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1.
Gut and Liver ; : 273-283, 2021.
Article in English | WPRIM | ID: wpr-874594

ABSTRACT

Background/Aims@#Colorectal cancer (CRC) patients often exhibit peritoneal metastasis, which negatively impacts their prognosis. CD31 and D2-40 have recently been suggested to be predictors of breast cancer prognosis, but their role in colorectal peritoneal metastasis (CRPM) remains unknown. @*Methods@#The expression profiles of CD31 and D2-40 were analyzed in CRC patients with or without CRPM and in CRC cell lines with increasing metastatic potential. Overexpression and short hairpin RNA knockdown assays were performed in CRC cells, and the effects of these alterations on epithelial-mesenchymal transition (EMT) in vitro, growth of xenograft tumors in vivo, and peritoneal metastasis potential in a mouse model of CRPM were examined. @*Results@#The expressions of CD31 and D2-40 were upregulated in CRC tumor tissues and was elevated further in tumor tissues from patients with CRPM. CD31 and D2-40 expression levels exhibited increasing trends parallel to the EMT potential of CRC cells. CD31 and D2-40 are essential for CRC cell EMT in vitro as well as for xenograft tumor growth and peritoneal metastasis in vivo. @*Conclusions@#CD31 and D2-40 contribute to CRPM by promoting EMT and may serve as prognostic markers and therapeutic targets for CRC, particularly in patients with peritoneal metastasis.

2.
Article in Chinese | WPRIM | ID: wpr-868615

ABSTRACT

Objective:To explore the method of improving the accuracy of dose calculation of treatment plan in radiotherapy for patients with metal implants.Methods:A CT simulator with metal artifact reduction technique (MAR) was utilized to scan the CIRS intensity-modulated phantom with metal rods and 8 patients with steel nails implanted in the centrum for radiotherapy. Radiotherapy plans were designed using conventional CT images, MAR images and density-filled images. The dose calculation errors between single field and intensity-modulated radiotherapy (IMRT) plan were compared. The effect of mental implants and their artifacts on the irradiation dose of IMRT plan was evaluated.Results:In the conventional CT images of the phantom, when the incident path of the field failed to pass through the metal region, the dose calculation error for a single field was 3.85%, and the range of dose error for the field was 4.46%-74.11% when passing through the metal region. IMRT planning errors might exceed the clinically acceptable range when the incident path of the field passed through the metal region, and the errors tended to increase with the increase of dose weight of this field. After processing the images with density filling and artifact reduction techniques, the errors of the single field were 1.23% and 0.89%-4.73%, respectively, and the dose error of IMRT was 1.84%. The error of IMRT plan was 1.88% if density filling technique alone was employed to process the metal region. Due to the influence of metal implants and their artifacts, the minimum dose, average dose and prescription dose coverage actually received in the tumor target area were lower than IMRT plan results based on conventional CT images. The dosimetric difference of organs at risk was not statistically significant.Conclusions:In the radiotherapy plan based on conventional CT images, there may be a large dose calculation error when the incident path of field passes through the metal region. If the metal material is known, density filling of the metal region in the planning system can effectively improve the accuracy of dose calculation. Metal artifact reduction technique can significantly improve the image quality and further reduce dose calculation error, which should be a routine technique for CT machines equipped with this function to perform simulated localization of patients with metal implants.

3.
Article in Chinese | WPRIM | ID: wpr-863937

ABSTRACT

Objective:To investigate the relationships of estrogen receptor-α (ESR1) gene PvuⅡ (rs2234693, C>T) and XbaⅠ (rs9340799, A>G) polymorphisms and susceptibility of type 1 diabetes for female children (T1D) .Methods:From Jan. 2016 to Dec. 2019, 86 female children with newly diagnosed T1D who were admitted to Chongqing Three Gorges Central hospital were selected as the study subjects, and 100 healthy children who underwent physical examination in our hospital during the same period were selected as the healthy control. The height, weight and related metabolic indexes of the subjects were measured. The ESR1 gene was genotyped by capillary electrophoresis and SNaPshot. The mRNA expression of ESR1 gene was detected by real-time fluorescence quantitative polymerase chain reaction (RT-PCR) .Results:Genotyping results showed that PvuII genotype distribution between T1D group and the control group was statistically significant ( χ2=11.672, P=0.003) , but XbaI genotype distribution between T1D patients and controls had no significant difference ( χ2=5.433, P=0.066) . PvuII locus T allele frequency and XbaI locus G allele frequency were significantly in T1D group higher than in the control group (PvuII T vs C: OR=1.909, 95% CI=1.261-2.892, P=0.002; XbaI G vs A: OR=1.815, 95% CI=1.112-2.961, P=0.016) . Glycated hemoglobin (HbA1c) and total cholesterol (TC) levels in T1D patients with PvuII T allele were significantly higher than those with CC genotype (all P<0.05) . Low-density lipoproteins (LDL-C) and total cholesterol (TC) levels in T1D patients with XbaI G allele were significantly higher than those with AA genotypes (both P<0.05) . The relative expression of ESR1 gene mRNA in T1D patients was significantly lower than that in the control group (0.42±0.05 vs 1.04±0.16, t=6.227, P<0.001) . The relative expression of ESR1 gene mRNA in T1D patients with PvuII CC, CT and TT genotypes was statistically different ( F=5.823, P<0.001) , and the relative ESR1 gene mRNA in T1D patients with XbaI AA, AG and GG genotypes was also statistically different ( F=5.415, P<0.001) . Conclusion:PvuII and XbaI olymorphismsof ESR1 genes may be involved in the occurrence and development of T1D in female children by influencing gene expression.

