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1.
Article in Chinese | WPRIM | ID: wpr-912989

ABSTRACT

@#Objective    To analyze the results and rationality of the lesion-focused strategy with subsegment as the pulmonary anatomical unit for pulmonary nodules with a diameter of ≤2 cm which require surgery. Methods    Clinical data of 246 patients with pulmonary nodules who underwent surgery in the Department of Thoracic Surgery of The First Affiliated Hospital of Nanjing Medical University from January 2017 to October 2018 were retrospectively analyzed, including 76 males and 170 females, with an average age of 53.30±11.82 years. The patients were divided into four groups, a single segmentectomy group, a segmentectomy combined with adjacent subsegmentectomy group, a single subsegmentectomy group and a combined subsegmentectomy group, according to the different surgical approaches, to compare preoperative, intraoperative, and postoperative related data. Results    There was no perioperative death. Among the four groups, there was no statistical difference in gender (P=0.163), age (P=0.691), diameter of the nodule (P=0.743), longitudinal position of the nodule (depth ratio, P=0.831), postoperative pulmonary leakage (P=0.752), intraoperative blood loss (P=0.135), pathological type (P=0.951) or TNM stage (P=0.995); there were statistical differences in transverse position of the nodule (P<0.001) and number of subsegments involved (P<0.001). The results of multivariate logistic regression analysis showed that compared with combined subsegmentectomy, the odds ratio (OR) of the lung nodule in segmentectomy combined with adjacent subsegmentectomy as intersegment nodules was 5.759 (95%CI 1.162 to 28.539, P=0.032). Conclusion     The surgical strategy of lesion  focused and subsegment as anatomical unit is safe and feasible for surgical treatment of pulmonary nodules with diameter ≤2 cm. The transverse position of the nodules is an important factor affecting the choice of surgical method for the middle and lateral nodules with a diameter of ≤2 cm, and the longitudinal location of the nodule is not an influencing factor. For nodules in inner zone, the diameter also is one of the factors influencing the choice of surgical method.

2.
Article in Chinese | WPRIM | ID: wpr-907161

ABSTRACT

Objective To observe the effects of Shexiang Baoxin pill combined with intracoronary injection of nicorandil on myocardial perfusion and short-term prognosis after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Methods 151 patients with acute myocardial infarction after PPCI were enrolled in this study. Those patients were admitted to our hospital during January 2017 to January 2018. According to the numerical randomization method, 51 patients were selected as routine treatment group (group A), 50 patients with intracoronary injection of nicorandil (group B) and 50 patients received intracoronary injection of nicorandil plus oral Shexiang Baoxin pills (group C). Intra-operative corrected TIMI frame count (cTFC), postoperative TIMI grade 3 blood flow ratio, 2-hour ECG ST segment fallback >50% index, the incidence of major adverse cardiovascular events (MACE) during hospitalization and the incidence of angina and MACE within 3 months after surgery were evaluated. Results cTFC, 2 hours postoperative ECG ST segment fall >50% index in group B and C were better than group A (P<0.05). The results from group C were better than group B. Group C exhibited better results than group B and C in post-operative angina pectoris 3 months after surgery (P<0.05). Conclusion Shexiang Baoxin pills combined with intra-coronary injection of nicorandil can improve myocardial perfusion and short-term prognosis after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction

