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OBJECTIVES@#To compare the application value of the likelihood ratio (LR) method and identity by state (IBS) method in the identification involving half sibling relationships, and to provide a reference for the setting of relevant standards for identification of half sibling relationship.@*METHODS@#(1) Based on the same genetic marker combinations, the reliability of computer simulation method was verified by comparing the distributions of cumulated identity by state score (CIBS) and combined full sibling index in actual cases with the distributions in simulated cases. (2) In different numbers of three genetic marker combinations, the simulation of full sibling, half sibling and unrelated individual pairs, each 1 million pairs, was obtained; the CIBS, as well as the corresponding types of cumulative LR parameters, were calculated. (3) The application value of LR method was compared with that of IBS method, by comparing the best system efficiency provided by LR method and IBS method when genetic markers in different amounts and of different types and accuracy were applied to distinguish the above three relational individual pairs. (4) According to the existing simulation data, the minimum number of genetic markers required to distinguish half siblings from the other two relationships using different types of genetic markers was estimated by curve fitting.@*RESULTS@#(1) After the rank sum test, under the premise that the real relationship and the genetic marker combination tested were the same, there was no significant difference between the simulation method and the results obtained in the actual case. (2) In most cases, under the same conditions, the system effectiveness obtained by LR method was greater than that by IBS method. (3) According to the existing data, the number of genetic markers required for full-half siblings and half sibling identification could be obtained by curve fitting when the system effectiveness reached 0.95 or 0.99.@*CONCLUSIONS@#When distinguishing half sibling from full sibling pairs or unrelated pairs, it is recommended to give preference to the LR method, and estimate the required number of markers according to the identification types and the population data, to ensure the identification effect.
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Humans , Siblings , Genetic Markers , Computer Simulation , Irritable Bowel Syndrome/genetics , Reproducibility of Results , GenotypeABSTRACT
Severe acute pancreatitis (SAP) is a common gastrointestinal disease, often accompanied by systemic inflammatory reactions and organ dysfunction. SAP has an acute onset, severe condition, rapid progression, and poor prognosis. The development of SAP is closely related to the excessive release of inflammatory factors. In the comprehensive treatment of SAP, continuous blood purification (CBP) can clear inflammatory mediators, improve the stability of Internal environment, improve organ function, reduce blood lipids, regulate immunity, and significantly improve the condition of SAP patients. It is an important means of treating SAP. This article reviews the research progress of CBP in the treatment of SAP.
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Objective:To analyze the application of robot-assisted thoracoscopic surgery in the treatment of pulmonary sequestration in children.Methods:The clinical data of 20 children with pulmonary sequestration admitted to the Children's Hospital Zhejiang University School of Medicine from May to November 2020 were analyzed retrospectively. There were 13 males and 7 females, ages ranged from 6 months to 5 years old, with median age of 10 months. Body weight ranged from 7.5 to 18.0 kg, with mean weight of(9.95±2.46)kg. Abnormal blood supply vessels in pulmonary sequestration were found by chest enhanced CT and were further confirmed during surgery. All the other 19 cases were found to have pulmonary lesions by prenatal ultrasound except 1 case due to repeated infection. The lesions were located in left lung in 15 cases and right lung in 5 cases.Results:1 case was converted to thoracotomy due to failure of intraoperative single lung ventilation and inability of artificial pneumothorax to collapse the lung lobe, and other 19 cases were successfully completed by robot-assisted thoracoscopic surgery. The operation time ranged from 40 to 270 min, mean(88.25±55.68) min. All 10 patients with extralobar sequestration underwent simple pneumonectomy, including 2 patients with intra-diaphragmatic pulmonary sequestration. In 10 cases of intralobar sequestration, 2 cases underwent wedge resection, 2 cases underwent segmental resection, and 6 cases underwent lobectomy. No operative death occurred. The postoperative hospital time ranged from 3 to 10 days, mean(5.00±1.89) days. All patients recovered well and no complications such as pleural effusion and atelectasis were observed during 1-6 months follow-up.Conclusion:The robotic surgical system is safe and effective for the treatment of pulmonary sequestration in children.