4.
Article in Chinese | WPRIM | ID: wpr-744382

ABSTRACT

Objective To analyze the effect of long-term wearing of hard corneal contact lens and its effect on the stability of tear film.Methods From April 2016 to April 2017,150 patients of myopia in Yongkang Hospital were selected in this study and randomly divided into study group and control group,with 75 cases in each group.The patients in the study group wore hard corneal contact lens for a long time before operation,the patients in the control group had no hard corneal contact lens before operation.The basal tear secretion amount,tear film break-up time(TBUT) and the incidence of postoperative complications were compared between the two groups.Results One year after operation,the basal tear secretion amount of the study group [(11.1 ± 1.5) mL] was significantly lower than that of control group[(18.5 ± 3.2) mL] (t =12.235,P < 0.05).The TBUT of the study group [(15.8 ± 1.5) min] was significantly shorter than that of the control group [(25.1 ± 4.8) min] (t =11.935,P < 0.05).The incidence rates of dry eye,corneal staining in the study group were 22.7%,18.7%,respectively,which were significantly lower thanthose in the control group (33.3%,34.7%),there were statistically significant differences between the two groups (x2 =5.931,6.425,all P < 0.05).Conclusion Long-term wearing hard contact lens seriously affects the tear secretion and TBUT,and reduces the stability of tear film.Although the incidence of postoperative complications islow,tear film damage can not be avoided.In order to protect the stability of the tear film,the patients with myopia should try to avoid the wear of the hard corneal contact lens and choose to wear frame glasses.

5.
Article in Chinese | WPRIM | ID: wpr-802292

ABSTRACT

The experienced prescriptions of famous prestigious Chinese physicians are effective prescriptions developed by prestigious Chinese doctors during their long-time clinical practice, which reflect the traditional Chinese medicine (TCM) understanding of the disease development regularity and core pathogenesis. These experienced prescriptions provide valuable experience for medication and prescription regularities, and represent the highest level of TCM treatment and the major sources of new drug research, development and technology innovation. It is of great significance to inherit academic thoughts and clinical experiences of prestigious Chinese physicians, explore and summarize experienced prescriptions, and develop new Chinese drugs. The researches of new drugs based on experienced prescriptions are the major direction encouraged by the government, with the maximum amount of new TCM drug applications but a low approval rate in recent years. The main reason for the low number of approved new TCM drug applications is that researchers know less about evaluation concepts and relevant techniques, leading to problems in research and development strategy. To facilitate a smooth advance of the new drug research and development and take full advantage of the experienced prescriptions, in this paper, we focus on the problems about new drug development of experienced prescriptions, lay emphasis on the new TCM drug research and development concepts of clinical value, history of human application and whole-process quality control, and deeply and systematically analyze concerns in such links as pharmacy, pharmacodynamics, toxicology and clinic application. The purpose of this article is to provide the reference in solving actual problems, the reliable basis of further researches on experienced prescriptions, and the important guarantee for developing more safe, effective and high-quality controllable drugs to meets clinical requirements, so as to achieve the strategy of a healthy China.