3.
Article in Chinese | WPRIM | ID: wpr-932193

ABSTRACT

Objective:To investigate the distribution and antimicrobial resistance patterns of common pathogens in children with urinary tract infections in a single center in Shanghai, and to provide basis for the selection of empirical antibiotics in the clinical practice.Methods:The clinical data, urine culture and drug sensitivity tests results of children with urinary tract infections between 0 to 14 years admitted to the Children′s Hospital of Fudan University from January 2016 to December 2019 were retrospectively analyzed. According to the time of onset and the complicated factors, the patients were divided into different groups. The distributions and antimicrobial resistance patterns of common pathogens were compared among the groups. The chi-square test was used for statistical analysis.Results:Among the 1 832 children, 1 042 cases had positive urine culture, with the culture positive rate of 56.9%. The top five pathogens detected were Escherichia coli (375 strains, 36.0%), Enterococcus faecium (164 strains, 15.7%), Klebsiella pneumoniae (133 strains, 12.8%), Enterococcus faecalis (95 strains, 9.1%) and Pseudomonas aeruginosa (44 strains, 4.2%). The annual detection rates of gram-negative bacteria (65.3% to 72.9%) were always higher than those of gram-positive bacteria (22.6% to 30.1%). The distributions of pathogens among the years were not significantly different ( χ2 =27.79, P=0.146). In patients with complicated urinary tract infections, the detection rates of Pseudomonas aeruginosa (5.8%(40/688) vs 1.1%(4/354)) and fungi (6.5%(45/688) vs 1.7%(6/354)) were significantly higher than those in patients with simple urinary tract infections ( χ2=12.68 and 11.79, respectively, both P<0.050). Both of Escherichia coli and Klebsiella pneumoniae had the highest resistance rates to ampicillin, which were 87.2%(301/345) and 87.1%(115/132), respectively. The resistance rates of Escherichia coli to amikacin, nitrofurantoin, fosfomycin, cefmetazole, piperacillin/tazobactam, ertapenem, imipenem and meropenem were 1.4%(5/345), 6.1%(21/345), 6.1%(21/345), 8.3%(11/132), 11.6%(40/345), 6.4%(22/345), 4.6%(16/345) and 4.6%(16/345), respectively. The resistance rates of Klebsiella pneumoniae to these drugs were 6.1%(8/132), 37.9%(50/132), 15.2%(20/132), 23.2%(13/56), 26.5%(35/132), 23.5%(31/132), 17.4%(23/132) and 16.7%(22/132), respectively, which were all higher than those of Escherichia coli, and the differences were all statistically significant ( χ2=6.02, 76.17, 9.99, 7.94, 16.04, 28.29, 20.79 and 18.84, respectively, all P<0.050). The resistance rates of Pseudomonas aeruginosa to cefoperazone/sulbactam, piperacillin/tazobactam and ceftazidime were 6.8%(3/44), 4.5%(2/44) and 2.3%(1/44), respectively, while those to carbapenems, amikacin and ciprofloxacin were all 0(0/44). The resistance rate of Enterococcus faecium to ampicillin was 96.8%(153/158), while that of Enterococcus faecalis was 9.1%(8/88). There was no Enterococcus strain resistant to vancomycin, teicoplanin or linezolid. When dynamically comparing the trends of the antimicrobial resistance from 2016 to 2019, the resistance rates of Escherichia coli and Klebsiella pneumoniae to β-lactams (including carbapenems) antimicrobial agents had shown a downward trend. Conclusions:Gram-negative bacteria are still the main pathogens of urinary tract infections in children, with a downward trend of drug resistance rates to β-lactams (including carbapenems) antimicrobial agents.

4.
Chinese Journal of Lung Cancer ; (12): 207-213, 2022.
Article in Chinese | WPRIM | ID: wpr-928799

ABSTRACT

Cancer-associated fibroblasts (CAFs) and tumor-infiltrating immune cells are the most essential components of the tumor microenvironment (TME). They communicate with each other in tumor microenvironment and play a critical role in tumorigenesis and development. CAFs are very heterogeneous and different subtypes of CAFs display different functions. At the same time, it can contribute to the regulation of the function of tumor-infiltrating immune cells and eventually result in the carcinogenesis, tumor progression, invasion, metastasis and other biological behaviors of tumors by producting various growth factors and cytokines etc. Based on the current research results at home and abroad, this paper reviews the recent research progress on the regulation of CAFs on infiltrating immune cells in tumor microenvironment.
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Subject(s)
Cancer-Associated Fibroblasts/metabolism , Carcinogenesis , Cell Transformation, Neoplastic/metabolism , Humans , Lung Neoplasms/metabolism , Tumor Microenvironment
5.
Article in English | WPRIM | ID: wpr-888688

ABSTRACT

Although microRNA-155 (miR-155) is considered a pro-inflammatory mediator, cumulative evidence indicates that it also has anti-inflammatory effects in macrophages and dendritic cells. In this study, we identified the dramatic expression changes of more than half of potential miR-155-targeted genes upon lipopolysaccharide (LPS) stimulation; 223 genes were down-regulated and 85 genes were up-regulated, including suppressor of cytokine signaling 1 (