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Objective:To introduce a modified stent technique of nasal septal extension graft (SEG) with auricle cartilage, and to explore its effect on rhinoplasty.Methods:For 116 patients that underwent rhinoplasty, the cartilage of bilateral auricula was sutured with shell alignment and the dovetail was modified to prepare SEG stent; PTFE or silicone prosthesis was used for nasal dorsal graft. The patients were follow up for 6-18 months after surgery. A number of indicators including length of nose, tip projection, nasal tip and nasolabial angle morphology were used to assess surgical outcomes.Results:The 116 patients obtained satisfactory appearance immediately after operation. Length of nasal extension was 3-6 mm, tip projection was extended by 2-5 mm. Following up for 6-18 months showed stable effect (0.5-1.5 mm retraction) and satisfactory nose tip and nasolabial angle. The skin color was normal. No deformity occured in the ear cartilage donor area existed with no obvious scar.Conclusions:The modified SEG stent of auricle cartilage has good support and stability. It has a good effect on the slight and moderate extension of the short nose. In addition, the elevation of the nasal tip and the severe short nose of the first rhinoplasty and secondary rhinoplasty with mild contracture are also improved.
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Objective:To evaluate the efficacy of anatomic thoracoscopic pulmonary segmentectomy in the treatment of congenital pulmonary diseases in children and infants.Methods:There were 38 cases, 21 males and 17 females, aged from 6 months to 10 years old and 2 months, mean(28.1±20.7) months, and weight 6.0-27.5 kg, mean(11.93±4.05) kg who were scheduled to undergo thoracoscopic segmental pneumonectomy from July 2019 to March 2020. Among the 38 cases, there were 27 cases of congenital pulmonary airway malformation and 11 cases of intralobar pulmonary sequestrations, including 1 case of intralobar pulmonary sequestrations with extralobar pulmonary sequestrations and 1 case of intralobar pulmonary sequestrations with bronchial cyst. 3D computed tomography bronchography and angiography(3D-CTBA) was performed before operation to identify the specific lung segment of the lesion. According to the results to plan the operation plan, determine the specific resection of the lung segment.Results:The operation was completed successfully in all groups. The operation time was(72.5±18.2)min, the bleeding volume was(17.3±2.9) ml, chest tube drainage time was(3.1±0.8) days, and the postoperative discharge time was(8.1±2.8) days. Postoperative complications included infection(1 case), atelectasis(1 case), hydropneumothorax(1 case) and pneumothorax(1 case). There was no conversion to thoracotomy and enlarged pulmonary lobectomy. There was no recurrence during the follow-up of 1-9 months.Conclusion:Lung-preserving segmentectomy is technically feasible and safe for congenital pulmonary diseases in children. The 3D-CTBA technique can be used to understand the specific pulmonary segments invaded by the lesions and the relationship between the corresponding pulmonary vessels and bronchi before operation, which is of positive significance for the resection of complex pulmonary segments and good preoperative surgical planning.
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Objective:To evaluate the effect of vacuum disk(VD) for non-invasive treatment of recurrent and acquired pectus excavatum(PE).Methods:From June 2017 to June 2019, 29 patients recruited from our outpatient clinic were included in this retrospective study and followed-up every 3 month according to the schedule. The patients were distributed into three groups(group 1 treated ≤6 months; group 2 treated from 6 months to 12 months; group 3 treated >12 months). The device should be applied regularly for more than 2 hours daily. The deformity chest wall was scanned by three-dimensional(3D)scanner at clinic, and the 3D-depth(3D-DE) and 3D-Haller index(3D-HI) of PE were calculated through Geomagic software.Results:In this cohort, 29 patients were eligible, 18 symmetrical PE and 11 asymmetric PE. The application time ranged from 3 months to 15 months(average 7.6 months). 4 paitents was lifted to a normal level, 23 patients were differently improved. However, 2 paitents had no improvement. The average of the depth and 3D-HI of all patients were improved from 17.7 mm to 11.6 mm and 1.739 to 1.598, respectively. It’s no statistically significant difference for the elevation of 3D-DE and 3D-HI between symmetrical and asymmetric PE( t=-2.821, P=0.558; t=0.074, P=0.068). When comparing the improvement of 3D-DE or 3D-HI of PE to the patient's treatment time, a statistically significant difference was proved between the group 2 and group 1( t=-2.261, P=0.014; t=-0.436, P=0.043), but not between the group 3 and group 2( t=-1.240, P=0.139; t=0.622, P=0.568). The main side effects include moderate subcutaneous hematoma(84%), petechial bleeding(27%), thoracalgia(32%) and chest tightness(17%), no other side effect appear till now. Conclusion:VD for treatment of recurrent and acquired PE is convenient, safe and noninvasive, which can be an alternative treatment for recurrent and acquired PE, However, long term of efficacy evaluation is still needed.
