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OBJECTIVE To observe the clinical efficacy and safety of albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy followed by concurrent radiochemotherapy in the treatment of loco-regionally advanced nasopharyngeal carcinoma. METHODS The clinical data of 45 patients （observation group ） with loco-regionally advanced nasopharyngeal carcinoma（Ⅲ/Ⅳa stage ）who received albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy in our hospital from August 2017 to July 2018 were retrospectively analyzed. Propensity score was used to match 45 patients（control group ）with loco-regionally advanced nasopharyngeal carcinoma who received docetaxel combined with cisplatin and fluorouracil inductive chemotherapy. After inductive chemotherapy ，both groups received intensity-modulated radiochemotherapy （IMRT）；observation group was additionally given concurrent nedaplatin chemotherapy ，and control groups was given concurrent cisplatin chemotherapy. Clinical efficacy and the incidence of ADR were compared between 2 groups. RESULTS All patients completed treatment and 3-year follow-up. After inductive chemotherapy and 1，3 months after concurrent radiochemotherapy ，there was no statistical significance in short-term response between 2 groups（P＞0.05）. There was no significantly difference in 3-years local control rate and 3-years free from distant metastasis between 2 groups（P＞0.05）. The incidences of leucopenia （grade 3 or above ）in the observation group were significantly lower than those in the control group ，and the incidence of peripheral neuropathy in observation group was higher than that in control group （P＜0.05）. The incidences of thrombocytopenia （grade 2 or above ），rash and vomiting （grade 2 or above ）in the observation group were lower than those in the control group ，but the difference was not statistically significant （P＞0.05）. There was no significant difference in the incidence of other ADR between 2 groups（P＞0.05）. CONCLUSIONS Albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy followed by concurrent chemoradiotherapy in the treatment of loco-regionally advanced nasopharyngeal carcinoma is effective and tolerable ．
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This study analyzed the characteristics and change trend of Guangzhou citizens' demands related to vaccination through government hotlines 12345 and 12320 from 2018 to 2020. It understood the hotspots and needs of the public for vaccination work, analyzed the problems existing in vaccination work, and provided reference and suggestions for health departments to improve vaccination services and formulate relevant policies: to timely improve the professional ability and knowledge reserve of hotline personnel; to strengthen the construction of vaccination service system;to optimize the appointment vaccination service application; to scientifically purchase HPV vaccine and ensure the production and supply of vaccine.
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Government , Hotlines , Humans , Papillomavirus Vaccines , VaccinationABSTRACT
The construction of multiple campuses of one public hospital is an effective way to enlarge supply of high-quality medical resources. On the basis of sorting out the key and difficult problems faced in " multiple campuses" , People′s Hospital of Zhengzhou took " integrated management, homogeneous service, joint logistics support, and high quality development" as the main goal. It followed the guidelines of " Party committee taking overall charge, headquarters taking charge of building, campuses taking charge of routine operations, and orchestrated logistics support" . The hospital took the tactics of " collaborative oriented homogenization management" and " demand oriented and differentiated hospital positioning and discipline layout" . The practice and effect of the hospital included building multiple campuses in terms of management system, medical quality system, outstanding service system, personnel management system, cost management system, cultural construction system, and information management system. By such measures, the hospital has scientifically determined its orientation and discipline layout of every campus, hence offering references for the establishment and management model of " multiple campuses" at public hospitals at large.
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Objective:To evaluate the effects of neuromuscular blocking agents (NMBA) on oxygenation and respiratory conditions in patients with acute respiratory distress syndrome(ARDS).Methods:English databases such as MEDLINE, Embase and Web of Science were searched online, as well as Chinese databases such as China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database and Wanfang Database. Randomized controlled trials (RCTs) of NMBA therapy for ARDS with publication date up to May 2020 were retrieved. Literature was screened according to inclusion and exclusion criteria, and the main analysis indicators were oxygenation index.Results:A total of 5 RCTs were included, and 1 462 ARDS patients were enrolled. Compared with the control group, the ratio of partial arterial oxygen pressure to fraction of inspired (PaO 2)/(FiO 2) significantly improved in the intervention group after 72 hours MD=14.39, (95 %CI 6.40-22.38, P=0.000 4) and 96 hours of NMBA, but there was no difference between PaO 2/FiO 2 at 24 and 48 hours ( P>0.05).Positive end expiratory pressure (PEEP) significantly decreased at 72 hours ( MD=-0.45, 95 %CI -0.87--0.03, P=0.04) and 96 hours ( MD=-0.82, 95 %CI -1.39--0.26, P=0.004) treatment with NMBA, while there was no significant difference in PEEP between 24 and 48 hours after treatment ( P>0.05). At 96 h, plateau pressure (Pplat) in the intervention group was significantly lower ( MD=-1.69, 95 %CI -2.64--0.75, P=0.000 4), and there was no significant difference in Pplat between 24, 48 and 72 h after treatment ( P>0.05). Conclusion:The early use of NMBA within 48 hours has a delayed improvement effect on oxygenation and ventilator conditions in ARDS patients.
