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Resumo Fundamento A trombose completa da falsa luz facilita a remodelação da dissecção aórtica tipo B (DATB). As características morfológicas afetam a trombose na falsa luz. Objetivos Discutir os fatores pré-admissão presentes, que influenciam a trombose da falsa luz em pacientes com DATB. Metodologia Ao todo, 282 pacientes diagnosticados com DATB em nosso hospital foram estudados, no período entre janeiro de 2008 e dezembro de 2017. Os indivíduos foram divididos em um grupo trombótico e um grupo não trombótico, com base na detecção de qualquer trombo na falsa luz. Analisamos as diferenças entre os dois grupos com relação aos dados clínicos, o comprimento vertical da dissecção e o diâmetro da aorta. Valores de p < 0,05 foram considerados estatisticamente diferentes de modo significativo. Resultados Diferenças significativas entre o grupo trombótico e o grupo não trombótico foram encontradas com relação à idade (53,92 ± 11,40 vs. 50,36 ± 10,71, p = 0,009) e proporção de pacientes com insuficiência renal (7,83% vs. 16,38%, p = 0,026). Nas zonas 3-9, o diâmetro da luz verdadeira do grupo trombótico foi significativamente maior do que no grupo não trombótico (p < 0,05). A análise de regressão logística binária mostrou que o diâmetro da luz verdadeira na zona 5 e a insuficiência renal foram preditores independentes de trombose da falsa luz. Conclusões A idade e a função renal estiveram associadas à trombose na falsa luz. Potencialmente, a diferença entre o diâmetro da luz verdadeira e o da falsa luz pode influenciar na trombose da falsa luz.
Abstract Background Complete thrombosis of the false lumen facilitates remodeling of type B aortic dissection (TBAD). Morphological characteristics affect thrombosis in the false lumen. Objectives Discuss the factors present before admission that influence false lumen thrombosis in patients with TBAD. Methods We studied 282 patients diagnosed with TBAD in our hospital between January 2008 and December 2017. We divided the subjects into a thrombotic group and a non-thrombotic group based on whether any thrombus was detectable in the false lumen. We analyzed the differences between the two groups with respect to clinical data, the vertical length of the dissection, and the diameter of the aorta. P values < 0.05 were considered statistically significantly different. Results Significant differences between the thrombotic group and non-thrombotic group were found with respect to age (53.92 ± 11.40 vs. 50.36 ± 10.71, p = 0.009) and proportion of patients with renal insufficiency (7.83% vs. 16.38%, p = 0.026). In zones 3-9, the true lumen diameter of the thrombotic group was significantly larger than in the non-thrombotic group (p < 0.05). Binary logistic regression analysis showed that true lumen diameter in zone 5 and renal insufficiency were independent predictors of false lumen thrombosis. Conclusions Age and renal function were associated with thrombosis in the false lumen. Potentially, the difference between the diameter of the true lumen diameter and that of the false lumen may influence the thrombosis of the false lumen.
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Objective:To explore the quality differences of systemic biopsy specimens from different regions in prostate biopsy.Methods:The data of 806 patients who underwent transperineal prostate biopsy from May 2013 to December 2020 in Northern Jiangsu People’s Hospital were retrospectively reviewed. The median age of the patients was 72 (66, 77) years old, median PSA was 18.4 (10.3, 34.2) ng/ml, and prostate volume was 43 (32, 56) ml. Tissue quality were graded from low to high as follows. One score means multiple fragments with fragmented tissue ≤5 mm. Two scores means at least one fragment >5 mm and ≤10 mm. Three scores means at least one fragment >10 mm. The prostate specimens fragmentation scores and the length of the specimens in different regions of the prostate were collected to analyze.Results:A total of 806 patients were included in our study. The number of tissues was 8 866, and the mean length of tissues was 1.2 (1.0, 1.5) cm. The tissues of different region were scored according to the scoring criteria, of which 618 (7.0%) prostate tissues were scored as 1 score, 2 720 (30.7%) tissues were scored as 2 scores, and 5 528 (62.4%) tissues were scored as 3 scores. In the prostate apex, tissue quality of 1 score accounted for 11.7%(94/806), 2 scores accounted for 34.7%(280/806), and 3 scores accounted for 53.6%(432/806). While in the prostate base, tissue quality of 1 score accounted for 6.5%(524/8 060), 2 scores accounted for 30.3%(2 449/8 060), and 3 scores accounted for 63.2%(5 096/8 060)( H=35.850, P<0.05). The mean length of the prostate apical tissue was 1.0 (0.8, 1.3) cm, which was significantly shorter than prostate basal tissue of 1.2(1.0, 1.5) cm ( Z=-11.353, P<0.05). Conclusions:In transperineal prostate biopsy, the apical tissue was more fragmented and shorter, prostate apex should be concerned.
