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1.
Article in Chinese | WPRIM | ID: wpr-885274

ABSTRACT

Objective:To investigate the relationship between T/N take-up value and the clinic feature of breast cancer, and explore the predictive ability of T/N take-up value for breast cancer prognosis.Methods:Breast cancer patients treated at Zhongshan Hospital, Fudan University and undergoing BSGI examination before surgery from Jan 2014 to Nov 2018 were collected. The relationship between T/N take-up value and the clinical features of breast cancer and DFS was analyzed.Results:A total of 419 breast cancer patients were collected. The median follow-up time after operation was 34 months. At the end of the follow-up, 43 cases relapsed and 376 cases did not. The average T/N values of CC position and MLO position before surgery were 2.74 and 2.58. The T/N value of CC is related to tumor stage (χ 2=22.077, P<0.05), lymph node metastasis ( Z=2.138, P<0.05) and degree of invasion ( Z=3.371, P<0.05). The T/N value of MLO is related to tumor stage (χ 2=23.091, P<0.05), lymph node metastasis ( Z=2.531, P<0.05) and degree of invasion ( Z=2.99, P<0.05). The best cut-off values of CC position and MLO position calculated by ROC curve are 2.59 and 2.97. Univariate analysis showed that tumor staging ( HR: 2.039, 95% CI: 1.404-2.962, P=0.001), T/N value at CC position ( HR: 4.349, 95% CI: 2.141-8.883, P<0.001) and T/N value at MLO position ( HR: 2.767, 95% CI: 1.520-5.039, P<0.001) is an independent risk factor for the prognosis of breast cancer. Multivariate COX regression analysis showed that tumor stage ( HR: 1.959, 95% CI: 1.302-2.946, P=0.001) and T/N value at MLO position ( HR: 3.498, 95% CI: 1.531-7.992, P=0.003) are independent risk factor of breast cancer prognosis. Conclusion:The BSGI T/N value has a certain correlation with breast cancer DFS.

2.
Article in Chinese | WPRIM | ID: wpr-885064

ABSTRACT

Objective:To evaluate the effects of stellate ganglion block (SGB) on the activation of M1 microglia during cerebral ischemia-reperfusion (I/R) in rats.Methods:Fifty-four SPF healthy male Sprague-Dawley rats, aged 8-10 weeks, weighing 240-270 g, were divided into 3 groups ( n=18 each) using a random number table method: sham operation group (group Sham), cerebral I/R group (group IR) and SGB group.Blood vessels were only exposed, without occlusion in group Sham.Cerebral I/R was induced by occlusion of the middle cerebral artery for 90 min followed by reperfusion in group IR.Cervical sympathetic trunk transaction was performed to induce left SGB immediately after onset of reperfusion in group SGB.Blood samples were collected from the apex of the heart at 6, 12 and 24 h of reperfusion for determination of the concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β in the serum (using enzyme-linked immunosorbent assay). The animals were sacrificed after the neurological function was evaluated at 24 of reperfusion, and brain tissues were removed for microscopic examination of the pathological changes in cortex, for determination of percentage of cerebral infarct size (by TTC staining), for assessment of cell apoptosis and apoptosis rate in cortex (by TUNEL), and for determination of the expression of microglial biomarker Iba-1 and activated M1 microglia biomarker CD68 (by Western blot). Results:Compared with group Sham, the neurological function score, percentage cerebral infarct size, apoptosis rate in cortex, concentrations of TNF-α, IL-6 and IL-1β in the serum, and the expression of Iba-1 and CD68 were significantly increased in IR and SGB groups ( P<0.05). Compared with group IR, the neurological function score, percentage cerebral infarct size, apoptosis rate in cortex, concentrations of TNF-α, IL-6 and IL-1β in the serum, and the expression of Iba-1 and CD68 were significantly decreased in group SGB ( P<0.05), and the pathological changes of brain tissues were significantly attenuated in group SGB. Conclusion:The mechanism by which SGB reduces cerebral I/R injury is related to inhibiting activation of M1 microglia in rats.

