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Objective:To establish the normal reference value of left ventricular function parameters by cadmium-zinc-tellurium (CZT) SPECT stress gated myocardial perfusion imaging (G-MPI) in low-likelihood of stable coronary artery disease (SCAD).Methods:From March 2022 to August 2022, 348 consecutive SCAD patients (146 males, 202 females, age (58±10) years) who underwent exercise or pharmacological stress G-MPI (CZT SPECT) in Beijing Anzhen Hospital, Capital Medical University were retrospectively recruited. Left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), and left ventricular ejection fraction (LVEF) were acquired using quantitative gated SPECT (QGS) analysis. EDV and ESV were corrected by body surface area (BSA) to obtain EDV index (EDVI) and ESV index (ESVI), respectively. Independent-sample t test, one-way analysis of variance and Mann-Whitney U test were used for data analysis. The influences of EDV, ESV, EDVI, ESVI and LVEF were analyzed by multiple regressions for linear models. Results:There were 314 patients with low-likelihood of SCAD (128 males, 186 females, age (58±10) years) and 34 normal controls (18 males, 16 females, age (55±10) years). There were no significant differences of basic clinical characteristics and left ventricular function parameters in different genders between 2 groups ( z values: from -1.74 to -0.02, t values: from -1.16 to 1.17, all P>0.05). Using the 95% CI as the cut-off value for left ventricular function parameters in patients with a low-likelihood of SCAD, the upper limits of EDV, ESV, EDVI and ESVI in females and males were 84 and 111 ml, 30 and 44 ml, 47 and 54 ml/m 2, 17 and 21 ml/m 2, respectively, and the lower limit of LVEF in females and males were 58% and 55%, respectively. In the low-likelihood of SCAD group, the EDV ((58±13) vs (77±17) ml) and ESV ((16±7) vs (26±9) ml) of females were smaller than those of males ( t values: 10.65, 10.35, both P<0.001), while LVEF of females was higher than that of males ((72±7)% vs (67±6)%; t=-6.23, P<0.001). However, there were no significant differences in left ventricular function parameters among different age groups with the same gender ( F values: 0.12-2.19, all P>0.05). Based on multiple regression for linear models, the primary predictors of EDV, ESV and LVEF were gender and weight ( β values: from -0.380 to 0.358, all P<0.05). Conclusions:Normal reference values of left ventricular function parameters are established by CZT SPECT stress G-MPI in low-likelihood of SCAD patients. Left ventricular EDV and ESV of females are smaller than those of males, while LVEF of females is higher than that of males. The influence of gender on left ventricular function parameters should be considered in clinical practice.
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Liver diseases are common in China and the incidence and mortality of primary liver cancer are among the top in the world. As one of the therapeutic methods for hepatocellular carcinoma (HCC), liver transplantation has become an important technique in hepatic surgery. Most of patients with HCC have progressed to stage B or C of Barcelona Clinic Liver Cancer staging when diagnosed. How to reduce the dropout rate of HCC patients due to the progression of tumor when waiting for liver transplantation, develop individualized immunosuppressant plans for HCC patients after liver transplantation, and accurately manage patients with HCC recurrence after liver transplan-tation are the current hotspots of research. The authors review the relevant literature, summarize the treatment experience, and discuss the hot issues in liver transplantation for HCC, in order to provide reference for related treatment.
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【Objective】 To investigate the HIV infection among voluntary blood donors in Jinhua area through the analysis of HIV antibody detection and confirmation results, so as to guarantee the safety of clinical blood use. 【Methods】 419 823 samples of voluntary blood donors in Jinhua Central Blood Station from 2013 to 2020 were detedcted for HIV twice. Samples reactive with one assay were double-well retested. Samples initially reactive with two assays or positive with one retest assay were subjected to the CDC for confirmatory test. The HIV antibody infection and epidemiological characteristics of voluntary blood donors were retrospectively analyzed. 【Results】 A total of 419 823 samples of blood donors were dectected, among which 335 were reactive for HIV screening, 48 confirmed positive, with the positive rate at 0.11‰(48/419 823), of which 31 were registered residence in Jinhua and 17 in other places; 46 males and 2 females; 35~45 years old accounted for 28.23%; freelancers 43.61%; coinfection 4.16%.The positive rates differed significantly by gender (male 0.18 ‰ vs female 0.01 ‰, P0.05). 【Conclusion】 The positive rate of HIV antibody in Jinhua area was lower than that in other areas. Blood stations should continue to carry out ELISA and NAT, strengthen the publicity and education of AIDS prevention and control, and ensure the safety and effectiveness of clinical blood use.
