The fatality rate of oral PQ poisoning is more than 90%. So far, there is no specific antidote. Seek effective treatment measures for PQ poisoning has become the focus of clinical medical research. In November 2017, a patient with acute severe PQ poisoning was treated in the intensive care unit (ICU) of Shouguang People's Hospital Affiliated to Weifang Medical College. The patient refused blood purification therapy and was rescued successfully only by continuous fluid therapy, diuresis, catharsis and routine treatment. By reviewing the treatment process of this case, new treatment ideas for the clinical treatment of PQ poisoning in primary hospitals were provided. Patients with acute PQ poisoning should be rescued by immediate administration of emetic, gastric lavage, catharsis and oral montmorillonite powder. For those without dysfunction of heart, lung and and kidney, a large amount of fluid treatment and diuresis should be given immediately to promote the excretion of poison. The key to improve the success rate of rescue of acute PQ poisoning is to eliminate PQ from the body as soon as possible.
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Objective@#To investigate the correlation between ultrasonographic features of papillary thyroid carcinoma and central cervical lymph node metastasis.@*Methods@#We retrospectively analyzed 486 patients with papillary thyroid carcinoma(PTC), pathologically confirmed after surgery in Tianjin Medical University Cancer Institute & Hospital. All patients were divided into central cervical lymph node metastasis group and non-metastasis group. No lateral cervical lymph node metastasis was found in preoperative ultrasonography and postoperative pathology. The characteristics of the ultrasound was observed and analyzed.@*Results@#297 out of 486 patients with papillary thyroid carcinomahad central metastasis, and the other 189 cases did not. Take pathology results as a standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of preoperative ultrasound diagnosis in PTC patients with central cervical lymph node metastasis were 35.3%, 88.6%, 83.2%, 47.4%, 56.6%, respectively. Univariate analysis showed that multi-focus, taller-than-wide, diameter>1 cm, located in the lower pole, ill-defined margin, hypoechogenicity, micro-calcification, capsule invasion more than 1/4 perimeter of papillary thyroid carcinoma were significantly associated with central cervical lymph node metastasis (all P<0.05). Multivariate analysis showed that diameter>1 cm, micro-calcification, capsule invasion more than 1/4 perimeter of papillary thyroid carcinoma became independent risk factors of central cervical neck lymph node metastasis (all P<0.05).@*Conclusions@#Preoperative description of ultrasonographical features has important value to assess central cervical lymph node metastasis in patients with papillary thyroid carcinoma. More information could be provided for clinical treatment. When the papillary thyroid carcinoma presented as diameter>1 cm, micro-calcification, and capsule invasion more than 1/4 perimeter of, there will be a greater risk of central cervical lymph node metastasis, and we shall suggest prophylactic central lymph cervical node dissection.
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Objective To investigate the clinical effect of therapeutic cervical cerclage on short cervix syndrome for anti-premature birth in the second trimester. Methods Totally 44 singleton pregnant patients were diagnosed as short cervix syndrome, which was cervical length ≤2.5 cm without cervical dilatation,and received treatment from January 2008 and July 2015 in Peking University Third Hospital were collected. Among them, 30 patients who received therapeutic cervical cerclage were defined as cerclage group and another 14 cases who received conservative treatment were defined as un-cerclage group. The days of conservative treatment, delivery rate of different gestational weeks, birth weight of newborns, neonatal survival rate within 7 days of birth were analyzed between the two groups. Results There were no significant differences between the two groups in days of pregnancy conservative treatment [103(84-141)vs 105(85-114)days], delivery weeks [38.0(35.5-39.4)vs 38.5(37.3-39.5)weeks], birth weight of newborns [3120(2750-3400)vs 3130(2760-3545)g], and survival rate of newborns [100％(30/30)vs 13/14]. The fetuses of both groups were all delivered after 28 weeks. There was no significant difference in accumulated delivery rate between the two groups after 32 weeks, 34 weeks, and 37 weeks, respectively(all P>0.05). Conclusions The treatment of cervical cerclage is not superior to conservative means in single pregnancy of cervical length ≤2.5 cm without cervical dilatation. For such patients with short cervix syndrome, the treatment of cervical cerclage may not be necessary, but dynamic monitoring and search for the causing factors and prompt treatment are more important.