6.
Chinese Journal of Hepatology ; (12): 698-703, 2019.
Article in Chinese | WPRIM | ID: wpr-797928

ABSTRACT

Objective@#To preliminary, explore the effect of small intestinal epithelial dendritic cells on the occurrence and development of nonalcoholic fatty liver disease in mice.@*Methods@#Thirty-two (half male and half female) 4-week-old C57BL/6 mice were randomly divided into two groups. The mice were fed with normal diet (SD group) and high-fat diet (HFD group). Eight mice (half male and half female) were randomly killed from each group over the 14 and 20-weeks feeding period to observe their body weight, liver and small-intestine wet weight. Alanine aminotransferase, aspartate aminotransferase, blood glucose, high-density lipoprotein, low-density lipoprotein, total cholesterol and triglyceride were determined by eyeball blood samples. Pathological diagnosis and alcoholic fatty liver disease activity score were collected. The number of mice small intestinal dendritic cells was observed under a microscope. Statistical analysis was performed to compare two groups of independent samples with homogeneity test of variance, t test, and covariance analysis.@*Results@#The body weight, liver wet weight, serum alanine aminotransferase and aspartate aminotransferase of mice in HFD group were significantly higher than those of control group at 20 weeks (P < 0.05), and the serum high density lipoprotein of mice in HFD group was significantly higher than that of SD group at 14 weeks (P < 0.05). At 14th weeks, the liver tissue of mice in HFD group had early pathological manifestations of hepatitis (fatty degeneration, punctate necrosis and balloon-like degeneration). Of which 87.5% (7/8) of them were diagnosed as non-alcoholic steatohepatitis or non-alcoholic fatty liver disease, while only a few mice in SD group had early pathological manifestations of hepatitis. At 20th weeks, all mice in HFD group were diagnosed with non-alcoholic steatohepatitis or non-alcoholic fatty liver disease, while none of the mice in SD group was diagnosed with non-alcoholic fatty liver disease. At both time points, the percentage of small intestinal dendritic cells in HFD group was significantly higher than that in SD group (14 weeks: 4.181 ± 4.314 vs. 15.099 ± 10.349; 20 weeks: 9.615 ± 8.267 vs. 32.839 ± 24.475, both P < 0.05). Statistical analysis combined with the alcoholic fatty liver disease activity score showed that there was no linear correlation between the two groups (regression coefficient was 20.196%).@*Conclusion@#The number and different staging of small intestinal dendritic cells in mice is associated with the occurrence and development of NAFLD.

7.
Chinese Journal of Cardiology ; (12): 360-366, 2019.
Article in Chinese | WPRIM | ID: wpr-805166

ABSTRACT

Objective@#To investigate the blood lipid levels and prevalence of dyslipidemia in people with hypertension and diabetes in Henan province.@*Methods@#From April 2016 to April 2017, multi-stage cluster sampling was adopted to investigate 71 285 local residents aged between 35 and 75 from 6 districts and counties in Henan province including Zhongmu county of Zhengzhou city, Huojia county of Xinxiang city, Hualong district of Puyang city, Qi county of Hebi city, Xigong district of Luoyang city, and Wugang city of Pingdingshan city. Blood samples were collected. According to the diagnostic criteria of hypertension and diabetes, the study population was divided into control group (n=29 427), hypertension group (n=21 965), diabetes group (n=8 009) and hypertension-diabetes group (n=11 884). Comparisons on blood lipid levels and dyslipidemia between 4 groups were performed.@*Results@#The total cholesterol (TC) level of all subjects was 4.37 (3.78, 5.05) mmol/L. The triglyceride (TG) level was 1.27 (0.97, 1.80) mmol/L, the low-density lipoprotein cholesterol (LDL-C) level was 2.34 (1.88, 2.88) mmol/L and the high-density lipoprotein cholesterol (HDL-C) level was 1.31 (1.08, 1.59) mmol/L. Except for the TC level in women aged 65-75 years and LDL-C levels in women aged 55-64 and 65-75 years, there were significant differences in TC, TG, LDL-C and HDL-C levels between subjects of control group, hypertension group, diabetes group, and hypertension-diabetes group in different age ranges (including 35-44, 45-54, 55-64,and 65-75 years) and genders(all P<0.01).Except for the LDL-C and HDL-C in men aged 35-44 years and LDL-C in women aged 65-75 years, there were significant differences in the dyslipidemia rates of TC, TG, LDL-C and HDL-C between subjects of control group, hypertension group, diabetes group and hypertension-diabetes group in different age ranges and genders(P<0.01 or <0.05). After adjusting for age, gender, smoking, drinking, snoring, region, and body mass index, multivariate logistic regression analysis showed that hypertension (OR=1.221, 95%CI 1.113-1.339, P<0.01), diabetes (OR=1.636, 95%CI 1.461-1.833, P<0.01) and hypertension-diabetes (OR=1.832, 95%CI 1.658-2.023, P<0.01) were independent risk factors for TC abnormality. Hypertension (OR=1.566, 95%CI 1.478-1.659, P<0.01), diabetes (OR=2.182, 95%CI 2.031-2.342, P<0.01) and hypertension-diabetes (OR=2.655, 95%CI 2.492-2.829, P<0.01) were also independent risk factors for TG abnormality. Diabetes (OR=1.510, 95%CI 1.309-1.742, P<0.01) and hypertension-diabetes (OR=1.461, 95%CI 1.285-1.661, P<0.01) were independent risk factors for LDL-C abnormality. Diabetes (OR=1.261, 95%CI 1.180-1.346, P<0.01) and hypertension-diabetes (OR=1.195, 95%CI 1.126-1.268, P<0.01) were independent risk factors for HDL-C abnormality.@*Conclusion@#The prevalence of dyslipidemia in patients with hypertension and diabetes is high in Henan province, so adequate blood lipid education and control should be applied to people with risk factors as soon as possible.