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With the development of laparoscopic technology and the accumulation of experience, total laparoscopic total gastrectomy has been gradually popularized and applied. Among them, laparoscopic esophagojejunostomy is the biggest challenge in this surgery because of its high difficulty. More and more surgeons have been trying to find a more feasible anastomosis method. So far, there have been many kinds of esophagojejunostomy, and they are constantly being improved. The purpose of this article is to review the technical tips and pitfalls of common laparoscopic esophagojejunostomy.
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Objective To investigate the prognostic value between gastric cancer and esophageal adenocarcinoma staging system from International Union Against Cancer (UICC) / American Joint Committee on Cancer (AJCC) 8th edition in treatment of the patients with advanced Siewert type Ⅱ adenocarcinomas of esophagogastric junction (AEG) in China. Methods A total of 67 patients who were pathologically diagnosed as pT3-pT4 Siewert type Ⅱ AEG in Shanxi Provincial Cancer Hospital from November 2012 to September 2013 were enrolled. The stage distribution and survival of the patients in two staging systems were compared. The homogeneity and discriminative power of the two staging systems were compared by using likelihood ratio chi-square test and linear trend chi-square test. Log likelihood and C-index were used to evaluate the prognostic value of the two staging systems. Results The stage distribution in gastric cancer staging system of 67 patients was ⅡA (16.4％), ⅡB (14.9％), ⅢA (31.3％), ⅢB (34.3％), ⅢC (3.0％), and 5-year survival rates ofⅡA, ⅡB, ⅢA, ⅢB were 81.8％, 70.0％, 39.1％ and 36.6％, respectively (χ2= 8.221, P= 0.042); the stage distribution of esophageal adenocarcinoma staging system was ⅡB (22.4％), ⅢB (40.3％) and ⅣA (37.3％), and 5-year survival rates were 80.0％, 43.7％and 40.0％, respectively (χ2=7.671, P=0.022). The likelihood ratio chi-square value and linear trend chi-square value of the gastric cancer classification system were more than those of esophageal adenocarcinoma staging system (7.855 vs. 6.692, 6.051 vs. 5.351), and Log likelihood estimation value of the gastric cancer classification system was less than that of esophageal adenocarcinoma classification system (241.324 vs. 242.045), and C index of the gastric cancer classification system was more than that of esophageal adenocarcinoma staging system (0.7289 vs. 0.7215). Conclusion UICC/AJCC 8th edition gastric cancer TNM staging system is superior to esophageal adenocarcinoma TNM staging system in predicting the prognosis of advanced Siewert typeⅡAEG.
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Objective To investigate the effect of Shenqi-Tongmai decoction in Stable Angina pectoris Patients with Qi-deficiency-blood-stasis syndrome and the influence on serum associated adhesion factors. Methods A total of 110 patients with stable angina pectoris treated in the department of cardiology of traditional Chinese medicine hospital of Xinle city from Feb. 2015 to Feb. 2017 were divided into 2 groups according to the number random table method, with 55 in each group. All the patients were given the standardized treatment with western medicine, and the treatment group were aditionally treated with the Shenqi-Tongmai decoction. All the patients were treated for a course of 4 weeks. The TCM syndrome score, Seattle angina questionnaire (SAQ) score, electrocardiographic examination index and serum soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1) level of the two groups before and after treatment were compared, and the clinical curative effect of the two groups was compared. Results The TCM syndrome score (7.1 ± 2.2 vs. 11.4 ± 3.0, t=8.590), serum sICAM-1 (227.69 ± 42.81 ng/ml vs. 275.33 ± 48.62 ng/ml, t=5.454) level, serum sVCAM-1 (272.04 ± 39.87 ng/ml vs. 296.58 ± 42.60 ng/ml, t=3.127) level and lead ecg ST segment down number (2.7 ± 0.6 vs. 3.2 ± 0.6, t=4.067), T wave of low lead numbers (1.7 ± 0.3 vs. 2.1 ± 0.3, t=6.807), numbers of T wave inversion lead (1.7 ± 0.3 vs. 2.1 ± 0.2, t=9.908) of the treatment group were significantly lower than those of the control group (P<0.01). The SAQ scores (76.8 ± 10.5 vs. 67.4 ± 10.1, t=4.805) was higher than that of the control group (P<0.01). The curative effect of angina pectoris and electrocardiogram of the treatment group were 91.0% (50/55) and 92.7%(51/55), and the control group were 76.4% (42/55) and 78.2% (43/55). The difference was statistically significant between the two groups (χ2=4.251, 4.681, P<0.05). Conclusions Traditional Chinese medicine Shenqi-Tongmai decoction can effectively improve the SAQ scores and TCM syndrome score and electrocardiogram examination index, improve the clinical curative effect in the treatment of Stable Angina pectoris based on the western medicine (Qi-deficiency-blood-stasis syndrome) and its mechanism may be related to improving of the serum levels of sICAM 1, sVCAM 1.