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Objective:To analyze and summarize adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia caused by Linezolid in elderly patients, in order to enhance clinicians' awareness of adverse reactions of Linezolid.Methods:One case with Linezolid-induced lactic acidosis, pancytopenia and hypoglycemia was reported in a patient receiving long-term and repeated use of Linezolid for recurrent urinary tract infections(RUTI)in Beijing Hospital.National and international literature on the three severe and rare adverse reactions caused by Linezolid before December 2018 was reviewed, and the risk factors, clinical characteristics and prognosis of the three severe adverse reactions caused by Linezolid were summarized and analyzed.Results:A total of 86 cases with Linezolid-induced adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia were analyzed.Among them, the ratio of males to females was 1.8∶1.0, the median age was 64.5 years, and 44 cases were over 65 years, accounting for 51.2%.Among the 57 patients with lactic acidosis, 25 lactic acidosis cases were combined with liver and kidney diseases, which were the most commonly involved organs(43.9%, 25/57). The time of onset for lactic acidosis was 4 h-109 d, with a median value of 32 d, and the peak values of blood lactate were 2.6-38.1 mmol/L, with a median value of 13.3 mol/L.Pancytopenia occurred 4 h-120 days after the treatment, and the median value was 21 days.The time of onset for hypoglycemia was 8 h-26, and the median time was 10.3 days.The lowest value of blood glucose was 0.2 mmol/L.Of the 86 cases, 61(70.9%)patients improved, and 12 cases of 51 patients with lactic acidosis died, with a mortality rate of 23.5%.Conclusions:Clinicians should be aware of serious adverse reactions including hypoglycemia, lactic acidosis and pancytopenia during Linezolid treatment in elderly patients.It is recommended to monitor changes in blood glucose, blood lactate and blood cell count during Linezolid treatment, and to avoid long-term use of Linezolid, so as to maximize the benefits for patients.
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OBJECTIVE: To analyze the clinical feature and prognosis during hospitalization of pulmonary thromboembolism(PTE) patients with hemoptysis. METHODS: Between January 2010 and January 2015, a total of 220 patients diagnosed with acute PTE were recruited in our study in Beijing Hospital. Baseline characteristics, clinical signs and symptoms, laboratory tests, imaging findings, therapy and hospitalization outcomes(including mortality, and incidences of bleeding events) were collected. All the patients were divided into two groups according to whether hemoptysis occurred. A variety of clinical parameters in clinical features and prognosis were compared between the two groups.RESULTS: Among 220 patients, 16(7.3%) had hemoptysis and 204(92.7%) did not. Hemoptysis group were significantly younger [(59.7±16.6)vs.(67.2±13.6) years, P=0.037] and there were more males(75.0% vs. 44.6%, P=0.034). Compared to patients without hemoptysis, those with hemoptysis had a higher incidence of fever(31.3% vs. 11.3%, P=0.037) and chest pain(50.0% vs. 26.0%; P=0.039). The average diagnosis time of hemoptysis group was(8.91 ± 6.09) days. Patients in the hemoptysis group had a higher proportion of inferior vena cava filter(IVCF)(18.8%vs. 3.4%, P=0.028). There was no significant difference in severity and in-hospital mortality between the two groups. CONCLUSION: The lack of specificity of hemoptysis caused by PTE often leads to misdiagnosis or delayed diagnosis. Early diagnosis is helpful to correct treatment and reduce the adverse consequences of improper measures.