8.
Acta Physiologica Sinica ; (6): 514-526, 2019.
Article in English | WPRIM | ID: wpr-777160

ABSTRACT

Glucagon-like peptide-1 (GLP-1) expression is shared by both intestinal cells and neurons of brainstem, which plays anorexigenic role on food intake. However, the exact source of physiological GLP-1 influencing food intake and pertinent mechanism of GLP-1 receptor agonists (GLP-1RA) remain unelucidated. In this study, the immediate early gene product c-Fos was chosen as the specific antigen for immunohistochemistry to show the certain areas of central nervous system (CNS) activation by the GLP-1RA. Thirty normal SD rats were randomly assigned to 3 groups, which were single intraperitoneally injected with Liraglutide (200 μg/kg), Exenatide (10 μg/kg) and saline, respectively. After injection, the amount of food intake and acute glycemic variation were assessed for comparison. The results showed that acute pharmacological dosage of GLP-1RA (Liraglutide or Exenatide) could significantly influence food intake. However, glycemic change indicated that the anorexic effect was dissociated with change in blood glucose in normal rats. Moreover, c-Fos was expressed significantly higher in major critical nuclei related to food intake in GLP-1RA groups when compared with the control group, and its expression was also found in spinal cord. The results suggested that acute administration of pharmacological doses of GLP-1 influences CNS via circulation and vagal pathways, especially on the arcuate nucleus (ARC) and the nucleus of solitary tract (NTS), and GLP-1 modulates autonomic nervous activities.


Subject(s)
Animals , Eating , Exenatide , Pharmacology , Glucagon-Like Peptide-1 Receptor , Liraglutide , Pharmacology , Random Allocation , Rats , Rats, Sprague-Dawley
9.
Article in Chinese | WPRIM | ID: wpr-734324

ABSTRACT

Objective To reduce the risk of radiation-induced cardiac injury in patients with left breast cancer after breast-conserving surgery by multileaf collimator (MLC) shielding technique.Methods A total of 18 patients with left breast cancer after breast conserving surgery were selected to obtain 3DCT and 4DCT images at free breathing state.The target area was identified on the 3DCT image by registration with 4DCT images and to develop a hybrid intensity-modulated treatment plan (H_IMRT) and a heart sparing hybrid intensity-modulated treatment plan (HSH_IMRT) to introduce MLC shielding technology to reduce the cardiac exposure dose,and to perform dosimetry verification of the treatment plan by using the Compass verification system.The prescription dose was 50 Gy in 25 fractions.The dosimetry parameters of the target area and the organs at risk were compared between the two treatment plans and the dose verification result.Results The result of the treatment plan showed that compared with H_IMRT,the dose uniformity of the target area of HSH_IMRT was better,and the difference of conformability was not statistically significant (P>0.05).The mean dose of the whole heart decreased by 23.67% (t =13.693,P<0.05) compared with the former.Dmax and D of other substructures of the heart were lower than the former.The result of dose verification showed that there was no statistically significant difference in uniformity and conformity between the two planned target doses (P> 0.05).The mean dose of the whole heart of HSH_IMRT was 24.88% (t =13.782,P<0.05) lower than that of H_IMRT,and except for the left ventricle and right ventricle,the Dmax of other heart substructures and D of all heart substructures decreased.Both the planned and the dose verification result showed that the V20 and the D of the affected lung were lower in HSH_IMRT.Conclusions Reasonable introduction of MLC shielding technology in H_IMRT can reduce the exposure dose of cardiac and further reduce the risk of radiation damage in heart.

