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Objective:To observe the effect of preoperative application of butorphanol tartrate on postoperative recovery quality in patients undergoing thoracoscopic lobectomy.Methods:A prospective selection was conducted on 96 lung cancer patients who underwent thoracoscopic lobectomy and were admitted to Linyi People′s Hospital from May 2021 to September 2021. They were randomly divided into observation group and control group using a random table number method, with 48 patients in each group. The observation group received intravenous injection of 0.02 mg/kg butorphanol tartrate 15 minutes before anesthesia induction; The control group was given an equal volume of physiological saline. The operation site, operation time, remifentanil dosage during operation, heart rate (HR) and mean arterial pressure (MAP) at each time point of admission (T 0), intubation (T 1), 5 min after intubation (T 2), extubation (T 3), 5 min after extubation (T 4), and 15 min into post-anaesthesia care unit (PACU) (T 5) were recorded; The awakening Restlessness score (RS), Ramsay score, Visual Analogue Scale (VAS) score at T 4 and T 5, the time required from completion to extubation, and postoperative anesthesia related adverse reactions were evaluated. Results:There was no significant difference in the operation site, operation time and remifentanil dosage between the two groups (all P>0.05). Compared with T 0, the HR at T 2, T 3 and T 4, MAP at T 1, T 2, T 3 and T 4 in the two groups decreased significantly (all P<0.05). The HR of the observation group at T 1 and T 3 was significantly lower than that of the control group, and the difference was statistically significant (all P<0.05). The VAS scores of T 4 and T 5 in the observation group were lower than those in the control group after surgery, while the Ramsay score were higher than those in the control group (all P<0.001). The incidence of postoperative restlessness, nausea and vomiting in the observation group was lower than that in the control group ( P<0.05). Conclusions:Administering 0.02 mg/kg butorphanol tartrate 15 minutes before anesthesia induction can improve the quality of recovery in patients undergoing thoracoscopic lobectomy, reduce restlessness and related adverse reactions during recovery.
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Objective:To analyze the clinical characteristics of Chlamydia psittaci pneumonia in the elderly, and factor related to the disease severity. Methods:Clinical data of 32 elderly patients with Chlamydia pneumoniae pneumonia admitted in the First People′s Hospital of Xiaoshan District from January 2019 to January 2021 were retrospectively analyzed. The patients were diagnosed by the second generation sequencing using bronchoalveolar lavage fluid (BALF) samples. There were 17 patients in moderate group and 15 patients in severe group; the liver function, muscle enzymes, imaging and lymphocyte subsets of the two groups were compared. Results:There were no significant differences in the age, gender and basic diseases, bird contact history, flaccid fever and dry cough symptoms between two groups, while there were significant differences in mental symptoms and gastrointestinal symptoms between the two groups ( P=0.032, 0.018). There were significant differences in ALT , AST, LDH , CK , CK-MB, CRP, BNP , troponin-T and PCT between the two groups (all P<0.001). The increase of leukocytes was not significant in both groups. The moderate group was dominated by single lobe involvement, while the severe group was dominated by multi lobe involvement and pleural effusion ( P=0.043, 0.015, 0.023). The total lymphocytes, T lymphocytes, CD4 + T cells, CD8 + T cells, CD4 +/CD8 + ratio, NK cells, B cells, CD4 +CD8 + double positive T cells decreased in both groups, while those in the severe group decrease more markedly ( P<0.05). CD4 -CD8 - double negative T cells were higher in the severe group than those in the moderate group ( P<0.001). CD4 +/CD8 + ratio and CD4 -CD8 - double negative T cells were correlated with severity index PSI and CURB-65 ( P<0.05). Conclusions:The liver function, muscle enzyme, lymphocyte immune function in patients with Chlamydia psittaci pneumonia are impaired, which were more markedly in severe patients. The multileaf infiltration and increased procalcitonin may indicate the severe pneumonia. CD4 +/CD8 + ratio and CD4 -CD8 - double negative T cells are correlated with the severity of pneumonia.