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Although herbal medicines(HMs)are widely used in the prevention and treatment of obesity and obesity-associated disorders,the key constituents exhibiting anti-obesity activity and their molecular mechanisms are poorly understood.Recently,we assessed the inhibitory potentials of several HMs against human pancreatic lipase(hPL,a key therapeutic target for human obesity),among which the root-extract of Rhodiola crenulata(ERC)showed the most potent anti-hPL activity.In this study,we adopted an integrated strategy,involving bioactivity-guided fractionation techniques,chemical profiling,and biochemical assays,to identify the key anti-hPL constituents in ERC.Nine ERC fractions(retention time=12.5-35 min),obtained using reverse-phase liquid chromatography,showed strong anti-hPL activity,while the major constituents in these bioactive fractions were subsequently identified using liquid chromatography-quadrupole time-of-flight mass spectrometry(LC-Q-TOF-MS/MS).Among the identified ERC constituents,1,2,3,4,6-penta-O-galloyl-β-D-glucopyranose(PGG)and catechin gallate(CG)showed the most potent anti-hPL activity,with pIC50 values of 7.59±0.03 and 7.68±0.23,respectively.Further investigations revealed that PGG and CG potently inhibited hPL in a non-competitive manner,with inhibition constant(Ki)values of 0.012 and 0.082 μM,respectively.Collectively,our integrative analyses enabled us to efficiently identify and characterize the key anti-obesity constituents in ERC,as well as to elucidate their anti-hPL mechanisms.These findings provide convincing evidence in support of the anti-obesity and lipid-lowering properties of ERC.
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@#Abstract: Objective To investigate the distribution and drug resistance characteristics of pathogenic bacteria in patients with neutropenic acute leukemia (AL) and bloodstream infections (BSI). Methods The clinical data of 258 neutropenic acute leukemia patients with bloodstream infections, who admitted to Shengjing Hospital of China Medical University from January 2016 to December 2021, were collected and analyzed for pathogenic bacteria and drug resistance. Results A total of 268 strains of pathogenic bacteria were isolated from 258 patients, including 180 strains of gram-negative bacteria (67.16%), 61 strains of gram-positive bacteria (22.76%), and 27 strains of fungi (10.07%). Gram-negative bacteria were mainly Klebsiella pneumoniae (53/268, 19.78%), Escherichia coli (49/268, 18.28%) and Pseudomonas aeruginosa (41/268, 15.30%). Gram-positive bacteria were mainly coagulase negative Staphylococcus (31/268, 11.57%) and Staphylococcus aureus(17/268, 6.34%). The main fungi were Candida tropicalis (25/268, 9.33%). Escherichia coli (33/268, 12.31%) was the most common pathogen isolated from acute myeloid leukemia (AML), followed by Pseudomonas aeruginosa (25/268, 9.33%), coagulase-negative Staphylococcus (18/268, 6.72%) and Candida tropicalis (18/268, 6.72%). Klebsiella pneumoniae (35/268, 13.06%) was the most common pathogen isolated from acute lymphoblastic leukemia (ALL),followed by Pseudomonas aeruginosa (15/268, 5.60%) and Escherichia coli (14/268, 5.22%). The resistance of Gram-negative bacteria to piperacillin/tazobactam, cefoperazone/sulbactam, imipenem, meropenem, ertapenem, amikacin, cefoxitin, amoxicillin/clavulanic acid was low. Gram-positive bacteria were sensitive to linezolid and vancomycin. Candida was sensitive to flucytosine, amphotericin B and itraconazole. Conclusions In patients with granulosa after AL chemotherapy combined with BSI, the pathogenic bacteria isolated from AML are diverse, and the pathogenic bacteria isolated from ALL are mainly gram-negative bacteria. Pathogenic bacteria have different degrees of drug resistance to commonly used antibacterial drugs, so it is important to strengthen the monitoring of the distribution of pathogenic bacteria and the change of drug resistance and rational use of antibacterial drugs to minimize the death of patients.
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Objective: To introduce and compare four analysis methods of multiple parallel mediation model, including pure regression method, method based on inverse probability weighting, extended natural effect model method and weight-based imputation strategies. Methods: For the multiple parallel mediation model, the simulation experiments of three scenarios were carried out to compare the performance of different methods in estimating direct and indirect effects in different situations. Dataset from UK Biobank was then analyzed by using the four methods. Results: The estimation biases of the regression method and the inverse probability weighting method were relatively small, followed by the extended natural effect model method, and the estimation results of the weight-based imputation strategies were quite different from the other three methods. Conclusions: Different multiple parallel mediation analysis methods have different application situations and their own advantages and disadvantages. The regression method is more suitable for continuous mediator, and the inverse probability weighting method is more suitable for binary mediator. The extended natural effect model method has better performances when the residuals of two parallel mediators are positively correlated and the correlation degree is small. The weight-based imputation strategies might not be appropriate for parallel mediation analysis. Therefore, appropriate methods should be selected according to the specific situation in practice.