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Objective To investigate the clinical value of multi-slice spiral CT (MSCT)in the diagnosis of focal pulmonary ground-glass opacity nodules(fGGO)of 1 cm or less.Methods The MSCT examination data of 95 patients with subcentimeter fGGO was analyzed and compared with pathology results.The different pathological types of fGGP lesion size,internal solid component size,mixed type ground glass nodules (mGGO)proportion and pleural sag,lesion shape,grave leaves,burr,cavitation and the boundary conditions were compared. According to the relationship of the lesions and the surrounding blood vessels,3 types were classified,and the relationship of fGGO and blood vessel were analyzed.Results The minimal lesion was 0.41 cm of 95 cases and the maximum was 0.99 cm.There was statistically signifi-cant difference in the lesion size,solid component sizes,mGGO and lobulation occupied the percentage of the group before infiltrating and the adenocarcinoma group (P 0.05).The difference was statistically significant in the leaflet occupied the percentage of the benign group com-pared with the adenocarcinoma group,and the differences of the remaining features were not statistically significant compared with the adeno-carcinoma group(P >0.05).According to the relstionship between fGGO and the vessels,patients in the benign group were type Ⅰ or typeⅡ,type Ⅲ was found in 10 cases of the group before infiltrating (25.6%),and type Ⅲ in 17 cases of the adenocarcinoma group (39.5%), the proportion of type Ⅲ of the group before infiltrating and the adenocarcinoma group was higher than that of the benign group (P <0.05). Conclusion The qualitative diagnosis of pulmonary fGGO is difficult,and the relationship between the morphology of the lesions under the MSCT and the surrounding vessels have some value for the diagnosis of the lesions.
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Objective To investigate the effects of transarterial chemoembolization (TACE)treatment interval on the prognosis of patients with advanced hepatocellular caisinoma(HCC).Methods We retrospectively collected clinical data of 123 advanced HCC patients treated with repeated TACE.The patients were divided into two groups (group A with fixed repeated treatment interval and group B with that according to the clinical needs).Cox regression,survival curve and log-rank test were used to assess the effects of the treat-ment intervals on prognosis.Results The treatment intervals of the group A and group B were (1.1±0.3)months and (3.0±1.5) months,respectively (P <0.001).Multivariate Cox analysis showed the efficacy (P =0.024)and repetition periods (P <0.001 ) were independent prognostic factors.Conclusion TACE interval is independent risk factor for the prognosis of patients with ad-vanced HCC.Repeated TACE treatment according to clinical needs may be more favorable for prognosis of the patients.
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Objective To evaluate the differential diagnosis value of enhanced multi-slice spiral CT (MSCT) scan on adrenal adenoma and metastases in patients with malignant tumor.Methods Thirty-nine malignant tumor patients complicated with adrenal nodules were chosen, and all patients underwent MSCT plain scan and enhanced scan.Features of adrenal adenomas and metastases of MSCT enhanced were analyzed.Results Forty-nine adrenal gland nodules were found in 39 patients, and 35 adrenal metastasis were found in 25 patients.They were shown quasi-circular, oval or irregular shaped nodules.The average diameter was (2.6 ± 0.7) cm.Part of them were uneven density, and the CT value of the solid part was (32.8 ± 6.1) Hu.The solid part of tumor in enhancement scanning arterial phase was underwent mild to moderate strengthening, and the CT value was (49.5 ±6.9)Hu.The solid part of tumor was underwent further strengthen scanning in the venous phase, and the CT value was (74.9 ±8.0)Hu.The average CT value of solid part in after 3 min scanning tumor was (72.4 ± 7.6) Hu.Fourteen adrenal adenomas were found in 14 patients.CT value was (19.6 ± 4.5) Hu, and tumor diameter was (1.8 ± 0.4) cm.Enhanced scanning the tumors showed mild to moderate homogeneous enhancement in arterial phase, the CT value was (43.8 ± 8.1) Hu.Venous phase enhanced obviously, the average of CT value was (67.7 ±9.2)Hu.The strong degree in the delay period was decreased significantly, the average value of CT was (55.9 ± 8.8) Hu.The adrenal metastasis tumor diameter (t =4.006, P ＜ 0.001), CT value of plain scan (t =7.320, P ＜ 0.001), CT value of arterial phase enhanced scan (t =2.486, P =0.017) , venous phase enhanced scan (t =2.727, P =0.009) and CT value of the delay period (t =6.653, P ＜ 0.001) were higher than those in adrenal adenoma.Conclusion Enhanced MSCT scan can reflect the hemodynamic changes of adrenal lesions, and provide the bases for the differential diagnosis of enhanced MSCT scan on adrenal adenoma and metastases in patients with malignant tumor.