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Objective:To evaluate the ability of vascular endothelial growth factor receptor 2(VEGFR2)/integrin α vβ 3 dual-targeted microubble (MBD) to target angiogenesis of renal cell carcinoma (RCC) in vivo. Methods:Non-targeted microbubble (MBN) USphere LA was employed as a template to prepare single- and dual-targeted microbubbles which could bind VEGFR2 and/or integrin α vβ 3 (MBV and MBI) by the biotin-avidin bridging method. A total of 40 RCC nude mice models were established by subcutaneously injecting 786-O cells.Twenty of the models were all injected with MBN, MBV, MBI and MBD in a random order, and the other 20 models were registered for antibody blocking assays. The results of ultrasound images were used for quantitative analyses, and the following quantitative parameters were obtained: intensity increment (a 1), peak halving speed (a 2), curve rising slope (a 3), perfusion time (t 0), time to peak (TTP), peak intensity (PI), mean transit time (MTT) and area under the curve (AUC) for the first three minutes, peak intensity at 10 s before (P 1) and after (P 2) ultrasound destruction, and the differences of tissue enhancement (dTE) between P 1 and P 2 (dTE=P 1-P 2). All the quantitative parameters of four contrast agents and the antibody blocking assays were compared.Besides, the immunohistochemical assays were performed to evaluate the expression of CD31, VEGFR2 and integrin α vβ 3 in tumor tissues. Results:The differences of parameters of a 1, a 3, t 0, TTP, PI and P 2 among four different microbubbles had no statistical significances (all P>0.05), and all parameters between the two single-targeted contrast agents were not statistically different (all P>0.05). The parameters of AUC, MTT, P 1 and dTE all showed a trend that dual-targeted bubbles > single-targeted bubbles > non-targeted bubbles (all P<0.05). On the contrary, the trend of dual-targeted bubbles < single-targeted bubbles < non-targeted bubbles (all P<0.05) was observed for a 2. In the antibody blocking experiment, a 2 was faster after the antibody injection ( P<0.001), while AUC, MTT, P 1 and dTE were all lower than those before the antibody injection ( P<0.001), and the other parameters were not statistically different before and after the antibody injection (all P>0.05). Immunohistochemical analyses confirmed the high expression of CD31, VEGFR2 and integrin β 3 in tumor tissues. Conclusions:The VEGFR2 and integrin α vβ 3 dual-targeted microbubble has a good potential to target the angiogenesis of human RCC in vivo.