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Objective To determine activity concentrations of natural and artificial radionuclides in the surface soils in Huhhot city,measure environmental radiation level,and evaluate risks to residents health.Methods Radionuclides in 48 surface soil samples were determined by means of the high purity germanium γ spectrometer;environmental radiation level was measured using an environment γ dose rate meter;comparison was made of average activity concentrations in soils between domestically and globally;and the radiation dose to the local residents was estimated by using the methods recommended by UNSCEAR and reported in the related literatures.Results The average values for specific activity of 238U,232Th,226 Ra,40K and137 Cs in the surface soil samples in Huhhot city were (29.29 ± 12.95),(39.33±4.34),(29.77 ±3.21),(650.49 ±62.21) and (1.62 ± 1.53) Bq/kg,respectively;the measured air absorbed dose rate was (86.32 ± 11.92) nGy/h;the annual effective dose to local residents from outdoor γ radiation was 79.27 μSv/year.Conclusions The specific activities of radionulcides in soils and the environmental radiation in surface soil in Huhhot city were at a normal background level,with low risks to health of the local residents.
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Objective To investigate the value of TI-RADS for sonographic diagnosis of papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) and to evaluate the sonographic findings of FTC compared to PTC.Methods The clinical and sonographic data of 363 cases of pathology confirmed thyroid nodules were retrospectively analyzed.The thyroid nodules were classified by TI-RADS grading criteria,the accuracy of TI-RADS and sonographic findings between FTC and PTC was analyzed.Results In 363 thyroid nodules,114 cases were confirmed as benign lesions;249 cases were confirmed as carcinomas,including 50 FTC cases and 199 PTC cases.The sensitivity,specificity,PPV,NPV,and accuracy of PTC were 97.0％ (193/199),85.1％ (97/114),91.9％ (193/210),85.8％ (97/113),95.7％ (290/303) respectively.The sensitivity,specificity,PPV,NPV,and accuracy of FTC were 97.0％(193/199),85.1％ (97/114),91.9％ (193/210),85.8％ (97/113),95.7％ (290/303) respectively.There were significant differences of nodule size,shape,margin,echogenecity,calcification,halo and flow between FTC group and PTC group (P ＜ 0.05).Conclusion TI-RADS has higher value in the sonographic diagnosis of PTC than that of FTC.FTC are greatly different from PTC in many sonographic findings making it less valuable for the diagnosis of FTC.
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Objective To investigate the adjuvant therapeutic efficacy of three-dimensional conformal radiotherapy (3D-CRT) in treating patients who underwent surgical operation for biliary drainage.Methods Clinical data on 88 clinically diagnosed advanced pancreatic head carcinoma patients who received palliative biliary drainage surgery in Tanshan Gongren Hospital from Jan 2006 to Jan 2010 were retrospectively reviewed. The cases were categorized according to the treatment into control group ( n=34 ) , chemotherapy group ( n=23 ) and radiotherapy group ( n=31 ) . The patients in control group received no chemotherapy or radiotherapy after biliary drainage surgery.The patients in chemotherapy group received chemotherapy of 1 000 mg/m2 gemcitabine intravenous infusion on day 1 and day 8, 80 mg/m2 cisplatin intravenous infusion on day 1 for each treatment cycle.Each cycle lasted for 21 days and was repeated for 3 cycles at an interval of 7 days in a treatment course.Patients in radiotherapy group received 3D-CRT for 6 successive days followed by an interval on the 7th day.The treatment course was completed within 10~15 days with the total dosage of 3 000~4 800 cGy.The therapeutic effects and survival time were analyzed.Results The incidence of cancer associated pain was 52.9%, 39.1%and 9.7%in control group, chemotherapy group and radiotherapy group, respectively, which was significantly lower in radiotherapy than that in the other two groups (both P<0.05). The incidence of mild gastrointestinal symptoms was 8.8%, 73.9% and 16.1%, respectively, and that of bone marrow suppression was 0%, 82.6% and 9.7%, respectively, which were both significantly lower in radiotherapy group than in chemotherapy group (both P<0.05).The 1-year, 2-year and 3-year survival rate was 30.1%, 8.3%, 0% in control group, 35.3%, 14.8%, 0% in chemotherapy group and 46.4%, 21.1%, 3.6%in radiotherapy group, which in radiotherapy group was significantly higher than that in control group and chemotherapy group (all P<0.05).Conclusions 3D-CRT was a palliative strategy for advanced pancreatic head cancer, which could prolong the survival of patients.
