ABSTRACT
Objective:To investigate the computed tomography (CT) examination anato-mical features and clinical significance of paraesophageal vein (PEV) in portal hypertension.Methods:The retrospective and descriptive study was conducted. The clinical data of 173 patients with portal hypertension who were admitted to the People's Hospital of Ningxia Hui Autonomous Region from January 2018 to June 2021 were collected. There were 124 males and 49 females, aged from 22 to 71 years, with a median age of 47 years. Observation indicators: (1) preoperative CT examinations; (2) surgical situations; (3) follow-up. Follow-up was conducted using outpatient examination to detect surgical effects once every 3 months within postoperative 6 months and once every 6 months after postoperative 6 months. The follow-up was up to June 2021. Measurement data with skewed distribution were represented as M(range) and count data were described as absolute numbers. Results:(1) Preoperative CT examinations. The CT detection rate of PEV in the 173 portal hyper-tension patients was 52.60%(91/173). Of 173 patients, 82 cases were negative with PEV and 91 cases were positive with PEV. Of the 91 patients who were positive with PEV, there were 46 cases with paraesophageal varices, 24 cases with thick PEV, 21 cases with thin PEV, 8 cases without esophageal varices and 83 cases accompanied with esophageal varices. Of the 83 patients who were accom-panied with esophageal varices, there were 44 cases with PEV converged alone with azygos vein or semiazygos vein, 39 cases with paraesophageal varices formed above the diaphragm confluent with esophageal varices into azygos vein. (2) Surgical situations. All the 173 patients underwent surgery successfully, including 8 cases undergoing splenectomy, 86 cases undergoing splenectomy combined with modified complete devascularization, 35 cases undergoing splenectomy combined with spontaneous gastrorenal shunt reconstructing devascularization, 41 cases undergoing splenectomy combined with PEV preserving devascularization and 3 cases undergoing splenectomy combined with PEV ring constriction. None of 173 patients had surgical relative death, 67 cases had complica-tions, including 3 cases undergoing splenectomy, 29 cases undergoing splenectomy combined with modified complete devascularization, 11 cases undergoing splenectomy combined with spontaneous gastrorenal shunt reconstructing devascularization, 23 cases undergoing splenectomy combined with PEV preserving devascularization and 1 case undergoing splenectomy combined with PEV ring constriction underwent complications. (3) Follow-up. Of the 173 patients, 159 cases were followed up for 6 to 42 months, with a median follow-up time of 28 months. In the 7 cases undergoing splenectomy who were followed up, there were 6 cases without esophageal varices and 1 case with recurrence of esophageal varices. In the 79 cases undergoing splenectomy combined with modified complete devascularization who were followed up, there were 5 cases without esophageal varices, 67 cases with mild to moderate residual of esophageal varices, 5 cases with severe residual of esophageal varices, 1 case with recurrence of esophageal varices and 1 case with recurrence of esophageal varices hemorrhage. In the 34 cases undergoing splenectomy combined with sponta-neous gastrorenal shunt reconstructing devascularization who were followed up, there were 7 cases without esophageal varices and 27 cases with mild to moderate residual of esophageal varices. In the 36 cases undergoing splenectomy combined with PEV preserving devascularization who were followed up, there were 4 cases without esophageal varices, 21 cases with mild to moderate residual of esophageal varices, 5 cases with severe residual of esophageal varices, 4 cases with recurrence of esophageal varices and 2 cases with recurrence of esophageal varices hemorrhage. In the 3 cases undergoing splenectomy combined with PEV ring constriction who were followed up, there were 2 cases with mild to moderate residual of esophageal varices, 1 case with severe residual of esophageal varices.Conclusions:The CT detection rate of PEV in portal hypertension patients is >50% and the internal diameter and distribution of blood vessels are different in patients. CT examination anatomical features of PEV can be used to guide the formula-tion of surgical methods.
ABSTRACT
Objective:To explore the relationship between family function and neurodevelopment of preterm infants in the NICU.Methods:A total of 195 preterm infants in the NICU and their parents were selected from January to August 2020 in Children′s Hospital of Soochow University by convenience sampling method. A questionnaire survey was conducted using the general information questionnaire and Family Assessment Device. 0 to 6-year-old Children′s Neuropsychological Development Checklist were used to assess neurodevelopmental status of preterm infants in the third month after their discharge.Results:The development quotient of preterm infants in the NICU in the third month after discharge was 76.00(73.00, 81.00) points. The family function score was 146.00(131.00, 161.00) points. The total score of family function and item score were negatively correlated with development quotient ( r values were -0.646 to -0.505, all P<0.05). Hierarchical regression analysis showed that communication, problem solving, and behavior control accounted for 21.9% of neurodevelopmental variability in preterm infants. Conclusions:Nurses should promote the family function of preterm infants by improving family communication, problem solving and behavior control, thereby enhancing their neural development level.