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ObjectiveTo observe the clinical efficacy of Jiawei Xiaochaihutang combined with microwave ablation （MWA） in the treatment of primary hepatocellular carcinoma （HCC） and its influence on tumor microenvironment. MethodA total of 128 patients were randomly divided into control group （64 cases： 2 cases of dropout，2 cases of elimination，and 60 cases of completion） and observation group （64 cases： 3 cases of dropout，2 cases of elimination，and 59 cases of completion）. Both groups were given comprehensive treatment after MWA surgery. Patients in control group took Biejiajian Wan orally （3 g/time，3 times/d）， and those in observation group took Jiawei Xiaochaihutang （1 dose/d）. The treatment lasted for 3 consecutive months. The size of solid tumor before and after treatment was evaluated to record the progression-free survival （PFS）. The alpha-fetoprotein-L13 （AFP-L3），des-γ-carboxy prothrombin （DCP），Golgi protein 73 （GP73），tumor necrosis factor-α （TNF-α），transforming growth factor-β （TGF-β），vascular endothelial growth factor （VEGF） and matrix metalloproteinase-2 （MMP-2） levels，as well as performance status （PS），liver function and syndrome of liver depression and Qi stagnation scores were also detected before and after treatment. In addition， the incidence of side effects of grade Ⅲ and above was compared. ResultThe total effective rate of solid tumor in observation group was 91.53% （54/59），higher than that （76.67%， 46/60） in control group（χ2=4.895，P<0.05）. The PFS in observation group was （7.16±0.95） months， longer than that （6.24±0.89 months） in control group （P<0.01）. The effective rate of traditional Chinese medicine （TCM） syndrome in observation and control groups were 88.14% （52/59）and 70.00% （42/60）， respectively （χ2=5.897，P<0.05）. The observation group （57.63%，34/59） had higher marked effective rate of TCM syndrome than control group （31.67%，19/60） （χ2=8.116，P<0.01）. The AFP-13，DCP，GP73，TNF-α，TGF-β，VEGF and MMP-2 levels and the PS，liver function and syndrome of liver depression and Qi stagnation scores in observation group were lower than those in control group （both P<0.01）. The cumulative incidence of side effects of grade Ⅲ and above in observation and control groups was 16.95% and 33.33%， respectively（χ2=4.261，P<0.05）. ConclusionConsolidation treatment of HCC after MWA surgery with Jiawei Xiaochaihutang relieved symptoms and side effects，improved PS and liver function，regulated tumor microenvironment，inhibited tumor markers and prolonged survival time. The clinical effect was better than that of Biejia decoction pill， and thus it was worthy of clinical use.
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OBJECTIVES@#To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China.@*METHODS@#A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined.@*RESULTS@#The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05).@*CONCLUSIONS@#It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
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Female , Fetal Growth Retardation , Gestational Age , Hospitalization , Humans , Incidence , Infant , Infant, Newborn , Infant, Premature , Infant, Very Low Birth Weight , Prospective Studies , Risk FactorsABSTRACT
Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.
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Objective:To retrospectively analyze the effect of sleeve gastrectomy (SG) on patients with obesity and type 2 diabetes mellitus (T2DM) and explore factors influencing of diabetes remission.Methods:The clinical data of 114 obese patients with T2DM who underwent SG at the First Affiliated Hospital of Nanjing Medical University from Jan. 2015 to Jun. 2019 were retrospectively analyzed, and the patients’ age, body weight and BMI, preoperative fasting blood glucose (FBG), HbA1c and methods of blood glucose control were recorded. The patients’ postoperative body weight, BMI, FBG, HbA1c, methods of blood glucose control and complications were collected through follow-up database and telephone interview.Results:The mean preoperative age of patients was 32.7±10.9 years old, BMI was 38.6±7.1 kg/m 2, HbA1c was 7.2%±1.4%, FBG was 7.8±2.6 mmol/L, and the duration of diabetes was 14.5±30.2 months. The mean operation time was 73±24 minutes, and the postoperative hospital stay was 3.2±1.1 days. There were no major complications such as leakage, bleeding or stenosis. The follow-up rates at 1, 3 and 5 years was 71.1% (81/114), 58.5 (38/65) and 46.2% (12/26), respectively. The total weight loss rate at 1, 3 and 5 years was 29.8%±7.8%, 27.2%±9.8% and 25.3%±10.0%, respectively. The complete remission rate of diabetes at 1, 3 and 5 years was 66.7%, 55.3% and 33.3%, respectively, and the partial remission rate of diabetes was 18.5%, 26.3% and 50%, respectively. Univariate analysis suggested that patients with short duration of diabetes, lower preoperative HbA1c and without using insulin had better remission of diabetes. Multivariate analysis suggested that the duration of diabetes and insulin used or not were independent factors of remission of diabetes. Conclusions:Sleeve gastrectomy is effective and safe in the treatment of obesity and diabetes. The duration of diabetes and preoperative insulin use or not are independent factors for remission of diabetes after sleeve gastrectomy.