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Objective To investigate clinical features and prognosis of patients with cancerrelated isolated distal deep vein thrombosis(IDDVT).Methods Data of 64 patients with malignant tumor complicated with IDDVT at our hospital from January 2003 to January 2013 were retrospectively analyzed for the clinical features and prognosis.Results Among the 64 patients,32 male and 32 female cases were involved,aged 37 to 87 years,average(66.0 ± 12.6) years.There were 42 cases aged 65 years and older and 22 cases aged under 65 years.The IDDVT involved veins of lower extremity in 64 patients,unilaterally (47/64)or bilaterally (17/64).The intermuscular veins were involved by IDDVT in 46 cases(71.9％).Posterior tibial veins were involved in 17 cases(26.6％),peroneal veins were involved in 14 cases(21.9％),anterior tibial veins were involved in 2 cases (3.1 ％).Common symptoms were swollen lower extremity and pain (53.1％).Bleeding occurred in 2 (3.6 ％) of the 55 patients(55/64,85.9 ％) who underwent anticoagulant therapy,and no major bleeding occurred.The cumulative incidence of IDDVT at 3,6,and 12 months after tumor diagnosis was 64.0％ (41/64 cases),75.0 ％ (48/64 cases) and 85.9 ％ (55/64 cases),respectively.The cumulative incidences of IDDVT at 3 and 6 months were higher after diagnosis of lung cancer than after diagnosis of digestive tract tumors(P =0.005 and 0.035).By the end of follow-up(a median follow-up of 13.0 months),30 patients(46.9 ％)died.The mortality rate was lower in the non-elderly group than in the elderly group (22.7％ vs.59.5％,x2 =7.850,P=0.005).The mortality rate was lower in patients with stage Ⅰ-Ⅲa than in patients with stage Ⅲb-Ⅳ(24.0％ vs.68.8％,x2=11.246,P=0.001).The mortality rate was lower in patients with gynecologic tumors(10.0％) than in patients with lung cancer(55.6％),digestive tract tumors (40.0％) and hematologic tumors (71.4％) (P =0.041,0.037 and 0.035,respectively).TNM Ⅲ b-Ⅳ (OR =8.42,95 ％ CI:1.93-30.00,P =0.004) and age ≥ 65 years (OR =6.28,95％CI:1.50-27.76,P=0.012)were independent risk factors for death.Conclusions Cancerassociated IDDVT most commonly involves the intermuscular veins.The incidence of hemorrhage after anticoagulant therapy is low.For patients without anticoagulation contraindications,active anticoagulant therapy should be recommended.The advanced cancer and old age are independent risk factors for cancer-related IDDVT death.
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Objective To compare the survival outcomes between operative versus non-operative treatment of advanced intrahepatic cholangiocarcinoma.Methods This is a retrospective study.The data from 122 patients with intrahepatic cholangiocarcinoma treated at the Hunan People's Hospital,the Hepatobiliary Hospital and the Oncology Department from January 2012 to October 2017 were retrospective studied.87 patients who underwent radical surgery (anatomical hepatectomy + regional lymph node dissection) formed the operation group;35 patients who were treated with chemotherapy and/or radiotherapy and/or biological targeted therapy formed the non-operative group.The general characteristics of the two groups including age,sex,ALT,AST,CA19-9,liver function,Child's classification,AJCC staging,tumor number,vascular (hepatic artery,portal vein) invasion and regional lymph node metastasis rates were compared.The overall survival of the two groups was compared.Results There were no significant differences in age,sex,ALT,AST,CA19-9,liver function,Child's classification,AJCC staging,tumor number,vascular (hepatic artery,portal vein) invasion and regional lymph node metastasis rates (P＞0.05).The overall survival of the operation group was significantly longer than that of the non-operative group (P＜0.05).The mean overall survival for the 2 groups of patients were 32 months and 15 months respectively.The 1-year survival rates were 74.8％ and 58.7％,and the 3 year survival rates were 42.4％ and 6.5％,respectively.The 5 years survival rates were 12.3％ and 0,respectively.Conclusion Operative treatment resulted in better median survival,as well as 1-,3-and 5-year survival rates than non-operative treatment for patients with advanced intrahepatic cholangiocarcinoma.
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Objective To control the quality of realgar in compound Huanglian Ointment.Methods As2O3which is the toxic component of realgar was carried limit test by Gutzeit's test; Potassium sulfate, ammonium sulfate and sulfuric acid were used to digest, and then titration method was used to determine the content of As2S2in compound Huanglian Ointment. Results The content of the soluble As in compound Huanglian Ointment was no higher than 15.6 μg/g. The content of As2S2in compound Huanglian Ointment was no less than 2.21 mg/g. Conclusion The method is simple and easy,which can be applied as the quantity control method of compound Huanglian Ointment.