10.
China Pharmacy ; (12): 1613-1617, 2019.
Article in Chinese | WPRIM | ID: wpr-817108

ABSTRACT

OBJECTIVE: To study improvement effect and mechanism of Shuangshen yin on liver function and the degree of liver fibrosis in liver fibrosis model rats. METHODS: Healthy SD rats were collected and given 40% CCl4 olive oil solution intraperitoneally for consecutive 7 weeks to induce liver fibrosis model. 47 model rats were randomly divided into model group, positive control group and Shuangshen yin low-dose, medium-dose and high-dose groups, with 9, 9, 9, 10, 10 rats respectively; another 10 healthy SD rats were included in normal group. From the next week after model induction, model group and normal group were given water intragastrically; positive control group [colchicines 0.2 mg/(kg·d)] and Shuangshenyin groups [Shuangshen yin water decoction 3, 6, 12 g/(kg·d), by crude drug] were given corresponding medicines respectively for consecutive 28 d. The serum levels of liver function indicators (ALT, AST, TBIL, ALB, GLB) were determined by Rye’s analysis method. The serum levels of liver fibrosis indexes (HA, LN, Ⅲ-PC, Ⅳ-C) were determined by ELISA. The pathological changes of liver tissues were observed by HE staining and VG staining. The levels of SOD, MDA and HYP in liver tissues were determined by spectrophotometry. The expression of α-SMA was detected by immunohistochemistry. RESULTS: Compared with normal group, the serum levels of ALT, AST, TBIL, HA, LN, PC-Ⅲ and Ⅳ-C in model group were increased significantly, and the level of ALB was decreased significantly (P<0.05). There were some pathological phenomena such as vacuolar degeneration and fibrous tissue proliferation in rat liver. The levels of SOD in liver tissue were decreased significantly, while the levels of MDA and HYP were increased significantly (P<0.05). A large number of positive staining granules of α-SMA protein were observed in liver tissue, and the expression level of α-SMA protein was significantly increased (P<0.05). Comparison of model group, the serum levels of ALT, AST and liver fibrosis indexes were significantly decreased and ALB level was significantly increased in Shuangshen yin groups, while the TBIL levels in Shuangshen yin medium-dose, high-dose groups were significantly decreased (P<0.05); the phenomena of hepatocyte degeneration and fibrosis tissue proliferation were significantly improved; the levels of SOD in liver tissue were significantly increased, and the levels of MDA and HYP were significantly decreased (P<0.05); the positive staining of α-SMA protein decreased significantly, and the expression level of α-SMA protein was decreased significantly (P<0.05). CONCLUSIONS: Shuangshen yin has protective and anti-fibrotic effects on liver in rats with hepatic fibrosis, the mechanism of which may be associated with enhancing antioxidant capacity, down-regulating the expression of α-SMA, inhibiting the activation of hepatic stellate cells, reducing extracellular matrix synthesis so as to reverse liver fibrosis.

11.
Article in Chinese | WPRIM | ID: wpr-695762

ABSTRACT

Objective To investigate the therapeutic effect of neurotropin (NTP) combined with methylcobalamin for the treatment of residual neurological symptoms after surgery for degenerative lumbar disease (DLD).Methods A total of 96 cases with residual neurological symptoms after surgery for DLD from Jan.,2012 to Jun.,2015 were enrolled in this study and divided into three groups,32 cases in each group.The patients in group A were treated with methylcobalamin,the patients in group B were treated with NTP,and the patients in group C were treated with NTP + methylcobalamin.All the patients were treated for 2 weeks.The visual analogue scale (VAS) and oswestry disability index (ODI) were observed and documented at the beginning of the treatment,14 days,3 months,6 months and 12 months after the treatment,respectively.Results The VAS and ODI scores at 14 days,3 months,6 months and 12 months after the treatment in each group decreased obviously comparing with the scores before the treatment (P<0.05).At each time point the VAS and ODI scores in group C<group B<group A (P<0.05).The excellent rate at each time point in group C>group B>group A (P < 0.05).Conclusions NTP is effective in the treatment of residual neurological symptoms and its therapeutic effects is better than methylcobalamin.The combined application of NTP and methylcobalamin is superior to the single application of NTP or methylcobalamin for the treatment of residual neurological symptoms after surgery for degenerative lumbar diseases.

12.
Article in Chinese | WPRIM | ID: wpr-687332

ABSTRACT

Epimedii Folium has a long history in China as a common traditional Chinese medicine. Key factors of Epimedii Folium quality were summarized based on ancient literatures, Chinese Pharmacopoeias and modern research in different period of history. The main reason for unqualified Epimedii Folium is unstable icariin. Therefore, it's suggested that: the precondition of the quality control of epimedium is to find the proper quality marker. It's suggested that the medicinal parts should be reverted to "dry whole plant overground" to solve Epimedium resource shortage problem. In addition, it is necessary to strengthen the standardized cultivation, so as to ensure germplasm, production area, and producing method to guarantee the quality of Epimedium Folium. In the drying method, it is recommended to change "dry in the sun or shade" to "dry", namely dry in the sun, shade or drier, in order to provide a new method to improve the quality control and quality standard of Epimedii Folium.