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Objective To ascertain the gross α/β levels in drinking water in Inner Mongolia and to estimate the annual effective dose to the local residents from radionuclides in drinking water.Methods A total of 768 water samples were collected from 101 counties distributed over 12 cities of Inner Mongolia.Low background α/β measuring instrument was used to measure the radioactivity level;On this basis,use EPA Federal Guidance Report 11 universal method to estimate the annual effective dose to the local residents via intake of radionuclides from drinking water.Results The gross α radioactivity range was 0.016-1.003 Bq/L for tap water,O.016-0.975 Bq/L for factory water,0.017-1.544 Bq/L for river water,0.120-0.672 Bq/L for lake water,0.016-0.492 Bq/L for reservoir water,0.016-1.139 Bq/L for well water,0.032-3.156 Bq/L for spring water,respectively.The gross β radioactivity range was 0.030-0.828 Bq/L for tap water,0.031-0.571 Bq/L for factory water,0.066-0.873 Bq/L for river water,0.169-2.268 Bq/L for lake water,0.046-0.519 Bq/L for reservoir water,0.071-0.526 Bq/L for well water,0.087-1.063 Bq/L for spring water,respectively.Conclusions In Inner Mongolia,the gross α/β mean value in tap water is less than the World Health Organization-recommended value and the average annual effective dose from tap water is also less than the WHO-recommended value O.1 mSv/a.The gross α/β radioactivity from the other water samples is also within the range of the nationwide average.
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Objective: To establish a determination method for the related substances in nortriptyline hydrochloride by HPLC. Methods:An Agilent C18 (250 mm × 4. 6 mm,5 μm) column was adopted with a mobile phase consisting of acetonitrile-0. 2% trieth-ylamine(pH 3. 0)(34 ∶66). The flow rate was 1. 0 ml·min-1, the detection wavelength was set at 210 nm, the column temperature was 40℃ and the injection volume was 20 μl. Results:The resolutions of the related substances were acceptable. The detection limit and the quantitation limit of the samples was 0. 40 ng and 1. 35 ng, respectively. Conclusion: The method is sensitive, accurate and specific, and can be used to determine the related substances in nortriptyline hydrochloride.
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Objective By detecting the DNA methylation and gene expression of long-chain 3-hydroxyacyl CoA dehydrogenase (LCHAD) in trophoblast cells, analyze the correlation of DNA methylation and gene expression in early-onset preeclampsia (EPE), hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and antiphospholipid syndrome (APS), to investigate the molecular basis of long-chain fatty acid oxidation changes in different preeclampsia and pathological pregnancy. Methods Primary human cytotrophoblast cells and HTR8/Svneo cells were treated with serum from patients with EPE (14 cases), HELLP (12 cases), APS (14 cases), and normal pregnant women (NP, 14 cases). The methylation level of LCHAD gene promoter region through the MassARRAY platform and mRNA expression level by real-time fluorescent quantitative PCR technique were conducted. Results (1) Cytosine-phosphate-guanine (CpG)sites in human LCHAD DNA promoter region:CpG sites were detected in the range of 558 bp before LCHAD gene transcription start site, the detected CpG sites were 11 sites including 8 single sites and 3 complex sites. The position of these sites were at-984,-960,-899,-853,-811,-796,-774,-727,-615,-595,-579 respectively. (2) The sites of-899,-853,-615 and-595 showed increased methylation level in EPE and HELLP groups. The methylation level at-899,-853 and-615 sites in EPE and HELLP groups were significantly higher than those in NP group(P<0.01). The methylation level at-853 site was higher in EPE group than that in HELLP group(P<0.05). The-595 site showed the unmethylated in EPE, HELLP and APS groups. There were significantly difference between the 3 groups and EPE group(P<0.01). (3) The gene expression of LCHAD mRNA in EPE(0.048±0.005), HELLP(0.045±0.006)and APS(0.044±0.004) groups were significantly lower than NP group(0.076 ± 