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Objective:To investigate the drug resistance factors in postoperative gemci-tabine chemotherapy after radical resection of pancreatic cancer.Methods:The retrospective case-control study was constructed. The clinicopathological data of 255 patients with pancreatic cancer who were firstly admitted to the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi ′an Jiaotong University from January 2018 to June 2021 were collected. There were 140 males and 115 females, aged (59±10)years. All patients underwent radical resection of pancreatic cancer and received postoperative gemcitabine-based adjuvant chemotherapy. Observation indicators: (1) follow-up; (2) postoperative chemotherapy; (3) drug resistance and changing of regimen; (4) factors influencing postoperative chemotherapy resistance. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and compari-son between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the Pearson chi-square test. Univariate analysis was conducted using the corresponding statistical methods based on data type. Multivariate analysis was conducted using the Logistic regression model with forward method. Kaplan-Meier method was used to draw survival curve, and Log-Rank test was used for survival analysis. Results:(1) Follow-up. All 255 patients were followed up for 18.6(16.7,21.4)months. The median survival time of 255 patients was 18.2[95% confidence interval ( CI) as 15.8-20.6]months. (2) Postoperative chemotherapy. Of the 255 patients, there were 5 cases receiving postoperative chemotherapy as gemcitabine monotherapy, 167 cases receiving postoperative chemotherapy as the AG combination (gemcitabine plus albumin-bound paclitaxel), 74 cases receiving postoperative chemotherapy as the GS combination (gemcitabine plus S-1) and 9 cases receiving postoperative chemotherapy as the GP combination (gemcitabine plus platinum). (3) Drug resistance and changing of regimen. Of the 255 patients, 81 cases completed the course of postoperative chemotherapy and evaluation. Of the 81 patients, there were 18 cases with no recurrence or metastasis of tumor, 10 cases with tumor local recurrence, 40 cases with tumor lymph node metastasis or distant metas-tasis, 3 cases with tumor local recurrence combined with distant metastasis, 10 cases with elevation of CA19-9. Of the 81 patients, 18 cases responded to chemotherapy, 63 cases underwent resistant to chemotherapy, including 11 cases with primary resistance and 52 cases with acquired resistance. The 63 patients with chemotherapy resistance underwent changing of regimen. (4) Factors influencing postoperative chemotherapy resistance. Results of multivariate analysis showed that chemotherapy cycle<6 is an independent risk factor for postoperative chemotherapy resistance in patients ( hazard ratio=17.18, 95% CI as 2.07-142.28, P<0.05). Conclusion:Adjuvant chemotherapy cycle <6 is an independent risk factor for postoperative chemotherapy resistance for gemcitabine based chemo-therapy in pancreatic cancer patients receiving radical resection.
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Objective: To analyze the therapeutic effect and safety of pancreatic extracorporeal shock wave lithotripsy(P-ESWL) for patients with chronic pancreatitis complicated by stones of the pancreatic duct and to investigate the influencing factors. Methods: A retrospective analysis was performed on clinical data from 81 patients with chronic pancreatitis complicated by pancreatic duct calculus treated with P-ESWL in the Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi 'an Jiaotong University from July 2019 to May 2022. There were 55 males(67.9%) and 26 females(32.1%). The age was (47±15)years (range: 17 to 77 years). The maximum diameter(M(IQR)) of the stone was 11.64(7.60) mm, and the CT value of the stone was 869 (571) HU. There were 32 patients (39.5%) with a single pancreatic duct stone and 49 patients(60.5%) with multiple pancreatic duct stones. The effectiveness, remission rate of abdominal pain, and complications of P-ESWL were evaluated. Student's t test, Mann Whitney U test, χ2 test, or Fisher's exact test was used to compare the characteristics between the effective and ineffective groups of lithotripsy. The factors influencing the effect of lithotripsy were analyzed by univariate and multivariate logistic regression analysis. Results: Eighty-one patients with chronic pancreatitis were treated with P-ESWL 144 times, with an average of 1.78 (95%CI:1.60 to 1.96) times per person. Among them, 38 patients(46.9%) were treated with endoscopy. There were 64 cases(79.0%) with effective removal of pancreatic duct calculi and 17 cases(21.0%) with ineffective removal. Of the 61 patients with chronic pancreatitis accompanied by abdominal pain, 52 cases(85.2%) had pain relief after lithotripsy. After lithotripsy treatment, 45 patients(55.6%) developed skin ecchymosis, 23 patients(28.4%) had sinus bradycardia, 3 patients(3.7%) had acute pancreatitis, 1 patient(1.2%) had a stone lesion, and 1 patient(1.2%) had a hepatic hematoma. Univariate and multivariate logistic regression analysis showed that the factors affecting the efficacy of lithotripsy included the age of patient(OR=0.92, 95%CI: 0.86 to 0.97), the maximum diameter of the stone(OR=1.12,95%CI:1.02 to 1.24) and the CT value of the stone(OR=1.44, 95%CI: 1.17 to 1.86). Conclusions: P-ESWL is effective in the treatment of patients with chronic pancreatitis complicated by calculi of the main pancreatic duct.Factors affecting the efficacy of lithotripsy include patient's age, maximum stone diameter, and CT value of calculi.