13.
Article in Chinese | WPRIM | ID: wpr-259775

ABSTRACT

<p><b>OBJECTIVE</b>To observe the clinical effect of ceramic on ceramic total hip arthroplasty(THA)in Crowe IV developmental dysplasia of the hip(DDH).</p><p><b>METHODS</b>From April 2008 to December 2015, 137 hips of 111 Crowe IV DDH patients received THA using Forte or Delta ceramic on ceramic by one senior surgeon, which consists of 85 unilateral hips and 26 bilateral hips. The average age of the patients was(38.88±10.83) years old ranging from 18 to 68 years old. The mean follow-up was(41.16±21.50) months ranging from 12 to 96 months. All the patients were evaluated by Harris Hip Score. Radiographic evaluations were made preoperatively and during follow-up. Harris scores, the incidence of complications such as ceramic fracture, squeaking, dislocation were observed.</p><p><b>RESULTS</b>The mean preoperative Harris score was 56.54±15.67, the mean postoperative Harris score was 88.30±6.86(=0.017). Periprosthetic osteolysis was not deteced around any cup. No ceramic fracture occurred. There were 3 cases of revision surgery due to infection, losening of the stem and limb length discrepancy, respectively; 3 cases of dislocation occurred. Seventy-seven patients were recorded the gait and the hip mobility, the hip flexion of 69 patients were above 120 degrees.</p><p><b>CONCLUSIONS</b>Ceramic on ceramic bearing showed an encouraging result in Crowe IV DDH total hip arthroplasty.</p>

14.
Article in Chinese | WPRIM | ID: wpr-259773

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the risk factors for the failure in treating periprosthetic infection of coagulase-negative staphylococci by two-stage revision.</p><p><b>METHODS</b>From January 2005 to June 2015, 57 patients with periprosthetic hip and knee joint infection of coagulase-negative staphylococcus by two-stage revision were retrospectively reviewed with an average age of (61.3±11.9) years old. According to the drug resistance of methicillin, the patients were divided into methicillin sensitive group(MSCoN) and methicillin resistance(MRCoN) group, 25 cases in MSCoN group(9 knees and 16 hips) included 12 males and 13 females, 32 cases in MRCoN group(11 knees and 21 hips) included 14 males and 18 females. Follow-up for at least 2 years, the inflammatory markers, incidence rate of sinus and the duration of the symptoms, reinfection or persistent infection rate after two-stage revision were compared between two groups.</p><p><b>RESULTS</b>MSCoN group and MRCoN group were followed up(81.7±38.3) months and(65.9±33.8) months, respectively;23 cases and 27 cases were successfully treated;there was no significant difference between two groups(=0.643). The patients who had surgery history were 4.04 times higher of failure than the patients without a history of surgery[OR=4.04, 95%CI(0.62, 26.5)]. Patients who had sinus were 4.26 times higher of failure than the patients without sinus[OR=4.26, 95%CI(0.7, 25.9)].</p><p><b>CONCLUSIONS</b>Two-stage revision is an effective procedure in treating patients infected by MSCoN and MRCoN. There is no significant difference of treatment failure rate between MSCoN and MRCoN group by two-stage revision. Surgery history and sinus maybe the risk factors of treatment failure, while methicillin-resistance is not.</p>

15.
Article in Chinese | WPRIM | ID: wpr-789834

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BACKGROUND: Data on the mechanical ventilation (MV) characteristics and radiologic features for the cases with H7N9-induced ARDS were stil lacking. METHODS: We describe the MV characteristics and radiologic features of adult patients with ARDS due to microbiologically confirmed H7N9 admitted to our ICU over a 3-month period. RESULTS: Eight patients (mean age 57.38±16.75; 5 male) were diagnosed with H7N9 in the first quarter of 2014. All developed respiratory failure complicated by acute respiratory distress syndrome (ARDS), which required MV in ICU. The baseline APACHE II and SOFA score was 11.77±6.32 and 7.71±3.12. The overall CT scores of the patients was 247.68±34.28 and the range of CT scores was 196.3–294.7. The average MV days was 14.63±6.14, and 4 patients required additional rescue therapies for refractory hypoxemia. Despite these measures, 3 patients died. CONCLUSION: In H7N9-infected patients with ARDS, low tidal volume strategy was the conventional mode. RM as one of rescue therapies to refractory hypoxemia in these patients with serious architectural distortion and high CT scores, which could cause further lung damage, may induce bad outcomes and requires serious consideration. Prone ventilation may improve mortality, and should be performed at the early stage of the disease, not as a rescue therapy.

16.
Article in Chinese | WPRIM | ID: wpr-700062

ABSTRACT

Object To design a surgical instrument preprocessor to facilitate the following cleaning.Methods The preprocessor was composed of a plastic shell, a liquid holding tank, an abluent adding mechanism, a charging pump, a set of temperature control device for heating and temperature calibration, truckles and a tank cover. The tigntness of the preprocessor was realized by a depressor under the tank cover, a spring connecting the depressor with the cover, a rope crossing through the cover and linked with the depressor as well as a ropewinder.Results The preprocessor eliminated easily the bloodstain and etc and prevented the biomembrane from coming into being.Conclusion The preprocessor behaves well in easy operation, automation and cleaning efficiency.