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OBJECTIVE@#To investigate the changes of skin temperature, blood infusion and inflammatory cytokines of cutaneous tissue in the sensitized area of colitis model rats, as well as the relationship between sensory and sympathetic nerves and the formation of sensitized area, and to initially reveal the partial physical-chemical characteristics of the sensitized area in the colitis model rats.@*METHODS@#Thirty-five male SD rats were randomly divided into a control group (n=10), a model group (n=18) and a guanethidine group (n=7). 5% dextran sulfate sodium (DSS) was adopted for 6-day free drinking to establish colitis model in the model group and the guanethidine group. On day 6 and 7, in the guanethidine group, guanethidine solution (30 mg/kg) was injected intraperitoneally for sympathetic block. On day 7, after injection of evans blue (EB) solution, the EB extravasation areas on the body surface were observed to investigate the distribution and physical-chemical characteristics of the sensitized area. The control area was set up, 0.5 cm away from the sensitized area, and with the same nerve segment innervation. Disease activity index (DAI) score of rats was compared between the normal group and the model group, and the morphological changes in the colon tissue were investigated with HE method. Using infrared thermal imaging technology and laser speckle flow imaging technology, skin temperature and blood infusion were determined in the sensitized area and the control area of the rats in the model group. Immunofluorescence technique was adopted to observe the expression levels of the positive nerve fibers of substance P (SP), calcitonin gene-related peptide (CGRP) and tyrosine hydroxylase (TH), and the correlation with blood vessels; as well as the expression levels of SP positive nerve fibers/tryptase+ mast cells, and tryptase+ mast cells/5-hydroxytryptamine (5-HT) in skin tissue in the sensitized area and the control area of the rats in the model group. MSD multi-level factorial method and ELISA were applied to determine the contents of pro-inflammatory and anti-inflammatory cytokines (e.g. TNF-α, IL-1β, IL-6, IL-4 and IL-10) and anti-inflammatory substance corticosterone (CORT).@*RESULTS@#Sensitization occurred at the T12-S1 segments of the colitis model rats, especially at L2-L5 segments. Compared with the normal group, DAI score was increased in the rats of the model group (P<0.05), and the colonic mucosal damage was obvious, with the epithelial cells disordered, even disappeared, crypt destructed, submucosal edema and a large number of inflammatory cells infiltrated. In comparison with the control area, the skin temperature and blood infusion were increased in the sensitized area of the model group (P<0.05, P<0.01); as well as the expression levels of the positive nerve fibers of SP, CGRP and TH of skin tissue (P<0.05), which was specially distributed in peripheral vessels, the expression levels of SP positive nerve fibers/tryptase+ mast cells, and tryptase+ mast cells/5-HT of the skin tissue were all expanded (P<0.05) in the sensitized area of the model group. Compared with the model group, the number of sensitized areas was reduced in the guanethidine group (P<0.05). In comparison with the control area of the model group, in the sensitized area, the contents of pro-inflammatory cytokines, e.g. TNF-α, IL-1β and IL-6, and the anti-inflammatory substance CORT of skin tissue were all increased (P<0.05); and the contents of IL-6 and TNF-α were negatively correlated with CORT (P<0.05).@*CONCLUSION@#The sensitized areas on the body surface of colitis rats are mainly distributed in the L2-L5 segments. Sensory and sympathetic nerves are involved in the acupoint sensitization, and the sensitized areas may have the dynamic changes in pro-inflammatory and anti-inflammatory substances.
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Animals , Anti-Inflammatory Agents , Calcitonin Gene-Related Peptide/metabolism , Colitis/metabolism , Cytokines/metabolism , Guanethidine , Interleukin-6 , Male , Rats , Rats, Sprague-Dawley , Serotonin , Skin Temperature , Substance P/genetics , Tryptases , Tumor Necrosis Factor-alphaABSTRACT
Objective:To summarize our preliminary experience of the individual transurethral en bloc resection of bladder tumor (ERBT) based on vesical imaging-reporting and data system (VI-RADS).Methods:The clinical data of 32 bladder cancer patients admitted from January 2019 to October 2019 were retrospectively analyzed, including 26 males and 6 females. Among them, there were 27, 5, 26 and 6 patients who had primary, recurrent, single or mutiple blader tumors, respectively. And the median number of bladder tumor was 1(1-3) and the mean diameter was 2(0.6-4.5)cm.The patients were aged 37 to 82 years, with a median age of 63 years. All patients underwent multi-parameter magnetic resonance imaging (mpMRI) before surgery and acquired a VI-RADS score. Among the 32 patients, there