ABSTRACT
The rapid development of next-generation sequencing (NGS) technology, including advances in sequencing chemistry, sequencing technologies, bioinformatics, and data interpretation, has facilitated its wide clinical application in precision medicine. This review describes current sequencing technologies, including short- and long-read sequencing technologies, and highlights the clinical application of NGS in inherited diseases, oncology, and infectious diseases. We review NGS approaches and clinical diagnosis for constitutional disorders; summarize the application of U.S. Food and Drug Administration-approved NGS panels, cancer biomarkers, minimal residual disease, and liquid biopsy in clinical oncology; and consider epidemiological surveillance, identification of pathogens, and the importance of host microbiome in infectious diseases. Finally, we discuss the challenges and future perspectives of clinical NGS tests.
ABSTRACT
Objective To explore the reliability of the modified Penn spasm frequency scale (MPSFS),the spinal cord assessment tool for spasticity (SCATS),the spinal cord injury spasticity evaluation tool (SCI-SET) and visual analogue scales (VASs) and their inter-correlation so as the provide evidence for clinical application.Methods The spasticity of thirty-five patients with spinal cord injury was assessed by 2 raters using the 4 scales with an interval of half an hour between assessments.Three days later,all of the subjects were again evaluated by one of the 2 raters in the same environment.The intra-class correlation coefficient (ICC),standard error of measurement (SEM) and minimal detectable difference (MDD95) were calculated,and the correlations among the 4 scales were analyzed.Results The test-retest ICC for the MPSFS was 0.94 and the inter-rater reliability ICC was 0.90.For the SCATS they were 0.948 and 0.939 respectively.,For the VAS they were 0.962 and 0.974,and for the SCI-SET they were 0.969 and 0.989.There was significant inter-correlation among all four scales,with negative correlation between the SCI-SET and the others.The observed correlations were all of medium strength (r=-0.421 to-0.5),except for a high correlation between the SCI-SET and VAS results (r=0.55 to 0.94).Conclusion The MPSFS,SCATS,VAS and SCI-SET are all reliable tools for evaluating spasticity among people with spinal cord injury.All can be applied in clinical practice.
ABSTRACT
Objective To investigate clinical value of inflame factors in child patients with sepsis at different time points before the diagnosis time.Methods A retrospective model was performed in this study.24 child patients with sepsis in Department of Paediatrics from January 2014 to October 2016 were selected.At the time 72 h(group A),48 h(group B),24 h(group C) before the diagnosis time,plasma levels of HBP and serum levels of IL-6,IL-10 were detected by ELISA,and pre calcitonin (PCT) and high sensitive C reactive protein (hs-CRP) were detected by immunofluorescence.Compared to the same period,22 healthy cases were selected as the control.Repeated measure anova and Receiver operating characteristic curve analysis were performed.Results The plasma levels of HBP were (9.69 ± 1.30) μg/L,(12.82 ±2.03) μg/L,(15.46 ± 1.02) μg/L,(18.60 ± 1.10) μg/L at group A,group B,group C before the diagnosis time respectively.The plasma levels of HBP at all time points before the diagnosis time were significantly higher than the control (t =6.27,P ＜ 0.01;t =16.82,P ＜ 0.01;t =25.16,P ＜ 0.01).The serum levels of HBP at group B,group C were significantly higher than the last time point (t =5.62,P ＜0.01;t =10.25,P ＜ 0.01).Receiver operating characteristic curve(ROC) revealed that the areas of HBP at group A(0.823),group B (0.898),was significantly higher than the other inflame factors(Z =2.41,P ＜0.01;Z=2.02,P＜0.05;Z=0.38,P＞0.05;Z=0.32,P＞0.05)(Z=0.43,P＞0.05;Z=0.46,P＞0.05;Z =0.26,P ＞ 0.05;Z =0.57,P ＞ 0.05).It also revealed that at group C,area of PCT(0.941) was significantly higher than the other inflame factors (Z =0.12,P ＞ 0.05;Z =0.08,P ＞ 0.05;Z =0.03,P ＞0.05;Z-0.10,P ＞ 0.05).Conclusions HBP has a wide diagnostic window period for sepsis.IL-6,IL-10,PCT and hs-CRP have diagnostic value in partial periods of sepsis.
ABSTRACT
Objective To explore whether quercetin-loaded PEG-PE micelles(M-Q) can synergize the growth-in-hibitory activity of adriamycin prepared ( ADR) by reversing the drug resistance of MCF-7 ADRr breast cancer cells in vitro.Methods M-Q was prepared by adding saline to lipid film containing quercetin and PEG-PE.The size of M-Q was characterized by dynamic light scattering ( DLS) .The inhibition of MCF-7 ADRr cells was evaluated by MTS assay after incubation with M-Q and ADR.Results The incorporation efficiency of quercetin by the micelles was above 74%.The average size of M-Q was 11.11 nm.Compared with the quercetin dissolved in ethanol , M-Q more effectively reversed the drug resistance of MCF-7 ADRr cells in vitro.Conclusions PEG-PE micelles may potentially deliver quercetin to cancer cells for reversal of drug resistance .