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Humans , Bias , Computer Simulation , Mediation Analysis , Models, Statistical , Probability , Regression Analysis , Research DesignABSTRACT
Objective:To explore the feasibility and safety of the clinical application of the diagnosis and treatment mode combining rapid frozen pathological examination of prostate biopsy tissue with radical prostatectomy.Methods:Suspected prostate cancer patients with PSA>10 ng/ml and PI-RADS score ≥4 in, Northern Jiangsu People's Hospital from April to September 2021 were collected. The included patients underwent mpMRI/TRUS image fusion-guided transperineal prostate targeted biopsy with 16G biopsy needle, 2-3 needles for biopsy, and rapid frozen pathological examination. Robot-assisted laparoscopic radical prostatectomy (RALP) was performed immediately for patients with prostate cancer with rapid freezing pathology. For undiagnosed prostate cancer, 18G biopsy needle for prostate targeted + systematic biopsy were used, 18-22 needles for systematic biopsy, and routine pathological examination. The baseline data, frozen pathological results, perioperative conditions, pathological results and follow-up data of all patients were collected.Results:Eleven patients were included in the study, the mean age of the patients was 69.9(66-73) years, the mean BMI was 22.8(19-26) kg/m 2, the mean PSA was 23.2(14.25-32.00), the mean prostate volume was 45(32-52) ml, mean PSAD 0.54(0.33-0.75). PI-RADS score was 4 in 3 cases and 5 in 8 cases; digital rectal examination was positive in 5 cases. All 11 cases underwent rapid freezing and the pathological results showed that: 9 cases were prostate adenocarcinoma, and RALP was performed immediately. The operation time was 111.5(96-126) min, the intraoperative blood loss was 78.9(55-105) ml, and the postoperative extubation time was 4.3(3.5-5.0) days, postoperative hospital stay 5.8(5.0-6.5) days. Postoperative pathology showed that Gleason score 3+ 4=7 in 1 case, 4+ 3=7 in 3 cases, 8 points in 4 cases, and 10 points in 1 case; 3 cases had positive resection margins, and 1 case had seminal vesicle invasion, the average number of dissected lymph nodes was 10.9 (8.5-14.0), and there was no tumor metastasis. Pathological T staging included 2 cases of T 2b stage, 5 cases of T 2c stage, 1 case of T 3a stage, and 1 case of T 3b stage. Two patients were undiagnosed by rapid freezing pathology, of which one was prostate adenocarcinoma with a Gleason score of 4+ 3=7, and then received RALP; the other one was prostate inflammation. 11 patients were followed up; the postoperative follow-up time was 3-7 months, with an average of 5.2 months. Among the 10 patients who underwent RALP, 8 patients recovered urinary continence 2 weeks after surgery, and all recovered within 2 months after surgery. Three patients with positive surgical margins were given regular androgen deprivation therapy in the second week after surgery. PSA did not drop below 0.1 ng/ml in patients with positive margins and seminal vesicle invasion 3 months after surgery. No complications of Clavien grade Ⅰ or higher occurred after operation and during follow-up. Conclusions:For patients with high suspicion of prostate cancer, rapid frozen pathological examination of prostate biopsy tissue is performed. RALP is performed immediately for patients with prostate cancer. The results show that this diagnosis and treatment model could be safe and feasible.
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Objective:To explore the value of different radiomics models based on machine learning in predicting the risk of distant recurrence and metastasis of triple-negative breast cancer after neoadjuvant therapy.Methods:The clinical and imaging data of 150 patients with triple-negative breast cancer (TNBC) confirmed by histopathology were retrospectively analyzed. All patients underwent neoadjuvant chemotherapy and surgical resection from August 2011 to May 2017 in Fudan University Shanghai Cancer Center and Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. One hundred and nine patients from Shanghai Fudan University Shanghai Cancer Center were used as the training group, and 41 patients from Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were used as the validation group. The features were extracted from dynamic contrast-enhanced MRI (DCE-MRI) before treatment and were added with time domain features innovatively. Least absolute shrinkage and selection operator cross validation and recursive feature elimination were applied to select features. Six different supervised machine learning algorithms (logistic regression, linear discriminant analysis, k-nearest neighbor, naive bayesian, decision tree, support vector machine) were used to predict the prognosis. ROC curve, accuracy and F1 measure were used to evaluate the performance of the six algorithms, and also verified by the validation group.Results:The support vector machine algorithm had the best predictive effect in the recurrence and metastasis model based on 15 features, with the highest area under curve (training group was 0.917, validation group was 0.859), and the highest accuracy rate (training group was 87.5%, validation group was 82.9%) and the highest F1 measure (training group was 0.800, validation group was 0.741). In addition, of the 15 imaging features, 12 were the time domain features and 3 were spatial features.Conclusion:With the help of the time domain features and machine learning algorithms, radiomics signatures based on preoperative DCE-MRI can help predict the distant prognosis for TNBC after neoadjuvant chemotherapy and provide support for clinical decision making and follow-up management.