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Objective:To investigate the optimal emergency endoscopy timing in patients with esophagogastric variceal bleeding (EGVB).Methods:The clinical data of patients with EGVB emergency endoscopy in Renmin Hospital of Wuhan University from December 2018 to November 2020 were collected and analyzed. According to the time interval from admission to the start of emergency endoscopy, they were divided into emergency endoscopy group (<6 h, n=115) and early endoscopy group (6-24 h, n=57). The baseline data, clinical efficacy and postoperative situation of the two groups were compared, and the risk factors of 6-week mortality of EGVB emergency endoscopy were analyzed by univariate and multivariate analysis. Results:In terms of baseline characteristics, there were no significant differences in age, gender, causes, shock index, model for end-stage liver disease (MELD) score, charlson complication index (CCI) score, portal hypertension related complications between the two groups ( P<0.05). However, the albumin (ALB) in emergency endoscopy group was significantly lower than that in early endoscopy group ( P<0.001). There were significant differences in Child Pugh grading and Child Pugh score between the two groups ( P=0.002, P=0.001). In terms of endoscopic efficacy, the detection rate of bleeding site in emergency endoscopy group was significantly higher than that in early endoscopy group (90.4% and 73.7%, P<0.05). There was no significant difference in operation duration, immediate hemostasis success rate, 5-day rebleeding rate, rescue treatment demand and 6-week mortality between the two groups ( P>0.05). There was no significant difference in bleeding related death between the two groups ( P>0.05). In addition, there was no significant difference in blood product consumption, intensive care unit (ICU) stay and total hospital stay between the two groups ( P>0.05). Multivariate analysis showed that Child Pugh grade C ( P=0.018), MELD score ( P=0.005) and CCI score ( P=0.001) were independent risk factors for 6-week death outcome of EGVB patients, while emergency endoscopic intervention time was not related to 6-week death outcome ( P=0.5). Conclusions:The efficacy of early endoscopic intervention is no worse than that of emergency endoscopic intervention, except for the identification of bleeding site. Child-Pugh grade C, MELD score, and CCI score are the independent risk factors for 6-week mortality, while the timing of emergency endoscopy is not associate with 6-week mortality in EGVB patients.
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Objective:To understand the supportive care needs of patients with prostate cancer during their illness, so as to construct the supportive care needs intervention program.Methods:Purposive sampling method was used to conduct semi-structured interviews on 17 patients with prostate cancer from June 2019 to January 2020 in Haikou Hospital of Xiangya Affiliated Hospital of Central South University, and the data were analyzed by content analysis method.Results:Seven themes were extracted: the need of health information, the need of social support, the need of health care services, psychological and emotional need, the need of symptom management, the need of economic support and disease specific need.Conclusions:Patients with prostate cancer have multiple supportive care needs. The results of this study could be important reference for medical staff to provide comprehensive, personalized and humanistic care for patients and improve patients′ the quality of life and medical experience.
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Objective:To evaluate the difference of dosimetry between three-dimensional and two-dimensional plans based on CT images of occult perforation in brachytherapy of cervical cancer, aiming to provide clinical reference.Methods:A total of 817 patients with cervical cancer received simple intrauterine (intrauterine tandem plus vaginal colpostats) three-dimensional brachytherapy in Chongqing University Cancer Hospital from January 2019 to December 2020 were retrospectively reviewed. Among them, 16 patients had occul uterine perforation. Based on Oncentra Brachy Therapy plan system, the single prescription dose was 6Gy. Three-dimensional (3D group) and two-dimensional (2D group) plans were designed on the perforated CT images The target volume, conformal index (CI), conformal index coformity index (COIN) and organs-at-risk (OAR) D 2cm 3 parameters were used to assess the plans between two groups. Results:The incidence of pccult uterine perforation was 1.96%(16/817) during brachytherapy for cervical cancer. The volume of prescription dose curve in the 3D group was (40.74±14.98) cm 3, significantly smaller compared with (91.46±19.71) cm 3 in the 2D group ( P<0.05), whereas the volume of the high-risk clinical target area wrapped by prescription dose curve did not significantly differ between two groups ( P>0.05). The CI and COIN in the 3D group were 0.79±0.10 and 0.72±0.96, significantly higher compared with 0.38±0.09 and 0.37±0.18 in the 2D group (both P<0.05). The D 2cm 3 of bladder, rectum, sigmoid colon, small intestine in the 3D group were (306.06±77.57) cGy, (252.27±72.60) cGy, (127.25±62.84) cGy and (228.79±94.90) cGy, significantly lower than (548.03±164.21) cGy, (411.16±118.74) cGy, (227.45±94.48) cGy and (450.95±157.96) cGy in the 2D group (all P<0.05). Conclusions:Application of image guidance in brachytherapy of cervical cancer is helpful to detect occult uterine perforation. When occult uterine perforation occurs, the use of three-dimensional plan can basically meet the clinical needs, which is significantly better than the two-dimensional plan.