3.
Article in Chinese | WPRIM | ID: wpr-883471

ABSTRACT

Objective:To explore the application value of video-electroencephalogram(VEEG) monitoring in the diagnosis and localization of children with epilepsy.Methods:The clinical data of 310 children with clinical epilepsy symptoms diagnosed and treated in Tangshan Maternal and Child Health Care Hospital and Qilu Children′s Hospital Affiliated to Shandong University from May 2018 to April 2020 were analyzed. All children underwent routine EEG (REEG), VEEG monitoring, and positron emission computed tomography (PET-CT) for children undergoing surgery. REEG and VEEG was compared to monitor epileptic form discharges; the location of epileptic lesions was compared by different examination methods, and children were followed up after surgery.Results:Among the 310 children, 247 children were diagnosed with epilepsy and 63 children were suspected of epilepsy. The detection rate of VEEG epileptic form discharge was higher than that of REEG: 87.4% (216/247) vs. 45.7% (113/247), and the difference was statistically significant ( χ2 = 6.3042, P<0.05). Among 247 children with epilepsy, during the VEEG test, 81 children (32.8%) had clinical symptoms, of whom 65 had seizures and 16 had non-epileptic seizures. The detection rate of VEEG for epilepsy was higher than that of clinical seizures: 87.5% (216/247) vs. 32.8% (81/247), and the difference was statistically significant ( χ2 = 8.6148, P<0.05). Among the 247 children with epilepsy diagnosed, 144 children had epilepsy syndrome, temporal lobe epilepsy accounted for 54.17% (78/144), and frontal lobe epilepsy accounted for 34.2% (50/144). The accuracy of preoperative VEEG localization of epilepsy lesions in 50 children undergoing surgery was higher than that of PET-CT and REEG: 80.0% (40/50) vs. 56.0% (28/50), 54.0% (27/50), and the differences were statistical significance ( χ2 = 5.3014, 5.6031, P<0.05). Postoperative follow-up of 50 children who had underwent surgery showed that 50.0% (25/50) of the children had no seizures, and 38.0% (19/50) of the children had significant improvements in postoperative seizure time, seizure period, and clinical manifestations. 12.0% (6/50) of the children had no significant improvement in clinical symptoms. Conclusions:VEEG can improve the detection rate of epileptic form discharges, and provide an important basis for clinical diagnosis of epilepsy, and have important value in locating epilepsy lesions before surgery.

4.
Article in Chinese | WPRIM | ID: wpr-883233

ABSTRACT

Objective:To investigate the surgical treatment for compression of inferior vena cava (IVC) by hepatic hydatid cyst.Methods:The retrospective and descriptive study was conducted. The clinical data of 10 patients with hepatic hydatid cyst compressing inferior vena cava who were admitted to the First Affiliated Hospital of School of Medicine of Shihezi University from May 2013 to May 2018 were collected. There were 7 males and 3 females, aged (46±5)years, with a range from 38 to 51 years. Patients underwent subadventitial close total pericystectomy, subadven-titial partial pericystectomy or subadventitial close total pericystectomy with partial IVC resection according to the relative distance between hepatic hydatid cyst and IVC, and the feasibility of total pericystectomy. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using outpatient examination or telephone interview. Patients were followed up at the outpatient department at postoperative 3, 6, 12, 24 months using color Doppler ultrasound examination to detect the recurrence of hepatic hydatid cyst and inferior vena cava occlusion. The endpoint of follow-up was 2 years after operation, and the secondary endpoint of follow-up was recurrence of hepatic hydatid cyst. The follow-up time was up to May 2020. Measure-ment data with normal distribution were represent as Mean±SD, and count data were described as absolute numbers. Results:(1) Surgical situations: 10 patients underwent surgery successfully without massive hemorrhage and septic shock during the operation, including 7 patients undergoing subadventitial close total pericystectomy, 2 patients undergoing subadventitial partial pericys-tectomy, and 1 patient undergoing subadventitial close total pericystectomy with partial IVC resection. The operation time and volume of intraoperative blood loss of 10 patients were (99±27)minutes and (99±48)mL, respectively. (2) Postoperative situations: the time to drainage tube removal and duration of postoperative hospital stay of 10 patients were 2-5 days and (7.1±1.8)days. None of patients underwent postoperative bleeding, residual cavity infection, biliary fistula, or perioperative death. (3) Follow-up: of 10 patients, 9 patients completed the endpoint of follow-up and no recurrence of hepatic hydatid cyst or inferior vena cava occlusion formation was detected. The other 1 patient was followed up at postoperative 3, 6 months but failed to be followed up at postoperative 12 months, and no recurrence of hepatic hydatid cyst or inferior vena cava occlusion formation was detected during the follow-up time.Conclusion:Complete resection of hepatic hydatid cyst can be achieved by subadventitial close total pericystectomy, subadventitial partial pericystectomy or subadventitial close total pericystectomy with partial IVC resection.