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Male , Female , Humans , Retrospective Studies , Acute Disease , Treatment Outcome , Calculi/pathology , Lithotripsy , Pancreatitis, Chronic/pathology , Pancreatic Diseases/complications , Pancreatic Ducts , Abdominal Pain/therapyABSTRACT
Objective To explore PM2.5 concentration modeling and prediction based on the monthly average concentrations of PM2.5 in Shanghai since 2015, and to provide new ideas about PM2.5 prediction methods. Methods The seasonal factors were introduced into the Grey Model (GM). GM(1,1) model modified with seasonal factors was established and compared with seasonal autoregressive integrated moving average model (ARIMA) model. The data of 2015-2021 was used for modeling and prediction, and the data from January to October in 2022 was used as a validation set to evaluate the prediction effectiveness. The monthly average PM2.5 concentrations in Shanghai from November to December in 2022 were predicted. Results Seasonal ARIMA model showed RMSE=4.02 and MAPE=15.50% in the validation set, while GM(1,1) model modified with seasonal factors showed RMSE=3.30 and MAPE=11.59%. GM(1,1) model modified with seasonal factors predicted the monthly average PM2.5 concentrations in Shanghai from November to December in 2022 to be 24.99 and 34.83μg/m3, respectively. Conclusion The prediction effect of GM(1,1) model modified with seasonal factors has better predictive performance than seasonal ARIMA model. The grey prediction model modified with seasonal factors can be considered when predicting seasonal time series such as the concentration of PM2.5.
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【Objective】 Based on Gene Expression Omnibus (GEO) database and The Cancer Genome Atlas (TCGA) database, survival analysis was used to screen the key prognostic genes involved of pancreatic cancer patients. 【Methods】 Two pancreatic cancer gene chips (Microarray) from the GEO database and transcriptome sequencing (RNA-seq) from the TCGA database were used to filter the survival-related genes using Kaplan-Meier (KM) analysis and Cox risk model, and the target genes were intersected. Prognosis-associated genes were screened first and then pathway enrichment analysis or immune-enrichment analysis was performed based on these genes to find out their potential molecular mechanisms in regulating pancreatic cancer. 【Results】 In this study, five survival-related genes (i.e., CDO1, DCBLD2, FAM83A, ITGA3 and SLC16A3) were screened out. Multifactorial Cox regression analysis and clinical correlation analysis showed that high CDO1 expression was a protective factor for pancreatic cancer prognosis, and its antitumor effect was associated with its role in inhibiting the malignant biological behavior of pancreatic cancer cells and promoting the infiltration of immune killer cells in pancreatic cancer. 【Conclusion】 This study suggests that CDO1 is a potential tumor suppress gene of pancreatic cancer, and the tumor inhibition effect of CDO1 may be related to its role in remodeling the immune microenvironment of pancreatic cancer.
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Objective:To evaluate the safety and efficacy of intra-arterial tirofiban infusion during endovascular reperfusion therapy in patients with acute cardiogenic cerebral embolism.Methods:Clinical data of 72 patients with acute cardiogenic cerebral embolism caused by large artery occlusion were retrospectively analyzed in Department of Neurology, Strategic Support Force Medical Center from August 2015 to August 2020.Among those, 52 patients were treated with intra-arterial tirofiban, the other 20 patients were treated with control medication. The baseline characteristics, modified thrombolysis in cerebral infarction (mTICI) score of responsible vessels, modified Rankin scale (mRS) score 90 days after operation, incidence of symptomatic intracranial hemorrhage and mortality were evaluated and compared in two groups.Results:The proportion of effective recanalization of the offending vessels (mTICI≥2b) in tirofiban group was higher than that in control group (92.3% vs. 75.0%), but the difference was not statistically significant ( P=0.104). At 90 days after operation, the rate of patients with good prognosis (mRS≤2) in tirofiban group (61.5%) was significantly higher than that in control group (35.0%) ( P<0.05). The incidence of symptomatic intracranial hemorrhage and mortality were comparable between the two groups ( P>0.05). Conclusion:Intra-arterial tirofiban infusion in patients with acute cardiogenic cerebral embolism is effective and feasible, which improves the prognosis without increasing the risk of intracranial bleeding complications.
