ABSTRACT
Glioma is a common primary malignant brain neoplasms which is characterized with easy recurrence and poor prognosis. The overall survival of glioma patients is not satisfying. Tumor treating fields (TTFields) is an emerging low-toxicity treatment for solid neoplasms, and its technical basis is to form an anti-tumor electric field in a specific area. TTFields can inhibit the proliferation of tumor cells through inhibiting cell mitosis, replicating stress, inducing autophagy and apoptosis, and inhibiting DNA damage and repair, and induce the cell death without affecting normal cells in the resting phase. At present, TTFields has been approved for various types of gliomas and is gradually becoming an effective treatment protocol for glioma following surgery, radiotherapy and chemoradiotherapy. Many preclinical and clinical studies have confirmed that TTFields inhibits glioma cells and significantly increases the overall survival rates of patients.This paper reviews the progress of related researches.
ABSTRACT
Objective:To compare the clinical effects of two enteral nutritional emulsions, TP-HE and TPF, in elderly patients with severe pneumonia.Methods:This was a randomized study with contemporaneous controls.A total of 56 elderly patients over 65 years old who met the diagnostic criteria for severe pneumonia and were receiving insulin were enrolled.They were randomly divided into the observation group(n=28, enteral TPF-HE at a uniform rate through a nasogastric tube)and the control group(n=28 cases, enteral TPF at a uniform rate through a nasogastric tube). The total daily energy supply was calculates based on the ideal weights of patients.Prealbumin(PA), serum albumin(ALB), body mass index(BMI)and hemoglobin(Hb)were continuously measured at 1, 2, 3, 4, 5, 6 and 7 days after treatment.The effects of the enteral nutritional emulsions in elderly patients with severe pneumonia were analyzed by using repeated measures analysis of variance in a general linear model.Results:There was no significant difference in PA(244.5±55.1)mg/L vs.(237.8±40.4)mg/L, ALB(37.6±5.6)mg/L vs.(38.3±5.5)mg/L, BMI(21.9±0.2)kg/m 2vs.(22.4±0.2)kg/m 2)or Hb(104.4±26.8)mg/L vs.(103.6±25.6)mg/L between the TP-HE group and the TPF group before admission( P>0.05). The energy received from the enteral nutritional emulsions was not significantly different between the TP-HE group and the TPF group(79.8±4.8)kcal/d vs.(79.3±6.6)kcal/d( P>0.05). PA and serum ALB levels had significant differences between the TP-HE group and the TPF group at 1, 2, 3, 4, 5, 6 and 7 days after treatment( P<0.01 or 0.05). Increases in PA and serum ALB levels varied at certain time points between the TP-HE group and the TPF group.Hb levels had no significant difference at 1 and 2 days( P>0.05), but were significantly different at other time points between the two groups( P<0.01). There was no significant difference in BMI between the two groups( F=1.709, P>0.05). Conclusions:Both of the enteral nutrition emulsions can improve PA, ALB and Hb levels, with TP-HE offering more significant effects on PA, ALB and Hb levels.There is no difference in BMI at any time point whether patients receive TP-HE or TPF.
ABSTRACT
Objective To compare the efficacy of radiofrequency ablation versus surgical resection in treatment of colorectal liver metastases with a maximum diameter ≤ 3 cm and a number ≤ 3, and to analyze the risk factors of recurrence. Methods The data of 97 patients with colorectal liver metastases from January 2012 to June 2016 treated at Tianjin Medical University Cancer Institute and Hospital were analyzed retrospectively. There were 66 males and 31 females. The patients were divided into the radiofre-quency ablation group (23 patients) and the surgical resection group ( 74 patients). The patients were followed up. The clinicopathological features of the two groups before treatment were compared. Kaplan-Meier curves were drawn, and the recurrence-free survival curve and overall survival curve of the two groups were compared by log-rank test. Univariate and multivariate Cox regression analysis was used to analyze the risk factors of recurrence. Results There were no significant differences in age, location of primary tumor, number and size of liver metastases, and preoperative carcinoembryonic antigen level between the two groups (P＞0. 05). On the date this study was censored, there were 50 patients who had developed recurrence in the surgical resection group and 22 patients in the ablation group, (67. 6% vs. 95. 7% ). The difference was significant (P＜0. 05). The 1-and 2-year recurrence-free survival rates were 54. 6% and 39. 0% in the surgical resection group and 39. 1% and 8. 7% in the radiofrequency ablation group, respectively. The difference was significant (P＜0. 05). There was no local recurrence in either of the two groups. There was no significant difference in the overall survival curves between the two groups (P＞0. 05). Univariate and multivariate analysis showed that N 1 ～2 staging (HR=1. 908, 95% CI: 1. 094～3. 325), simultaneous liver metastasis (HR=1. 662, 95% CI: 1. 024～2. 695) and radiofrequency ablation (HR=2. 708, 95% CI: 1. 589～4. 617) were independent risk factors of recurrence for colorectal liver metastasis. Conclusions Radiofrequency ablation can achieve complete ablation in patients with colorectal liver metastases with maximum diameter ≤3 cm and number≤3, but the recurrence rate of radiofrequency ablation is significantly higher than that of surgical resection. N 1 ～2 staging, simultaneous liver metastasis and radiofrequency ablation were independent risk factors for recurrence of colorectal liver metastasis.
