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Objective:To investigate the therapeutic effect of comprehensive geriatric assessment(CGA) in elderly patients with chronic heart failure(CHF) complicated with sarcopenia, and to provide a theoretical reference for clinical application.Methods:This study was a prospective randomized controlled study. 110 elderly CHF patients with myopenia admitted to the Third People's Hospital of Hefei from January 2019 to February 2022 were selected. Using the random number table method, 56 cases were divided into an observation group and 54 cases into a control group. Before treatment, the control group of patients underwent a selective single assessment based on the hospital's requirements and the patient's actual situation, including a fall risk assessment, nutritional risk screening checklist assessment, and routine medication to improve cardiac function and prognosis; Before treatment, the patients in the observation group were assessed with CGA, including the assessment of physical function, mental and psychological status, multiple drug management, pain, Sleep disorder, and social environment. According to the assessment results, individual diagnosis and treatment plans were formulated, implemented, and dynamically adjusted. The two groups were treated for 12 weeks. The general information, treatment compliance, B-type brain natriuretic peptide (BNP) level, left ventricular Ejection fraction (LVEF), 6 min walking distance (6MWD), arm strength of upper limbs and 6 m walking speed, clinical efficacy and prognosis of the two groups were compared before and after treatment. The measurement data is represented by xˉ± s, group t-tests are used for inter group comparison, and paired t-tests are used for intra group comparison before and after treatment; Counting data is represented as an example (%), and inter group comparisons are made using χ 2 test, non parametric rank sum test was used for inter group comparison of hierarchical data. Results:There was no statistically significant difference in gender, age, course of CHF, smoking, alcohol consumption, number of comorbidities, cardiac function grading, and treatment compliance between the two groups of patients (all P>0.05), indicating comparability. Before treatment, there was no statistically significant difference in plasma BNP, LVEF, 6MWD, upper limb grip strength, and 6-meter walking speed between the two groups of patients (all P>0.05); After treatment, the BNP of both groups of patients was lower than before treatment and the observation group was lower than the control group. LVEF, 6MWD, upper limb grip strength, and 6-meter walking speed were all higher than before treatment and the observation group was higher than the control group [(343.45±34.95) ng/L vs (387.09±46.96) ng/L, (49.61±7.11)% vs (42.94±5.72)%, (348.92±37.73) m vs (297.74±43.48) m, (22.64±3.82) kg vs (19.48±3.88) kg, (0.97±0.10) m/s vs (0.83±0.12) m/s], The differences were statistically significant ( t-values were 5.51, -5.40, -6.60, -4.31, -6.60, all P<0.001). After 12 weeks of treatment, there was no statistically significant difference in clinical efficacy between the two groups of patients ( P=0.216), but the overall poor prognosis rate in the follow-up observation group was lower than that in the control group [7.14%(4/56) vs 22.22% (12/54)], and the difference was statistically significant (χ 2=5.03, P=0.025). Conclusions:Developing, implementing, and dynamically adjusting the individualized treatment plan involving CGA can improve the prognosis of elderly CHF patients with sarcopenia, help improve cardiac function, increase grip strength and somatic function, and reduce the risk of major adverse cardiovascular events ,all-cause mortality in elderly patients with CHF combined with sarcopeni and has certain clinical application value.
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Objective@#To explore the relationship between isochronous substitution and BMI, waist circumference (WC), and body fat rate (FAT) among physical activity (PA), sedentary (SB), and sleep (SLP), so as to provide effective measures for obesity control in adolescents.@*Methods@#A total of 193 adolescents aged 12-15 (90 males and 103 females) was randomly selected, and their height, weight, and BMI were measured using routine testing methods from May to August 2022. The PA, SB and SLP of the participants were measured using a 3D accelerometer (ActiGraph GT3X+).@*Results@#The arithmetic mean value overestimated SLP (40.8%) and SB (39.6%) to some extent, and underestimated LPA (16.1%) and MVPA (3.5%) to some extent. Based on the ISM at 15 min, MVPA was substituted for other activity, BMI Z decreased by 0.17-0.22 units, WC Z decreased by 0.16-0.20 units, and FAT Z decreased by 0.17-0.22 units. The substitution between MVPA and for other activity exhibited significant asymmetry. The effects of MVPA substitutions for SB was the largest, followed by the effects of MVPA substitutions for SLP, and the effects of MVPA substitutions for LPA was the lowest. As MVPA substitutions for other behaviors, it reached its maximum (0.06-0.08 units ) when the MVPA time increased by 5 minutes.@*Conclusions@#MVPA plays an irreplaceable role in the control of adolescent obesity . While reducing SB time, MVPA duration should be increased to ensure that the daily MVPA duration is not less than 55 minutes in order to effectively control obesity.