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Objective:To analyze the epidemiological trends and major risk attribution of pancreatic cancer in China, Japan and South Korea from 1990 to 2019.Methods:The descriptive epidemiological method was conducted. The overall incidence rate, mortality rate, age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of pancreatic cancer in China, Japan and South Korea from 1990 to 2019 were collected from the Global Burden of Disease (GBD) Database. Age-standardized rates were calculated based on the worldwide standardized population structure provided by GBD Database 2019. Observation indicators: (1) incidence and motality of pancreatic cancer in China, Japan and South Korea in 2019; (2) age-period-cohort model analysis of incidence and mortality rates of pancreatic cancer in China, Japan and South Korea from 1990 to 2019; (3) trends of ASIR and ASMR of pancreatic cancer in China, Japan and South Korea from 1990 to 2019; (4) trends of major risk attribution of pancreatic cancer related death in China, Japan and South Korea from 1990 to 2019. Count data were represented as absolute numbers, percentages and ratios. Joinpoint V.4.7.0.0 software was used to calculate the annual percentage change (APC), the average annual percentage change (AAPC) of incidence and mortality rates of pancreatic cancer in different time periods and 95% confidence interval (95% CI). The age-period-cohort model in STATA V.15.0 software was used to analyze the influence of different ages, periods and birth cohorts on the risk of onset and death of pancreatic cancer after controlling the other two variables, with the risk effect size described as relative risk (95% CI). Results:(1) Incidence and motality of pancreatic cancer in China, Japan and South Korea in 2019. In 2019, the incidence rate of pancreatic cancer in China increased from 0.07/100,000 among 15-19 years old to 64.01/100,000 among 85-89 years old, with increasing from 0.09/100,000 to 94.71/100,000 in males and from 0.04/100,000 to 47.47/100,000 in females. The mortality rate of pancreatic cancer in China increased from 0.04/100,000 among 15-19 years old to 79.58/100,000 among 85-89 years old, with increasing from 0.05/100,000 to 116.50/100,000 in males and from 0.03/100,000 to 59.69/100,000 in females. The incidence rate of pancreatic cancer in Japan increased from 0.03/100,000 among 15-19 years old to 162.26/100,000 among 85-89 years old, with increasing from 0.03/100,000 to 177.67/100,000 in males and from 0.04/100,000 to 153.67/100,000 in females. The mortality rate of pancreatic cancer in Japan increased from 0.02/100,000 among 15-19 years old to 154.88/100,000 among 85-89 years old, with increasing from 0.02/100,000 to 170.93/100,000 in males and from 0.02/100,000 to 145.94/100,000 in females. The incidence rate of pancreatic cancer in South Korea increased from 0.04/100,000 among 15-19 years old to 136.78/100,000 among 85-89 years old, with increasing from 0.03/100,000 to 153.78/100,000 in males and from 0.04/100,000 to 129.73/100,000 in females. The mortality rate of pancreatic cancer in South Korea increased from 0.02/100,000 among 15-19 years old to 135.98/100,000 among 85-89 years old, with increasing from 0.02/100,000 to 156.21/100,000 in males and from 0.02/100,000 to 127.59/100,000 in females. The peak incidence and mortality of pancreatic cancer in China were found in males aged 65-69 years, and the overall incidence and mortality of males in different age groups were higher than those of females in the same age group. In Japan, the peak incidence of pancreatic cancer occurred in females aged 80-84 years and the peak mortality occurred in males aged 75-79 years. The morbidity and mortality of males aged <80 years were higher than those of females in the same age group, while the morbidity and mortality of males aged ≥80 years were lower than those of females in the same age group. In South Korea, the peak incidence of pancreatic cancer occurred in females aged 80-84 years, and the peak mortality occurred in males aged 70-74 years. The morbidity and mortality of males aged <75 years were higher than those of females in the same age group, while the morbidity and mortality of males aged ≥75 years were lower than those of females in the same age group. (2) Age-period-cohort model analysis of incidence and mortality rates of pancreatic cancer in China, Japan and South Korea from 1990 to 2019. Age effect: after adjustment for the period and cohort effects, the risk of incidence and mortality rates of pancreatic cancer in both males and females of China, Japan and South Korea increased with age, which is more obvious in females than males, and more obvious in Japanese than Chinese and Korean populations. Period effect: after adjustment for age and cohort effects, the risk of incidence and mortality rates of pancreatic cancer in both males and females of China, Japan and South Korea increased from 1990 to 2019, with the period effect more significant in the Chinese population. Cohort effect: after adjustment for age and period effects, the risk of morbidity and mortality rates of pancreatic cancer decreased with the passage of birth cohort in China, Japan and South Korea. (3) Trends of ASIR and ASMR of pancreatic cancer in China, Japan and South Korea from 1990 to 2019. The ASIR and ASMR of pancreatic cancer in China increased yearly from 1990 to 2019, and the ASIR and ASMR in 2019 were 1.82 times and 1.79 times those in 1990, respectively. The ASIR and ASMR of pancreatic cancer in Japan showed a slowly increasing trend, and the ASIR and ASMR in 2019 were 1.09 times and 1.05 times those in 1990, respectively. The ASIR and ASMR of pancreatic cancer in South Korea increased firstly, then