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Objective:To identify the hub differentially expressed genes(DEGs)of glomerular pathological changes and potential pathways in molecular process of type 2 diabetic nephropathy(DN)based on bioinformatics technology.Methods:The differentially expressed genes of Gene Expression Omnibus(GEO)dataset GSE96804 in DN and normal kidney tissues were analyzed by R 3.6.2 software. DEGs were further assessed by Gene Ontology(GO)function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)signal pathway analysis. Subsequently, the hub genes and their associated pathways were analyzed using String 11.0 and Cytoscape 3.7.2 software.Results:A total of 168 DEGs were obtained in the dataset. Among them, seven hub genes were identified, including ALB, FN1, EGF, PTGS2, PLG, KDR, and LOX. Three hub genes, ALB, EGF, PLG, exerted a direct action on glomerulus. GO enrichment analysis of DEGs was mainly manifested in extracellular matrix organization, extracellular structure organization, platelet degranulation and other biological processes, extracellular matrix, secretory granule lumen, platelet alpha granule and other cell components, chaperone binding, copper ion binding, antioxidant activity, and other molecular functions. DEGs mainly regulated metabolic process, which was related to fatty acid degradation signal pathway, exogenous substance metabolism related to CYP enzyme and drug metabolism signal pathway.Conclusion:A bioinformatics analysis of DN from the perspective of glomerulopathy is helpful to understand the potential molecular mechanism of DN and provide reference for further validation.
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In the study of oral orthodontics, the dental tissue models play an important role in finite element analysis results. Currently, the commonly used alveolar bone models mainly have two kinds: the uniform and the non-uniform models. The material of the uniform model was defined with the whole alveolar bone, and each mesh element has a uniform mechanical property. While the material of the elements in non-uniform model was differently determined by the Hounsfield unit (HU) value of computed tomography (CT) images where the element was located. To investigate the effects of different alveolar bone models on the biomechanical responses of periodontal ligament (PDL), a clinical patient was chosen as the research object, his mandibular canine, PDL and two kinds of alveolar bone models were constructed, and intrusive force of 1 N and moment of 2 Nmm were exerted on the canine along its root direction, respectively, which were used to analyze the hydrostatic stress and the maximal logarithmic principal strain of PDL under different loads. Research results indicated that the mechanical responses of PDL had been affected by alveolar bone models, no matter the canine translation or rotation. Compared to the uniform model, if the alveolar bone was defined as the non-uniform model, the maximal stress and strain of PDL were decreased by 13.13% and 35.57%, respectively, when the canine translation along its root direction; while the maximal stress and strain of PDL were decreased by 19.55% and 35.64%, respectively, when the canine rotation along its root direction. The uniform alveolar bone model will induce orthodontists to choose a smaller orthodontic force. The non-uniform alveolar bone model can better reflect the differences of bone characteristics in the real alveolar bone, and more conducive to obtain accurate analysis results.
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Humans , Biomechanical Phenomena , Computer Simulation , Finite Element Analysis , Models, Biological , Periodontal Ligament , Stress, Mechanical , Tooth Movement TechniquesABSTRACT
Objective:To reports the nursing care of a patient with superior mesenteric artery syndrome after posterior spinal correction for adolescent idiopathic scoliosis.Methods:While in hospital, conservative treatment requires fasting and water deprivation, gastrointestinal decompression. Combined with perioperative nursing measures of spinal orthopedics, the nursing focus of patients during hospitalization includes: enteral and parenteral nutrition, designed the condition record sheet, and dynamically monitor the patient′s condition; personalized guidance about function exercise was gibien.In addition,continuous care after discharge were provided through health education before discharge and post-discharge follow-up.Results:After the implementation of the nursing measures, the patient recovered well after surgery, the symptoms of superior mesenteric artery syndrome were effectively controlled, and the patient resumed eating through the mouth. Two months after discharge, the patient gained 4kg of body weight.Conclusion:The treatment and nursing of superior mesenteric artery syndrome is a long-term process, nurses should place emphasis on observation and nutrition support, and also the patient psychological care.