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Objective:To identify the distribution of research hotspots and frontiers of multidrug-resistant bacteria in intensive care units in China through the method of visualization, and to predict future research directions, analyze the research development process, so as to provide reference basis for further research in this field.Methods:Studies related to multidrug-resistant bacteria in intensive care units published in China from 2000 to 2019 by CNKI were reviewed. According to the keywords by CiteSpace 5.6.R2, the co-occurring network was generated to analyze the distribution of research hotspots in this field. Meanwhile, the mutation map of keywords was used to forecast the future research directions to a certain extent.Results:A total of 1 324 articles were finally included in the quantitative analysis. From 2000 to 2019, the number of publications in the field of multi-drug resistant bacteria in intensive care units showed a gradual increase, of which the number of publications increased rapidly from 2008 to 2014 (the number of publications increased from 34 to 124 articles). In the initial stage of research, conceptual keywords appeared, such as intensive care unit, infection, pathogenic bacteria and drug resistance among others. A dense keywords group appeared from 2008 to 2014, which covered several aspects, such as nosocomial infection, Acinetobacter baumannii, pathogenic bacteria, drug resistance, pulsed field gel electrophoresis and nursing etc., suggesting that research in this field has entered a period of vigorous development. High-frequency keywords, such as risk factors, pathogens, antibiotics, nosocomial infections, drug resistance genes and homology appeared from 2015 to 2019, thus representing the hotspots in recent years. Conclusions:The overall research on multidrug-resistant bacteria in intensive care units in China has gradually improved. The current studies focus on homology analysis and multidrug-resistant bacteria infections, among other topics. Further explorations at the genetic level will be conducted to fill the research vacancy in this field and to provide molecular biological basis for reducing the occurrence of multidrug-resistant bacteria in the future.
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Objective:To evaluate the efficacy and safety of lactulose combined with polyethylene glycol for bowel preparation before colonoscopy in patients of different risks.Methods:A total of 208 patients undergoing colonoscopy were enrolled, including 108 high-risk and 100 low-risk patients. The high-risk patients were divided into group A (54 taking lactulose + polyethylene glycol) and group B (54 taking polyethylene glycol), and the low-risk patients were divided into group C (49 taking lactulose + polyethylene glycol) and group D (51 taking polyethylene glycol). The Boston bowel preparation score, cecal intubation time, withdrawal time, the detection rate of colonic polyps and adenoma, and the incidence of adverse reactions were observed.Results:Among the high-risk patients, the Boston bowel preparation score and adenoma detection rate in group A [(6.35±1.15) scores, 46.3%] were significantly higher than those in group B [(5.76±0.89) scores, 22.2%, both P<0.05], and the first defecation interval in group A was significantly shorter than that in group B [(1.20±0.85) h VS (3.29 ± 2.93) h, P<0.05]. There was no significant difference in adequate bowel preparation rate, polyp detection rate, frequency of defecation or incidence of adverse reactions between group A and B. In the low-risk patients, the first defecation interval in group C was significantly shorter than that in group D [(1.65 ± 1.35) h VS (3.42 ± 2.64) h, P<0.05], and the incidence of adverse reactions was significantly lower than that in group D (44.9% VS 64.7%, P<0.05). There was no significant difference in adequate bowel preparation rate, Boston bowel preparation score, adenoma detection rate, polyp detection rate or frequency of defecation between group C and D. Conclusion:For the high-risk patients, the effect of lactulose combined with polyethylene glycol for bowel cleansing is better than that of traditional polyethylene glycol in the improvement of the Boston bowel preparation score, adenoma detection rate, and the first defecation interval. For low-risk patients, lactulose combined with polyethylene glycol regimen has few advantages over traditional polyethylene glycol regimen.
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Breast cancer patients experience many symptoms during treatment. In most cases, the symptoms do not appear alone, but several symptoms appear at the same time and form symptoms cluster, which causes severe physical and mental burden on the patient. This paper summarized the study on symptom cluster of breast cancer patients at home and abroad from the perspectives of concept, categories, influencing factors and management, so as to provide basis for future symptom cluster management.