5.
Article in Chinese | WPRIM | ID: wpr-882773

ABSTRACT

The data of a child with early-onset epileptic encephalopathy in Qilu Children′s Hospital of Shandong University in February 2020 were analyzed retrospectively.The child was a 4-month-old girl, who was admitted to the hospital because of " repeated convulsions for 4 months and feeding difficulty for 1 month" at the age of 4 months.The patient suffered from epilepsy 1 day after birth, and the epilepsy type was tonic seizures.Severe developmental retardation was observed in the patient.Electroencephalogram showed multifocal discharge, which then turned to hypsarrhythmia.The cranial imaging was negative.Feeding difficulty occurred at the age of 3 months.The genetic testing revealed a de novo heterozygous missense mutation in the FGF12 gene (Arg114His). Various antiepileptic drugs and ketogenic diet were ineffective.There was no attack in 2 months after adding Phenytoin.The child could eat on her own after seizure control, but there was no progress in intellectual and motor development.Mutations in the FGF12 gene lead to poor prognosis of early-onset epileptic encephalopathy, and the seizures are difficult to control.Sodium ion channel blockers such as Phenytoin should be used as soon as possible.

6.
Article in Chinese | WPRIM | ID: wpr-881252

ABSTRACT

@#In the absence of symptoms, silent cerebral infarction can be discovered incidentally during an imaging or neuropathological examination. After cardiovascular surgery with cardiopulmonary bypass, the morbidity is high, and it may contribute to neurocognitive dysfunction, symptomatic cerebral infarction and increased risk of death. The embolus caused by various operations intraoperatively are closely associated with this progress. However, controversies over the prevention still persist. As a result, an overall summary of silent cerebral infarction after cardiovascular surgery with cardiopulmonary bypass will be presented in this review.

7.
Journal of Chinese Physician ; (12): 228-232, 2020.
Article in Chinese | WPRIM | ID: wpr-867230

ABSTRACT

Objective To analyze the changes of Survivin,MSH6 and MSH2 expression in colorectal cancer and explore their relationship with clinical and pathological parameters.Methods 197 cases of colorectal adenocarcinoma and 20 cases of inflammatory intestinal mucosa were detected by immunohistochemistry with Survivin,MSH6 and MSH2,and the correlation between Survivin,MSH6 and MSH2 expression was analyzed.Results In the control group of 20 cases with inflammatory non-tumor intestinal mucosa,the positive expression rate of MSH2,MSH6,Survivin were 95%,95%,10%,respectively.While the positive expression rate of MSH2,MSH6,Survivin were 88.3%,74.1% and 84.3% in 197 cases of colorectal cancer.Survivin positive expression rate in colorectal cancer group was significantly higher than that in inflammatory control group (P < 0.05).Survivin expression was correlated with invasion depth and lymph node metastasis in colorectal cancer tissue (P < 0.05),but not with gender,age,tumor size,gross type or degree of differentiation (P > 0.05).MSH2 expression was correlated with tumor size and lymph node metastasis (P < 0.05),but not with gender,age,gross type,depth of infiltration and degree of differentiation (P > 0.05).MSH6 expression was related to gender and lymph node metastasis (P < 0.05),but not to age,tumor size,gross type,infiltration depth and differentiation (P > 0.05).Colorectal cancer tissues showed positive correlation between MSH6 and MSH2 (r =0.326,P < 0.01),positive correlation between MSH2 and Survivin positive expression (r =0.277,P < 0.01),and positive correlation between MSH6 and Survivin positive expression (r =0.435,P < 0.01).Conclusions The positive expression rate of Survivin in colorectal cancer is high.MSH2,MSH6 and Survivin in colorectal cancer play an important role in the development and progression of colorectal cancer,and can provide evidence for the detection of these three factors,including metastasis risk,prognosis assessment and clinical treatment.In particular,Survivin gene may provide evidence for gene therapy.