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Objective@#To assess the value of multi-parametric MRI in mammographically detected breast imaging reporting and data systems (BI-RADS) 3 to 4 exclusive microcalcifications.@*Methods@#A retrospective analysis was performed in 152 patients with mammographically detected BI-RADS 3 to 4 exclusive microcalcifications from January 2013 to December 2017. All patients underwent bilateral breast multi-parametric MRI before surgical biopsy. Microcalcifications were classified according to BI-RADS by two radiologists with more than 10 years′ experience in breast imaging. The area under the curve (AUC), sensitivity and specificity of BI-RADS 3 to 4 exclusive microcalcifications diagnosis by mammography and mammography plus MRI were calculated and compared using pathology as the gold standard.@*Results@#A total of 152 lesions (93 benign lesionsand 59 malignant lesions) were assessed in this study. The positive predictive value (PPV) of mammography for BI-RADS 3, 4A, 4B and 4C microcalcifications diagnosis were 22.2%(16/72), 5.0%(1/20), 48.5%(17/35) and 100.0%(25/25) respectively. The PPV of MRI for BI-RADS 2, 3, 4, 5 microcalcifications diagnosis were 1.6%(1/62), 7.1%(2/28), 72.2%(13/18) and 97.7%(43/44).The area under curve, sensitivity and specificity of mammography for BI-RADS 3 to 4 microcalcifications diagnosis were 0.676,72.9% and 60.2%. The area under curve, sensitivity and specificity of mammography plus MRI for BI-RADS 3 to 4 microcalcifications diagnosis were 0.982, 94.9% and 93.6%.@*Conclusions@#Multi-parametric MRI can improve the diagnostic accuracy in mammographically detected BI-RADS 3 to 4 exclusive microcalcifications, which is helpful to differentiate benign and malignant breast lesions with microcalcifications and avoid unnecessary biopsies.
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Objective To analyze the diagnosis and treatment of pancreatic sinistral portal hypertension (PSPH).Methods A total of 28 patients with PSPH were retrospectively analyzed,and the clinical characteristics,diagnosis and treatment experience of the disease were summarized.Results There were primary pancreatic diseases in all the cases,including 16 cases of pancreatitis and 12 cases of pancreatic tumor in the tail.12 cases underwent distal pancreatectomy plus spleenectomy,2 cases did spleenectomy and pericardial devascularization,9 cases received miscellaneous surgical procedures,and 5 case were managed by non-surgical medical treatments.After 1 year of follow-up,20 of 23 postoperative patients were alive and well.Among the 5 conservatively treated patients,2 had repeated upper gastrointestinal bleeding.Conclusion PSPH,especially caused by chronic pancreatitis yields to personalized surgical procedures based on pancreatectomy.
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Objective To assess the value of multi-parametric MRI in mammographically detected breast imaging reporting and data systems (BI-RADS) 3 to 4 exclusive microcalcifications. Methods A retrospective analysis was performed in 152 patients with mammographically detected BI-RADS 3 to 4 exclusive microcalcifications from January 2013 to December 2017. All patients underwent bilateral breast multi-parametric MRI before surgical biopsy. Microcalcifications were classified according to BI-RADS by two radiologists with more than 10 years′ experience in breast imaging. The area under the curve (AUC), sensitivity and specificity of BI-RADS 3 to 4 exclusive microcalcifications diagnosis by mammography and mammography plus MRI were calculated and compared using pathology as the gold standard. Results A total of 152 lesions (93 benign lesionsand 59 malignant lesions) were assessed in this study. The positive predictive value (PPV) of mammography for BI-RADS 3, 4A, 4B and 4C microcalcifications diagnosis were 22.2%(16/72),5.0%(1/20),48.5%(17/35) and 100.0%(25/25) respectively. The PPV of MRI for BI-RADS 2, 3, 4, 5 microcalcifications diagnosis were 1.6%(1/62),7.1%(2/28),72.2%(13/18) and 97.7%(43/44).The area under curve, sensitivity and specificity of mammography for BI-RADS 3 to 4 microcalcifications diagnosis were 0.676,72.9% and 60.2%. The area under curve, sensitivity and specificity of mammography plus MRI for BI-RADS 3 to 4 microcalcifications diagnosis were 0.982, 94.9% and 93.6%. Conclusions Multi-parametric MRI can improve the diagnostic accuracy in mammographically detected BI-RADS 3 to 4 exclusive microcalcifications, which is helpful to differentiate benign and malignant breast lesions with microcalcifications and avoid unnecessary biopsies.