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Objective:To explore the prognostic risk factors of thymoma patients after resection, and establish a novel nomogram to predict progression free survival(PFS) of patients with thymoma.Methods:A retrospectively analysis was performed on clinicopathological datas of 267 cases of thymoma patients underwent thymoma resection in Beijing Tongren Hospital from January 2010 to December 2019. The univariate and multivariate Cox risk ratio models were used to analyze the related factors that might affect PFS, and the prediction nomogram of PFS after thymoma resection was established using the screened independent risk factors. Then the predictive ability of the model was evaluated. Results:The univariate analysis showed that age, type of surgery, completeness of resection, WHO histologic classification, TNM stage and postoperative adjuvant therapy were significantly correlated with PFS after thymoma resection( P<0.05). The multivariate analysis showed that only age and TNM stage were independent prognostic factors affecting PFS after thymoma resection( P<0.05). The concordance index( C- index) of the prediction model for the prognosis of thymoma patients established by this method was 0.866(95% CI: 0.809-0.923), which had remarkable predictive efficiency. Conclusion:The nomogram model is constructed and verified based on age and TNM stage, excluding the interference of other clinicopathological factors on prognosis assessment, and which is convenient for clinicians to quickly and individually evaluate the prognosis of patients after thymoma resection.
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Objective:To investigate the application and effect of esophageal varus extraction in the treatment of cervical tumors(laryngopharynx and cervical esophagus).Methods:A retrospective analysis was performed on 238 patients with cervical tumors(laryngopharynx and cervical esophagus) who underwent thoracic surgery in Beijing Tongren Hospital affiliated to Capital Medical University from March 2010 to March 2020. There were 135 males and 103 females, aged from 42 to 78 years, with a median age of 62 years.Surgical methods included open abdominal surgery in 96 cases and laparoscopic surgery in 142 cases. The intraoperative abdominal bleeding volume, abdominal operation time and postoperative abdominal drainage volume were analyzed. χ2 test was used to compare the clinical characteristics of the two groups, t test was used to compare the clinical indicators, and statistical software SPSS 13.0 was used to analyze. Results:No intraoperative death occurred in all patients.In the laparoscopic group, all cases successfully completed tubular gastric traction through the original esophageal bed to the neck, and completed cervical anastomosis.One patient(0.70%) was converted to thoracotomy due to aortic tear, and no post-operative bleeding occurred.No incision infection and wound liquefaction. Splenectomy was performed in 1 patient(1.04%), incision infection in 2 patients(2.08%), and fat liquefaction in 3 patients(3.12%) in the open surgery group.The intraoperative abdominal bleeding volume in the open surgery group and the laparoscopic group was(187±28)ml and(79±23)ml, respectively( t=1.836, P=0.032); the postoperative abdominal drainage volume in the two groups was(172±33)ml and(56±24)ml, respectively( t=1.964, P=0.028), and there was a significant difference between the two groups.The operation time of open operation group and laparoscopy group was(125±33) min and(118±27) min respectively( t=1.224, P=0.203), and there was no significant difference between the two groups. Conclusion:Laparoscopic esophageal varus extraction has advantages over traditional laparotomy in the treatment of laryngopharyngeal tumors and cervical esophageal tumors, such as beautiful incision, small surgical trauma, clear surgical field exposure and less postoperative complications, which conforms to the current minimally invasive treatment concept.The application of pneumoperitoneum-free suspension device solves the key links of mediastinal compression hemostasis after esophageal extubation and traction of tubular stomach to neck under pneumoperitoneum-free condition, so that laparoscopic surgery can be applied.However, such operations need to strictly grasp the indications to avoid the occurrence of serious complications.