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Objective@#The effectiveness of two different sound therapies in chronic subjective tinnitus was compared. The effectiveness of different degrees of hearing loss patients on two different sound therapies were analyzed preliminarily and the possible mechanisms were discussed.@*Methods@#This clinical trial was conducted in the Peking Union Medical College Hospital, China from January 2018 to April 2018. Patients were received sound therapy when they were diagnosed as subjective tinnitus. This was a double-blinded randomized controlled trial. In our clinical trial, we included 56 participants who were randomly divided into Groups A and B with different sound therapies by using a computer allocation sequence. Pure tone audiometry, tympanometry and tinnitus matching were performed. The patients were followed up for 2 weeks, 1 month, 2 months and 3 months. Tinnitus handicap inventory (THI) and visual analog scales (VAS) measuring were used to evaluate the handicap, loudness and anxiety of tinnitus. An analysis of variance (ANOVA) of 2×5 repeated-measures was conducted.@*Results@#With the prolongation of the treatment time, both groups showed significantly lower scores after 3 months training compared with baseline which were measured by THI scores. While there was no effect between the two groups. According to the degree of hearing loss, Group A and B were divided into normal to mild hearing loss group (26-40 dB HL, Group A1, Group B1), moderate to profound hearing loss group (41 dB HL group and above, Group A2, Group B2). In the patients with normal hearing and mild hearing loss, the THI (P=0.013), VAS loudness and annoyance scores (P<0.01) after 3 months in Group B1 was significantly lower than those at baseline and the sound therapy in Group B1 was effective. In patients with moderate to profound hearing loss, the THI, VAS loudness and annoyance scores (P<0.01) after 3 months in Group A2 was significantly lower than those at baseline and the sound therapy in Group A2 was effective.@*Conclusions@#Sound therapy may be effective for some patients. Sound therapy for patients with different degrees of hearing loss are different. The tinnitus of most patients could not disappear completely, but reduce or eliminate. Doctors should use appropriate and individualized acoustic parameters for different characteristics of tinnitus. Doing so would provide effective and specific sound therapy for patients and reduce or eliminate tinnitus.
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Objective To investigate the clinical efficacy of dynamic anterior plate-screw system(DAPSQ)assisted by preoperative digital design in the treatment of acetabular bi-column fractures.Methods A retrospective case-control study was conducted to analyze the clinical data of 34 patients with acetabular bi-column fractures admitted to the General Hospital of Central Theater Command from January 2012 to January 2018.There were 24 males and 10 females,aged 21-65 years [(43.0±14.2)years].According to the treatment method,the patients were divided into Group A treated with DAPSQ assisted by preoperative digital design and Group B treated with conventional DAPSQ.Group A was consisted of 17 patients,including 11 males and six females aged 22-64 years [(42.7±12.4)years].Group B consisted of 17 patients,including 13 males and four females aged 21-65 years [(43.2±14.6)years].The operation time,intraoperative blood loss,hospitalization time,fracture healing time,Matta radiological standard score of fracture reduction,Merle d' Aubignre-Postel score and complications were recorded and compared between the two groups.Results All patients were followed up for 12-62 months [(32.8±9.1)months].The operation time [(160.8±38.5)minutes] and intraoperative bleeding [(455.6±190.4)ml] in Group A were significantly less than those in Group B [(216.9±59.5)minutes] and [(780.2±211.6)ml](P＜0.05).There were no significant differences in hospitalization time,fracture healing time,Matta radiological standard score,modified Merle d' Aubignre-Postel score at the last follow-up between the two groups(P＞0.05).In Group A,four patients had traumatic arthritis,with one patient receiving total hip replacement.In Group B,three patients were found with traumatic arthritis,and one with avascular necrosis of femoral head who underwent total hip replacement.None of the two groups had complications such as screws' entry into articular cavity,failure of internal fixation,and incision infection.Conclusions For acetabular bi-column fractures,DAPSQ can effectively maintain the stability of the fracture,without the risk of screws entering the joint cavity,and obtain satisfactory clinical effect.Compared with conventional DAPSQ,preoperative digital design can significantly shorten the operation time and reduce intraoperative bleeding.