decreased, and slowly increased. From 1990 to 2019, the AAPC of ASIR of pancreatic cancer in China was 2.08% (95% CI as 1.91% to 2.24%, P<0.05) and AAPC of ASMR was 2.02% (95% CI as 1.86% to 2.19%, P<0.05). The AAPC of ASIR of pancreatic cancer in Japan was 0.28% (95% CI as 0.15% to 0.42%, P<0.05) and AAPC of ASMR was 0.13% (95% CI as 0.03% to 0.24%, P<0.05). The AAPC of ASIR of pancreatic cancer in South Korea was 0.50% (95% CI as 0.21% to 0.80%, P<0.05) and AAPC of ASMR was 0.15% (95% CI as -0.10% to 0.40%, P>0.05). (4) Trends of major risk attribution of pancreatic cancer related death in China, Japan and South Korea from 1990 to 2019. The main risk factors for pancreatic cancer related death in China, Japan and South Korea from 1990 to 2019 were smoking, high fasting glucose and high body mass index (BMI). The trend of pancreatic cancer related death, mainly attributed to smoking, showed that the proportion of Chinese males increased from 31.4% in 1990 to 34.1% in 2000, then decreased to 31.1% in 2015, and then showed a slow increase to 31.7% in 2019. The proportion of Chinese females increased from 6.7% in 1990 to 10.4% in 2005 and then dropped to 8.7% in 2019. The proportion of Japanese males decreased from 38.8% in 1990 to 26.9% in 2019 and the proportion of Japanese females decreased from 20.9% in 1990 to 14.8% in 2019. The proportion of South Korean males decreased from 37.5% in 1990 to 30.3% in 2019 and the proportion of South Korean females decreased from 12.6% in 1990 to 10.0% in 2019. The trend of pancreatic cancer related death proportion, mainly attributed to high fasting blood glucose, showed that the proportion of Chinese males increased from 5.9% in 1990 to 7.1% in 2019 and the propor-tion of Chinese females increased from 6.2% in 1990 to 6.8% in 2019. The proportion of Japanese males increased from 7.0% in 1990 to 7.7% in 2019 and the proportion of females increased from 5.0% in 1990 to 5.5% in 2019. The proportion of South Korean males increased from 6.8% in 1990 to 9.7% in 2019 and the proportion of females increased from 6.1% in 1990 to 8.2% in 2019. The trend of pancreatic cancer related deaths proportion, attributed mainly to high BMI, showed that the proportion of Chinese males increased from 1.3% in 1990 to 3.0% in 2019 and the proportion of females increased from 2.1% in 1990 to 4.3% in 2019. The proportion of Japanese males increased from 2.0% in 1990 to 2.4% in 2019 and the proportion of females increased from 3.1% in 1990 to 3.4% in 2019. The proportion of South Korean males increased from 1.9% in 1990 to 3.1% in 2019 and the proportion of females increased from 3.4% in 1990 to 4.3% in 2019. Conclusions:The incidence of pancreatic cancer in China may continue to rise but to be stable in Japan and South Korea. The incidence of pancreatic cancer in females, especially elderly women, needs more attention. Smoking remains the most critical risk factor for pancreatic cancer. More attention should also be paid to the increased risk of pancreatic cancer associated with high BMI and high fasting plasma glucose.
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Whether in the West or the East, the connection between the ear and the rest of the body has been explored for a long time. Especially in the past century or more, the relevant theoretical and applied research on the ear has greatly promoted the development of ear therapy, and finally the concept of transcutaneous auricular vagus nerve stimulation (taVNS) has been proposed. The purpose of taVNS is to treat a disease non-invasively by applying electrical current to the cutaneous receptive field formed by the auricular branch of the vagus nerve in the outer ear. In the past two decades, taVNS has been a topic of basic, clinical, and transformation research. It has been applied as an alternative to drug treatment for a variety of diseases. Based on the rapid understanding of the application of taVNS to human health and disease, some limitations in the development of this field have also been gradually exposed. Here, we comprehensively review the origin and research status of the field.
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Objective To investigate the expression of MPZL1 in gastric cancer tissues, its relation with the prognosis, and its effects on proliferation and colony formation of gastric cancer. Methods GEPIA and UALCAN databases were used to analyze the expression of MPZL1 in various malignant tumors. The KM Plotter database and UALCAN database were used to analyze the effect of MPZL1 on the overall survival of gastric cancer patients. The expression of MPZL1 protein and the changes of apoptosis-related proteins in gastric cancer cells were detected by Western blot, and the effects of MPZL1 expression on cell proliferation and colony formation were detected by CCK-8 and colony formation assay, respectively. Results MPZL1 was found to be highly expressed in various malignant tumors by GEPIA database. The results of UALCAN and KM Plotter databases analysis showed that MPZL1 was highly expressed in gastric cancer tissues, and might be correlated with the overall survival of gastric cancer patients. The results of CCK-8 and colony formation assay showed that the overexpression of MPZL1 promoted the proliferation and colony formation ability of gastric cancer cells (P < 0.05). Western blot results showed that compared with control group, the expression levels of pro-apoptotic proteins Bad and Caspase-7 in the overexpression group were significantly lower while those in knockdown group were higher. Conclusion MPZL is highly expressed in gastric cancer tissues and promotes the proliferation and colony formation of gastric cancer cells, which may be related to the inhibition of apoptosis.