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Preterm delivery caused by various reasons leads to intestinal flora dysplasia in premature infants.In the early stages of life, there is a parallel development window between the intestinal microflora and the nervous system.Premature infants represent a unique population, whose brain development can be influenced by early microbial colonization.Microbiota optimization can improve the development of the nervous system.In this article, factors affecting the intestinal flora of premature infants, the effects of intestinal flora imbalance on the nervous system development, and the impact of early addition of probiotics on the development of premature infants were reviewed.Understanding the role of early optimization of the microbiota in the brain development of premature infants is essential for developing specific treatments for intestinal microbiota imbalance and protecting premature infants from a series of neurodevelopmental disorders caused by preterm delivery.
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Objective:To analyze the clinical and CT imaging characteristics of sub-centimeter solitary pulmonary nodules (SSPNs) with ground glass opacity.Methods:The clinical and imaging data of 258 patients with SSPN who underwent surgical treatment in Beijing Tongren Hospital from May 2015 to May 2020 were retrospectively reviewed. There were 113 males and 145 females with a median age of 45 (range 30-84) years. The CT images of the lesions showed ground glass opacity, including 60 cases of pure ground glass nodule (pGGO) and 198 cases of mixed ground glass nodule (mGGO). The largest diameter of the lesion was ≤ 10 mm, and the lesions were all resected by video-assisted thoracic surgery, and diagnosed by postoperative pathological examination. The relationship between the lesion size and the detection rate of malignancy; the diagnostic value of CT imaging features for differentiating benign and malignant SSPN, and postoperative immunohistochemical indexes and target gene mutations for differentiating primary from metastatic lung cancer were analyzed.Results:Of the 258 patients, 59 had lesions<7 mm in diameter and 199 between 7 and 10 mm in size. There were no intraoperative deaths. The postoperative pathological examination confirmed primary bronchial lung cancer in 190 cases, metastatic lung cancer in 12 cases, and benign lung lesions in 56 cases. The detection rates of malignant lesions in mGGO and pGGO were 81.31% (161/198) and 68.33% (41/60), respectively (χ 2=4.66, P = 0.032). The detection rates of malignant lesions and primary cancer in mGGOS with diameter 7-10 mm was higher than those with diameter<7 mm[(87.01%(134/154) vs. 61.37%(27/44) and 83.77%(129/154) vs. 56.82%(24/44), χ 2=14.82, χ 2=12.93, all P<0.001 ]. The border irregularity on CT imaging was presented in 47.03% (95/202) of malignant lesions, which presented in 48.42% (92/190) of primary lung cancers; while only presented in 17.86% (10/56) of benign lung lesions (χ 2=15.46, χ 2=16.64, all P<0.001). The frequency of vascular signs was 56.44% (114/202) in lung malignant lesions, 54.74% (110/190) in primary bronchial lung cancer; while only 5.35% (3/56) in lung benign lesions (χ 2=46.16, χ 2=48.07, all P<0.001). Among mGGO patients with lesion diameter<7 mm, those with irregular lesion borders and vascular signs on CT imaging 91.30% (21/23) were pulmonary malignant lesions, while those without these two signs only 28.57% (6/21). Immunohistochemistry results showed that the primary bronchial lung cancer group had a higher positive rate of new aspartic proteinase A (Napsin A, 79.47%) and thyroid transcription factor-1 (TTF-1, 75.79%) than the metastatic lung cancer group. There were three patients with BRAF-v600e mutation in our series, and all of them were finally confirmed as metastatic thyroid cancer. Conclusion:In sub-centimeter solitary pulmonary nodules with ground glass opacity, mGGO lesions are more likely to be malignant lesions than pGGO lesions, and the lesions with larger size are more likely to be malignant. Imaging features such as irregular lesion borders and vascular signs are important in differentiating between benign and malignant lesions. For metastatic lesions, immunohistochemical and genetic testing are helpful in determining the primary tumor site.