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Objective To investigate the use of smartphone applications in the adherence with inhaled glucocortiocoids (ICS) therapy in asthma children. Methods Sixty-six asthma children and their caregivers in Shanghai Childrren's Medical center from July 2016 to February 2017 were recruited in this study using convenience sampling . All participants were randomly allocated to intervention and control groups. All participants were given routine education and technical guidance on inhalation. In addition all participants had the same chips attached to their regular nebulizers. The APP was installed on each caregivers' smartphone in the intervention group. Key modules of mobile applications include real-time monitoring of medication and health education. The ICS adherence rates were recorded by the chips and were monitored monthly by researcher. The frequency of asthma exacerbations, emergency department visits and hospital admissions in intervention group was collected by smartphone APP every 3 months. the frequency of asthma exacerbations, emergency department visits and hospital admissions in control group was investigated by researcher every 3 month. Results After 6 months follow up, although ICS compliance decreased in both groups. The first month's adherence in the intervention group was 98(97.0, 100.0)％, in the sixth month's was 96(92.0, 100.0)％. The first month's adherence in the control group was 93(68.5,100.0)％, in the sixth month's was 28(0, 55.5)％. The difference in adherence between the two groups was significant (Z=2.664, 4.318, P<0.01). The decline trend of the control group was significantly greater than that of the intervention group (F=25.097, P<0.01). The compliance of the control group was less than 60％from the third month and below 30％by the sixth month, below the average ICS compliance of 30％ to 60％ in China. Though the ICS compliance of intervention group was declining, the ICS compliance was more than 90％ and higher than the mean compliance in our country. No significant differences were found in the frequency of asthma exacerbations, emergency department visits and hospital admissions between the intervention and control group (χ2=3.043, 1.065, 1.015, P>0.05). But the frequency of asthma exacerbations, emergency department visits and hospital admissions of two times or more intervention group was lower than that in the control group. Conclusions Smartphone APP significantly improved the compliance of children with asthma aged 0 month to 3years old.
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Objective: To establish an HPLC-fluorescence detection method for the determination of thioguanosine-monophosphate (TGMP), thioguanosine-diphosphate (TGDP) and thioguanosine-triphosphate (TGTP) in red blood cells (RBC), as well as quantify the individual thioguanine nucleotides metabolites in kidney transplant recipients with azathioprine (AZA) therapy.Methods: The individual thioguanosine phosphates were extracted from RBC by dichloromethane and subsequently oxidized by potassium permanganate.The separation was achieved on a Nucleosil C18 column (150 mm×4.6 mm,5 μm) with an ion pairing reagent and detected by a fluorescence detector (excitation at 315 nm, emission at 390 nm).The mobile phase consisted of 20 mmol·L-1 potassium phosphate buffer (pH was adjusted to 6.8 by 5 mmol·L-1 tetrabutylammonium hydrogensulfate)-acetonitril (80:20) with the flow rate of 1.0 ml·min-1.Results: TGMP, TGDP and TGTP were quantified from RBC within the range of 50-500, 50-1000 and 100-5 000 pmol·ml-1, respectively.The limit of quantification (LOQ) was 50, 50 and 100 pmol·ml-1 RBC for TGMP, TGDP and TGTP, respectively.The intra-and inter-day RSDs were below 7.0% with the method recovery between 95.0% and 103.6%.The mean extraction recovery was above 90%.The assay was applied in the blood samples of 30 kidney transplant recipients with AZA therapy, and the results indicated that TGTP was the predominant phosphate metabolite in RBC.Conclusion: The method is simple, rapid, sensitive and specific, and it can quantitatively determine the individual thioguanosine phosphates in RBC of kidney transplant recipients with AZA therapy.
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Objective@#To investigate the cause of intraocular metallic foreign body injury during hammer percussion and to observe the structure of the metallic foreign bodies.@*Methods@#A retrospective analysis was performed in 21 inpatients with metallic foreign body injury in the posterior segment from January 2013 to April 2016. The foreign bodies were removed by magnetic drawing through external route of the sclera or vitrectomy. The shape of the foreign bodies was analyzed and the structural characteristics were observed under a metallurgical microscope. The visual acuity of the patients was compared before and after treatment.@*Results@#All patients were discharged at one week after surgery. There was no significant difference in mean best corrected visual acuity of the patients between before treatment and after treatment (1.20±0.87 vs. 1.08±0.89, t=1.516, P>0.05). The metallic foreign bodies in all the 21 cases were magnetic and the injuries in 15 cases (71.43%) were caused by hammering on hard objects. The foreign bodies were mainly lamellar and shaped like a leaf or a lance. And the lamellar martensite structure was observed under a metallurgical microscope.@*Conclusion@#The intraocular metallic foreign body injury often occurs during hammer percussion and the microstructure of the foreign bodies is lamellar martensite structure.