8.
International Journal of Surgery ; (12): 265-268, 2020.
Article in Chinese | WPRIM | ID: wpr-863314

ABSTRACT

The number of women of childbearing age having overweight or obesity problems keeps increasing globally. Besides diabetes, hypertension and other chronic conditions, these women may develop metabolic disorders of sex hormones, manifested by irregular menstruation, infertility and obstetric complications. Bariatric surgery offers prominent weight loss and improves obesity-related conditions. Women patients also benefit from elevated chances of pregnancy postoperatively. However, the timing of pregnancy for obese women after surgery has impact on the effects of weight loss surgery, pregnancy complications, delivery outcomes and long-term prospects of mother and child. This article reviews the clinical studies on the timing of pregnancies after bariatric surgery, weight loss results, as well as risks and outcomes.

9.
Chinese Journal of Burns ; (6): 624-625, 2019.
Article in Chinese | WPRIM | ID: wpr-810827

ABSTRACT

Children with burns often have uncooperative behaviors such as crying and struggling when changing dressing because of pain and fear, which affects dressing change of medical staff and increases the psychological burden of the family members of children and dressing change personnel. In order to solve the above problems, the author′s team designs and makes the mobile soothing screen for pediatric dressing change. Dressing change personnel are isolated from the children′s sight through the screen′s shielding function, and the children′s favorite program showed on the tablet computer attracts the children′s attention. The wound dressing change is completed by using the disposal window on the screen, which has good clinical application effects.

10.
Article in Chinese | WPRIM | ID: wpr-798176

ABSTRACT

Objective@#To investigate the clinical research of Guo's Liulian therapy in treating acute pancreatitis intestinal mucosal barrier dysfunction and provide reference for the patients with acute pancreatitis.@*Methods@#The 68 patients with acute pancreatitis who were admitted to our hospital from September 2016 to May 2018 were selected as study subjects. According to the random number table method, the patients were divided into the observation group and the control group, with 34 cases in each group. The patients in the control group were treated with conventional western medicine. The patients in the observation group were treated with Guo's Liulian therapy on the basis of the above treatment. The time of intestinal paralysis was compared between the two groups. The changes of intestinal mucosal barrier function and serum inflammatory factor related indexes before and after treatment were analyzed in the two groups. The difference of therapeutic effects between the two groups was observed.@*Results@#In the observation group, the abdominal pain relief time, abdominal distention relief time, bowel sound recovery time, and first bowel anus defecation time were significantly lower than those in the control group (t=7.621, 5.332 6.625, 8.762, all Ps<0.01). After treatment, serum LPS, DAO, ET, D-lactic acid, TNF-α, IL-1, IL-6, IL-8, and IL-10 and urine L/M were significantly lower in the observation group, while the serum ITF and MFG-E8 were significantly higher in the observation group (t=9.856, 6.974, 9.784, 16.068, 9.550, 12.506, 22.343, 16.625, 6.774, 23.469, 20.118, 23.031, all Ps<0.01).@*Conclusions@#The Guo's Liulian therapy treatment of acute pancreatitis in patients with intestinal mucosal barrier dysfunction can reduce the palsy remission time, reduce inflammation, increase serum ITF, MFG-E8 levels, repair of intestinal permeability, and improve the intestinal barrier function.