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<p><b>OBJECTIVE</b>To evaluate the feasibility of endoscopic lobectomy for pulmonary sequestration in children.</p><p><b>METHODS</b>Clinical data of 47 children with pulmonary sequestration treated with endoscopic lobectomy from April 2015 to November 2017 were reviewed. According to the operation date, 19 children received operation from April 2015 to December 2016 were early group, and 23 children received operation from January 2017 to November 2017 were late group (5 children with lesions inside diaphragm were excluded). The operation time, intraoperative blood loss, retention time of drainage tube, length of hospital stay and incidence of complications were compared between two groups.</p><p><b>RESULTS</b>Among 47 children, endoscopic lobectomy was successfully completed in 45 children, and the rest 2 children were converted to thoracotomy. No death was observed. The operation time in late group was shorter than that in the early group (<0.05), and the intraoperative blood loss of the late group was less than that of early group (<0.05); while there were no significant differences in retention time of drainage tube and length of hospital stay between two groups (both >0.05). Postoperative complications occurred in 14 children, including 4 cases of pneumothorax, 8 cases of pleural effusion, 1 case of pulmonary infection, and 1 case of diaphragmatic hernia. The incidence rates of postoperative complications in late group and early group were 17.4% (4/23) and 42.1% (8/19), and the difference was not statistically significant(>0.05). During the follow-up (2-26 months), no relapse and thoracic collapes were observed, and CT examination found that the remaining lungs were well compensated in all children.</p><p><b>CONCLUSIONS</b>The endoscopic lobectomy is effective and safe with less trauma and bleeding, which is recommended for treatment of pulmonary sequestration in children.</p>
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Objective To explore the typing and surgical methods on intrahepatic stone complicated with atrophy-hypertrophy complex.Methods The clinical data of 32 cases of intrahepatic stone complicated with atrophy-hypertrophy complex from January 2014 to December 2015 in Hunan Province Peopole's Hospital were retrospectively analysed.Results These 32 cases of atrophy-hypertrophy complex accounted for 1.9％ of admitted hepatolith patients.We divided the intrahepatic stone complicated with atrophy-hypertrophy syndrome into 5 types,and type-Ⅱ the most common.We performed operation combined with fiber choledochoscope to examine,smash and remove the stone.This methods could reduce the rate of residual stone to 6％.The liver will be partly atrophy with stones inside it,and the residual liver will become hypertrophy.Stones of intrahepatic bile duct lead to the change of the position of porta hepatis and straitness of primary bile duct,and the bile cannot smooth out.there will be lithogenesis and relapsing cholangitis.Patients were treated by intrahepatic biliary double-opening drainage,and followed-up for 12-36 months.There were no death cases,and the total effective rate was 94％.Conclusions Intrahepatic stones complicated with atrophy-hypertrophy complex could be diagnosed by CT scan.Selecting proper operation method to treat atrophy-hypertrophy complex may decrease residual stones and improve the quality of life.
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Objective Retrospectively analysis of our hospital thoracoscopic lobectomy cases in infants and children.This study evaluates the safety and efficacy of thoracoscopic lobectomy in infants and children.Methods Retrospective analysis of our hospital from April 2015 to August 2016,50 consecutive patients were plans to implement thoracoscopic lobectomy,excluding extralobar isolated,lung bullae,lung biopsies.35 males and 15 females,aged 2 months and 13 years,the average (5.94 ±3.94) years,3.25-59.00 kg body weight,average(22.15 ± 12.54) kg.11 cases of prenatal ultrasound to confirm.21 cases have a history of recurrent pneumonia.3 patients had a history of hemoptysis,are leaf-type isolation within the lung.Results 50 patients were successful in 46 cases by thoracoscopic surgery,4 patients underwent thoracotomy,transit rate of 8％.Transfer 4 cases,2 cases of left upper lobe,13 year-old and 15 year old children,preoperative recurrent pneumonia,pleural adhesions.1 case of right lower lobe,right lower pulmonary artery surgery damage the basal segments,bleeding.1 case of left lower lobe,the upper and lower leaf division stunted.VATS 40-300 minutes,an average of 120 minutes.There was no operative mortality,postoperative bleeding reoperation case who,as a transit cases thoracotomy.Lesion distribution right upper lobe in 5 cases,1ease of right middle lower,19 cases of right lower lobe,left upper lobe in 7 cases,18 cases of left lower lobe.Histological examination showed bronchial pulmonary cyst in 4 cases,leaf-type isolation within the lung in 15 cases,cystic adenomatoid malformation in 30 cases(type I 17 eases,type Ⅱ 13 cases).Indwelling chest tube after 2-3 days in hospital after 5-10 days,an average of 7 days.Postoperative follow-up 1-12 months,no recurrence and thoracic collapse,the remaining lung well compensated.Conclusion VATS lobectomy with less trauma,quicker recovery after surgery.However,due to the small chest in children,one lung difficulties,thoracoscopic operation requires a longer learning curve.Preoperative recurrent infections,pleural adhesions,fissure dysplasia will increase the rate of conversion to open.