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Objective:To investigate the differential diagnosis of MRI between male malignant and benign breast lesions.Methods:Totally 34 patients with male breast lesions who underwent breast MRI examination from January 2011 to March 2019 were collected from Shanghai Cancer Center.All images were evaluated by two radiologists who were blinded to pathological results. When there was a disagreement, another independent senior radiologist assessed the imaging features. The imaging features including lesion location, T 1WI signal, T 2WI signal, lesion type and accompanying signs were evaluated. All lesions were confirmed by biopsy or surgical pathology. Twelve patients were in benign group, 22 patients in malignant group. The imaging findings of MRI were recorded and statistically analyzed by univariate analysis (continuous variables were tested by Mann-Whitney U test and categorical variables were tested by Fisher′s exact test). Results:Among the 34 patients, 31 cases clinically touched the mass and 3 cases showed simple nipple bleeding. In MRI signs, breast cancer showed mass-like enhancement (22/22), benign lesions showed non-mass enhancement (7/12), the difference was statistically significant ( P<0.05). And ipsilateral axillary enlarged lymph nodes only appeared in breast cancer, which was significantly different from that in benign lesions ( P<0.05). There was no significant difference in age, lesion location, T 1WI signal, T 2WI signal, skin thickening and nipple invagination between benign and malignant lesions. There was no significant difference in the size, shape and edge of the mass between benign and malignant lesions on MRI ( P>0.05). Conclusions:MRI can distinguish male malignant and benign breast lesions. Most of non-mass enhancement are benign lesion and enlarged lymph nodes are helpful to detect breast cancer, nipple retraction and skin thickening in the diagnosis of male breast cancer are limited.
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Objective:To investigate the value of bedside transthoracic echocardiography(TTE) in volume reactivity assessment of children with septic shock.Methods:A total of 41 children aged from 1 to 5 years with septic shock requiring mechanical ventilation admitted to PICU from January 2017 to June 2020 were prospectively included.Under the condition of complete mechanical ventilation, full sedation and analgesia, and no spontaneous breathing(tidal volume 8 to 10 mL/kg), volume expansion was given to children.Hemodynamic indexs such as cardiac index(CI), stroke volume index(SVI) and stroke volume variability(SVV) were measured before and after volume expansion by noninvasive cardiac output monitoring(NICOM) and TTE.Moreover, aortic flow velocity time integral variable degrees(ΔVTI), inferior vena cava variability(ΔIVC) and inferior vena cava dilation index(dIVC) were also measured by TTE.Patients were considered to be responsive to volume expansion if SVI NICOMincreased≥15%.Based on the responsiveness of volume expansion, all the patients were divided into response group and non-response group.The value of SVV TTE, ΔVTI, ΔIVC, dIVC, ΔCVP and SVV NICOMin predicting volume responsiveness were analysed. Results:(1) There were 23 cases in response group and 18 cases in non-response group.Before volume expansion, there were no statistically significant differences in general hemodynamic indexes HR, MAP, CVP, EF, CI NICOM, and CI TTEbetween two groups( P>0.05). (2) In response group, HR, MAP, CI, SVI and CVP were all improved after volume expansion( P<0.001). In non-response group, only CVP was significantly increased after volume expansion, while other indexes were not improved( P>0.05). (3)Before the volume expansion, SVV TTE, ΔVTI, ΔIVC, and dIVC in response group were higher than those in non-response group( P<0.001). After volume expansion, these indicators were significantly reduced in response group.In non-response group, only ΔIVC significantly reduced after volume expansion.(4) The receiver-operating characteristic curve analysis showed that the area under the curve of SVV TTEand ΔVTI was 0.971, with 12.04% as the threshold, the sensitivity was 0.957 and the specificity was 0.944. The area under the curve of ΔIVC was 0.981, with 25.98% as the threshold, the sensitivity was 0.870 and the specificity was 1.000.The area under the curve of dIVC was 0.980, with 29.86% as the threshold, the sensitivity was 0.870 and the specificity was 1.000. The area under the curve of ΔCVP was 0.778, with 2.5 cmH 2O(1 cmH 2O=0.098 kPa) as the threshold, the sensitivity was 0.913 and the specificity was 0.556. The area under the curve of SVV NICOMwas 0.874, with 12.50% as the threshold, the sensitivity was 0.869 and the specificity was 0.778. Conclusion:The dynamic indexes SVV, ΔVTI, ΔIVC and dIVC monitored by TTE have good accuracy in evaluating children′s volume responsiveness, among which the accuracy of ΔIVC and dIVC is relatively the highest; the value of ΔCVP in predicting volume responsiveness is limited.
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Objective To determine the effects of the"double random"supervision model of public places in Yangpu District, Shanghai. Methods Using the"double random"data of public places in Yangpu District of Shanghai from 2018 to 2019, we determined the proportion of unqualified public places assessed by daily supervision and"double random"supervision in 2018 and 2019. Moreover, we identified that if the public places that had been penalized in 2018 would be penalized in 2019, which may reflect the effects of the"double random"supervision model. Results The proportion of unqualified public places assessed by"double random"supervision was significantly higher than daily supervision in 2018(χ2 = 58.04, P < 0.05)and 2019(χ2 = 79.24, P < 0.05);however, the proportion of being penalized in the following year between"double random"supervision and daily supervision had no significant difference(χ2 = 1.81, P = 0.18). Conclusion "Double random"supervision may be easier to identify the problems of the supervision subjects than daily supervision; however, it warrants continual efforts to consolidate the regulatory effects.