11.
Article in Chinese | WPRIM | ID: wpr-791325

ABSTRACT

Objective To analyze clinical outcome of high grade squamous intraepithelial lesion (HSIL) within 24 months after loop electrosurgical excision procedure (LEEP),and to explore risk factors of recurrent cervical HSIL,the risk of progress into cervical cancer and methods of follow-up.Methods This retrospective study was carried out on 1 005 patients who underwent LEEP,diagnosing with HSIL after LEEP from January 2011 to December 2013 at Obstetrics and Gynecology Hospital Affiliated to Fudan University to confer the difference between non-recurrent group and recurrent group 24 months after the LEEP conization.Patients were followed with ThinPrep cytologic test (TCT),high risk HPV (HR-HPV) test,colposcopy guided biopsy.Results A total of 1 005 cases were enrolled in this study with HSIL in the LEEP specimen,no residual HSIL in the 6-month follow up,and have follow up records in 24 months after LEEP.HSIL recurred in 5 cases,microinvasive carcinoma in 1 case,low grade squamous intraepithelial lesion (LSIL) in 17 cases at 12 months follow-up.HSIL recurred in 8 cases,LSIL in 11 cases,adenocarcinoma in situ in 1 case,and invasive cervical carcinoma in 1 case in Ⅰ b1 stage at 24 months after LEEP.The recurrence rate was 1.3% (13/1 005),and the progression rate was 0.3% (3/1 005).There was no significant difference in age,length,circumference and width of LEEP between recurrent and non-recurrent patients (P > 0.05).The recurrence rate was highest in the endocervical positive margin group with 3/16,which was higher than ectocervical positive margin and negative margin (P<0.01,P=0.040,respectively).The recurrence rate of endocervical positive margin group and fibrous interstitial positive margin group showed no significant difference (P=0.320).There was no significant difference between ectocervical positive margin and negative margin [2.8% (2/72) vs 0.7% (6/882),P=0.117].Postoperative cytological examination combined with HR-HPV detection has a high sensitive and high negative predictor value of HSIL recurrence with both 100.0%.Multivariate logistic regression analysis showed that positive endocervical positive margin,abnormal follow-up cytological examination and positive HR-HPV after LEEP were independent factors affecting recurrence of HSIL patients after LEEP (P<0.05).Conclusions Age,length,circumference and width of LEEP have no effect on recurrence within 24 months after HSIL.The high risk factors for HSIL recurrence within 24 months after LEEP in HSIL patients include:positive HPV,abnormal cytology,and positive endocervical positive margin.Colposcopy biopsy and endocervical curettage have important role in diagnosing HSIL recurrence and progression.

12.
Article in English | WPRIM | ID: wpr-719250

ABSTRACT

OBJECTIVES: Although patients with grade I and II endometrioid endometrial adenocarcinoma (EEA) are considered with good prognosis, among them 15%–25% died in 5 years. It is still unknown whether integrating estrogen receptor (ER) and progesterone receptor (PR) into clinical risk stratification can help select high-risk patients with grade I–II EEA. This study was to investigate the prognostic value of ER and PR double negativity (ER/PR loss) in grade I–II EEA, and the association between ER/PR loss and The Cancer Genome Atlas (TCGA) classification. METHODS: ER and PR were assessed by immunohistochemistry on hysterectomy specimens of 903 patients with grade I–II EEA. ER and PR negativity were determined when < 1% tumor nuclei were stained. Gene expression data were obtained from the TCGA research network. RESULTS: Compared with ER or PR positive patients (n=868), patients with ER/PR loss (n=35) had deeper myometrial infiltration (p=0.012), severer FIGO stage (p=0.004), and higher rate of pelvic lymph node metastasis (p=0.020). In univariate analysis, ER/PR loss correlated with a shorter progression-free survival (PFS; hazard ratio [HR]=5.25; 95% confidence interval [CI]=2.21–12.52) and overall survival (OS; HR=7.59; 95% CI=2.55–22.60). In multivariate analysis, ER/PR loss independently predicted poor PFS (HR=3.77; 95% CI=1.60–10.14) and OS (HR=5.56; 95% CI=1.37–22.55) for all patients, and poor PFS for patients in stage IA (n=695; HR=5.54; 95% CI=1.28–23.89) and stage II–IV (n=129; HR=5.77; 95% CI=1.57–21.27). No association was found between ER/PR loss and TCGA classification. CONCLUSION: Integrating ER/PR evaluation into clinical risk stratification may improve prognosis for grade I–II EEA patients.


Subject(s)
Adenocarcinoma , Carcinoma, Endometrioid , Classification , Disease-Free Survival , Endometrial Neoplasms , Estrogens , Female , Gene Expression , Genome , Humans , Hysterectomy , Immunohistochemistry , Lymph Nodes , Multivariate Analysis , Neoplasm Metastasis , Progesterone , Prognosis , Receptors, Progesterone
13.
Journal of Chinese Physician ; (12): 1688-1692, 2019.
Article in Chinese | WPRIM | ID: wpr-824289