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Objective Retrospectively analysis of our hospital thoracoscopic lobectomy cases in infants and children.This study evaluates the safety and efficacy of thoracoscopic lobectomy in infants and children.Methods Retrospective analysis of our hospital from April 2015 to August 2016,50 consecutive patients were plans to implement thoracoscopic lobectomy,excluding extralobar isolated,lung bullae,lung biopsies.35 males and 15 females,aged 2 months and 13 years,the average (5.94 ±3.94) years,3.25-59.00 kg body weight,average(22.15 ± 12.54) kg.11 cases of prenatal ultrasound to confirm.21 cases have a history of recurrent pneumonia.3 patients had a history of hemoptysis,are leaf-type isolation within the lung.Results 50 patients were successful in 46 cases by thoracoscopic surgery,4 patients underwent thoracotomy,transit rate of 8％.Transfer 4 cases,2 cases of left upper lobe,13 year-old and 15 year old children,preoperative recurrent pneumonia,pleural adhesions.1 case of right lower lobe,right lower pulmonary artery surgery damage the basal segments,bleeding.1 case of left lower lobe,the upper and lower leaf division stunted.VATS 40-300 minutes,an average of 120 minutes.There was no operative mortality,postoperative bleeding reoperation case who,as a transit cases thoracotomy.Lesion distribution right upper lobe in 5 cases,1ease of right middle lower,19 cases of right lower lobe,left upper lobe in 7 cases,18 cases of left lower lobe.Histological examination showed bronchial pulmonary cyst in 4 cases,leaf-type isolation within the lung in 15 cases,cystic adenomatoid malformation in 30 cases(type I 17 eases,type Ⅱ 13 cases).Indwelling chest tube after 2-3 days in hospital after 5-10 days,an average of 7 days.Postoperative follow-up 1-12 months,no recurrence and thoracic collapse,the remaining lung well compensated.Conclusion VATS lobectomy with less trauma,quicker recovery after surgery.However,due to the small chest in children,one lung difficulties,thoracoscopic operation requires a longer learning curve.Preoperative recurrent infections,pleural adhesions,fissure dysplasia will increase the rate of conversion to open.
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Objective To explore the clinical characteristics and prognosis of patients with malignant tumor of digestive system combined with venous thromboembolism(VTE).Methods The clinical data of 77 patients admitted in Beijing Hospital from January 2003 to April 2013 with digestive system malignant tumor complicated with VTE were retrospectively analyzed.The incidence,clinical features and prognosis of the patients with digestive system cancer were analyzed.Results Among 77 patients,57 cases of male and 20 cases of female were involved,with an average age of(68.7 ± 12.4)years,including 60 cases(77.9 ％)of adenocarcinoma.The pathological results showed that differentiated tumors accounted for 61.0％ (47/77).Among the 77 patients,pulmonary thromboembolism (PTE) accounted for 33.8 ％ (26 cases) and deep vein thrombosis(DVT)in the low extremities accounted for 66.2 ％ (51 cases).Among all the patients,the most common symptoms were dyspnea and swelling or pain in the extremities.The incidence of VTE was 24.7％ (19/77),13.0％(10/77),19.5％(15/77),5.2％(4/77),5.2％ (4/77),32.5％ (25/77) at 1,3,6,9,12,＞ 12 months after diagnosis of digestive system malignancies,respectively.By April 2013,the 54.5 ％ (42/77) patients died,among which 73.8 ％ (31/42) died of digestive system malignancies,11.9 ％ (5/42) died of PTE,14.3 ％ (6/42) died of other causes.The mortality rates at 1,3,6,9,12,＞ 12 months after the diagnosis of VTE were 20.8％ (16/77),6.5 ％ (5/77),13.0 ％ (10/77),5.2 ％ (4/77),2.6 ％ (2/77),6.5 ％ (5/77),respectively.The difference in VTE incidence between the group aged ≥65 years and group aged ＜65 years at 1,3,6,9 and 12 months after the diagnosis of tumors was not statistically significant(P =0.309).The differences in mortality(P =0.357) and in the median survival time(x2 =0.290,P =0.591) between the two groups were not statistically significant at 1,3,6,9 and 12 months after the diagnosis of VTE.Conclusions The risks for VTE are high in patients with digestive tract malignant tumor,advanced malignant tumor,poor histologic grade(poorly or moderately differentiation),and chemotherapy or surgery,which mostly occurs within 3-6 months after diagnosis.Most deaths occur within the 1st year after the diagnosis of VTE.