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Objective To analyze the relationship between the changes of fasting plasma level of leptin and obesity in patients with insulinoma before operation.Methods From January 2003 to May 2008,40 patients with insulinoma diagnosed at Peking Union Medical College Hospital were selected.Preoperative fasting plasma samples of them were collected.From January 2003 to May 2008,the plasma samples of 28 volunteers matched with age,gender and body weight matched with the patients were collected as the controls.All the subjects were divided into overweight-obesity group and normal weight group according to their body mass index (BMI).Plasma levels of leptin of all the subjects were measured by enzyme linked immunosorbent assay (ELISA).The Mann-Whitney U test and the correlation coefficient test were used for statistical analysis.Results The plasma leptin level of patients with insulinoma was 0.35 ng/mL (0.25 ng/mL to 1.13 ng/mL),which was higher than that of the control group (0.29 ng/mL,0.25 ng/mL to 1.15 ng/mL),and the difference was statistically significant (U =324.50,P =0.003).In the normal-weight group,the plasma leptin level of the patients with insulinoma was 0.35 ng/mL (0.27 ng/mL to 0.62 ng/mL),which was higher than that of the control group (0.28 ng/mL,0.25 ng/mL to 0.37 ng/mL),and the difference was statistically significant (U =28.000,P =0.001).While in the overweight-obesity group,the plasma leptin levels of the patients with insulinoma and the controls were 0.35 ng/mL (0.25 ng/mL to 1.13 ng/mL) and 0.34 ng/mL (0.26 ng/mL to 1.15 ng/mL),respectively,and the difference was not statistically significant (U =153.500,P =0.525).Plasma leptin levels in both the patients with insulinoma and the controls,were correlated with BMI (r =0.355,P =0.025;r =0.571,P =0.001,respectively).Conclusion Preoperative fasting plasma level of leptin increase in patients with insulinoma which is correlated with BMI.
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Objective@#To investigate the clinical and histological features, diagnosis and differential diagnosis of myofibroma/myofibromatosis.@*Methods@#The clinical data and pathology features of nine cases of myofibroma/myofibromatosis were collected from August 2011 to November 2016 in Affiliated Drum Tower Hospital, Nanjing University Medical School and Children′s Hospital of Nanjing Medical University. Immunohistochemistry(IHC), PDGFRB molecular analysis and ETV6-NTRK3 gene fusion were performed and relevant literature reviewed.@*Results@#There were 7 males and 2 females, with age ranging from 3 days to 18 years (mean 5 years). The tumors were located in head and neck (eight cases) and trunk (one case). Clinically, the tumors presented as freely movable nodules. Microscopically, they appeared biphasic with alternating light- and dark-staining areas. The light-staining area consisted mainly of plump myoid spindle cells with eosinophilic cytoplasm arranged in nodules, short fascicles, or whorls.The dark-staining area was composed of round or polygonal cells with slightly hyperchromatic nuclei or small spindle cells arranged around a distinct hemangiopericytoma-like vascular pattern. IHC showed the tumor cells in the light-staining area were strongly positive for vimentin and SMA, while cells in dark-staining area were strongly positive for vimentin, and weakly for SMA. Tumor cells were negative for desmin, S-100 protein, h-Caldesmon, CD34 and STAT6. Analysis of PDGFRB mutations was performed in seven cases. Two cases showed 12 exon point mutation c. 1681 c>T(p.R561C), one case showed 14 exon point mutation c. 1998C>G (p.N666K). ETV6-NTRK3 gene fusion was not detected by fluorescence in situ hybridization in four patients under three years old. All cases were followed for 6 to 68 months, with two recurrences.@*Conclusions@#Myofibroma/myofibromatosis is an uncommon benign myofibroblastic tumor of infancy and childhood. The tumor can appear biphasic, and may show PDGFRB point mutation which is of potential diagnostic value.
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Objective@#Dynamic visual acuity (DVA) is defined as the visual acuity when there are relative movements between subjects and visual targets. The purpose of this study was to discuss the correlation between bedside DVA test and other examinations of vestibular function, and to assess the value of DVA test for clinical diagnosis.@*Methods@#Retrospective analysis of 323 cases with peripheral vestibular disorder, and analyzing the correlation between bedside DVA results and caloric test were performed.@*Results@#Out of these 323 cases, 113 cases showed positive results of DVA.Among these 113 cases with positive DVA test, 109 cases were bilateral or unilateral vestibular function loss according to the results of caloric test or VEMP. The disease with the highest positive rate of DVA was bilateral vestibulopathy(BVP), followed by vestibular neuritis (VN) and profound sudden sensorineural hearing loss (pSSNHL).@*Conclusions@#Bedside DVA is effective to determine the cases with BVP and severe unilateral vestibular function loss.