ABSTRACT

Objective To investigate the expression of serum Neurensin 2 (NRSN2) in patients with nasopharyngeal carcinoma (NPC),and to analyze its relationships with epstein-barr virus (EBV) antibody and EBV-DNA.Methods 120 patients with NPC admitted to our hospital from April 2016 to May 2018 were selected as the study group,and 56 healthy people in the physical examination center were selected as the control group.Enzyme linked immunosorbent assay (ELISA) was used to detect the expressions of serum viral capsid antigen-IgA (VCA-IgA),nuclear related tumor antigen-IgA (EBNA-IgA) and early antigen-IgG (EA-IgG).The expression of serum NRSN2 and EBV-DNA were detected by fluorescence quantitative polymerase chain reaction (qPCR).Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of serum NRSN2 level for NPC.Spearman was used to analyze the relationship between serum NRSN2 and EBV antibody with EBV-DNA in nasopharyngeal carcinoma,multivariate logistic regression analysis was used to analyze the risk factors of NPC.Results The positive rates of serum VCA-IgA,EBNA-IgA and EA-IgG in the study group were significantly higher than those in control group (P <0.05);the level of serum NRSN2 and the positive expression rate of EBV-DNA in the study group was significantly higher than that in the control group (P < 0.05);ROC curves showed that the area under curve (AUC) of serum NRSN2 level in diagnosing NPC disease was 0.759,with sensitivity 63.33%,specificity 80.36%;there were significant positive correlations between serum NRSN2 with VCA-IgA,EBNA-IgA,EA-IgG and EBV-DNA in NPC patients (P < 0.05);multivariate regression analysis showed that VCA-IgA,EBNA-IgA,EA-IgG,EBV-DNA and NRSN2 expressions were supportive predictive value for diagnostic NPC (P < 0.05).Conclusions Up-regulation of serum NRSN2 levels in NPC patients is positively correlated with serum VCA-IgA,EBNA-IgA,EA-IgG and EBV-DNA levels,which may provide a reference for the prediction,diagnosis and treatment of NPC.

14.
Clinical Medicine of China ; (12): 10-13, 2019.
Article in Chinese | WPRIM | ID: wpr-734083

ABSTRACT

Objective To analyze the relationship between non-sentinel lymph node ( NSLN ) metastases and clinicopathologic features in breast invasive ductal carcinoma patients with 1, 2 positive sentinel lymph node(SLN). Methods A total of one hundred and ninety-eight patients with breast invasive ductal carcinoma from January 2013 to December 2017 were enrolled in this prospective study. Modified radical mastectomy was performed after SLN1-2 positive cases were confirmed by biopsy. Postoperative NSLN was counted and the relationship between NSLN and clinical factors was analyzed. Results The positive rate of NSLN in 198 patients was 40. 9%(81/198),of which 80 cases were positive at axillary level I and only 1 case was positive at axillary level I and II. There was no significant correlation between NSLN positive and age (χ2=1. 258),lesion grade (χ2=1. 327),molecular typing (χ2=1. 020),neoadjuvant chemotherapy (χ2=0. 923),estrogen receptor (χ2=0. 189),progesterone receptor ( χ2=0. 109),Ki67 ( χ2=1. 755) ( P>0. 05). The positive rate of NSLN in HER-2 positive patients was 56. 9%(29/51),which was significantly higher than 35.4%(52/147) in HER-2 negative patients (χ2 =6.136,P=0.034).Logistic regression analysis showed that HER-2 positive was an independent risk factor for NSLN ( OR=0. 031,95%CI 0. 012-0. 615,P=0. 022) . Conclusion The risk of NSLN positive in breast cancer patients such as SLN1-2 positive patients is still high,and the risk of NSLN positive in HER-2 positive patients is higher.