ABSTRACT
This paper reviewed and summarized experiences of Shanghai Hospital Development Center in the design and implementation of infrastructure planning for municipal public hospitals in Shanghai.The capital construction of more than 10 years has effectively upgraded infrastructure of such hospitals,enforced the people-oriented awareness,expanded the service ability and service capacity, further balanced the layout of quality medical resources,and significantly improved the sustainability of development.Furthermore, ever increasing government investment keeps business performance and service capability of such hospitals on the rise.
ABSTRACT
To summarize the advances in mechanisms of damage and treatments of cerebral ischemia and reperfusion and fore -casts future research directions .The existing achievements in literatures were summarized .Cerebral ischemia and reperfusion damage were related to inflammatory response , intracellular calcium overload , free radicals injury , release of excitatory amino acids and other factors.The treatments included reducing ischemia time , blocking glutamate receptors , free radical scavenging , inhibition of apoptosis , reducing inflammation , and promoting neuronal growth , etc.Multi-target treatment would be future directions in treatment of cerebral ischemia.
ABSTRACT
The adapter protein Lamellipodin (Lpd) plays an important role in cell migration. In particular, Lpd mediates lamellipodia formation by regulating actin dynamics via interacting with Ena/VASP proteins. Its RA-PH tandem domain configuration suggests that like its paralog RIAM, Lpd may also mediate particular Ras GTPase signaling. We determined the crystal structures of the Lpd RA-PH domains alone and with an N-terminal coiled-coil region (cc-RA-PH). These structures reveal that apart from the anticipated coiled-coil interaction, Lpd may also oligomerize through a second intermolecular contact site. We then validated both oligomerization interfaces in solution by mutagenesis. A fluorescence-polarization study demonstrated that Lpd binds phosphoinositol with low affinity. Based on our crystallographic and biochemical data, we propose that Lpd and RIAM serve diverse functions: Lpd plays a predominant role in regulating actin polymerization, and its function in mediating Ras GTPase signaling is largely suppressed compared to RIAM.
Subject(s)
Humans , Actins , Metabolism , Amino Acid Sequence , Binding Sites , Carrier Proteins , Chemistry , Genetics , Metabolism , Crystallography, X-Ray , Membrane Proteins , Chemistry , Genetics , Metabolism , Molecular Sequence Data , Mutagenesis , Phosphatidylinositols , Metabolism , Polymerization , Protein Binding , Protein Structure, Tertiary , Recombinant Proteins , Chemistry , Genetics , Signal Transduction , ras Proteins , MetabolismABSTRACT
Objective To explore the role of 256 CT iterative reconstruction in improving image quality and reducing radiation dose of carotid artery into cranial segment.Methods Sixty patients underwent head and neck CTA on a 256 CT scanner.Conventional dose scanning was performed in 30 patients using a filtered back projection (FBP) reconstruction (group A) and iterative iDose4 reconstruction (group B).Low dose scanning was performed in the other 30 patients using FBP reconstruction (group C) and iDose4 reconstruction (group D).The noise,SNR,CNR,score of image quality and effective radiation dose were evaluated in four groups.One-way ANOVA was used to analyze the image quality index between groups.Independent sample of Kruskal-Wallis test of ranked data was used to compare image quality score between groups.Paired t test was used to compare the effective radiation doses between the low dose group and conventional dose group.Results The image noise of four groups were 8.21 ±0.88,7.31 ± 0.33,11.17 ± 2.02 and 6.50 ± 0.49 respectively.SNR were 43.21 ± 4.49,5 1.83 ± 3.64,42.88 ± 9.19 and 53.47 ± 4.88,respectively.CNR were 37.88 ± 4.02,61.21 ± 6.31,36.63 ± 8.20 and 62.99 ±5.90,respectively.There were statistic differences (F =112.786,97.041 and 86.098,P ＜0.01).The differences of image noise between group A and B had no statistic significance,which was statistic different between group A and C (P ＜ 0.01).Except that the differences of SNR and CNR between group A and C,B and D had no statistic significance,the differences between other two groups had statistic significance (P ＜ 0.01).In case of image quality score of 1,2 and 3,there were 2,13 and 15 patients in group A; 0,7 and 23 patients in group B; 5,15 and 10 patients in group C; and 0,5 and 25 patients in group D.There was statistic differences of image quality score between each group (H =22.575,P ＜0.01).The effective radiation dose was (2.31 ±0.13) mSv in conventional dose group and (0.84 ±0.04) mSv in low dose group.There was statistic difference between the two groups (t =60.682,P ＜ 0.05).Conclusion Compared with conventional dose,iDose4 iterative reconstruction algorithms can obtain excellent images of CTA for carotid artery into the cranial segment with more than 50％ radiation dose decrease.