0.009;P<0.01). (4) The correlation of methylation level and gene expression in all groups: the methylation level at-899,-853,-727,-615 and-579 sites were negatively correlated with gene mRNA expression in EPE group (P<0.05). The methylation level at-899,-853 and-615 sites were negatively correlated with gene mRNA expression in HELLP group(P<0.05). Conclusions The variation of LCHAD DNA methylation of trophoblast cells are found among EPE, HELLP syndrome and APS. The different correlation of LCHAD DNA methylation and gene expression are different in pathological groups. LCHAD DNA methylation of EPE and HELLP syndrome were significantly increased and negatively correlated with LCHAD gene mRNA expression. These results further revealed the molecular basis of long-chain fatty acid oxidation in different preeclampsia and pathological pregnancy.
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Objective:To characterize the clinical and epidemiological changes, treatments, and prognoses of primary esophageal small cell carcinoma (PESC). Methods:A retrospective analysis was conducted using the clinical epidemiology data of 529 PESC patients se-lected from the clinical databases of 500,000 esophageal and gastric cardiac carcinomas of the Henan Key Laboratory for Esophageal Cancer Research (1992-2015). Among these patients, 241 cases were included in the survival analysis. The five-year survival rate was calculated using Kaplan-Meier analysis, and the differences in survival rates were compared using the Log-rank analysis model. Re-sults:All 529 PESC cases were analyzed, which accounted for 0.2%of esophageal cancers diagnosed in the same period. The incidence of PESC increased annually (R2=0.574). The survival rates for 1-, 2-, 3-, and 5-year of 241 PESC patients were 55%, 40%, 29%, and 9%, respectively, and the median survival time was 21.9 months. On the basis of the VALSG criteria of lung small cell carcinoma, a statisti-cal difference was observed in the overall survival rates for limited and extensive diseases (P=0.003), with the median survival time of 24.3 and 17.5 months, respectively. Furthermore, significant differences were observed on survival with various treatment modalities (P=0.004). The median survival time of PESC patients treated with combined surgery and radiochemotherapies (28.8 months) was lon-ger than those with either chemotherapy (17.8 months, P=0.015) or chemoradiotherapy (14.5 months, P=0.004). In limited disease pa-tients, the median survival time was longer in patients treated with surgery (27.7 months) than in those without surgery (16.2 months, P=0.007). Notably, the biopsy diagnosis before surgery for PESC was only 40.8%. Conclusion:PESC is a rare malignant carcinoma with increasing incidence. PESC presents poor prognosis, and the survival rate can be improved through combined therapies based on sur-gery. A high misdiagnosis rate for PESC is observed before surgery with biopsy.
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Objective:To explore the effect of irbesartan in the treatment of the patients with hypertension complicated with diabetes mellitus and its influence on urine trace albumin. Methods:Totally 62 cases of patients with hypertension complicated with diabetes mel-litus were divided into the observation group and the control group randomly with 31 patients in each. The patients in the control group were given the conventional blood sugar and blood pressure control, and the patients in the observation group were treated with irbesartan additionally. The treatment course was 3 months. The changes of blood pressure and urine trace albumin of the patients in the two groups before and after the treatment were compared, and the effect of blood pressure control and the adverse effects were evaluated as well. Re-sults:The total effective rate of the observation group was 96. 8%, which was much higher than that of the control group (83. 9%, P0. 05). Conclusion:The clinical effect of irbesartan in the treatment of patients with hypertension complicated with diabetes mellitus is promising with low incidence of adverse effects,which can effectively protect renal function as well.