15.
Article in Chinese | WPRIM | ID: wpr-755155

ABSTRACT

Objective To study the impact of splenectomy and devascularization on liver function and liver fibrosis in patients with non-cirrhotic portal hypertension (NCPH). Methods The clinical data of patients with NCPH who were treated in Beijing You'an Hospital of Capital Medical University from April 2008 to December 2017 were retrospectively analyzed. The patients were divided into the observation group (n=16 ) and the control group ( n =30 ) according to their treatment methods. The observation group underwent splenectomy combined with devascularization, while the control group received conservative treatment. The changes in liver function, ascites, varicose vein rupture and bleeding before and after treat-ment, and the changes in liver blood flow before and after treatment in the observation group were compared. Results The before and after treatment of the 2 groups in ALT, AST, total bilirubin, albumin showed no statistically significant difference (P>0. 05). Six months after treatment, the rates of ascites and bleeding were significantly higher than the observation group, (P<0. 05). Ten patients who had a history of preoper-ative variceal hemorrhage in the observation group did not bleed within 6 months after treatment. Further-more, in the observation group after treatment when compared with the control group, the PC-Ⅲ [(32. 3 ± 12. 1) g/L vs. (56. 7 ± 15. 3)g/L],Ⅵ-C [(46. 6 ± 35. 0) g/L vs. (121. 3 ± 30. 4)g/L], LN [(32. 5 ± 10. 5) g/L vs. (65. 8 ± 11. 1) g/L] were significantly lower than the control group ( P <0. 05). The preoperative portal venous blood flow in the observation group was significantly higher than that after surgery [(1 056. 8 ± 679. 8) ml/min vs. (481. 0 ± 227. 6) ml/min, P<0. 05]. Conclusion Splenectomy and devascularization effectively stopped variceal bleeding and delayed liver fibrosis in NCPH patients without affecting the liver function.

16.
Chinese Journal of Radiology ; (12): 480-484, 2019.
Article in Chinese | WPRIM | ID: wpr-754943

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Objective Electrocardiographic (ECG) gated 4?dimensional CT angiography (4D?CTA) was performed to analyze the morphological characteristic differences between ruptured and unruptured intracranial aneurysms less than 5 mm to predict the rupture risk of small intracranial aneurysms. Methods A total of 118 patients with intracranial aneurysms less than 5 mm who underwent 4D?CTA examinations in our hospital from May 2014 to May 2017 were retrospectively analyzed. The whole study population was divided into ruptured group and unruptured group. Seventy?two patients were in the ruptured group and 46 patients were in the unruptured group. Original scanning data were reconstructed to produce 20 data sets of cardiac cycles with 5% time intervals. In addition, 20 groups of images and dynamic graphs were generated using three?dimensional software. We concluded the convex was point of impulse if small bubble or small pointed convex could be found in continuous three or more images at the same location. The morphological characteristics and clinical features of the two groups of aneurysms were firstly analyzed by univariate analysis, and then the meaningful indicators were analyzed by logistic regression, and the optimal diagnostic cutoff values were calculated using ROC curves. Results Univariate analysis showed that women, smoking history, location of aneurysm at the bifurcation, pulsation point, aspect ratio (AR) and size ratio (SR) were statistically significant different between the two groups of small aneurysms (P<0.05), but age, hypertension, type 2 diabetes, family history, history of multiple aneurysms, history of drinking, location, size, neck and tumor height had no significant differences between the two groups (P>0.05). Multivariate regression analysis showed that pulsation point (odds ratio=8.843, 95% confidence interval: 2.800—27.925) and large SR value (odds ratio=4.484, 95% confidence interval: 1.094—18.385) were independent risk factors for the aneurismal rupture. when the SR value was greater than 1.65, the area under the ROC curve was 0.832, the sensitivity to diagnose the risk of small aneurysm rupture was 76%, and the specificity is 70%. Conclusion The occurrence of pulsation point and SR value greater than 1.65 are independent predictors of the risk of intracranial aneurysm rupture less than 5 mm.

17.
Clinical Medicine of China ; (12): 406-408, 2019.
Article in Chinese | WPRIM | ID: wpr-754324

ABSTRACT

Objective To investigate the auxiliary effect of artificial tiger bone powder on the fragile fracture healing and functional recovery.Methods From June 2014 to June 2015,64 patients with fragile fracture in the second Hospital of Tangshan were randomly divided into treatment and control groups,32 cases in each group.All the selected patients were given routine treatment of fracture.The treatment group was given artificial tiger bone powder,while the control group was given vitamin D and calcium carbonate.The clinical fracture healing time of the selected patients were recorded.At the beginning and 3,6 months after treatment,the Barthel Index ( BI) and functional independent measure ( FIM) were recorded.Results There was no significant difference in general condition, BI score and FIM score between the two groups before treatment.At the 3rd and 6th month after treatment,the BI scores were(( 65.74 ± 7.94 ),( 76.05 ±8.07 ) value),and FIM scores were(( 76.61± 9.08),(( 87.91 ± 6.76) valu)],those in the treatment group were higher than those in the control group( BI:( 61.12 ± 8.67), ( 71.25 ± 8.32) value and FIM:(71.03±9.34),(79.01±7.32) value),( P<0.05).The the fracture healing time in the treatment group was shorter((12.78±2.09) weeks) than that in the control group((13.94± 2.32) weeks),( t=2.101,P<0.05).Conclusion Artificial tiger bone powder can shorten the healing time of fracture, which has auxiliary effect on the healing of fragile fracture.It can promote the functional recovery of fragile fracture patients,and improve their life and activity.