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Objective To explore the clinical characteristics and prognosis of patients with malignant tumor of digestive system combined with venous thromboembolism(VTE).Methods The clinical data of 77 patients admitted in Beijing Hospital from January 2003 to April 2013 with digestive system malignant tumor complicated with VTE were retrospectively analyzed.The incidence,clinical features and prognosis of the patients with digestive system cancer were analyzed.Results Among 77 patients,57 cases of male and 20 cases of female were involved,with an average age of(68.7 ± 12.4)years,including 60 cases(77.9 ％)of adenocarcinoma.The pathological results showed that differentiated tumors accounted for 61.0％ (47/77).Among the 77 patients,pulmonary thromboembolism (PTE) accounted for 33.8 ％ (26 cases) and deep vein thrombosis(DVT)in the low extremities accounted for 66.2 ％ (51 cases).Among all the patients,the most common symptoms were dyspnea and swelling or pain in the extremities.The incidence of VTE was 24.7％ (19/77),13.0％(10/77),19.5％(15/77),5.2％(4/77),5.2％ (4/77),32.5％ (25/77) at 1,3,6,9,12,＞ 12 months after diagnosis of digestive system malignancies,respectively.By April 2013,the 54.5 ％ (42/77) patients died,among which 73.8 ％ (31/42) died of digestive system malignancies,11.9 ％ (5/42) died of PTE,14.3 ％ (6/42) died of other causes.The mortality rates at 1,3,6,9,12,＞ 12 months after the diagnosis of VTE were 20.8％ (16/77),6.5 ％ (5/77),13.0 ％ (10/77),5.2 ％ (4/77),2.6 ％ (2/77),6.5 ％ (5/77),respectively.The difference in VTE incidence between the group aged ≥65 years and group aged ＜65 years at 1,3,6,9 and 12 months after the diagnosis of tumors was not statistically significant(P =0.309).The differences in mortality(P =0.357) and in the median survival time(x2 =0.290,P =0.591) between the two groups were not statistically significant at 1,3,6,9 and 12 months after the diagnosis of VTE.Conclusions The risks for VTE are high in patients with digestive tract malignant tumor,advanced malignant tumor,poor histologic grade(poorly or moderately differentiation),and chemotherapy or surgery,which mostly occurs within 3-6 months after diagnosis.Most deaths occur within the 1st year after the diagnosis of VTE.
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BACKGROUND:As previously reported, poly-L-lactic acid stents have been mostly used as coronary artery stents, but this stent has a lack of early support force and produces some acidic products that wil induce local vascular inflammatory reactions. OBJECTIVE:To explore the biocompatibility of a novel amorphous calcium phosphate drug-eluting stent, after implantation into mini-swine coronary artery. METHODS:Twenty mini-swine were randomly equivalently divided into observation group and control group. The right femoral arteries of animals were separated layer by layer and the new type of biodegradable stent and poly-L-lactic acid stent were implanted, respectively. RESULTS AND CONCLUSION:The vessel lumes in the two groups were smooth and unobstructed showed by coronary artery angiography immediately after implantation. At 4 weeks after implantation, the coronary angiography showed the patency of vessel lumens with no stent thrombosis and stenosis in both two groups. The C-reactive protein levels in the two groups had no significant differences before and 4 weeks after stent implantation. At 4 weeks after implantation, the number of lymphocytes and inflammatory score in the observation group were significantly higher than those in the control group, but the neointimal area and percentage of stenosis area had no significant difference between the two groups. These results indicate that the novel amorphous calcium phosphate drug-eluting stent after implantation into mini-swine coronary artery has good biocompatibility.