were 8, 17, 2, 5, and 0 patients in the VI-RADS score category 1, 2, 3, 4, and 5, respectively. Based on the VI-RADS score and tumor size, morphology and number provided by the mpMRI, the urologists classified the tumor types into type 1, 2a, 2b, 2c, 3a, 3b, 3c, 4a, 4b or 5, and designed the surgical protocol for each type including the resection plan, boundary and depth. There were 8, 6, 7, 4, 0, 1, 1, 3, 2 and 0 patients in each type, respectively. The tumor types were further confirmed during the operation, and the operation was completed according to the surgical plans for different tumor types.Patients received intravesical therapy of gemcitabine within 24 hours after surgery.Results:All operations were successfully completed and none was converted to the traditional transurethral resection of the bladder tumor. The operation time was 5 to 35 minutes with a median time of 15 minutes. Tumor specimens from all patients contained the muscularis propria. Among the patients with scores 1, 2, 3 and 4, there were 8, 16, 1 and 0 patients diagnosed with non-muscle invasive bladder cancer (NMIBC), respectively. All the patients with NMIBC had negative basal resection margins and 6 out 7 muscle invasive bladder cancer (MIBC) patients had negative resection margins. There were no intraoperative complications such as bladder perforation and obturator reflex. Four patients experienced obvious postoperative bladder irritation and relieved after symptomatic treatment or removing catheter. Twelve patients received second resections, including 10 NMIBC patients and 2 MIBC patients. No residual tumor was found in the re-resected specimens. There were 9 and 12 NMIBC patients received regular intravesical therapy of gemcitabine or BCG, respectively. Among the 7 MIBC patients, 5 received radical cystectomy and two received bladder-preserving treatment including second resection, adjuvant chemotherapy and radiotherapy. The follow-up period was 3-12 months, with a median of 6 months. One NMIBC patient relapsed at 9th months after surgery and underwent ERBT.Conclusions:The personalized ERBT based on VI-RADS is safe and feasible, and can achieve negative margins in all NMIBC and some MIBC without severe complications.
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OBJECTIVE: To analyze the experience of diagnosis and treatment of a case of brodifacoum poisoning. METHODS: The clinical data of a case of unexplained brodifacoum poisoning was retrospectively analyzed. RESULTS: The patient went to the doctor for unexplained bleeding. The bleeding symptoms included nasal o blood ozing, blood in saliva and skin ecchymosis. Blood anticoagulative rodenticide test showed positive with brodifacoum. The results of coagulative function tests showed that the indexes of partial prothrombin time, prothrombin time and fibrinogen were increased. The patient was diagnosed as brodifacoum poisoning based on the clinical symptoms and laboratory test results. The combined use of 40 mg/d of vitamin K_1 and frozen plasma improved the clotting time and quickly alleviated the bleeding symptoms of the patient. However, the patient′s bleeding symptoms recurred when vitamin K_1 was discontinued. The patient was hospitalized for 62 days and then discharged. With follow-up one month after discharge, the patient showed no bleeding symptoms, but brodifacoum could still be detected in the blood. CONCLUSION: The symptoms of brodifacoum poisoning may relapse and the treatment course is long. Vitamin K_1 could be used as the first-choice medicine for the treatment of brodifacoum poisoning, but its usage needs to be optimized.
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Objective To study the characteristics of self-esteem and life position of children with mild intellectual disability and the effects of adaptive behavior on self-esteem and life position. Methods From November, 2019 to January, 2020, 162 children with mild intellectual disabilities in Shanghai were investigated and evaluated with Adaptive Behavior Assessment System-Second version (ABAS-Ⅱ), Rosenberg Self-esteem Scale (SES) and Life Position Scale (LPS). Structural equation model was used to explore the specific effects of adaptive behavior on self-esteem and life position. Results The score of SES was (23.52±5.49), which was slightly lower than the norm (28.75±4.86) (t = -12.140, P < 0.001). The score of LPS was (50.76±11.85). Structural equation model showed that conceptual skill in adaptive behavior negatively affected life position (B = -0.450, P < 0.05); social skill (B = 0.480, B = 0.331, P < 0.05) and practical skill (B = 0.490, B = 0.294, P < 0.05) positively affected both life position and self-esteem. Conclusion Self-esteem decreases in children with mild intellectual disability, and the life position reached the theoretical median level. Among adaptive behavior, both social skill and practical skill positively affect self-esteem and life position, while conceptual skill negatively affects life position.