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Objective To assess the association between polymorphisms in HIF1α gene and prognosis of advanced hepatocelluar carcinoma.Methods We collected prognosis data from a cohort of 448 advanced HCC patients treated by transarterial chemoembo-lisation,and used 5ml peripheral blood from patients for extraction DNA.Three SNPs (rs2301 1 13、rs2057482 and rs1 957757 )in HIF1αgene were selected and genotyped.Multivariate Cox proportional hazards model,Kaplan-Meier curve and log-rank test were used for prognosis analyses.Results The variant-containing genotypes (WV+VV)of SNP rs2301 1 13 exhibited a significant associ-ation with a better overall survival in HCC patients who had tumor size smaller than 5 cm (hazard ratio [HR],0.58,95% confidence interval [CI],0.35-0.96,P =0.036).In the patients taken single tumor subgroup,the variant-containing genotypes (WV+VV) of SNP rs2301 1 13 exhibited a significant association with a better overall survival (log-rank P =0.048),comparing to those carrying wild-type genotype.Conclusion Our results suggest that polymorphisms in HIF1αgene may serve as an independent prognosis bio-marker for advanced HCC patient.
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Thrombosis disease is a common complication of cancer. Researches show that venous thromboembelism ( VTE ) can increase the mortality rate of patients with cancer.Tissue factor (TF) and cancer procoagulant (CP) and other pathological factors are related to VTE.VTE risk factors in cancer patients can be grouped into 3 general categories:patient-related factors,cancer-related factors and treatment-related factors.Assessment of risk factors and early prevention can reduce the incidence of VTE.Immediate treatment and chronic therapy should be performed immediately after the diagnosis of VTE.
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Objective To explore the change and its clinical significance of neuron-specific enolase (NSE) and S-100? in serum and hippocampus tissue in rats with epilepsy induced by Kainic acid (KA).Methods 180 Wistar rats were randomly classified into control, KA and carbamazepine (CBZ) group, and the later two groups were further divided into 6 sub-groups (1 h, 4 h, 12 h, 24 h, 48 h and 72 h ) according to epileptic attack at different time point. The NSE and S-100? concentrations in serum and homogenate of hippocampus were determined by radioimmunity assay (RIA) and enzyme linked immunosorbent assay (ELISA), respectively.Results The concentrations of NSE and S-100? were dynamic change during 72 h after epileptic attack in serum and hippocampus homogenate, and the changes were synchronous. The concentrations reached peak at 12 h. Both NSE and S-100? concentrations in KA and CBZ group were obviously higher than those in control group ( P
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Objective To study genomic polymorphic DNA and genetic distance of 7 species of ticks.\ Methods\ Ticks used in this study were Dermacentor nuttalli, D.silvarum, Haemaphysalis qinghaiensis, H.formosensis, H.punctata, Amblyomma testudinarium, and Ixodes ovatus. DNA extracts of the 7 species of ticks were amplified by random amplified polymorphic DNA (RAPD) and PCR technique using 5 primers with different arbitrary single chain polynucleotide sequences. DNA fingerprint maps were analyzed and the genetic distance among 7 species of ticks were counted. \ Results \ The amplified products of the 7 species of ticks by RAPD all showed their specific DNA band. The average genetic distance among them was 0^71. Conclusion RAPD can differentiate the 7 species of ticks.