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Objective:To investigate the efficacy of arthroscopic debridement followed by imrecoxib combined with sodium aescinate application in the treatment of knee osteoarthritis.Methods:Ninety patients with knee osteoarthritis who received treatment in Lianshui County People's Hospital, China between February 2019 and February 2020 were included in this study. They were randomly assigned to receive imrecoxib treatment (control group A, n = 30), sodium aescinate treatment (control group B, n = 30) or imrecoxib combined with sodium aescinate treatment (observation group, n = 30). The clinical efficacy of different treatment strategies was compared. Results:Total effective rate in the observation group [93.33% (28/30)] was significantly higher than that in the control group A [70.0% (21/30)] and control group B [76.67% (23/30)] ( χ2 = 9.615, P < 0.05). In the observation group, postoperative pain and knee joint inflammation were more greatly mitigated, and knee joint function was better recovered compared with the control groups A and B ( F = 4.124, 3.895, 4.879, all P < 0.05). In the observation group, interlekin-1 level was significantly lower and interleukin-1β was significantly higher than those in the control groups A and B ( F = 3.423, 2.362, all P < 0.05). Conclusion:Arthroscopic debridement followed by imrecoxib combined with sodium aescinate application in the treatment of knee osteoarthritis has a positive effect on postoperative knee joint function recovery, comfort and reduction of inflammatory factors, which deserves clinical popularization.
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Objective@#To evaluate the status of dietary diversity and determinants among school age left behind children.@*Methods@#A total of 501 children aged 9-10 years in Sheyang Mini Cohort Study were enrolled from Sheyang City in Jiangsu Province during 2019. A questionnaires survey was administrated to collect left behind and socioeconomic information. Twenty four hour dietary recall survey was conducted, dietary diversity score (DDS 10 and DDS) and food variety score (FVS) were computed according to Food and Agriculture Organization (FAO). Weight and height of children were measured and sex and age standardized body mass index was used to define obesity. Multivariable regression models were preformed to explore the determinants of dietary diversity in school age left behind children.@*Results@#The proportion of left behind children was 40.9%. The mean value and standard deviation of three kinds of dietary diversity score (DDS 10 , DDS, FVS) in left behind children were (5.69±1.31)(6.55±1.44) and (13.48± 4.23 ), respectively. All of these were lower than that in non left behind children (DDS 10 :5.99±1.29; DDS:6.79±1.40; FVS:14.15±4.22). Significant difference in DDS 10 between left behind and non left behind children was observed ( P =0.01). The results of multivariable regression demonstrated that gender, passive smoking, family education level and family economic status were related to dietary diversity scores ( P <0.05).@*Conclusion@#Dietary diversity in school age left behind children was not optimistic and gender, passive smoking, parental education level, family economic status and left behind situation play a critical role in dietary diversity among these children.
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To improve the efficacy of 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy (PDT), a fluorocarbon microemulsion-based gel (FMBG) loaded with both 5-ALA and carbon dioxide (CO2) was prepared in this study. Its physical and chemical properties such as particle size, zeta potential, morphology, pH value and viscosity were characterized. Acid-base titration experiment was used to determine the CO2 loading, a fluorescence derivatization method was established to determine the content of 5-ALA, and the confocal laser scanning microscope and Franz diffusion cell method were carried out to investigate its transdermal ability. Through the laser speckle contrast imaging, the CO2-affected blood flow perfusion of skin was measured. Finally, the skin irritation test was tested by hematoxylin-eosin staining (H&E) method. These results showed that the prepared FMBG was a milky white gel, with an average particle size of 202.4 nm, a zeta potential of -25.3 mV, a pH of 6.0, and a viscosity of 1 062.0 mPa·s. It can be stored stably for seven days at room temperature. The 5-ALA content of FMBG was measured to be approximately equal to 20% (w/w). At room temperature and normal pressure, the CO2 loading content of FMBG was 5.016 mg·L-1, which was 1.5 times as much as that of water. The transdermal absorption experiment and blood perfusion results showed that the FMBG can effectively enable the transdermal delivery of 5-ALA and CO2, and significantly increased the blood perfusion of skin. H&E staining results indicated that FMBG had negligible skin irritation (all animal tests were approved by the Ethics Committee of 900 Hospital of the Joint Logistics Team). In this study, a safe and stable FMBG loaded with both 5-ALA and CO2 was successfully prepared. It was suitable for transdermal application, having the potential of enhancing the efficacy of 5-ALA-mediated PDT.
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Objective:To investigate the clinical efficacy of concurrent chemotherapy in intensity-modulated radiotherapy (IMRT) for patients with stage Ⅲ nasopharyngeal carcinoma (NPC).Methods:Clinical data of 251 patients with stage Ⅲ NPC treated with IMRT alone or concurrent chemoradiotherapy (CCRT) at Sun Yat-sen University Cancer Center from February 2001 to December 2008 were retrospectively analyzed. The prognostic factors of NPC were analyzed and the efficacy of CCRT was assessed. The survival rate was calculated by Kaplan-Meier method. The differences between two groups were analyzed by log-rank test. The prognostic factors were analyzed by Cox model.Results:The 10-year locoregional-free survival (LRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) for NPC patients were 88.6%, 81.1%, 68.8% and 75.1%, respectively. Univariate and multivariate analyses demonstrated that N staging and nasopharyngeal tumor volume were the most important prognostic factors, and concurrent chemotherapy significantly improved PFS and OS (both P<0.05). In T 3N 0-1 patients, there was no significant difference in survival indexes between IMRT alone and CCRT (10y-LRFS: 93.8% vs. 93.2%, P=0.933; 10y-DMFS: 80.9% vs. 86.8%, P=0.385; 10y-PFS: 70.6% vs. 77.7%, P=0.513; 10y-OS: 71.8% vs. 83.6%, P=0.207). For T 1-3N 2 patients, CCRT was significantly better than radiotherapy alone in LRFS, PFS, and OS (10y-LRFS: 87.3% vs. 66.7%, P=0.016; 10y-PFS: 70.2% vs. 41.0%, P=0.003; 10y-OS: 78.5% vs. 51.7%, P=0.008), whereas there was an increasing trend in DMFS (10y-DMFS: 80.3% vs. 66.4%, P=0.103). Conclusions:Concurrent chemotherapy can improve clinical prognosis of stage Ⅲ NPC patients, and the most survival benefits are obtained in the N 2 group. Individualized treatment options should be delivered based on the risk of treatment failure.