6.
Article in Chinese | WPRIM | ID: wpr-799623

ABSTRACT

Objective@#To explore the therapeutic effect of bismuth potassium citrate combined with famotidine on peptic ulcer and its effects on the levels of lipid peroxide (LPO), malondialdehyde (MDA) and somatostatin (SS).@*Methods@#One hundred and fifty patients with peptic ulcer who were treated in Cixi Cilin Hospital from January 2018 to May 2019 were randomly divided into famotidine group and combined treatment group, with 75 cases in each group. Famotidine group was treated with famotidine, while bismuth potassium citrate combined with famotidine was used in combined treatment group. H+-K+-ATP ase activity, gastric acid-base value and gastric acid secretion function were detected in two groups. The levels of tumor necrosis factor-α (TNF-α), interleukin-7 (IL-7), hypersensitive C-reactive protein (hs-CRP) were detected by ELISA, T lymphocyte subsets were detected by flow cytometry, and the levels of T lymphocyte subsets were detected by immunotransmission turbidimetry. The levels of LPO, MDA and SS were measured, and the therapeutic effect, ulcer healing and adverse reactions were compared between two groups.@*Results@#After treatment, the activity of H+-K+-ATP ase in the combined treatment group was lower than that in the famotidine group [(2.54 ± 0.41) μmol/min vs. (2.87 ± 0.50) μmol/min], the acid-base value in stomach was higher than that in the famotidine group(5.56 ± 1.19 vs. 4.77 ± 0.89), and there were significant differences (P<0.05). After treatment, the levels of maximum gastric acid excretion after pentagastrin stimulation (MAO), peak gastric acid output (PAO), basal acid output (BAO), TNF-α, IL-17, hs-CRP, CD8+, LPO and MDA in combined treatment group were lower than those in famotidine group [(8.22 ± 1.76) mmol/h vs. (10.53 ± 2.21) mmol/h, (11.88 ± 2.51)mmol/h vs. (14.79 ± 2.76) mmol/h, (4.11 ± 1.32) mmol/h vs. (5.54 ± 1.49) mmol/h, (4.76 ± 1.52) ng/L vs.(6.91 ± 1.61) ng/L, (18.37 ± 3.25) ng/L vs. (22.83 ± 3.62) ng/L, (6.41 ± 1.81) mg/L vs. (8.67 ± 2.15) mg/L, 0.287 6 ± 0.030 5 vs. 0.325 5 ± 0.032 4, (0.06 ± 0.02) U/mg vs. (0.09 ± 0.03) U/mg, (10.19 ± 1.86) μmol/L vs. (13.25 ± 2.03) μmol/L], while the levels of CD3+, CD4+, SS were higher than those in the famotidine group [0.523 6 ± 0.040 9 vs. 0.476 3 ± 0.039 5, 0.356 6 ± 0.035 2 vs. 0.315 8 ± 0.033 9, (14.59 ± 2.67) ng/L vs. (10.36 ± 2.31) ng/L], and there were significant differences (P<0.05). The total effective rate and ulcer healing rate in combined treatment group were higher than those in famotidine group [93.33%(70/75) vs. 80.00%(60/75), 94.67%(71/75) vs. 82.67%(62/75)] (P<0.05). The incidence of adverse reactions in combined treatment group was slightly higher than that in famotidine group [16.00%(12/75) vs. 13.33%(10/75)], but there was no significant difference between the two groups (P>0.05).@*Conclusions@#Bismuth potassium citrate combined with famotidine in the treatment of peptic ulcer patients can improve gastric acid secretion function, regulate gastric acid-base value, inhibit inflammatory response, improve immune function, and reduce oxidative stress injury.

7.
Chinese Journal of Surgery ; (12): 81-84, 2020.
Article in Chinese | WPRIM | ID: wpr-799365

ABSTRACT

The rapid development of professional technology not only brings great benefits to patients, but also reveals the problem of non-technical skills. Technical competence is not enough to avoid the occurrence of adverse medical events or to get optimal post-operative outcomes. The development of technology is endless, we are desperate in need of non-technical skills, such as situation awareness, decision making, communication and teamwork, leadership. The only way we could achieve in the assistance of the perfect surgical operation with the combination of excellent surgical techniques and solid non-technical skills, and therefore relieve the patients as much as possible.