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Background and Objectives@#Sheep-induced pluripotent stem cells (siPSCs) have low reprogramming efficiency, thereby hampering their use in biotechnology and agriculture. Several studies have shown that some microRNAs play an important role in promoting somatic reprogramming in mouse and human. In this study, we investigated the effect of miR-200c-141 on somatic reprogramming in sheep and explored the mechanism of promoting the reprogramming. @*Methods@#and Results: The lentivirus system driven by tetracycline (TET)-on carrying Oct4, Sox2, c-Myc, Klf4, Nanog, Lin28, hTERT, and SV40LT (OSKMNLST) could reprogram sheep kidney cells into pluripotent cells. Overexpression of miR-200c-141 in combination with OSKMNLST could significantly improve the efficiency of sheep iPSC generation (p＜0.01). Sheep iPSCs derived from miR-200c-141 showed embryonic stem cell (ESC)-like pluripotent properties, were positive for alkaline phosphatase and some pluripotent markers by quantitative real-time PCR (qRT-PCR) and immunofluorescence, and were able to differentiate into three germ layers in vitro. Oar-miR-200c was transfected into HEK293FT cells and was able to target the zinc finger E-box-binding homeobox 1 (ZEB1) 3’UTR using dual luciferase reporting analysis. Overexpression of oar-miR-200c in SKCs significantly reduced the expression of ZEB1, but increased the expression of E-cadherin by qRT-PCR and western blotting analysis. @*Conclusions@#These results suggest that miR-200c-141 can promote the reprogramming of sheep somatic cells to iPSCs, and oar-miR-200c targeted ZEB1 3’UTR, significantly decreased expression of ZEB1, and increased expression of E-cadherin. Oar-miR-200c may improve the MET process by affecting the TGF-β signaling pathway, thus improving the efficiency of somatic cell reprogramming in sheep.
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The emergence of gut microbes has become one of the key regulatory factors of gut brain function, and has made people realize the importance of microbe gut brain axis.The gut microbiota and brain are interconnected through immune system, tryptophan metabolism, vagus nerve and endocrine system.Many factors can affect the composition of gut microbiota, including infection, mode of delivery, use of antibiotics, stress, and host genetics.Recent studies have shown that gut microbiota may be associated with many diseases, including autism, irritable bowel syndrome and so on.Future research will focus on understanding the underlying mechanisms of the microbial gut brain axis and attempt to elucidate microbial based intervention and treatment strategies for neuropsychiatric diseases.
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Intracranial aneurysms are local abnormal bulging of intracranial arterial wall caused by various reasons. Since the International Subarachnoid Aneurysm Trial (ISAT) in 2002 confirmed the safety and effectiveness of endovascular therapy, interventional materials and treatment concepts have been continuously innovated, and endovascular therapy has become the first-line treatment of intracranial aneurysms. This article reviews the interventional materials and their progress in the endovascular treatment of intracranial aneurysms.
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Purpose@#Globally, there is a high incidence of gastric cancer (GC). Leucine zipper-EF-hand containing transmembrane protein 1 (LETM1) is reported to play a vital role in several human malignancies. However, there is limited understanding of the role of LETM1 in GC. This study aims to investigate the effects of LETM1 on proliferation, migration, and invasion of GC cells. @*Materials and Methods@#The expression levels of LETM1 in the normal gastric mucosal epithelial cells (GES-1) and GC cells were analyzed by quantitative real-time polymerase chain reaction and western blotting. CCK-8, wound healing, and Transwell invasion assays were performed to evaluate the effect of LETM1 knockdown or overexpression on the proliferation, migration, and invasion of the GC cells, respectively. Additionally, the effect of LETM1 knockdown or overexpression on GC cell apoptosis was determined by flow cytometry. Furthermore, the effect of LETM1 knockdown or overexpression on the expression levels of PI3K/Akt signaling pathway-related proteins was evaluated by western blotting. @*Results@#The GC cells exhibited markedly higher mRNA and protein expression levels of LETM1 than the GES-1 cells. Additionally, the knockdown of LETM1 remarkably suppressed the GC cell proliferation, migration, and invasion, and promoted the apoptosis of GC cells, which were reversed upon LETM1 overexpression. Furthermore, the western blotting analysis indicated that LETM1 facilitates GC progression via the PI3K/Akt signaling pathway. @*Conclusions@#LETM1 acts as an oncogenic gene to promote GC cell proliferation, migration, and invasion via the PI3K/Akt signaling pathway. Therefore, LETM1 may be a potential target for GC diagnosis and treatment.