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Objective To evaluate the clinical efficacy of bronchial artery embolization in the treatment of massive hemoptysis ,and to evaluate the clinical efficacy and adverse reactions of 3-year recurrence and survival . Methods 80 patients with hemoptysis or chronic recurrent hemoptysis were selected as the research subjects , and they were randomly divided into two gourps according to the digital table ,40cases in each group.The interventional embolization group was given bronchial artery embolization .The drug group was treated with phentolamine and pituitrin.The index of the system were observed and evaluated:(1)the effect of controlling massive hemoptysis;(2) the adverse reaction of the patients;(3) the recurrence rate of 3 years.Results (1) The total effective rate of the interventional embolization group was 92.5％,which was significantly higher than 77.5％ of the drug group (χ2 =9.044,P<0.05);(2) The incidence rate of adverse reaction of the interventional embolization group was 12.5％, which was lower than 35.0％of the drug group ,the difference was not statistically significant between the two groups (χ2 =1.742,P>0.05).(3) The 3 years recurrence rate of the interventional embolization group was 7.5％,which of the drug group was 40.0％,the difference between the two groups was statistically significant (χ2 =12.557,P<0.05).The 3 years survival rate of the interventional embolization group was 95.0％,which of the drug group was 92.5％,the difference between the two groups was not statistically significant (χ2 =0.215,P>0.05).Conclusion The bronchial artery embolization in the treatment of hemoptysis has ideal clinical effect .It is a minimally invasive and effective clinical treatment method ,and the effect has safety ,less adverse reaction and low recurrence rate ,which is worthy of extensive promotion and application .
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Objective: To study the relationship between primary tooth discoloration and caries in preschool children. Methods: 675 preschool children enrolled from 5 preschools in Suzhou City, China were examined for dental caries and tooth surface stain. Parents completed the questionnaires about their children's eating habit and living habit. The relationship between primary tooth discoloration and caries was analyzed with the respect to diet, hygiene, and the use of medicine or medical supplements. Results: Of the 675 children, 117(17. 3％; 52 boys and 65 girls) had tooth discoloration with no significant differences between gender(P＞ 0. 05). In the 117 children with tooth discoloration, 36(30. 8％) had dental caries, and in the 558 children without tooth discoloration 325 had caries (58. 2％, between the 2 groups, P＜ 0. 05). The incidence of discoloration was related with the frequency of consuming pigmented foods, vegetable and Chinese herbal medicines(P＜ 0. 05). The frequency of brushing teeth, use of water purifier and the water intake quantity were not significantly associated with discoloration of the teeth(P＞ 0. 05). Conclusion: The discoloration of primary teeth was negatively correlated with caries in primary teeth. Intake of pigmented food and medicine, vegetable and Chinese herbal medicine is related to tooth discoloration in preschool children.
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Objective To investigate the clinical significance of peripheral blood metastasis in breast cancer and its relationship with the metastasis suppressor gene BRMS1.Methods Reverse transcription polymerase chain reaction (RT-PCR) was used to detect the expression of micrometastatic marker hMAM-RNA in the peripheral blood of 149 cases of invasive breast carcinoma.Immunohistochemical method was used to detect the expression of BRMS1 protein in breast cancer tissues after surgery.The recurrence was followed up.SPSS19.0 statistics software was used to analyze the data.Results Among the 149 cases of invasive breast carcinoma patients with preoperative peripheral blood,expression of hMAM-RNA was found in 71 cases,and the micrometastasis rate was 47.65％.Peripheral blood micrometastasis rate in breast cancer was closely related to tumor TMN stage,lymph node metastasis and postoperative recurrence (P＜0.05);while it had nothing to do with patients' age,tumor size,pathological types or tumor tissue typing (P＞0.05).The expression of BRMS1 in postoperative breast cancer tissue was detected in 56 cases,and the positive rate was 37.58％.For BRMS1 positive cases,16 cases had peripheral blood micrometastasis (the positive rate was 28.57％);For BRMS1 negative cases,55 cases had peripheral blood micrometastasis (the positive rate was 51.93％).The difference had statistical significance and the two showed a significant negative correlation(r=-0.296,P＜0.01).With the gradual increase of positive staining intensity of BRMS1 protein,the micrometastasis rate of peripheral blood of breast cancer showed a significant decrease (P＜0.05).At the same time,among patients with positive peripheral blood micrometastasis,the recurrence rate of patients with positive BRMS1 (12.5％) was significantly lower than that of patients with negative BRMS1 (43.64％),and the difference was statistically significant(P＜0.05).Conclusions BRMS 1 expression and breast cancer micrometastasis in peripheral blood is closely related.BRMS1 can also be used as an important molecular marker for determining micrometastasis in peripheral blood of breast cancer.Routine detection of BRMS1 expression in breast cancer tissue is helpful for clinical understanding of breast cancer patients,peripheral blood micrometastasis and postoperative recurrence,thus guiding clinical individualized treatment and prognosis.