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Objective:To evaluate the feasibility of CT radiomics method in predicting outcomes of simultaneous pulmonary nodules in breast cancer patients after treatment.Methods:Patients with breast cancer confirmed by pathology and with simultaneous pulmonary nodules (diameter>5 mm, number≤5) detected by preoperative CT were retrospectively enrolled in this study. Eighty female patients were included (median age: 52, quartile range: 45, 61). The pulmonary nodules (median size: 6.0 mm, quartile range: 5.5, 7.2 mm) were classified into stable group (without change over 2 years) and change group according to follow-up CT findings. The change group was further divided into improved group and progressive group. Eventually, 54 cases were in the stable group, 26 cases were in the change group. One hundred and five texture features were extracted using the python-based pyradiomics package based on preoperative CT images. Stepwise regression was used to exclude features without significant difference in predicting changes of pulmonary nodules. Classifiers model and 5 fold cross validation method were used to obtain the highest performance in predicting outcomes of pulmonary nodules. Receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic performance of the model.Results:After features exclusion and selection, three radiomics features were used to establish classifiers between stable group and change group. It was showed that the linear discriminate analysis was the optimal model with the specificity, sensitivity, accuracy and area under the ROC curve (AUC) as 0.980, 0.460, 0.813 and 0.770 respectively. One radiomics feature was chosen to establish classifiers between improved group and progressive group. The coarse gaussian support vector machine (CGSVM) was the optimal model, with the specificity, sensitivity, accuracy and AUC as 0.540, 0.920, 0.713 and 0.880 respectively.Conclusions:CT radiomics analysis has the potential to predict the outcomes of simultaneous indeterminate pulmonary nodules in breast cancer patients after treatment, and it may contribute to preoperative treatment and postoperative follow-up planning.
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Objective:To combine automatic image segmentation technology and machine learning methods to accurately classify and recognize mammography images.Methods:Taking mammography images with clustered pleomorphic calcification as the research object, which were in BI-RADS4 class from the Digital Mammogram Database (DDSM). The region of interest (ROI) of the images was automatically segmented. The characteristic features extracted by wavelet transform, Gabor filter and gray level co-occurrence matrix method were fused. The fused feature parameters were screened based on sensitivity analysis. Using ensemble learning method, the polynomial kernel SVM, random forest and logistic regression classifiers were integrated to form a classifier for automatic classification of mammography images. The ensemble learning method was soft voting integration.Results:The proposed ensemble classifier can efficiently recognize and classify mammography images, and its classification sensitivity, specificity and accuracy on the training set were 99.1%, 99.6% and 99.3%, respectively.Conclusions:The proposed mammography image processing, classification and recognition method can provide assistant detection basis for doctors' clinical judgment, and provide a technical basis for subdividing BI-RADS4 class images.
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This study aims to reveal the pharmacokinetics of Shuganning Injection in normal rats. In this experiment,ultra-high performance liquid chromatography-electrospray-tandem mass spectrometry( UPLC-ESI-MS/MS) was used to establish an analytical method for simultaneous determination of chlorogenic acid,gardenioside,oroxylin A and baicalin in rat plasma. Then,the non-compartmental model( NCA) in Phoenix WinN onL in 6. 4 software was used to fit pharmacokinetic parameters. The methodological validation showed that the linear relationship of the components in rat plasma samples were good( r>0. 995). The recovery rate and matrix effect of plasma samples with low,middle and high concentration were 79. 14%-101. 4%. The intra-day and inter-day precision,accuracy and stability meet the requirements of biological sample analysis. The half-life( t1/2) of chlorogenic acid,gardenioside,oroxylin A did not change significantly and the area under blood concentration-time curve( AUC0-t) is proportional to the dose,which suggested that three components showed a linear kinetic characteristics,but baicalin showed nonlinear kinetic characteristics. Moreover,the retention time of each component in rats was short. The established UPLC-MS/MS quantitative analysis method is rapid,sensitive and accurate,which can be used for the determination of chlorogenic acid,gardenioside,oroxylin A and baicalin in rat plasma and pharmacokinetic study of Shuganning Injection.
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Animals , Rats , Chlorogenic Acid , Chromatography, High Pressure Liquid , Chromatography, Liquid , Plasma , Rats, Sprague-Dawley , Reproducibility of Results , Tandem Mass SpectrometryABSTRACT
Objective: To establish an HPLC wavelength switching method for the simultaneous content determi- nation of verbascoside,paederosidic acid methyl ester,asperulosidic acid,asperuloside,calycosin7-O-β-D-glucopyran- oside,ononin,calycosin,formononetin and batatasinin Shenkangling granules(Radix Rehmanniae,Herba Hedyotis Diffusae,Radix Astragali,Rhizoma Dioscoreae,etc.). Methods: The Shenkangling granules were extracted with 50% aqueous methanol to prepare the test solution. The HPLC analysis was performed on thermostatic Agilent Eclipse XDB-C18 (250 mm×4.6 mm,5 μm)a 30℃,with the mobile phase consisting of acetonitrile-0.2% phosphoric acid solution at 0.9 ml/min flow rate in a gradient elution manner,and the detection wavelength was set at 334,238,254 and 270 nm, respectively. Results The above mentioned nine compounds showed good linearity in turn within the range of 3.09- 61.80,3.67-73.40,1.98-39.60,2.51-50.20,1.39-27.80,1.06-21.20,0.87-17.40,2.79-55.80,and 2.16-43.20 μg/ml, respectively,and their average recovery was 99.34%,100.03%,97.67%,98.63%,97.96%,96.93%,97.48%,99.87%, and 98.95% with the RSD of 0.88%,1.15%,1.28%,1.49%,0.99%,1.41%,1.37%,0.72%,and 1.25%,respectively.Conclusion: The method is easy to operate,repeatable,and can be used for quality control of Shenkangling granules.