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Objective To study the characteristics of self-esteem and life position of children with mild intellectual disability and the effects of adaptive behavior on self-esteem and life position. Methods From November, 2019 to January, 2020, 162 children with mild intellectual disabilities in Shanghai were investigated and evaluated with Adaptive Behavior Assessment System-Second version (ABAS-Ⅱ), Rosenberg Self-esteem Scale (SES) and Life Position Scale (LPS). Structural equation model was used to explore the specific effects of adaptive behavior on self-esteem and life position. Results The score of SES was (23.52±5.49), which was slightly lower than the norm (28.75±4.86) (t = -12.140, P < 0.001). The score of LPS was (50.76±11.85). Structural equation model showed that conceptual skill in adaptive behavior negatively affected life position (B = -0.450, P < 0.05); social skill (B = 0.480, B = 0.331, P < 0.05) and practical skill (B = 0.490, B = 0.294, P < 0.05) positively affected both life position and self-esteem. Conclusion Self-esteem decreases in children with mild intellectual disability, and the life position reached the theoretical median level. Among adaptive behavior, both social skill and practical skill positively affect self-esteem and life position, while conceptual skill negatively affects life position.
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The present study optimized the extraction of flavonoids from Lonicera rupicola Hook. f. et Thoms(LRH) and explored its pharmacological effects, such as resisting inflammation, relieving pain, enhancing immunity, and inhibiting pyroptosis, aiming to provide data support and scientific basis for the development and utilization of LRH. Response surface methodology(RSM) was applied to optimize the extraction of flavonoids from LRH based on the results of single-factor experiments. Anti-inflammatory and analgesic effects of LRH flavonoids were evaluated via inflammation and pain models in mice, such as xylene-induced ear swelling, carrageenan-induced footpad swelling, writhing caused by acetic acid, and paw licking. The effect of LRH flavonoids on the carbon clearance index of monocytes and serum immunoglobulin A(IgA) and IgM levels was analyzed on the immunosuppression model induced by cyclophosphamide in mice. The anti-oxidative effect in vivo of LRH flavonoids on liver superoxide dismutase(SOD), catalase(CAT), and malondialdehyde(MDA) levels was determined based on the chronic/subacute aging model in mice induced by D-galactose. The levels of cysteinyl aspartate specific proteinase-1(caspase-1), interleukin-1β(IL-1β), and IL-18 in the supernatant of J774 A.1 mononuclear phagocytes were detected to evaluate the effect of LRH flavonoids on the pyroptosis of mononuclear phagocytes in mice induced by the combination of lipopolysaccharide(LPS) and adenosine triphosphate(ATP). Meanwhile, the effect of LRH flavonoids on the cAMP-PKA signaling pathway was also explored. The optimum conditions for the extraction of LRH flavonoids are listed below: extraction temperature of 65 ℃, the ethanol concentration of 50%, extraction time of 60 min, a material-liquid ratio at 1∶25, and the yield of LRH flavonoids of 0.553%. RSM determined the multiple quadratic regression equation model of response value and variables as follows: the yield of LRH flavonoids=0.61-0.48A+0.1B+0.029C-0.014D+0.32AB+0.04AC-0.012AD-0.02BC+0.037BD-0.031CD-0.058A~2-0.068B~2-0.069C~2-0.057D~2. LRH flavonoids could effectively inhibit ear swelling and footpad swelling, reduced acetic acid-induced writhing, and delayed the paw licking response time in mice. Additionally, LRH flavonoids could improve the carbon clearance index in immunosuppressed mice, potentiate the activities of SOD and CAT and reduce MDA levels in the liver of aging mice induced by D-galactose, and effectively inhibit macrophage pyroptosis by decreasing the levels of caspase-1, IL-1β, and IL-18. The results reveal that LRH flavonoids possess excellent pharmacological activities such as resisting inflammation and oxidation, relieving pain, and enhancing immunity. They can inhibit pyroptosis by enhancing the cAMP-PKA signaling pathway. The results of this study can underpin the pharmacological research, development, and utilization of LRH.