ABSTRACT
Objective@#To assess the efficacy of supraclavicular artery island flap (SCAIF) for the reconstruction of hypopharynx and upper esophagus.@*Methods@#The SCAIF procedure on was used in 10 patients, including 8 with hypopharygeal carcinomas, 1 with esophageal carcinoma and neck skin invasion and 1 with hypopharyngeal leiomyosarcoma, at the Otorhinolaryngology Hospital, the First Affiliated Hospital, Sun Yatsen University between December 2015 and June 2017. The sizes of the flaps were measured in (4-8) cm×(5-12) cm. Clinical indexes such as harvesting time and survival were recorded.@*Results@#Harvesting time for SCAIF ranged from 20 to 30 minutes, averaging 26 minutes. Nine flaps survived, one flap had partially necrosis. Functional outcomes were excellent and the donor sites were direct closed without complications.@*Conclusions@#SCAIF is a versatile, reliable, and easily harvested flap, with good cosmetic and functional outcomes for reconstructing the defects of hypopharynx and upper esophagus.
ABSTRACT
Objective To investigate the effect of sertraline on negative emotional and adverse cardiovascular events in patients with coronary heart disease (CHD) complicated with depression. Methods The clinical data of 100 patients with CHD complicated with depression from August 2015 to August 2017 were retrospectively analyzed. The patients were divided into sertraline group and control group according to the treatment method with 50 cases each. All patients of 2 groups were treated with routine therapy of CHD and psychological intervention. The patients of sertraline group were combined with sertraline treatment, and the patients of control group were combined with shugan jieyu capsule. The improvement of negative emotion was evaluated by 17-item Hamilton depression rating scale (HAMD), and the incidence of adverse cardiovascular events was observed. The high-sensitivity c-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), endothelin-1 (ET-1) levels and sinus heart beat all the RR interphase (SDNN) before and after treatment were observed. Results The HAMD score after treatment in sertraline group was significantly lower than that in control group: (8.02 ± 1.19) scores vs. (10.57 ± 1.85) scores, and there was statistical difference (P＜0.01). The total effective rate in sertraline group was significantly higher than that in control group: 92.0% (46/50) vs. 68.0% (34/50), the incidence of the adverse cardiovascular events was significantly lower than that in control group: 4.00% (2/50) vs. 14.00% (7/50), and there were statistical differences (P＜0.05). There were no statistical differences in hs-CRP, IL-6, TNF-α and ET-1 after treatment between 2 groups (P＞0.05). The SDNN after treatment in sertraline group was significantly higher than that in control group: (111.04 ± 20.18) ms vs. (98.34 ± 23.30) ms, and there was statistical difference (P＜0.05). Conclusions Sertraline can effectively improve the depression status in patients with CHD complicated with depression, and it can reduce the incidence of adverse cardiovascular events and improve prognosis.