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Objective@#To investigate the associations between genetic variations in DNA mismatch repair genes and sensitivity as well as prognosis to preoperative chemoradiotherapy in patients with locally advanced rectal cancer.@*Methods@#Fourteen haplotype-tagging single nucleotide polymorphisms (htSNPs) of MLH1, MLH3 and MSH2 genes were genotyped by Sequenom MassARRAY method in 146 patients with locally advanced rectal cancer who received preoperative chemoradiotherapy. The associations between genotypes and response to capecitabine-based neoadjuvant chemoradiotherapy (nCRT) were measured by odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for sex, age, clinical stages and karnofsky performance score (KPS) by unconditional logistic regression model. The survival analyses were performed by the hazard ratios (HRs) and 95% CIs by Cox proportional regression model.@*Results@#Among 146 cases, 64 patients were nCRT responders with a response rate of 43.8%. MLH3 rs175057 C>T and MSH2 rs13019654 G>T loci were associated with the sensitivity to preoperative chemoradiotherapy. Compared with the rs175057 CC genotype, the adjusted OR for patients with CT and TT genotypes was 0.42 (95% CI: 0.19-0.91; P=0.029). Moreover, for rs13019654, the adjusted OR for patients with the GT or TT genotypes was 0.49 (95% CI: 0.24-0.98; P=0.047) than those with GG genotype. The remaining 12 SNPs, including rs1540354, rs4026175, rs1981929, rs2042649, rs2303428, rs3771273, rs4608577, rs4952887, rs6544991, rs6544997, rs10188090 and rs10191478, were not significantly associated with therapeutic response to preoperative chemoradiotherapy. Meanwhile, MLH3 rs175057 C>T locus was also associated with longer overall survival time in locally advanced rectal cancer (HR=0.44, 95% CI: 0.20-0.96, P=0.038), whereas MSH2 rs3771273 T>A, rs10188090 A>G and rs10191478 T>G loci were associated with shorter overall survival time (HR=1.74, 95% CI: 1.06-2.84, P=0.028; HR=1.64, 95% CI: 1.01-2.66, P=0.046; HR=1.71, 95% CI: 1.01-2.91, P=0.047, respectively). The remaining 10 SNPs, including rs1540354, rs4026175, rs1981929, rs2042649, rs2303428, rs4608577, rs4952887, rs6544991, rs6544997 and rs13019654, were not significantly associated with prognosis.@*Conclusions@#Genetic polymorphisms of MLH3 rs175057 and MSH2 rs13019654 loci can predict the nCRT response, while MLH3 rs175057 as well as MSH2 rs3771273, rs10188090 and rs10191478 may predict prognosis in patients with locally advanced rectal cancer who received preoperative chemoradiotherapy. Therefore, these SNPs could be used as potential genetic markers in the personalized therapy of rectal cancer.
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Objective To investigate the significance of whole mount sections after radical prostatectomy in the diagnosis of prostate cancer.Methods The data of 210 patients with radical prostatectomy in the Department of Urology of Northern Jiangsu People's Hospital from April 2018 to July 2015 were collected,of which 150 cases (control group) were examined with routine tissue section examination and 60 cases (study group) were examined with whole mount sections.The age of the study group and the control group were (69.0 ± 5.0) years and (70.0 ± 7.0) years respectively,and PSA was (18.8 ± 2.5) ng/ml and (19.3 ± 2.1) ng/ml respectively.The BMI of the study group was (23.0 ± 1.2) kg/m2,and the control group was (22.8 ± 0.6) kg/m2.The preoperative Gleason score of the study group and the control group were 7.9 ±0.9 and 7.7 ± 1.6 respectively.There were 137 patients (91.3％) with clinical stage cT1-T2 and 13 patients with cT3(8.7％) in control group.In the study group,there were 51 cases (85.0％) with clinical stage cT1-T2,and 9 cases with cT3 (15.0％).There was no significant difference between the two groups (P ＞ 0.05) in term of the patients' demographics.The postoperative Gleason score,positive surgical margin,seminal vesicle invasion lymph node metastasis and pathological stage were compared between the two groups.Results The median prostate volume of the study group was 45.2 (18.3-121.5) ml,and 47.1 (2 1.3-124.2) ml in the control group.The operation time of the study group was 138.2 (119.5-234.1) mins,and 133.5 (116.8-228.2) mins in the control group.In the control group,there were 8 cases(5.3％) with seminal vesicle invasion,and 8 cases (5.3％) with lymph node metastasis.The pathological stages were pT2-T3 in 145 cases(96.7％),and pT4 in 5 cases (3.3％) in control group.The postoperative Gleason score was 8.0 ± 0.9 in control group.In the study group,17 patients (28.3％) with seminal vesicle invasion were pathologically indicated,and there were 6 patients (10.0％) with lymph node metastasis.The pathological stages were pT2-T3 of 57 cases(95.0％),and pT4 of 3 cases (5.0％),postoperative Gleason score was 7.7 ± 1.0 in study group.There was no statistically significant difference in seminal vesicle invasion,lymph node metastasis,pathological stage and postoperative Gleason score between the two groups (P ＞ 0.05).There were 23 patients (15.3％) with positive margins in the control group,and 28 patients(46.7％) in the study group,which showed significant difference (P ＜0.01).For small lesions,there were 7 cases (4.7％) and 22 cases (36.7％) in the control group and the study group,respectively,which showed significant difference (P ＜ 0.01).There were 17 cases (28.3％) of increased Gleason score in the study group,while 31 cases (20.7％) in the control group,with no statistical difference (P =0.232).Conclusions The whole mount section technique can effectively improve the positive surgical margin and the small lesions detection rate in the pathological evaluation of radical prostatectomy,and provide a precise pathological diagnosis for the postoperative treatment and follow-up of the patients.