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Objective:To investigate whether the deficiency of death associated protein kinases (DAPK) 3 can reduce vascular calcification by inhibiting endoplasmic reticulum stress.Methods:The method of prospective cohort study was used to observe and analyze the cell culture in vitro.Human aortic vascular smooth muscle cells (VSMC) were cultured in F10K Kaighn′s modified medium, and divided into calcified group and non-calcified group according to whether β-phosphoglycerin (10 mmol/L) was added into the medium.The cells in calcified group and non calcified group were divided into DAPK3 inhibition group and its control group, endoplasmic reticulum stress inhibition group and its control group, mitogen-activated protein kinase (MAPK) activation group and its control group, DAPK3 inhibition + AMP-activated protein kinase (AMPK) inhibition and blank control group, respectively. DAPK3 mRNA and protein concentration, calcium content, alkaline phosphatase, protein concentration of VSMC differentiation marker genes (SM22α, α-SMA), osteogenic differentiation transcription factor (Runχ2, bone morphogenetic protein-2, BMP-2), endoplasmic reticulum stress markers (AFT4, GRP78, GRP94 and CHOP) and p-PAMK protein expression were measured.Results:The mRNA level(highest value was 15.24±0.72 on the 14th day ) and protein level(highest value was 11.31±0.38 on the 14th day) of DAPK3 were significantly higher than those in non calcified cells(5.63±0.62, 2.59±0.33, respectively). The difference was statistically significant ( P< 0.001). In the calcified cells, calcium content (86.54±8.21) mmol/g in dapk3 deficient group was significantly lower than that in control group (194.63±8.54) mmol/g ( t=22.35, P<0.001), alkaline phosphatase activity was significantly decreased((96.27±10.28) IU/g vs.(224.67±10.94) IU/g, t=20.951, P<0.001), the expression of the VSMC differentiation marker genes (SM22α, α-SMA) were upregulated significantly (SM22α: (0.82±0.14) vs.(0.44±0.13), t=4.872, P=0.001; α-SMA: (0.95±0.18) vs.(0.56±0.13), t=4.303, P=0.002), the level of bone differentiation transcription factor (Runχ 2, BMP2) was significantly decreased (Runχ 2: (1.12±0.28) vs.(2.21±0.35), t=5.957, P<0.001; BMP2: (0.82±0.12 ) vs.(1.26±0.16), t=5.39, P<0.001), MAPK level was up-regulated (DAPK3 inhibited group 0.74±0.12 of calcified cells, 1.04±0.14 of non calcified cells, higher than the control group 0.44±0.10 of calcified cells, 0.78±0.12 of non calcified cells, t=4.704, P=0.001; t=3.454, P=0.006), and the inhibited calcium content of ESR calcified cells significantly reduced (after inhibition of AMPK pathway, cells transfected with shRNA group 150.21±11.98, cells transfected with shRNA group 83.21±12.12 were lower than those transfection blank control group 164.82±12.34, P<0.001). The activity of alkaline phosphatase was significantly reduced (226.54±16.57) IU/g protein in the shRNA group and (112.34±15.96) IU/g protein in the shRNA group were significantly lower than 242.32±16.32 in the blank control group, P<0.001); calcium content and ALP activity in the calcified MAPK cells were significantly reduced ( P<0.001). Conclusion:DAPK3 deficiency can inhibit endoplasmic reticulum stress through AMPK signaling pathway to slow down VSMC calcification.
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BACKGROUND: The biomechanical characteristics of knee meniscus have been studied extensively at home and abroad, but most of them focus on the knee flexion motion. The finite element analysis of biomechanics of knee joint meniscus under the complete gait cycle is not yet perfect. OBJECTIVE: To understand the mechanism of biomechanical changes after meniscus injury in the complete gait cycle by comparing the lateral meniscus tear model with the healthy meniscus model. METHODS: Based on the CT scan data of healthy adult knee joints, a finite element model of healthy knee joint including tibia, meniscus and articular cartilage was established. The lateral meniscus tear of knee joint was constructed based on the healthy model. The biomechanical mechanism of lateral meniscus tear in the knee during complete gait cycle was explored and compared with the healthy knee model. RESULTS AND CONCLUSION: (1) The instantaneous stress variation of the tibia cartilage during the complete gait cycle was consistent in both models. The tibial cartilage stress at each instant in the meniscus tear model was higher than that of the healthy meniscus model. The maximum stress values of tibia cartilage in the meniscus tear model and the healthy meniscus model was 30 and 20.5 MPa. (2) The instantaneous stress variation of the meniscus during the complete gait cycle was consistent in both models. The meniscus stress at each instant in the meniscus tear model was higher than that of the healthy meniscus model. The maximum stress values of meniscus in the meniscus tear model and the healthy meniscus model was 69.8 and 41.3 MPa. (3) In the first 60% of the gait cycle, the maximum stress distribution of the tibia cartilage in the meniscus tear model was much larger than that in the healthy model, and as the gait cycle grew, the contact range gradually spread to the outer edge of the cartilage. After 60% of the gait cycle, the stress on the tibia cartilage was small, and the distribution range of the maximum stress was also small. (4) The stress distribution of the healthy medial meniscus was basically the same in the two models, while the maximum stress distribution of the torn outer meniscus was wider than that of the healthy medial meniscus. A more severe stress concentration phenomenon occurred around the crack, and with the gait cycle, the stress concentration area gradually shifted toward the crack near the anterior corner of the meniscus. (5) These results suggest that the meniscus is an important load-bearing component in human knee joint. From the perspective of biomechanics, the hazard of the meniscus injury on the human knee joint can be observed more intuitively.