17.
Article in Chinese | WPRIM | ID: wpr-699406

ABSTRACT

Objective :To explore therapeutic effect of subhypothermia combined cisternal nimodipine perfusion (CNP) on cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH).Methods :A total of 92 patients with CVS after SAH treated in our hospital from Feb 2014 to May 2016 were selected .The patients were randomly and e-qually divided into subhypothermia group (received subhypothermia treatment ) and combined treatment group (re-ceived subhypothermia treatment combined CNP) ,both groups were treated for 3 d .Therapeutic effect ,Glasgow coma scale (GCS) score ,middle cerebral artery (MCA) mean blood flow velocity ,serum levels of tumor necrosis factor (TNF)-α ,high sensitive C reactive protein (hsCRP) and interleukin (IL)-6 before and after treatment , and incidence rate of adverse events were compared between two groups .Results : Compared with before treat-ment ,after treatment ,there was significant rise in GCS score ,and significant reductions in MCA mean blood flow velocity ,serum levels of TNF-α ,hsCRP and IL-6 in two groups , P= 0.001 all ;compared with subhypothermia group after treatment ,there was significant rise in GCS score [ (10.26 ± 2.14) scores vs .(12.35 ± 2.56) scores] , and significant reductions in MCA mean blood flow velocity [(97.48 ± 18.20) cm/s vs.(89.74 ± 18.40) cm/s] ,se-rum levels of TNF-α [(0.56 ± 0.17) ng/ml vs.(0.34 ± 0.11) ng/ml] ,hsCRP [(186.75 ± 15.19) ng/L vs.(173.24 ± 15.23) ng/L] and IL-6 [ (10.41 ± 2.06) ng/L vs .(8.51 ± 2.13) ng/L] in combined treatment group ,P<0.05 or <0. 01. Total effective rate of combined treatment group was significantly higher than that of subhypothermia group (91.30% vs.71.74%) , P=0.016 ;and incidence rate of adverse events was significantly lower than that of subhypothermia group (6.52% vs.21.74%) ,P=0.032 .Conclusion :Subhypothermia treatment combined cisternal nimodipine perfusion can effectively reduce MCA blood flow velocity ,relieve inflammation and improve therapeutic effect with less adverse events ,which is worth extending .

18.
Article in Chinese | WPRIM | ID: wpr-698936

ABSTRACT

Objective To investigate the expression of Rab11 in children with sepsis at different sta-ges and severe sepsis and its relationship with the occurrence and development of sepsis in children. Methods A prospective control study was performed. All cases were enrolled from Bao′an Maternal and Children Health Care Hospital, and they were divided into sepsis group(40 cases) who were diagnosed as sepsis, severe sepsis group(20 cases) with diagnosis of severe sepsis,and healthy control group(40 healthy chil-dren) . Venous blood samples were collected at admission,and the expression level of blood leukocyte Rab11 was determined by Western blot. In the sepsis group,the expression levels of Rab11 were evaluated at the initial,the extreme and the recovery stages of sepsis,and were compared with those in severe sepsis group and healthy control group, respectively. Spearman correlation analysis was used to evaluate the relationship between the expressions of Rab11 and the levels of some parameters in blood,including white blood cell,neu-trophils,lymphocytes,monocytes,eosinophilic granulocyte,C-reactive protein and procalcitonin in blood,at the extreme stage. Meanwhile,the levels of Rab11 at extreme stage of sepsis,caused by different diseases, such as severe pneumonia,bronchiectasis complicated pulmonary infection,biliary tract infection,urinary tract infection, necrotizing enterocolitis and severe enteric viruses infection, were compared with each other. Results At the initial and the extreme stages of sepsis, as well as in severe sepsis group,the levels of Rab11 were significantly lower than that in the healthy control group(0. 54 times,0. 23 times and 0. 07 times, P<0. 05,respectively). There were no significant differences in the expression levels of Rab11 at the recovery stages of sepsis compared with that in the healthy control group(P>0. 05). There was no relation-ship between the level of Rab11 and the number of white blood cell, neutrophils, lymphocytes, monocytes, eosinophilic granulocyte, while the level of Rab11 was negatively correlated with C-reactive protein ( r =-0. 58,P=0. 014) and procalcitonin(r= -0. 63,P=0. 003) at the extreme stage of sepsis. There was no significant difference in the expression level of Rab11,at the extreme stage of sepsis,among those patients with severe pneumonia,bronchiectasis and pulmonary infection,biliary tract infection,urinary tract infection, necrotizing enterocolitis and severe enterovirus infection(P>0. 05). Conclusion The level of Rab11 is differently expressed at different stages of sepsis,and could be used as a predictor of the severity of sepsis in children.