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Asthma is a common disease in children. Adherence to inhaled glucocorticoid therapy directly affects the outcome of asthma. The article mainly reviews the adherence status, assessment method, patient barriers to non-adherence and intervention strategy,so as to provide references for clinical practices and scientific research of nursing staff.
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Objective:To study the association of RAC1 gene polymorphisms with protein expression levels of Rac1-GTP. Methods:A total of 182 healthy Hans population in Hubei were recruited. The 4 tag-SNPs in RAC1 gene were genotyped by Real time TaqMan-MGB genotyping assay. And the Rac1-GTP protein levels in plasma samples from all participants were determined by enzyme linked immunosorbent assays ( ELISA ) . The distribution characteristics of Rac1-GTP expression levels were also analyzed. Furthermore,the expression levels of Rac1-GTP were compared among different genotypes of the 4 tag-SNPs in RAC1 gene. Results:The distribution of Rac1-GTP expression levels was positive skewed in healthy Chinese Hans population. The expression levels were significantly higher in females than in males (P0. 05). Different expression levels of Rac1-GTP were observed in different genotypes for rs702482 and rs10951982 (P0. 05). Conclusion:RAC1 genetic polymorphisms can potentially affect the expression levels of Rac1-GTP protein in healthy Chinese Hans population.
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BACKGROUND AND PURPOSE: Encephalitis caused by Listeria monocytogenes (L. monocytogenes) is rare but sometimes fatal. Early diagnosis is difficult using routine cerebrospinal fluid (CSF) tests, while next-generation sequencing (NGS) is increasingly being used for the detection and characterization of pathogens. METHODS: This study set up and applied unbiased NGS to detect L. monocytogenes in CSF collected from three cases of clinically suspected listeria meningoencephalitis. RESULTS: Three cases of patients with acute/subacute meningoencephalitis are reported. Magnetic resonance imaging and blood cultures led to a suspected diagnosis of L. monocytogenes, while the CSF cultures were negative. Unbiased NGS of CSF identified and sequenced reads corresponding to L. monocytogenes in all three cases. CONCLUSIONS: This is the first report highlighting the feasibility of applying NGS of CSF as a diagnostic method for central nervous system (CNS) L. monocytogenes infection. Routine application of this technology in clinical microbiology will significantly improve diagnostic methods for CNS infectious diseases.
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Humans , Central Nervous System , Cerebrospinal Fluid , Communicable Diseases , Diagnosis , Early Diagnosis , Encephalitis , Listeria monocytogenes , Listeria , Magnetic Resonance Imaging , Meningitis, Listeria , Meningoencephalitis , MethodsABSTRACT
Objective:To develop a method for the detection of 10 single nucleotide polymorphisms(SNPs) of Nm23 gene,and to explore the genotypic and allelic distributions of the 10 SNPs in Chinese Hans population in Wuhan.Methods: Two hundreds healthy subjects ,115 men and 85 women included ,were enrolled as DNA sample donors.The real time TaqMan-MGB genotyping assay was used for the determination of the 10 SNPs selected ,and the results were validated by direct gene sequencing.Results:The method established could accurately and quickly screen the genotypes of the 10 SNPs of Nm23/NDPK gene.Distribution frequencies of the 10 SNPs were similar to these in other researches as well as these of HCB.All the loci follow the Hardy-Weinberg equilibrium.Highly linkage disequilibriums were found between rs 16949649 and rs7207370 , rs16949649 and rs34214448 , rs2159359 and rs2302254 , rs2159359 and rs8075231 ,rs2159359 and rs2041296 ,as well as rs2159359 and rs8071647 ,respectively.Four Tag SNPs:rs34214448 , rs2302254 ,rs11868380 and rs2318785 were initially selected by Heploview software.Conclusion:The method established for SNP gen-otyping can meet the needs for rapid analysis of Nm 23 gene polymorphisms ,and may have great values in investigating the association between gene polymorphisms and diseases as well as adverse drug reactions.
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Objective:To establish a method for the detection of 8 single nucleotide polymorphisms (SNPs) of RAC1 gene,and to analyze the genotypic and allelic distributions of the 8 SNPs in healthy Chinese Han population.Methods:The real-time fluorescence TaqMan-MGB probes allele classification technology was used for the determination of the 8 SNPs in 150 cases of healthy volunteers in Hubei China ,and the results were validated by direct gene sequencing.Results: The method established in this study can accurately screen the genotypes of the 8 SNPs of human RAC1 gene.Highly linkage disequilibriums were found between rs 10951982 and rs9374 , rs702482 and 836488 ,respectively.All the 8 sits were in accordance with Hardy-Weinberg equilibrium.Six Tag-SNPs were selected by Heploview software:rs10951982 ,rs6954996 ,rs6951997 ,r1s2977 ,rs702482 and rs702483.The MAFs of the 8 SNPs in our study were close to the MAFs in CHB and Asian in Hap Map database .Significant distribution differences were also observed in different races.Conclusion:No significant differences are observed in this study in healthy Chinese Han population.But differences are found when compared with the data of other races in Hap Map.