8.
Chinese Journal of Surgery ; (12): 81-84, 2020.
Article in Chinese | WPRIM | ID: wpr-799364

ABSTRACT

The rapid development of professional technology not only brings great benefits to patients, but also reveals the problem of non-technical skills. Technical competence is not enough to avoid the occurrence of adverse medical events or to get optimal post-operative outcomes. The development of technology is endless, we are desperately in need of non-technical skills, such as situation awareness, decision making, communication and teamwork, leadership. The only way we could achieve in the assistance of the perfect surgical operation with the combination of excellent surgical techniques and solid non-technical skills, and therefore relieve the patients as much as possible.

9.
Article in Chinese | WPRIM | ID: wpr-865458

ABSTRACT

Objective To explore the therapeutic effect of bismuth potassium citrate combined with famotidine on peptic ulcer and its effects on the levels of lipid peroxide (LPO),malondialdehyde (MDA) and somatostatin (SS).Methods One hundred and fifty patients with peptic ulcer who were treated in Cixi Cilin Hospital from January 2018 to May 2019 were randomly divided into famotidine group and combined treatment group,with 75 cases in each group.Famotidine group was treated with famotidine,while bismuth potassium citrate combined with famotidine was used in combined treatment group.H+-K+-ATP ase activity,gastric acid-base value and gastric acid secretion function were detected in two groups.The levels of tumor necrosis factor-ot (TNF-α),interleukin-7 (IL-7),hypersensitive C-reactive protein (hs-CRP) were detected by ELISA,T lymphocyte subsets were detected by flow cytometry,and the levels of T lymphocyte subsets were detected by immunotransmission turbidimetry.The levels of LPO,MDA and SS were measured,and the therapeutic effect,ulcer healing and adverse reactions were compared between two groups.Results After treatment,the activity of H+-K+-ATP ase in the combined treatment group was lower than that in the famotidine group [(2.54 ± 0.41) μmol/min vs.(2.87 ± 0.50) μmol/min],the acid-base value in stomach was higher than that in the famotidine group (5.56 ± 1.19 vs.4.77 ± 0.89),and there were significant differences (P < 0.05).After treatment,the levels of maximum gastric acid excretion after pentagastrin stimulation (MAO),peak gastric acid output (PAO),basal acid output (BAO),TNF-α,IL-17,hs-CRP,CD8+,LPO and MDA in combined treatment group were lower than those in famotidine group [(8.22 ± 1.76) mmol/h vs.(10.53 ± 2.21) mmol/h,(11.88 ± 2.51)mmol/h vs.(14.79 ± 2.76) mmol/h,(4.11 ± 1.32) mmol/h vs.(5.54 ± 1.49) mmol/h,(4.76 ± 1.52) ng/L vs.(6.91 ± 1.61) ng/L,(18.37 ± 3.25) ng/L vs.(22.83 ± 3.62) ng/L,(6.41 ± 1.81) mg/L vs.(8.67 ± 2.15) mg/L,0.287 6 ± 0.030 5 vs.0.325 5 ± 0.032 4,(0.06 ± 0.02) U/mg vs.(0.09 ± 0.03) U/mg,(10.19 ± 1.86) μmol/L vs.(13.25 ± 2.03) μmol/L],while the levels of CD3+,CD4+,SS were higher than those in the famotidine group [0.523 6 ± 0.040 9 vs.0.476 3 ± 0.039 5,0.356 6 ± 0.035 2 vs.0.315 8 ± 0.033 9,(14.59 ± 2.67)ng/L vs.(10.36 ± 2.31) ng/L],and there were significant differences (P<0.05).The total effective rate and ulcer healing rate in combined treatment group were higher than those in famotidine group [93.33% (70/75) vs.80.00% (60/75),94.67% (71/75) vs.82.67% (62/75)] (P< 0.05).The incidence of adverse reactions in combined treatment group was slightly higher than that in famotidine group [16.00%(12/75)vs.13.33% (10/75)],but there was no significant difference between the two groups (P>0.05).Conclusions Bismuth potassium citrate combined with famotidine in the treatment of peptic ulcer patients can improve gastric acid secretion function,regulate gastric acid-base value,inhibit inflammatory response,improve immune function,and reduce oxidative stress injury.