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STK1 is one important MAPK gene regulating the conidial development, osmotic stress and pathogenicity of Setosphaeria turcica. At first, the Pichia pastoris GS115 expression vector pPIC3.5K-EGFP containing enhanced green fluorescent protein gene (EGFP) was constructed, then STK1 gene was first amplified by PCR with the template of cDNA of S. turcica model isolate 01-23, and then cloned into the vector pPIC3.5K-EGFP with enhanced green fluorescent protein gene (EGFP) to construct the STK1-EGFP fusion gene expression vector pPIC3.5K-STK1-EGFP. The vector was transformed into the susceptible cells of Pichia pastoris GS115 by electric shock process, and the transformants were identified by MD medium screening and PCR determination. The STK1 gene and EGFP gene could be expressed effectively and stably in the transformants as detected by RT-PCR and fluorescence observation. In addition, we also found that the Kozak sequence before the start codon of STK1 gene could increase 4.8 folds expression level of STK1- EGFP fusion gene. The above research results laid a good foundation for subcellular localization and antibody preparation of STK1 protein.
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Objective To study the effects of restructuring tissue inhibitor of matrix metatloproteinase-3 (rhTIMP-3) in combination with cisplatin (DDP) on the growth and apoptosis of A549 lung cancer cell line.Methods We made individual and combined use of different concentrations of rhTIMP-3 and DDP on A549 cells.Methyl thiazoyl terazolium (MTT) colorimetry was used to analyze cell growth inhibition,and flow cytometry technique was used to determine the cell cycle distribution and apoptosis rate.Results rhTIMP-3 and DDP both could inhibit the proliferation of A549 cells.rhTIMP-3 exerted its effect in the time-and concentration-dependent manners while DDP did so in the concentration-dependent manner;both induced the apoptosis of A549 cells.rhTIMP-3 could make the cells stay in S and G2/M phases,and DDP made the cells stay in S phase.The combination of them obviously strengthened the inhibition of A549 cell growth,and had obvious synergy in inducing apoptosis.Conclusion Both rhTIMP-3 and DDP can inhibit the proliferation of A549 cells and induce their apoptosis.The combined use of them not only can increase the inhibition of cell growth but also has synergy in inducing cell apoptosis.
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Objective To investigate the efficacy of super selective intra-arterial infusion of verapamil for the treatment of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH).Methods From January 2013 to February 2016,the clinical data of 15 patients with subarachnoid hemorrhage (SAH) who had CVS after intracranial aneurysm clipping (n=8) or endovascular treatment (n=7) were analyzed retrospectively.All patients received whole brain digital subtraction angiography (DSA).Microcatheter super selection to spastic arteries was used and verapamil (11.1±3.4 mg) was infused.The findings of whole brain DSA before and after treatments were compared.The blood pressure and heart rate were collected during the treatment and the findings of transcranial Doppler ultrasonography were recorded.The patients were followed up for 6 months and the Glasgow outcome scale (GCS) scores were obtained.Results (1) A total of 20 intra-arterial infusion treatments were performed in 15 cases.They were compared before and after perfusion.CVS was improved on DSA in 14 cases,there was no significant change in on cases.(2) Transcranial Doppler ultrasonography showed that the mean blood flow velocity (mBFV) of the middle cerebral artery was decreased from 181±4 cm/s before the super selective intra-arterial infusion to 126±4 cm/s within 1 hour after treatment.There was significant difference (t=42.46,P0.05).(4) All patients were followed up for 6 months.The GOS score at 6 months:good recovery in 9 cases,moderate disability but could take care of themselves in 3 cases,severe disability and could not take care of themselves in 3 cases,no persistent vegetative state or death.Conclusion Super selective intra-arterial infusion of verapamil can effectively improve the treatment of aneurysmal SAH caused CVS.At the same time,it has no obvious effect on blood pressure and heart rate.