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As a first generation tyrosine kinase inhibitor, imatinib is the gold standard drug for the clinical treatment of chronic myelog-enous leukemia. However, interindividual differences in resistance and response to imatinib have been widely observed. In vivo and in vitro studies have confirmed that ATP-binding cassette transporters, organic cation transporters, and organic anion transporting poly-peptides have a large effect on imatinib pharmacokinetics and pharmacodynamics. In addition, the gene polymorphisms of drug trans-porters can directly or indirectly influence the intracellular concentration of imatinib, resulting in differences in treatment efficacy among chronic myelogenous leukemia patients. This review profiles the effect of drug transporter gene polymorphisms on susceptibili-ty to imatinib in chronic myelogenous leukemia so as to provide reference to further clinical researches.
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OBJECTIVE:To observe clinical efficacy and safety of Compound xiongshao capsules in the treatment of diabetic peripheral neuropathy (DPN).METHODS:A total of 97 DPN patients selected from our hospital during Jun.2015-Apr.2016 were divided into group A (compound xiongshao treatment group,46 cases) and control group (51 cases) according to random number table.The latter was divided into group B (epalrestat+beraprost sodium group,12 cases),group C (fursultiamine+mecobalamin group,12 cases) and group D (epalrestat group,27 cases) according to clinical symptoms and economic situation of patients.Four groups were given antidiabetic drugs for blood glucose control.Based on it,group A was additionally given Compound xiongshao capsules 0.9 g,tid;group B was additionally given Epalrestat tablets 50 mg,tid+Beraprost sodium tablets 40 μg,tid;group C was additionally given Fursultiamine tablets 50 mg,tid+Mecobalamin tablets 0.5 mg,rid;group D was additionally given Epalrestat tablets 50 mg,tid.All groups were treated for 6 months.Clinical efficacies were observed.TCSS scores,motor nerve conduction velocity (MCV),sensory nerve conduction velocity (SCV),incubation period and amplitude of median nerve and common peroneal nerve,the levels of hemorheology indexes,blood glucose,glycosylated hemoglobin,blood lipid,serum creatinine were compared before and after treatment.The occurrence of ADR was recorded.RESULTS:Total response rates of group A and B (82.61％,83.33％)were significantly higher than those of group C and D (33.33％,66.67％),total response rate of group D was significantly higher than that of group C,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in TCSS scores,MCV,SCV,incubation period and amplitude of median nerve,MCV and amplitude of common peroneal never,SCV,incubation period and amplitude of common peroneal never or whole blood high-shear viscosity among 4 groups (P＞0.05).After treatment,TCSS scores of group A,B and D were decreased significantly compared to before treatment,and those of group A and B were lower than those of group C and D,with statistical significance (P＜0.05).MCV,incubation period and amplitude of median nerve in group A and B,amplitude of median nerve in group C,MCV and amplitude of median nerve in group D were significantly better than before treatment;MCV,incubation period and amplitude of median nerve in group A and B were significantly better than group C and D,with statistical significance (P＜0.05).MCV,incubation period and amplitude of common peroneal never in group A,B,C were significantly better than before treatment,MCV and amplitude of common peroneal never in group A,B were significantly better than group C,D;the improvement of incubation period of common peroneal never in group A,B,D were significantly better than group C,with statistical significance (P＜0.05).SCV,incubation period and amplitude of median nerve,SCV and amplitude of common peroneal nerve in group A,B and D were significantly better than before treatment;SCV,incubation period and amplitude of median nerve,SCV and amplitude of common peroneal nerve in group A,SCV,incubation period and amplitude of median nerve and amplitude of common peroneal nerve in group B were significantly better than group C and D;SCV of median nerve in group D was significantly better than group C,with statistical significance (P＜0.05).Whole blood high-shear viscosity of group A was decreased significantly compared to before treatment,and significantly lower than those of group B,C and D,with statistical significance (P＜0.05).There was no statistical significance in total response rate and TCSS score between group A and B,and in the levels of blood glucose,glycosylated hemoglobin,blood lipid or serum creatinine among 4 groups (P＞0.05).No obvious ADR was found in 4 groups.CONCLUSIONS:Compound xiongshao capsules shows significant therapeutic efficacy for DPN,and improves nerve conduction velocity,incubation period and amplitude of median nerve and common peroneal nerve,whole blood high-shear viscosity.Its effect is similar to that of epalrestat combined with beraprost sodium,and better than those of fursultiamine combined with mecobalamin,epalrestat alone.It does not affect the blood glucose,blood lipid and serum creatinine levels with good safety.