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<p><b>OBJECTIVE</b>To investigate the clinical characteristics, therapeutic effects, long-term survival and prognostic factors of the newly diagnosed patients with Hodgkin lymphoma (HL).</p><p><b>METHODS</b>One hundred and thirty five newly diagnosed HL patients in West China hospital from January 1, 2000 to December 31, 2010 were analyzed retrospectively. Software SPSS18.0 was applied to determine the risk factors for therapeutic results and long term survivals.</p><p><b>RESULTS</b>Of 135 patients, 78 cases were male and 57 female, the median age was 32(7-77) years old, and the median follow-up of 42(12-141) months. The peak age of HL was 20 to 30 years old and lymph node enlargement was the first presenting symptom in 69.63% of the patients. Among the all pathological types of HL, mixed-cellularity subtype (MC) and nodular sclerosing (NS) were the most common types, accounting for 59.7% and 34.0%, respectively. In MC subtypes, 66.2% of patients were male, while in NS subtypes, 61.4% were female. Among the 114 patients with complete follow-up data, 73 patients (64.0%) obtained complete remission and the total response rate was 77.2%. The 2-, 3- and 5-year overall survival (OS) rates were 91.2%, 88.0% and 80.9%, respectively. The progression free survival rates were 76%, 80.3% and 81.6%%, respectively. Among the patients with early unfavorable prognosis, 96.3% of them accepted full course chemotherapy and 13(48.1%) were combined with local radiotherapy. The 3- and 5- year survival rates of early unfavorable patients were higher than that of early favorable and advanced patients, but the difference was not statistically significant. Age≥45 years old and B symptom were adverse factors affecting curative effect for MC and NS subtypes, respectively. Furthermore, Age≥45 years, B symptoms and hepatomegaly were independent risk factors affecting the survival.</p><p><b>CONCLUSION</b>HL is more common in young patients (age<45 years old) and usually diagnosed at the early stage, with predominance of MC subtypes. B symptoms were adverse prognostic factors of therapeutic effects. The standard- dose chemotherapy and suitable courses of treatment combined with radiotherapy may provide the best benefits for the HL patients.</p>
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Disease-Free Survival , Hodgkin Disease , Drug Therapy , Pathology , PrognosisABSTRACT
<p><b>OBJECTIVE</b>To Explore the poor prognostic factors of diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>The clinical data of 409 newly diagnosed patients with DLBCL from January 2000 to December 2010 were collected, and the prognostic factors by univariate and multivariate stratification were analyzed .</p><p><b>RESULTS</b>Of the 409 DLBCL patients, 244 were males and 165 females, the median age was 56(16-89) years old, the median follow-up time was 23(2-108) months. In univariate analysis, age, clinical stage, B symptoms, ECOG scores, the international prognostic index (IPI) scores, bone marrow involvement, low absolute lymphocyte count (ALC), high LDH, β2-MG>2 times of normal, regimen and therapeutic effect had significant influence on OS and PFS (P<0.05). Multivariate analysis showed that stage III-IV and high LDH were the poor prognostic factors of OS and PFS (P<0.05). When IPI scores were included, low ALC and IPI 3-5 scores were the poor predictors of OS and PFS in CHOP-like group (232 cases), revised IPI (R-IPI) was an independent poor predictors of OS and PFS in RCHOP-like group (177 cases).</p><p><b>CONCLUSION</b>Stage III-IV and high LDH have negative influence on OS and PFS in patients with DLBCL, low ALC and IPI 3-5 scores affect OS and PFS in CHOP-like group, R-IPI affects OS and PFS in RCHOP-like group.</p>
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Disease-Free Survival , Lymphoma, Large B-Cell, Diffuse , Drug Therapy , Pathology , Multivariate Analysis , PrognosisABSTRACT
The crime of accident of medical treatment is the new crime added to the Criminal law of 1997.Since it appeared in the Criminal law of 1997,there have been many debates about it.One of them is how to comprehend the "serious hurt".I think the prescript itself lacks pertinence and we should make the GBH as the standard of judging the "serious hurt".