10.
Article in Chinese | WPRIM | ID: wpr-864214

ABSTRACT

Objective:To analyze the clinical characteristics of plastic bronchitis(PB) caused by adenoviral pneumonia.Methods:The clinical data of 9 children diagnosed with PB caused by adenoviral pneumonia in the Xiamen Children′s Hospital from March to June 2019 were retrospectively analyzed.Results:Among the 9 children(3 boys and 6 girls), 6 patients were under 2 years old.All patients had fever, cough and dyspnea, with the duration of 6-15 days.Laboratory tests showed that procalcitonin(PCT) and increased in 7 children, D-dimer, fibrinogen degraded product (FDP) were increased in 6 children, and lactate dehydrogenase(LDH) was increased in 8 children.Chest imaging examination showed atelectasis with pulmonary consolidation in 9 children, including 4 cases of left lower lobe consolidation, 2 cases of right lower lobe consolidation, 1 case of right upper lung consolidation, and 2 cases of consolidation of multiple lungs in the lower lobe.Seven cases had pleural effusion.By fiberoptic bronchoscopy, the bronchial plastics was removed from the left lower lobe in 5 patients, from the right lower lobe in 3 patients, and from the right upper lobe in 1 patient on the 6th to 20 th day of the disease.Eight patients were discharged after clinical cure.One patient deve-loped multiple organ failure, and discharged from the hospital after the family members gave up rescue.The death was reported by the telephone follow-up death. Conclusions:PB is considered when patients with adenovirus pneumonia have persistent high fever, shortness of breath, dyspnea, pulmonary consolidation/lung atelectasis, increased PCT and LDH, hypercoagulability of the blood, and pleural effusion.Fiberoptic bronchoscopy plays an important role in confirming the diagnosis and improving the prognosis.

11.
Article in Chinese | WPRIM | ID: wpr-871593

ABSTRACT

Objective:To evaluate the effect of interstitial lung disease(ILD) on postoperative morbidity and mortality in pulmonary resection for lung cancer patients.Methods:We retrospectively analyzed 971 patients undergoing pulmonary operation from January 2010 to January 2018 in our hospital. Clinical data including age, sex, history of chronic obstructive pulmonary disease(COPD), smoking history, smoking index, American Society of Anesthesiologists(ASA) classification, forced expiratory volume in 1 s(FEV1) % predict, surgical procedure, video assisted thoracoscopic surgery(VATS) or not, intraoperative blood transfusion, anesthesia time, operation time/one-lung ventilation time, blood loss, histology, postoperative morbidity, 60-days mortality, onset of acute exacerbation of interstitial lung disease(AE-ILD), drainage, extubation time, and postoperative stay were collected and analyzed.Results:There were 80(8.2%) and 891(91.8%) patients in ILD and non-ILD group, respectively. AE-ILD occurred in 5 patients, with a 60-day mortality of 80%. A multivariate regression analysis identified that the sex( P=0.023), ILD( P=0.001), COPD( P=0.027) were independent risk factors for postoperative morbidity. ILD( P=0.023) and postoperative morbidity( P=0.001) were independent risk factors for 60-day mortality in multivariate analysis. Conclusion:Patients with ILD had a higher incidence of postoperative morbidity and 60-day mortality. Based on the obvious postoperative morbidity and mortality, special attention and management should be taken in ILD patients.

12.
Article in Chinese | WPRIM | ID: wpr-870088

ABSTRACT

Lymphocytic hypophysitis(LYH) is a rare autoimmune inflammatory disorder of the pituitary gland, usually affecting young women in late pregnancy or postpartum period. To enhance the knowledge of LYH, herein we reported a case of LYH in a female during postpartum who presented with pituitary crisis.