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Objective Establish a method for qualitative and quantitative analysis of paraquat dichloride in organs in rat by UPLC-MS/MS and study the rat animal model poisoned by intragastric administration of paraquat dichloride to investigate the postmortem distribution of paraquat dichloride in poisoning death rat. Methods The rats were given an intragastric administration of 1/2LD50 Paraquat dichloride. The rats were dissected at 0.5h, 2h, 4h, 8h, 12h, 24h, 48h, 72h respectively after the intragastric administration. The specimens of -the heart, liver, spleen, lung, kidney, brain, muscle, bladder and stomach-were collected and analyzed immediately. Qualitative and quantitative analysis were performed by UPLC-MS/MS. Results Within 4h, stomach is the main distribution organ. The content of paraquat dichloride is the highest in stomache and relatively low in other organs. The concentration of organization except stomach changed little within 4h. The concentration of stomach has a sharp decline after 4h. The concentration in organs except stomach has a sharp rise after 4h. There is a significant difference(P<0.05) between each organs and brain. Conclusion There was a postmortem maldistribution of paraquat dichloride in poisoning death rats and the concentration in organs changes with time. The analysis method of UPLC-MS/MS and postmortem distribution of paraquat dichloride can be applied to the forensic identification of paraquat dichloride poisoning death and provide direction for delete this part toxicology analysis.
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Objective To investigate the risk factors for hemorrhagic transformation (HT) and poor outcomes in patients with acute ischemic stroke after mechanical thrombectomy.Methods The patients with acute ischemic stroke received mechanical thrombectomy were enrolled retrospectively.The demography,vascular risk factors and other clinical data of the patents were collected.The modified Rankin scale (mRS) was used to evaluate the clinical outcomes at day 90.Good outcome was defined as mRS score 0-2.The patients were divided into either a HT group or a non-HT group according to their HT conditions.Multivariate logistic regression analysis was used to identify the independent risk factors for HT and poor outcomes.Results A total of 48 patients with acute ischemic stroke received mechanical thrombectomy were enrolled,including 25 males (52.1％).Their mean age was 64.77± 9.14 years.The mean National Institutes of Health Stroke Scale (NIHSS) score was 17.70 ± 3.77.Twenty-two patients (45.8％) occured HT,of which 9 were symptomatic HT;24 (50.0％) had good outcomes.The proportion of males in the HT group was significantly lower than that in the non-HT goup (30.4％vs.72.0％;x2 =8.293,P =0.004),while the proportions in patients with diabetes (65.2％ vs.36.0％;x2 =4.090,P =0.043) and atrial fibrillation (78.3％ vs.44.0％;x2 =5.880,P =0.015),as well as the baseline fasting blood glucose level (8.514 ± 4.400 mmol/L vs.6.354 ± 1.472 mmol/L;t =2.319,P =0.025) were significantly higher than those in the non-HT group.Multivariate logistic regression analysis showed that the atrial fibrillation (odds ratio [OR] 6.136,95％ confidence interval [CI] 1.617-23.291;P =0.042) was a risk factor for the occurrence of HT after mechanical thrombectomy.The proportion of diabetic patients (29.2％ vs.70.8％;x2 =8.333,P=0.04) and baseline NIHSS score (16.050±4.865 vs.19.210±4.423);t=2.310,P=0.026) of the good outcome group were significantly lower than those of the poor outcome group,while the proportions of patients in atrial fibrillation (75.0％ vs.45.8％;x2 =4.269,P =0.039),anterior circulation stroke (87.5％ vs.62.5％;x2 =4.000,P =0.046) middle cerebral artery (75.0％ vs.29.2％;x2 =10.113,P =0.006),vertebral basilar artery (37.5％ vs.12.5％;x2 =10.113,P =0.006) occlusion and parenchymal hematoma (33.3％ vs.4.1％;P=0.011) were significantly higher than the poor outcome group.Multivariate logistic regression analysis showed that diabetes (OR 5.898,95％ CI 1.699-20.479;P=0.005),baseline NIHSS score (OR 1.167,95％ CI 1.011-1.347;P =0.035),and parenchymal hematoma (OR 1.295,95％ CI 1.099-1.875;P=0.028) were the independent risk factors for poor outcomes.Conclusions Atrial fibrillation is an independent predictor of HT risk in patients with acute ischemic stroke after mechanical thrombectomy.Diabetes mellitus,higher baseline NIHSS score,and concurrent brain parenchymal hematoma are the independent predictors of poor outcomes.Therefore,the risk of HT and adverse outcomes should be fully assessed before mechanical thrombectomy in patients with acute ischemic stroke.