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Telocytes are novel interstitial cells with a specific structure:the body has an elliptical shape or a triangle shape,with slender and thin protrusions that connect with other cells to form a complex 3D network.This article summarizes the structural characteristics and identification Methods of Telocytes and demonstrates their potential functions as a new target for disease prevention and treatment.
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TelocytesABSTRACT
Objective: To observe the clinical efficacy of intradermal needle therapy for urinary retention after cervical cancer surgery. Methods: A total of 100 patients with urinary retention after cervical cancer surgery were randomized into a control group and an observation group, with 50 cases in each group. The control group was treated with basic nursing only, and the observation group was treated with additional intradermal needle therapy. Both groups were treated for 2 courses of treatment. The main symptom scores and residual urine volume of the two groups were observed before and after treatment, and the inpatient time, catheter indwelling time and the clinical efficacy were compared between the two groups. Results: The total effective rate was 96.0％ in the observation group and 88.0％ in the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the main symptom scores and residual urine volume in both groups decreased significantly (all P<0.05), and the scores and residual urine volume in the observation group were significantly lower than those in the control group (all P<0.05). The inpatient time and catheter indwelling time in the observation group were significantly shorter than those in the control group (both P<0.05). Conclusion: Intradermal needle therapy has an obvious effect in improving symptoms of urinary retention after cervical cancer surgery, and the effect is significantly more persistent than that of simple basic nursing.
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Objective:To review experience on the diagnosis and treatment of patients with pancreatic injury.Methods:There were 65 patients with pancreatic injuries who were managed in the First Affiliated Hospital of Xi’an Jiaotong University between January 1995 and December 2017. After excluding 6 patients with inadequate data and 4 patients with other associated injuries, the remaining 55 patients were enrolled in this retrospective study. All data, including the type of abdominal trauma, general information of patients, clinical manifestations, methods of diagnosis, treatment, operation and complication were collected and analysed. Analyze the cause, degree of injury, treatment measures, treatment results and complications of patients with pancreatic injury.Results:The most common cause of pancreatic injury was traffic accidents (23 patients, 41.8%), with a correct preoperative diagnostic rate of 61.8% for pancreatic injury. Compute tomography (CT) had a significantly higher sensitivity than sonography (80% vs. 37.5%, P<0.05). The number of patients with grade I-V pancreatic injury were 7, 19, 24, 1 and 4, respectively. Sixteen patients were successfully managed by conservative treatment, and 39 patients underwent various surgeries depending on the injury grade. Significantly more patients having severe grades (III-V) underwent surgical treatment than those having mild grades (I-II) (53.8% vs. 86.2%, P<0.05). Two patients died after surgery (mortality rate 5.1%, 2/39). Pancreatic fistula developed in 29 patients (74.4%), intra-abdominal infection in 10 patients (25.6%) and these were the main surgical complications. Patients having severe grades had a significantly higher pancreatic fistula rate than those having mild grades. Pancreatic pseudocyst was the most common complication on long-term follow-up (8 patients, 14.5%). This complication was significantly higher in patients who were managed with consecutive treatment than with operation (31.2% vs. 7.7%, P<0.05). Conclusions:The preoperative diagnosis of pancreatic injury was difficult, and CT should be the first line investigation. Grade I -II injuries could be managed by conservative treatment, while grade III-V should be treated by operations. The most common short- and long-term complications of pancreatic injury were pancreatic fistula and pancreatic pseudocyst, respectively.