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Analgesics/therapeutic use , Animals , Edema/drug therapy , Flavonoids/therapeutic use , Inflammation/drug therapy , Lonicera , Mice , Mice, Inbred ICR , Pain/drug therapy , Plant Extracts/therapeutic use , PyroptosisABSTRACT
Objective:To understand the status and influencing factors of the bowel function in patients with rectal cancer after sphincter-preserving surgery, and then to improve the patients′ quality of life.Methods:From January 2017 to April 2020, a total of 179 patients with rectal cancer after sphincter-preserving surgery in Sun Yat-sen University Cancer Center were selected as study subjects. General questionnaire and the scale about bowel function of patients with rectal cancer after sphincter-preserving surgery were used to investigate.Results:The total score of bowel function in patients with rectal cancer after sphincter-preserving surgery was (71.82±7.67), and the average score of all the items was (3.99 ± 0.43). In all dimensions of intestinal function, the average score of "defecation affected by diet" was the highest (4.39 ± 0.80), followed by "frequent and urgent defecation" (4.22 ± 0.49), and the average score of "defecation paresthesia" was the lowest (3.03 ± 0.67). Tumor distance from the anal border was the influencing factor of bowel function in patients with rectal cancer after sphincter-preserving surgery ( P<0.05). Conclusions:The bowel function of patients with rectal cancer after sphincter-preserving surgery was well, while the bowel function of patients with rectal cancer after sphincter-preserving surgery with the distance between the tumor and the lower edge of the anus <5.0 cm was relatively poor.
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Objective:To compare the clinical efficacy of autologous fat injection and conjunctival pedicled orbital septal fat grafting for infraorbital margin depression in young people.Methods:Fourty young patients with lower eyelid pouch and infraorbital margin depression with age of 20 to 40 years and average age of 30.6 yaers in the First Affiliated Hospital of Nanchang University from September 2017 to September 2019 were enrolled. According to the surgical method, all patients were divided into 2 groups with 20 cases each. Group 1 underwent transconjunctival orbital septum fat reset. Group 2 underwent various autologous fat injection after proper amount of orbital septal fat being removed, including structural fat, fine-particle fat and nano-fat, performed in different parts and layers. The tear trough rating scale (TTRS) scores and patients＇ satisfaction at 1 year after operation between 2 groups were compared.Results:Compared with the preoperative TTRS scores, the differences in scores at 6 months and 1 year after surgery were statistically significant ( P<0.01). The scores between two groups were compared at 6 months and 1 year respectively after the operation, and the difference were both statistically significant ( P<0.01). 6 months after the operation, the TTRS scores including four items were carefully compared between the two groups. It showed that the reduction of tear groove depth ( P<0.05), pigmentation ( P<0.01) and wrinkle ( P<0.01) in group 2 were more obvious than those in group 1. The percentage of satisfaction in group 2 (95%) was higher than that in the group 1 (70%), and the difference was statistically significant ( P<0.01). Conclusions:For infraorbital margin depression of young people, after proper amount of orbital septal fat being removed, various free fats graft injection into different parts and layers could obtain better treatment results, reducing not only the depth of the tear groove, but also periorbital pigmentation and fine wrinkles.
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In cardiac surgery such as myocardial infarction, congenital heart disease, and heart transplantation, myocardial ischemia-reperfusion (I/R) damages mitochondria, which in turn causes myocardium energy metabolism disturbance, homeostatic destruction, reactive oxygen species production and DNA damage, and activates myocardium apoptosis and necrosis signals, which eventually lead to myocardial dysfunction or heart failure. Different from the previous I/R treatment targets focusing on a certain pathway or a certain medium, autologous mitochondrial transplantation (AMT) is an emerging method, which transplant viable and respiration-competent mitochondria from healthy organs or tissues to the injured sites which suffer from I/R injury, to replace or repair damaged mitochondria. In recent years, AMT has achieved remarkable results in the prevention and treatment of myocardial I/R. This article reviews the role and mechanism of AMT in I/R myocardial protection.