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Objective To study the effect of citicoline on mild cognitive impairment MCI) in pa tients with middle cerebral artery stenosis (MCAS).Methods Eighty-six MCAS patients with MCI were divided into citicoline group (n=44) and control group (n=42).The patients in citicoline group were treated with citicoline (0.2 g,3 times a day) for 6 months on the basis of conventional treatment.Cerebrovascular reserve,PI,BHI and Vm between the two groups were compared by transcranial Doppler ultrasonography after treatment.MCI between the two groups was assessed according to the MoCA after treatment.Results The rate of cerebrovascular reserve,PI,BHI and Vm were significantly higher in citicoline group than in control group (13.59％± 1.16％ vs 7.61％±1.12％,P＜0.01;0.51±0.16 vs 0.58±0.12,P＜0.05;1.36±0.08 vs 0.74±0.11,P＜ 0.01;32.63％ ±2.32％ vs 16.92％ ± 1.68％,P＜0.05).The total MoCA score,attention,language,visuospatial and executive function,abstract,naming,orientation and memory were significantly higher in citicoline group than in control group (P＜0.01).Conclusion Early citicoline treatment can improve cerebrovascular reserve and alleviate MCI in MCAS patients.
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Cerebral venous thrombosis (CVT) refers to thrombosis of the intracranial veins and sinuses, which is a rare type of cerebrovascular disease.Due to this highly variable and nonspecific clinical presentations, CVT can be difficult to diagnose.Understanding the pathophysiology and etiology of CVT helps to understand its clinical symptoms and imaging findings and guide the treatment.This article reviews the related advances in the pathophysiology and etiology of CVT.
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Objective To investigate the clinical effect of pegylated interferon(IFN)on chronic hepatitis C and its effect on cellular immune function.Methods A total of 92 patients with chronic hepatitis C were enrolled in our hospital from June 2013 to October 2016.They were randomly divided into study group and control group by single and double numbers(admission order),with 46 cases in each group.The control group was treated with recombinant human interferon alpha-2b on the basis of conventional treatment.The study group was treated with pegylated interferon alpha-2a on the basis of conventional treatment.Results After treatment, the rates of RVR, EVR, ETVR and SVR in the study group(52.17%, 71.74%, 76.09% and 54.35%, respectively)were significantly higher than those in the control group(34.78%, 50%, 58.70%, 39.13%, respectively), The difference was statistically significant(P<0.05).There were no significant difference in the cellular immune function index between the two groups before treatment;After treatment,the CD3+, CD4+, CD4+/CD8+ and other immune function indexes of the study group were significantly higher than those before treatment, while the results of CD8+ were significantly lower than before treatment(P<0.05);There was no significant difference in the cellular immune function in the control group compared with before, and the difference of the cellular immune function between the 2 groups after treatment was statistically significant(P<0.05).Conclusion Pegylated interferon(IFN)on the basis of routine treatment can improve the virologic response and cellular immune function in patients with chronic hepatitis C.
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In order to explore the pathogenic characters,diagnosis and treatment of canine leptospirosis,a retrospective analysis of the pathogenetic factor,diagnosis and treatment of three dogs were reported which diagnosed as canine leptospirosis in China Agricultural University Teaching Animal Hospital from August to November,2015.The infected dogs showed symptoms of depressed,jaundice,anorexia and vomiting.Two of them had fever history and contacted the water resource outside before getting ill.All three dogs were confirmed anemia,liver and kidney damage by laboratory examination.They were diagnosed with canine leptospirosis according to the positive results of the Leptospira PCR examination base on urine.During the diagnosis and treatment process,one of them was dead,the rest two recovered after antibiotic and symptomatic therapy.In conclusion,dogs which infected with leptospirosis may have a contact with the infected water before.The Leptospira PCR examination base on urine can be used for the diagnosis method of the disease.As to treatment,the use of penicillin and tetracycline drugs such as doxycycline is recommended.