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Objective@#To evaluate the efficacy of low resistance thought induction psychotherapy (TIP) technique combined with acupuncture and oral Chinese medicine in treating chronic insomnia elderly patients with syndrome of heart-kidney imbalance.@*Methods@#One hundred sixty-four chronic insomnia patients with syndrome of heart-kidney imbalance were randomly divided into four groups with 41 cases in each group. The control group was treated with family doctor contract, sleep health education and Tianwang-Buxin decoction as the basic treatment, the group A was treated with acupuncture and the basic treatment, the group B was treated with TIP technique and the basic treatment, the group C was treated with the combination of acupuncture and TIP on the basic treatment. After one month' treatment, scores of Pittsburgh sleep quality index (PSQI) were used to evaluate sleep quality, sleep efficiency, and the clinical efficacy.@*Results@#After treatment, scores of sleep time, sleep efficiency, sleep time, sleep disturbance, daytime function of the group A, B, and C were significantly lower than those in the control group (F value were 44.322, 92.808, 107.131, 79.467, 98.638 respectively, all Ps<0.001), and the group C were significantly lower than those of the test group A and B (P<0.01). Scores of upset, dizziness, tinnitus, hot flashes, and night sweats, hand foot and heart fever, forgetfulness, sores on the tongue and dry stool of the group A, B, and C were significantly lower than those of the control group (F value were 103.32, 135.91, 93.35, 77.61, 57.514, 92.283, 126.097, 53.217, respectively, all Ps<0.001), and the group C were significantly lower than those of the test group A and B (P<0.01). The total clinical efficacy of TCM syndrome and insomnia in group A,B and C was significantly higher than that in the control group (χ2=16.169, P<0.01), and the group C was significantly higher than the group A and B (χ2=8.504, P<0.01). The total clinical efficacy of sleep efficiency in group A, B and C was significantly higher than that in the control group (χ2=14.078, P<0.01), and the group C was significantly higher than the group A and B (χ2=8.856, P<0.01).@*Conclusions@#TIP technique combined with acupuncture and oral Chinese medicine can improve sleep quality of chronic insomnia elderly patients with syndrome of heart-kidney imbalance.
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Objective: To measure the distance of the lateral, inferior, and superior microfoci from a gross tumor in a pathological speci-men and to provide scientific evidence for margin extension to form the clinical target volume (CTV) in high-dose radiotherapy for rec-tal cancer. Methods: Twenty-eight surgical specimens were collected from patients with rectal cancer who underwent total mesorectal excision (TME) in Hunan Cancer Hospital between October 2016 and April 2017. The nearest distance of the farthest peripheral micro-foci from the gross tumor was measured. The in vivo-in vitro tumor retraction factor (R1) was calculated by measuring the ratio of the tumor's perpendicular depth based on magnetic resonance imaging and immediate surgical specimens. The retraction factor (R2) in the process of pathological specimen makeup was calculated by knot labeling. The distance of microfoci extension was calculated based on that measured in pathological specimens including corrections with R1 and R2 and record as microcarcinoma extension mea-sured in vivo,MEin vivo. Results: Among the 28 pathological specimens, lateral, inferior, and superior microfoci were found in 17 (60.7%), 3 (10.7%), and 0 cases, respectively. The mean R1 was 0.913 and mean R2 was 0.803. The farthest distance measured inferiorly was 28 mm in vivo after correction. The maximum, minimum, and mean measured lateral distances were 12.03 mm, 3.03 mm, and 7.50 mm after correction, respectively. The 95% frequency value was within 10 mm. Conclusions: The lateral microfoci extension was within 10 mm for 95% of the rectal cancer patients. The margin expansion to form the CTV was suggested to be 10 mm for a late-course boost of high-dose radiotherapy for rectal cancer.
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OBJECTIVE@#To compare the efficacy difference between thumb-tack acupuncture with surrounding needling method plus medication and medication alone for herpes zoster (HZ) of stagnated heat in liver meridian type.@*METHODS@#According to random number table method, 60 patients with HZ of stagnated heat in liver meridian type were randomly divided into an observation group and a control group, 30 cases in each one. All the patients were treated with oral valaciclovir hydrochloride dispersible tablets (0.3 g per time, twice per day), mecobalamin tablets (0.5 mg per time, three times a day) and vitamin B (10 mg per time, three times a day) for 15 days. In addition, the patients in the observation group were treated with thumb-tack acupuncture at area 1 cm outside the herpes, with an interval of 3 cm between thumb-tack needles. The thumb-tack acupuncture was given once every 3 days, retained for 48 h, with an interval of 1 day between treatments, and totally 5 treatments were given. The index of herpetic evaluation (stopping time of herpes, scarring time, decrustation time), visual analogue scale (VAS), serum immune-related factors (IgG, IgM, IgA) and serum inflammatory factors (IL-4, IL-17, TNF-α, TGF-β1) were observed before and after treatment in the two groups.@*RESULTS@#After treatment, the stopping time of herpes, scarring time, decrustation time in the observation group were shorter than those in the control group (all 0.05), but the difference before and after treatment in the observation group was superior to that in the control group (<0.05). Compared before treatment, the levels of serum immune-related factors IgG, IgM, IgA were increased in the two groups after treatment (all <0.05), and the levels in the observation group after treatment were higher than those in the control group (all <0.05). Compared before treatment, the levels of serum inflammatory factors IL-4, IL-17, TNF-α, TGF-β1 were reduced in the two groups after treatment (all <0.05), and the levels in the observation group after treatment were lower than those in the control group (all <0.05).@*CONCLUSION@#The thumb-tack acupuncture with surrounding needling method plus medication have the advantages of rapid onset and analgesic effect for HZ of stagnated heat in liver meridian type, which could also improve serum immune-related factors and reduce inflammatory reaction.