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Objective:To investigate the application value of triangular modal construed for planning approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 10 patients who underwent local laparoscopic resection of liver tumors located in superior part of central liver lobe at the Affiliated Hospital of Qingdao University from January to June 2020 were collected. There were 6 males and 4 females, aged from 41 to 63 years, with a median age of 54 years. Preoperative triangular model was constructed for all patients to plan approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe. Observation indicators: (1) preoperative general situations of patients; (2) surgical situations; (3) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect tumor recurrence and survival of patients up to February 2021. Measurement data with normal distribution were expressed as Mean± SD. Count data were expressed was absolute numbers. Results:(1) Preoperative general situations of patients: hepatocellular carcinoma was found in 7 cases, inthahepatic cholangiocarcinoma was found in 2 cases and ovarian cancer with liver metastasis was found in 1 case. Three cases had tumors located in S4a segment, 2 cases had tumors located in ventral subsegment of S8 segment, 2 cases had tumors located in dorsal subsegment of S8 segment, and 3 cases had tumors across the ventral segment of S4a+S8. The diameter of tumors was (3.4±1.0)cm. (2) Surgical situation: all the 10 patients underwent R 0 resection successfully, with no intraoperative blood transfusion or conversion to open surgery. The operation time of 10 patients was (149±59)minutes, the volume of intraoperative blood loss was (294±163)mL, the minimum surgical margin of specimen was (1.1±0.2)cm. The alanine aminotransferase was (324±151)U/L on the postoperative first day, the aspartic aminotransferase was (401±113)U/L on the postoperative first day, and the duration of postoperative hospital stay was (9±4)days. No bile leakage, hemorr-hage, reoperation or other complications occurred in all patients. (3) Follow-up: 10 patients were followed up for 7?13 months, with a median follow-up time of 11 months. All patients had no margin recurrence or distant metastasis. Conclusion:It is safe and feasible to construct triangular modal for planning approach of local laparoscopic resection of liver tumors located in superior part of central liver lobe.
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Objective:To observe the efficacy of addition and subtraction therapy of Chuanxiong Chatiaosan combined with acupuncture for acute migraine attack with syndrome of wind phlegm blocking collaterals and to investigate its effect on neurovascular active medium. Method:One hundred and thirty-four patients were randomly divided into control group（67 cases） and observation group （67 cases）by random number table. During the treatment， 63 patients completed the study in control group （loss to follow-up in 2 cases， and elimination in 2 cases）. 64 patients completed the study in observation group （loss to follow-up in 3 cases）. Patients in both groups got ibuprofen sustained release tablets， 1 tablet/time， 2 times/day， Zolmitriptan tablets， 2.5 mg/time， 1 time/day， which were stopped when symptoms got relieved. Patients in control group got acupuncture treatment， 1 time/day， and Zhengtian pills by oral administration， 6 g/time， 2 times/day. Based on the treatment of acupuncture in control group， patients in observation group additionally received addition and subtraction therapy of Chuanxiong Chatiaosan， 1 dose/day， with a treatment course of 10 days in both groups. Before treatment， at the first day （2， 4 ， 12 ， 24 h） and second to tenth day after the treatment， scores of pain visual analoguescale （VAS） were graded； before and after treatment， scores of duration and degree of headache， concomitant symptoms， number of headache attacks， syndrome of wind phlegm blocking collaterals， migraine specific quality of life scale （MSQ） were graded. Levels of nitric oxide （NO）， endothelin-1 （ET-1）， calcitonin gene-related peptide （CGRP）， 5-hydroxytryptamine （5-HT）， and β endorphin （β -EP） were detected before and after treatment. Result:The clinical efficacy in observation group was better than that in control group （Z=2.115， P<0.05）. At the second and fourth hour after treatment， VAS scores were decreased in both groups， but there was no statistically significant difference between two groups. At the 12th and 24th hour after treatment， VAS scores were increased as compared with those at the previous time point （P<0.01）， and VAS scores in observation group at the 12th and 24th hour were lower than those in control group （P<0.01）， but there was no statistically significant difference in onset time for pain， effective rate for pain at second hour after treatment and the disappearance rate of pain at the third day after treatment. Time to pain relief in observation group was shorter than that in control group （P<0.01）. Degree of headache， duration of headache， number of headache attacks and accompanying symptoms were all lower than those in control group， while scores of MSQ and the total score of MSQ were all higher than those in control group （P<0.01）. Recurrence rate of pain in observation group was 18.75% （12/64）， lower than 36.51% （23/63） in control group at the 24th hour （P<0.05）. Disappearance rate of pain in observation group was 70.31% （45/64） and 90.63% （58/64） at the fifth day and tenth day after treatment， higher than 52.38% （33/63） and 76.19% （48/63） in control group （P<0.05）. Levels of NO， β-EP and 5-HT were higher than those in control group （P<0.01）， while levels of CGRP and ET-1 were lower than those in control group （P<0.01）. Conclusion:Chuanxiong Chatiaosan combined with acupuncture in the treatment of acute migraine attack in patients， has equivalent effect in terms of rapid pain relief， but with advantages of long-lasting analgesic effect， low recurrence rate， high pain relief rate and disappearance rate. In addition， it can also regulate neurovascular active mediators， more effectively control acute migraine attack， and improve the quality of life of patients， with a better clinical efficacy.