19.
Article in Chinese | WPRIM | ID: wpr-690963

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the effects of bortezomib(BTZ) and thalidomide(TM) on peripheral blood memory T-cells (T) and regulatory T cells(Tregs) in patients with multiple myeloma(MM).</p><p><b>METHODS</b>Eighty-six MM patients received 2 courses of chemotherapy were divided into effective (partial response at least) group (63 cases) and ineffective (no partial response) group (17 cases) according to therapeutic efficacy; these 80 patients were divided into BTZ group (38 cases) and TM group (42 cases) yet according to therapeutic regimens, 20 newly diagnosed MM patients were used as baseline group, 30 healthy volunteers were used as healthy control group. The T subsets and Treg in peripheral blood of each groups were detected by flow cytometry.</p><p><b>RESULTS</b>The CD4 central memory T cells (CD4 T) percentage of CD4 T, the CD18 T percentage of CD18T and ratio of CD8 T and CD8 effector memory T cells (T) (CD8 T/T) in baseline group were all significantly lower than those in healthy control group (P<0.05). After treatment with BTZ regimen or TM regimen, the CD8T percentage of CD8 T in effective group significantly increased to level of healthy control group (P<0.05); the Treg cell level in effective and in effective groups was not significantly different from that in baseline group(P>0.05), but the Treg percentage of CD4 cells ineffective group was significantly higher than that in baseline group and ineffective group (P<0.05). According to ROC curve, the critical value of CD8T/T for predicting chemotherapeutic response was 0.27 with sensitivity of 57.1% and specificity of 94.1%.</p><p><b>CONCLUSION</b>When MM patients are in an immuno-exhanstive status, the treatment with BTZ or TM both can reverse the immuno-inhibitory status of MM patients, moreover, does not affect the Treg cell count; the Treg percentage in BTZ and TM effective groups both are significantly higher than that in baseline group and ineffective group. The ratio of CD8T/T contributes to evaluating the chemotherapeutic efficacy.</p>


Subject(s)
Bortezomib , Flow Cytometry , Humans , Multiple Myeloma , T-Lymphocyte Subsets , T-Lymphocytes, Regulatory , Thalidomide
20.
Article in Chinese | WPRIM | ID: wpr-689569

ABSTRACT

<p><b>OBJECTIVE</b>To compare the pharmaco-economic effect of 3 chemotherapeutic regimens in the treatment of patients with multiple myeloma(MM).</p><p><b>METHODS</b>One hundred and thirty-eight newly diagnosed cases of MM in our hospital were analyzed retrospectively, and then MM patients were divided into group A, B and C group according to therapeutic regimen. Group A was treated with VCD therapeutic regimen (bortezomib + cyclophosphamide + dexamethasone, 63 cases), The patients in group B was treated with BiCTD therapeutic regimen (clarithromycin+cyclophosphamide+thalidomide+dexamethasone, 44 cases), The patients in group C was treated with CTD therapeutic regimen (cyclophosphamide+ thalidomide+dexamethasone, 33 cases). The clinical efficacy, adverse reaction, cost-effectiveness were observed and analysed after 4 courses of treatment among 3 groups.</p><p><b>RESULTS</b>The overall response rates of group A, B and C were 96.83%, 81.82% and 64.52% with statistical significant difference (P<0.01). The high efficiency response rates of 3 groups were 82.5%, 59.09%, 32.26% with very significant statistical difference (P<0.01). The infection rate of group A was statistically and significantly higher than other 2 groups (P=0.048), and the constipation rate in group A was statistically and significantly higer than that in group B and C (P<0.05). The cost-effectiveness ratios of 3 groups were 69567.44, 20765.12 and 21475.48, respectively. The incremental cost-effectiveness ratio of group A and B were 183933.21 and 22259.09, as compared with group C. The result was in accordance with sensitivity test.</p><p><b>CONCLUSION</b>Clinicial efficacy of group A is the best,but group B has advantages on cost-effectiveness ratio as compared with other groups, otherwise, group B has low incidence of adverse reaction. In the view of safety, therapeutic efficacy and pharmacoeconomics for treatment of patients with MM, the BiCTD regimen has been confirmed to be superior to the other 2 groups.</p>


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Bortezomib , Cost-Benefit Analysis , Cyclophosphamide , Dexamethasone , Humans , Multiple Myeloma , Retrospective Studies , Thalidomide , Treatment Outcome
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