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Piperazine drugs, N - benzyl piperazine (BZP), 1 - (3 - chlorobenzene) piperazine (mCPP), 1 - (3 - three lfuorinated methyl phenyl) piperazine (TFMPP) have excitation and hallucinogenic effects similar to MDMA. They have became the alternative LSDs, abuse of substitues in the world reported increased year by year. The paper reviewed three piperazines regulation, abuse, toxicology, detection methods, and hope to provide a reference for judicial departments to crack down on the crime of the drug uses.
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<p><b>OBJECTIVE</b>To evaluate the different pathological and clinical characteristics of thymomas with and without myasthenia gravis (MG) and to determine whether the presence of MG influences the prognosis in thymoma patients.</p><p><b>METHODS</b>The clinical data from 228 consecutive patients (median sternotomy were used in 153, video-assisted thoracoscopic themectomy were used in 75) operated on from January 1992 to December 2007 was analyzed retrospectively. These thymoma patients had been subdivided into two groups: thymoma with MG (n = 125) and thymoma without MG (n = 103). All thymic epithelial tumors were classified according to the WHO histologic classification and the Masaoka clinical staging system. The result was evaluated according to the Myasthenia Gravis Foundation of America's criterion. The clinical features of the 2 test was compared between the two groups by χ² test, and the survival were compared between the two groups by Cox analysis.</p><p><b>RESULTS</b>There were no peri-operative deaths. 19 cases were inoperable (6 in the group with MG, 13 without MG (χ² = 4.52, P = 0.035)). The proportions of type A and thymic carcinoma were 0 in the group with MG, 10.5% (11/103) and 11.6% (12/103) respectively in the group without MG. According to the Masaoka's clinical staging, in the group MG, 24.8% (31/125) patients were stage III and IV; in the group without MG, 33.0% (34/103) patients were stage III and IV. There was a significant difference between hyperplastic paraneoplastic thymus coexisting in 28.8% (36/125) patients with MG and only 5.8% (6/103) in patients without MG (χ² = 20.91, P = 0.000) Microthymoma was identified in the paraneoplastic thymus of 3 patients with MG. There were 198 patients followed up, the rate was 86.8% (198/228). There was no recurrence in patients with type A and a few patients with type AB, B1, B2, B3 thymoma and thymic carcinoma recurred. The actuarial 5- and 10-year survival rates were 89.3% and 81.2% for patients with MG respectively, and 90.0% and 78.9% for patients without MG respectively. Within 5 years postoperatively, 6 of 9 patients with MG died of myasthenia crisis, while 6 out of 7 deaths in patients without MG were attributable to inoperable tumors (stage IV) and thymic carcinoma.</p><p><b>CONCLUSIONS</b>The existence of myasthenia gravis has little influence on the prognosis of thymomas, but it is good for early diagnosis and treatment. Extended thymectomy should be performed to all patients with thymoma, no matter they have myasthenia gravis or not. The main cause of death is myasthenia crisis for thymoma patients with MG and stage IV and (or) thymic carcinoma for patients without MG.</p>
Subject(s)
Humans , Myasthenia Gravis , Pathology , Neoplasm Recurrence, Local , Neoplasm Staging , Neoplasms, Glandular and Epithelial , Pathology , General Surgery , Postoperative Period , Prognosis , Retrospective Studies , Sternotomy , Survival Rate , Thoracic Surgery, Video-Assisted , Thymectomy , Thymoma , Pathology , General Surgery , Thymus Neoplasms , Pathology , General SurgeryABSTRACT
OBJECTIVE:To observe the clinical efficacy of pegylated interferon α-2a(Peg-INFα-2a)combined with adefovir (ADV)in the treatment of HBeAg-positive chronic hepatitis B (CHB). METHODS:An open randomized controlled clinical trial was performed. According to random number table,70 patients with HBeAg-positive chronic hepatitis B were divided into observa-tion group and control group,with 35 cases in each group. Observation group received Peg-INF α-2a combined with ADV,and control group was treated with Peg-INF α-2a only. Therapeutic efficacy and safety evaluation were evaluated after 24 and 48 weeks of treatment. RESULTS:After 24 weeks of treatment,ALT normalization rate of observation group and control group were 51.43%and 25.71%,and HBV-DNA negative rate of 2 groups were 68.57% and 37.14% respectively,with statistical significance (P0.05). After 48 weeks of treatment,ALT normalization rate of observation group and control group were 77.14% and 54.29%,and HBeAg negative rate 54.29% and 31.43%,and HBV-DNA negative rate 82.86% and 42.86% respectively,with statistical significance(P0.05). CONCLUSIONS:Peg-INFα-2a combined with ADV have good clinical efficacy in the treatment of HBeAg-positive CHB,and it is better than Peg-INFα-2a monotherapy and has less ADR.