18.
Article in Chinese | WPRIM | ID: wpr-745494

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Objective To suty the clinical efficacy of neuroendoscopic hematoma removal and small bone window craniotomy in elderly patients with hypertensive intracranial hemorrhage.Methods One hundred and twelve hypertensive intracranial hemorrhage patients admitted to our hospital from January 2014to January 2017were divided into neuroendoscopic hematoma removal group (n=50)and small bone window craniotomy group(n=62).They underwent neuroendoscopic hematoma removal and small bone window craniotomy respectively.The operation time,intraoperative blood loss,hematoma clearance rate and postoperative complications,ADL and NDS scores on admission and at month 3after operation were compared between the two groups.Results The total effective rate was significantly higher in neuroendoscopic hematoma removal group than in small bone window craniotomy group(90.0%vs 83.9%,P<0.05).The operation time was significantly longer,the intraoperative hemorrhage volume was significantly smaller,the hematoma clearance rate was significantly higher in neuroendoscopic hematoma removal group than in small bone window craniotomy group(P <0.05).The ADL score was significantly higher while the NDS score was significantly lower in two groups at month 3after operation than at admission(P<0.05)and in neuroendoscopic hematoma removal group than in small bone window craniotomy group at month 3after operation than at admission(P<0.05).The incidence of complications was significantly higher in small bone window craniotomy group than in neuroendoscopic hematoma removal group(24.2%vs 20.0%,P<0.05).Conclusion The clinical efficacy of neuroendoscopic hematoma removal is significantly higher than that of small bone window craniotomy in elderly patients with hypertensive intracerebral hemorrhage.Neuroendoscopic hematoma removal can shorten the operation time,reduce the intraoperational bleeding volume,and is thus worthy of popularization in clinical practice.

19.
Article in Chinese | WPRIM | ID: wpr-751802

ABSTRACT

Objective To investigate the clinical research of Guo's Liulian therapy in treating acute pancreatitis intestinal mucosal barrier dysfunction and provide reference for the patients with acute pancreatitis. Methods The 68 patients with acute pancreatitis who were admitted to our hospital from September 2016 to May 2018 were selected as study subjects. According to the random number table method, the patients were divided into the observation group and the control group, with 34 cases in each group. The patients in the control group were treated with conventional western medicine. The patients in the observation group were treated with Guo's Liulian therapy on the basis of the above treatment. The time of intestinal paralysis was compared between the two groups. The changes of intestinal mucosal barrier function and serum inflammatory factor related indexes before and after treatment were analyzed in the two groups. The difference of therapeutic effects between the two groups was observed. Results In the observation group, the abdominal pain relief time, abdominal distention relief time, bowel sound recovery time, and first bowel anus defecation time were significantly lower than those in the control group (t=7.621, 5.332 6.625, 8.762, all Ps<0.01). After treatment, serum LPS, DAO, ET, D-lactic acid, TNF-α, IL-1, IL-6, IL-8, and IL-10 and urine L/M were significantly lower in the observation group, while the serum ITF and MFG-E8 were significantly higher in the observation group (t=9.856, 6.974, 9.784, 16.068, 9.550, 12.506, 22.343, 16.625, 6.774, 23.469, 20.118, 23.031, all Ps<0.01). Conclusions The Guo's Liulian therapy treatment of acute pancreatitis in patients with intestinal mucosal barrier dysfunction can reduce the palsy remission time, reduce inflammation, increase serum ITF, MFG-E8 levels, repair of intestinal permeability, and improve the intestinal barrier function.

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Article in Chinese | WPRIM | ID: wpr-751554

ABSTRACT

Aneurysmal subarachnoid hemorrhage (aSAH) has high disability and mortality.Cerebral vasospasm is the main cause of ischemic neurological deficit and even cerebral infarction after aSAH.At present,there are many studies on molecular signaling pathways of cerebral vasospasm.This article reviews the signaling pathways of cerebral vasospasm after aSAH.

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