ABSTRACT
Objective To explore the effects and mechanisms of prenatal hypoxia on vasomotor functions of fetal rats.Methods Sixteen pregnant Sprague-Dawley rats were randomly divided into two groups:control and hypoxia groups (eight in each group).Rats in the hypoxia group were provided with 10.5％ of oxygen from gestation day 5 to 21,while those in the control group were exposed to normoxic condition.Fetuses were removed from the pregnant rats by cesarean section on gestational day 21.Fetal body weight,blood gas and electrolyte levels were measured.Thoracic aorta rings were separated from fetal rats and used in different vascular function tests.Effects of hypoxia during pregnancy on angiotensin Ⅱ (Ang Ⅱ)-mediated vasoconstrictions and acetylcholine (Ach)-mediated vasodilatations in fetal thoracic aortas were measured.Changes in vasomotor functions were observed after both endothelial nitric oxide synthase (eNOS) inhibitor NG-nitro-L-arginine methyl ester (L-Name) and L-type calcium channel (LTCC) inhibitor nifedipine were administered.T-test and two-way analysis of variance were used for statistical analysis.Results (1) Compared with the control group,fetal body weight [(4.40±0.23) vs (3.33±0.42) g,t=2.871],blood partial pressure of oxygen [(50.64±2.17) vs (42.50-±-2.32) mmHg (1 mmHg=0.133 kPa),t=-2.618] and blood oxygen saturation [(58.95±1.97)％ vs (47.73±2.24)％,t=3.564] in the hypoxia group were significantly reduced (all P＜0.05).(2) Compared with the control group,Ang Ⅱ-mediated vasoconstrictions increased,but Ach-mediated vasodilatations in fetal thoracic aortas decreased in the hypoxia group (both P＜0.05).L Name induced stronger Ang Ⅱ-mediated contractions in thoracic aortas in the control group than that in the hypoxia group (P＜0.05).However,nifedipine decreased Ang Ⅱ-induced contractions,especially in the hypoxia group (P＜0.05).Conclusions Maternal hypoxia during pregnancy not only affects the growth and development of fetuses but also changes their blood vessel functions,which may be related to the change of LTCC and the impairment of eNOS.
ABSTRACT
Objective@#To investigate the effect of hypoxia inducible factor 2α (HIF-2α) on regulating CUB domain-containing protein 1 (CDCP1) and its role in hepatocellular carcinoma metastasis.@*Methods@#HIF-2α-knocked down and HIF-2α-stably overexpressing cells (MHCC97H) were prepared by small interfering RNA (siRNA) and lentivirus transfection, respectively. The expression of CDCP1 protein and mRNA in the above cells was detected by western blot and real-time PCR. The effect of HIF-2α on cell invasion ability was determined by Transwell assay. Furthermore, immunohistochemical staining was performed to detect the expression of CDCP1 in human HCC tissue samples.@*Results@#Both HIF-2α and CDCP1 were induced under hypoxic conditions. The activation of CDCP1 under hypoxic conditions was dependent on the expression of HIF-2α.When HIF-2α was overexpressed, the mRNA level of CDCP1 was greatly upregulated (5.92±0.28, P<0.05). When HIF-2α was knocked down by siRNA for 48 h and 72 h, the expression of CDCP1 was significantly downregulated (48 h: 0.25±0.04; 72 h: 0.18±0.02, all P<0.05). Moreover, analysis of human HCC samples showed that CDCP1 expression was correlated with tumor-free survival (P<0.05).@*Conclusions@#The results of this study indicate that the expression of CDCP1 is regulated by HIF-2α and is correlated with the progression of HCC. Inhibition of HIF-2α/CDCP1 may play certain inhibitory role in the metastasis of HCC.
ABSTRACT
Studies show that metformin inhibits the proliferation of several types of cancer cells.All evidences,therefore propose the anti-tumor effect of metformin.Metformin can repress the oxygen consumption of tumor cells,and suppress hypoxia-inducible factor-1α (HIF-1ct) accumulation through the translational and posttranslational mechanisms,and suppress the expression of HIF-1α by activating AMP-activated protein kinase (AMPK).
ABSTRACT
C-reactive protein (CRP) is an acute phase reaction protein,which is very sensitive to the inflammatory reaction.Many studies have confirmed that CRP is closely correlated with ischemic stroke and atherosclerosis.However,studies on correlation between CRP and intracerebral hemorrhage are less.This article reviews the relationship between CRP and intracerebral hemorrhage.
ABSTRACT
This paper first described the concept of competitive intelligence and hospital competitive intelligence.Then,the resources of hospital library intelligence was analyzed with the method of SWOT,and the feasibility of competitive intelligence service was discussed.Finally,three aspects of the service were elaborated,which included collection of competitive intelligence,instruction of the knowledge of competitive intelligence,and the establishment of competitive intelligence system in hospitals.
ABSTRACT
Objective To discuss the standard of endoscopic diagnosis of duodenal white spot syndrome and to test its accuracy by pathological diagnosis standard. Methods A total of 6,995 patients undergoing gastroscopy were detailedly examined through gastrofiberscope or electrogastroscope and endoscopic diagnosis were made by the standard of endoscopic diagnosis of duodenal white spot syndrome. Then, pathological examination was done to test and verify the accuracy of the standard of endoscopic diagnosis. Results There were 533 patients suffering from duodenal white spot pathological changes, accounting for 7.62%. And duodenal mucositis was confirmed by pathological findings in all 90 cases of the patients undergone their biopsy at the same time. Conclusions The appropriate standard of endoscopic diagnosis can improve the detection rate of duodenal white spot syndrome and there is a high coincidence rate between endoscopic diagnosis and pathological diagnosis.