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Mutations or inactivation of parkin, an E3 ubiquitin ligase, are associated with familial form or sporadic Parkinson's disease (PD), respectively, which manifested with the selective vulnerability of neuronal cells in substantia nigra (SN) and striatum (STR) regions. However, the underlying molecular mechanism linking parkin with the etiology of PD remains elusive. Here we report that p62, a critical regulator for protein quality control, inclusion body formation, selective autophagy and diverse signaling pathways, is a new substrate of parkin. P62 levels were increased in the SN and STR regions, but not in other brain regions in parkin knockout mice. Parkin directly interacts with and ubiquitinates p62 at the K13 to promote proteasomal degradation of p62 even in the absence of ATG5. Pathogenic mutations, knockdown of parkin or mutation of p62 at K13 prevented the degradation of p62. We further showed that parkin deficiency mice have pronounced loss of tyrosine hydroxylase positive neurons and have worse performance in motor test when treated with 6-hydroxydopamine hydrochloride in aged mice. These results suggest that, in addition to their critical role in regulating autophagy, p62 are subjected to parkin mediated proteasomal degradation and implicate that the dysregulation of parkin/p62 axis may involve in the selective vulnerability of neuronal cells during the onset of PD pathogenesis.
Subject(s)
Animals , Humans , Mice , Adaptor Proteins, Signal Transducing , Chemistry , Metabolism , HEK293 Cells , Heat-Shock Proteins , Chemistry , Metabolism , Lysine , Metabolism , Neurons , Metabolism , Pathology , Oxidopamine , Pharmacology , Parkinson Disease , Metabolism , Pathology , Proteasome Endopeptidase Complex , Metabolism , Protein Stability , Proteolysis , Sequestosome-1 Protein , Ubiquitin-Protein Ligases , Metabolism , UbiquitinationABSTRACT
Objective To evaluate the effects,safety and economic cost of long-term home noninvasive ventilation (NIV) therapy in elderly patients with chronic hypercapnic respiratory failure.Methods A total of 128 elderly patients with chronic hypercapnic respiratory failure were randomly assigned to two groups:the NIV group (n=66) with conventional therapy in addition to long-term home NIV therapy,and the control group (n=62) with conventional therapy alone.Compared were parameters before and after two year follow up,which included dyspnea grade,scale for accessory muscle use,scoring for emotional disorders,mean pulmonary pressure (mPAP) by electrocardiography,arterial blood gas,the times of pulmonary infection and hospitalization rates,the duration of hospitalization invasive ventilation,the duration of in RICU and in hospital stay,tracheal intubation rates and mortality.The medical cost was calculated.Results After two years,the differences in the dyspnea grade,scale for accessory muscle use,anxiety scores,depression scores,mPAP,arterial PaCO2 and PaO2,hospitalization rates,the times of pulmonary infection,the days of hospitalization for exacerbation in the home NIV group [2.2± 0.2,2.4 ± 0.3,4 ± 1,5.3 ± 1.2,(36.6±5.2)mm Hg,(50.2±4.5)mm Hg,(63.5±4.2)mm Hg,(1.3±0.2) times/year,(2.4±0.2) times/year,(15.8 ± 4.4) days/times] were statistically significant compared to the control group [4.1±0.2,4.9±0.5,12±3,11.3±1.6,(45.2±5.2)mm Hg,(67.3±4.5) mm Hg,(48.3±4.3)mm Hg,(5.4±0.4)times/year,(8.9 ±0.3) times/year,(38.5± 6.3) days/times] (all P＜0.01).The duration of invasive ventilation,the days in RICU and in hospital stay,tracheal intubation rates on admission to the hospital were significantly decreased in the home NIV group [(8.2 ± 2.2)days,(9.6±3.1) days,(15.8±4.4) days,(2±0.2) times/two years],as compared with the control group [(15.8±3.4) days,(18.6±4.4)days,(38.5±6.3)days,(8.0±0.8) times/two years].The mortality was decreased significantly in the home NIV group (3.0 ％)compared with the control group (29.0％) (P＜0.05).The medical cost in two years was significant lower in the home NIV group [(6.4 ± 0.5) thousand yuan],compared with the control group (18.4 ±0.6) thousand yuan (P＜0.01).Conclusions Long-term home NIV therapy in patients with chronic hypercapinc respiratory failure is effective,safe and can decrease the mortality and medical cost.