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Objective To analyze the imaging manifestations of chondromyxoid fibroma,so as to improve diagnostic accuracy.Methods The X-ray,CT and MRI manifestations of 8 cases with chondromyxoid fibroma confirmed by surgical pathology were analyzed retrospectively.Results All of 8 cases were in the long tubular bones.X-ray showed oval,well defined,eccentric,radiolucent lesion with surrounding sclerosis.The thick dense bony or coarse reticular septation were seen in 6 cases.CT scan showed osteolytic,surrounding sclerosis,and 1 case with foci of calcification.MRI images showed a low or medium signal on T1WI,high signal on T2WI,1 case with a equal T1WI and slight high T2WI signal intensity peripheral rim around.Two cases with diffused enhancement on T1WI after intravenous injection of gapentetate acid meglumine injection and a peripheral liner enhancement in 1 case.Conclusion Chondromyxoid fibroma has certain imaging characteristics,but should be combined with X-ray,CT and MRI to differentiate from other bone tumors with similar imaging manifestations.
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Objective To design a new type of hybrid bioartificial liver (HBAL), evaluate its efficacy in vitro, and explore the feasibility in clinical application.Methods CL-1 human hepatocytes were cultured on microcarriers for 5 days, when cell count reached about 4.0 × 109 with cell density of about 4.0 × 107/ml.CL-1 cells cultured on microcarriers in home-made bioreactor constitute the biological part of the HBAL.The abiotic part included blood perfusion and bilirubin adsorption, and blood pump was employed as the circulation driver, which were parts of HBAL.The changes of the concentrations of indirect bilirubin (UBD), chenodeoxycholic acid (CDCD), cholic acid (CA), blood ammonia (AA), AST, ALT and LDH were observed under the condition of in vitro circulation.Meanwhile, the function, morphology and the cell activity of CL-1 cells were also observed.Results After in vitro circulation for 24 h, the concentrations of UBD, CDCD, CA and AA significantly decreased from (335.3 ± 6.0) μmol/L, (395.0 ± 5.6) μmol/L, (155.7 ± 4.5) μmol/L, (39.0 ± 2.6) μmol/L at 0 h to (106.0 ± 10.9) μmol/L, (131.8 ± 28.7) μmol/L, (42.2 ± 7.3) μmol/L, (3.5 ± 1.0) μmol/L, respectively.At 48 h, ALT, AST and LDH significantly increased from (25.9 ± 4.2) IU/L, (22.0 ± 3.6) IU/L, (0.28 ± 0.09) μmol/L to (31.0 ± 2.6) IU/L,(31.6 ± 8.0) IU/L, (0.41 ± 0.12) μmol/L, meanwhile the count and vitality of CL-1 cells were significant declined.Conclusions (1) In the new HBAL system, CL-1 cells can keep its viability and function in vitro;and (2) the HBAL appears to be effective in purifying the serum in liver failure simulation model by clearing out non-conjugated bilirubin, chenodeoxycholic acid, cholic acid and ammonium chloride, which seems to be a promising therapeutic option.