ABSTRACT
Objective To evaluate the clinical application value of pathological diagnosis by using ultrasound-guided percutaneous needle core biopsy (PNCB) for cervical lymph lesions.MethodsTwo hundred and ten patients with cervical lymph lesions underwent ultrasound-guided PNCB,and pathological diagnosis were made based on core biopsy material.The results of study were concluded by comparing the pathological diagnosis from core biopsy of the lymph nodes with those from excision biopsy. Results There were 210 patients underwent ultrasound- guided PNCB,98.6％ (207/210) cases of core biopsies yielded adequate material at first time and 92.9％ (195/210) cases of those had pathologic diagnosis.The accuracy of ultrasound-guided PNCB in differentiating benign from malignant lymphadenopathy was 99.4％ ( 194/195 ).The diagnostic accuracy of metastatic tumor and lymphoma by ultrasound-guided PNCB was 96.4％ (135/140) and 86.1％ (31/36),respectively.Only 67.7％ (21/31) patients with lymphoma could be classified by ultrasound-guided PNCB.ConclusionUltrasound-guided PNCB in patients with neck lymph lesions is a safe,convenient and quick procedure that has a high diagnosis accuracy.Ultrasound-guided PNCB can replace the open surgery for neck lymph node diagnostic method.Due to the complicated and diverse pathologic performance,lymphoma should be cut by open surgery to confirm the diagnosis and classification.
ABSTRACT
Objective To evaluate contrast-enhanced ultrasonography (CEUS) in diagnosis of small hepatocellular carcinoma (SHCC) ( ≤ 2. 0 cm) with liver cirrhosis after contrast-enhanced CT (CECT) examination. Methods Forty five patients with liver cirrhosis received CECT and CEUS examinations before operation or needle biopsy and the diagnosis was confirmed by pathological examination.CEUS and CECT findings of 51 liver space-occupying lesions from 45 patients were retrospectively analyzed.Results Among all 51 lesions detected CEUS and CECT found 49 and 35, respectively. The typical characteristics of SHCC were "fast-in and fast-out" and "fast-in and slow-out". The sensitivity of CEUS and CECT in diagnosis of SHCC was 88. 9% (32/36) and 69. 4 % (25/36) respectively ( x2 = 3. 02, P =0. 08);the diagnostic accuracy was 84. 3 % (43/51 ) and 56. 9% (29/51 ) respectively ( x2 = 1.46, P =0. 22). Among 16 lesions missed by CECT, 12 were detected by CEUS. Conclusions CEUS and CECT show the similar diagnostic rate for typical SHCC ,however, CEUS is more sensitive for atypical lesions. With high time resolution, CEUS have advantages for follow-up study of benign liver lesions.
ABSTRACT
ObjectiveTo evaluate the clinical efficacy of intravenous catheter in combination with ultraviolet radiation for postherpetic neuralgia (PHN).Methods96 patients with PHN were randonly divided into three groups.Intravenous catheter plus UVB radiation was given in the test group(32 patients).Intravenous catheter or UVB radiation was only given in two control groups (32 patients/group), respectively.ResultsThe total effective rate in the test group was 96.88％ (31/32) and the average onset time was 1.55 days.However,the total effective rate in two control groups was 81.25％ (26/32) and 68.75％ (22/32) ,and the average onset time was 2.48 days and 7.41days.There was a statistical difference observed in curative rate (x2 = 5.33,42.42, P ＜ 0.05 or P ＜ 0.01), the total effective rate(x2 =4.59,8.89,P＜0.05 or P＜0.01) and the average onset time(t =22.96,11.96,all P＜0.01)between the test group and two control groups.Moreove,there was also a statistical difference observed in curative rate (x2 = 22.44, P ＜ 0.001) and the average onset time (t = 29.30, P ＜ 0.01) between two control groups.ConclusionIntravenous catheter in combination with UVB radiation was much better than intravenous catheter or UVB radiation only in the treatment of PHN.