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Objective To explore the feasibility and accuracy of urinary tissue inhibitor of metalloproteinase-2(TIMP-2) and insulin-like growth factor binding protein-7(IGFBP-7) for predicting acute kidney injury(AKI) occurrence in pediatric patients with sepsis.Methods A total of 174 pediatric patients with sepsis in PICU of Chengdu Municipal Women and Children Central Hospital and 30 healthy control children(control group) from March 2014 to March 2017 were included.Fasting venous blood was collected at 8:00 every morning during 7 d before admitting to PICU for detecting serum SCr level;fresh urine sample was taken at 8:00 am and 20:00 pm.for detecting TIMP-2 and IGFBP-7 levels.The AKI was diagnosed according to KDIGO criteria in 2012.Thus the septic children patients were divided into the AKI group and non-AKI group.The receiver operating characteristic(ROC) curve and the area under the curve(AUC) were adopted to analyze the predictive value of TIMP-2 and IGFBP-7 at 12,24,36,48 h before diagnosis for AKI.Results Within 7 d in 174 children cases admitting to PICU,52 cases(29.89％) were diagnosed as AKI.The TIMP-2 and IGFBP-7 levels had no statistical difference between the non-AKI group and control group(P＞0.05).Urinary TIMP-2 and IGFBP-7 levels at 12,24,36 h before diagnosing AKI were significantly increased compared with those at admitting to PICU(P＜0.01);AUC of urinary TIMP-2 and IGFBP-7 levels for predicting AKI occurrence within following 12,24,36 h were 0.967 (95 ％CI:0.946-0.989),0.898(95％CI:0.844-0.951) and 0.748(95％CI:0.669-0.827) respectively,the difference was statistically significant(P＜0.01).Conclusion The urinary TIMP-2 and IGFBP-7 increase can more accurately predict AKI occurrence in pediatric patients with sepsis.
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<p><b>OBJECTIVE</b>To evaluate the outcome of radical surgery combined with adjuvant radiotherapy for patients aged over 75 years with stage II( or III( rectal cancer.</p><p><b>METHODS</b>From 2000 to 2010, 178 patients aged over 75 years at diagnosis who underwent radical surgery in National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, were selected from 3995 patients with stage II( or III( rectal cancer in the database of the above center and enrolled into this retrospective cohort study, which was approved by ethics committee of the above hospital (ClinicalTrials.gov number, NCT02312284).</p><p><b>RESULTS</b>Median age of patients was 77 years (range 75-87). There were 37 (20.8%), 69 (38.8%), and 72 (40.4%) patients with tumors locating in the high, middle and low rectum respectively; 89(50%) patients of pathological stages II( and III( respectively; 21(11.8%), 137(77%), 19(10.7%), and 1(0.6%) patients with poorly, moderately, well differentiated adenocarcinoma, and mucinous adenocarcinoma respectively. The Charlson/Deyo comorbidity index (CCI) score was 0 in the majority (73.6%) of patients. Fifty-three patients underwent abdominoperineal resection, 116 underwent low anterior resection and 9 underwent Hartmann resection. All the patients received computed tomography-based simulation and treatment planning using an anal marker in a prone or supine position. Patients were treated with linear accelerator by megavoltage photons (6MV), with 2D technique in early years and 3D conformal or simplified intensity-modulated radiotherapy technique later, at a dose of 50 Gy in 25 fractions to the pelvis within an overall treatment time of 35 days. Sixty-one patients (34.3%) received surgery combined with radiation (ART group), in whom 16 received radiation alone 117 patients did not receive radiation(NORT group). The baseline data between ART and NORT group were not significantly different(all P>0.05). There was no significant difference in 5-year overall survival between ART and NORT groups (61.0% vs. 63.0%, P=0.586). The cumulative local relapse was 10.9% and 25.4% in ART and NORT group respectively (P=0.032). Cox multivariate analysis revealed that surgery combined with radiation improved local control significantly(HR=0.27, 95%CI:0.11-0.68, P=0.005).</p><p><b>CONCLUSIONS</b>For elderly patients aged over 75 years with stage II( or III( rectal cancer, radical surgery combined with radiation does not increase the overall survival, but can improve local control rate. It is reasonable to selectively apply adjuvant radiotherapy to the elderly patients in the setting of radical surgery.</p>