ABSTRACT
Objective To evaluate retrospectively the difference and complementary of contrastenhanced ultrasound (CEUS) and contrast-enhanced magnetic resonance (CEMR) in early diagnosis and differential diagnosis of small hepatocellular carcinoma (SHCC)(≤2.0 cm) in patients with liver cirrhosis.Methods Forty-five patients with space-occupying lesions in cirrhotic livers were included, who were referred to CEUS and CEMR before operations. Numbers as well as diagnosis results were recorded respectively,and all cases were confirmed by pathological examination. Results Seventy-five lesions were found after CEUS and CEMR,with 69 and 58 respectively. Forty-one lesions were diagnosed pathologically as SHCC by surgery or needle biopsy. Overlapping exited in enhanced mode between CEUS and CEMR.Most SHCC displayed as mode Ⅰ "fast-in and fast-out" and mode Ⅱ "fast-in and slow-out" in both examination,which can be considered as a reliable criterion. The diagnostic accuracy of CEUS and CEMR was 77. 3% (58/75) and 62. 7% (44/75) respectively (0. 50＜ P ＜0. 75). Differences of the diagnostic accuracy of SHCC with atypical enhanced mode between CEMR and CEUS were statistically significant.Conclusions There is no significant difference of diagnostic accuracy of SHCC between CEMR and CEUS.Both of these two examing procedure have its own advantages for atypical lesions, which accounts for its diagnostic difference of small SHCC and benign lesions.
ABSTRACT
Objective To evaluate the value of international normalized ratio (INR) in predicting and diagnosing hemorrhagic events in patients with nonvalvular atrial fibrillation (NVAF)receiving wafarin, to determine the optimal cut-off value of INR for predicting hemorrhagic events by receiver operator characteristic (ROC) curve. Methods The data of 231 patients with NVAF receiving wafarin were retrospectively analyzed, including 93 patients with hemorrhagic events and 138cases without hemorrhagic events as control group. The PT and INR were detected by Sysmex CA-500 with Medcalc software plotting ROC curve. Results The area under the ROC curve for INR was 0. 822 (95%CI: 0. 717-0. 900), the analysis of ROC curve revealed the optimal cut-off value of INR was 2.71, which presented a sensitivity of 77.40% and a specificity of 78.30%. Conclusions Through evaluation by ROC curve, the new cut-off value provides substantial improvement in sensitivity, with an acceptable loss of specificity. The value on predicting hemorrhagic events is better, the discriminative power of INR between hemorrhagic events and nonhemorrhagic events is satisfactory. The cut-off value of INR can guide the clinical physicians to predict the risks of hemorrhagic and promote proper use of clinical medications.
ABSTRACT
Recently, genome-wide association study (GWAS)has achieved great success in illuminating genetic basis of complex diseases. GWAS of type 2 diabetes is regarded as a paradigm of genetic dissection of complex human diseases, which are caused by both genetic and environmental factors. Some basic facts of GWAS,as well as implementation of GWAS in type 2 diabetes, are reviewed in this article.
ABSTRACT
OBJECTIVE@#To analyze the conservative management and outcomes of pharyngocutaneous fistula after total laryngectomy.@*METHOD@#Twenty-one patients with postoperative fistulas were identified and treated by conservative therapy.@*RESULT@#Different treatment were given basing on the three stages of pharyngocutaneous fistula: drainage and cleaning stage, pressure bandaging stage and healing stage. Fourteen patients (66.7%) with the conservative therapy resumed oral feeding after closure of fistula, the other 7 patients had to be cured by further operation.@*CONCLUSION@#Management basing on the stages of pharyngocutaneous fistula can achieve satisfied outcome. It can provide important information for pharyngocutaneous fistula's treatment.
Subject(s)
Humans , Carcinoma, Squamous Cell , General Surgery , Cutaneous Fistula , Therapeutics , Laryngeal Neoplasms , General Surgery , Laryngectomy , Pharyngeal Diseases , Therapeutics , Postoperative Complications , TherapeuticsABSTRACT
Objective To analyze reasons of postoperat iv e relapse of inguinal hernia and to explore the clinical significance of laparos copic transabdominal preperitoneal (TAPP) repair for recurrent hernia. Methods We retrospectively analyzed clinical data of 24 cases of recurr ent inguinal hernia treated by laparoscopic TAPP repair from June 1998 to Octobe r 2003 in this hospital. There were 11 cases of direct hernia and 13 cases of in direct hernia. Results Operations were completed successfully in all the 24 cases without conversions to open surgery. The operation time was 47~128 min (mean, 69 min), and the postoperative hospital stay, 2~5 days (mean, 3 days). Urinary retention happened in 6 cases after the operation, in which a F oley urethral catheter was indwelled for 1~3 days. There were no complications s uch as wound infection, scrotal hematoma or pneumatosis. Follow-up checkups were made for 2~66 months (mean, 27 months) in all the 24 cases. No recurrence was o bserved. Conclusions Laparoscopic TAPP repair for recurrent in guinal hernia has advantages of minimal invasion and few complications, being a safe and feasible option for treating recurrent inguinal hernia.
ABSTRACT
Functional requirement of LIS analyzed, this paper discusses the application of web technology to it. The choice of application server and security control and management are emphasized on, and then corresponding solutions are provided.