13.
Article in Chinese | WPRIM | ID: wpr-801106

ABSTRACT

Objective@#To investigate the clinical features and prognostic factors of extrahepatic biliary neuroendocrine neoplasms(EB-NENs).@*Methods@#The clinical data and survival of 21 patients with EB-NENs admitted from May 2014 to May 2018 were analyzed retrospectively.@*Results@#These 21 EB-NENs patients accounted for 1.6% (21/1313) of all biliary tract neoplasms treated during the study period. Seven (33.3%) cases had lymph node metastasis. Five (23.8%) suffered from distant metastasis. The follow up time was (4~46.5) months with median survival time of (23.23 ±4.17) months. Univariate analysis showed that the risk factors for survival were tumor TNM stage (χ2=9.066, P=0.003), lymph node metastasis(χ2=6.399, P=0.011) and distant metastasis (χ2=9.808, P=0.002). By multivariate analysis, independent risk factors were tumor TNM stage(P=0.008, RR=3.003, 95% CI: 1.332~6.774), lymph node metastasis(P=0.023, RR=5.382, 95% CI: 1.261~22.971) and distant metastasis or not(P=0.007, RR=7.423, 95% CI: 1.730~31.851).@*Conclusion@#EB-NENs was a rare malignant tumor with poor prognosis. Tumor TNM stage, lymph node metastasis and distant metastasis were independent prognostic factors for EB-NENs patients.

14.
International Journal of Surgery ; (12): 840-845, 2019.
Article in Chinese | WPRIM | ID: wpr-800683

ABSTRACT

Objective@#To explore the safety and effectiveness of transthoracic endoscopic thyroid surgery in thyroid surgery.@*Methods@#Retrospectively analyzed 230 patients with thyroid tumor aged from 19 to 71 years, including 67 males and 163 females, who were admitted to General minimally invasive surgery, First Affiliated Hospital of Henan University of Chinese Medicine from March 2018 to August 2019. All patients were divided into traditional operation group (n=95) and endoscopic group (n=135) according to the operation method. The general information of the two groups of patients before surgery, including the time of surgery and tumor removal, amount of bleeding during surgery, postoperative drainage and extubation time, were compared. And the hospital stay, hoarseness, postoperative bleeding, incision infection, numbness, twitching, satisfaction and other related indicators were calculated also. SPSS 22.0 software was used for statistical analysis. Normally distributed measurement data were expressed as Mean±SD, and conparisons between groups were calculated by t test or χ2 test. The non-normally distributed data were expressed as M(P25, P75) and were analyzed by the Mann-Whitney U test.@*Results@#Compared with the preoperative general data, the number of nodules in the traditional group was 3.00 (2.00, 3.00), and the number of nodules in the endoscope group was 2.00 (1.00, 3.00). The difference was statistically significant (Z=-4.461, P<0.01). The maximum diameter of the tumor in the traditional group is 1.00 (1.00, 2.00) cm, and the maximum diameter of the tumor in the endoscope group is 1.00 (1.00, 2.00) cm. The two are statistically significant (Z=-2.041, P=0.041). There were no significant differences in age, gender, course of disease, nodule type, cystic change, nodule location, aspect ratio, nodule echo, nodular morphology, and nodular calcification (all P>0.05). Comparison of intraoperative indicators, the operation time of the traditional group was shorter than that of the endoscope group [(67.51 ± 9.27) min vs (89.86 ± 10.32) min, t=11.462, P<0.01]; the tumor removal time of the traditional group was also shorter than that of the endoscope group [( 28.37 ± 8.94) min vs (33.35 ± 7.39) min, t=5.456, P<0.01]; the blood loss in the traditional group was significantly more than that in the endoscope group [(51.34 ± 3.26) ml vs (20.65 ± 5.89) ml, t=14.723, P<0.01]. The recurrent laryngeal nerve was explored intraoperatively in both groups with a detection rate of 100%, the anesthesia was good in both groups, and the drainage tubes were indwelling in both groups. The drainage volume of the traditional group was significantly higher than that of the endoscope group [(135.76 ± 60.55) ml vs (69.12 ± 37.13) ml, t=10.805, P<0.01]. The extubation time was longer in the traditional group than in the endoscope group [(5.54 ± 1.44) d vs (4.66 ± 1.55) d, t=2.384, P=0.023]. In terms of hospitalization time, the traditional group was significantly longer than the endoscope group [(10.48 ± 5.37) d vs (7.25 ± 3.68) d, t=11.549, P<0.01]. There were 11 cases of hoarseness in the traditional group and 4 cases of hoarseness in the endoscope group, and there has statistically significant (χ2=6.790, P=0.009). There were 5 cases of postoperative bleeding in the traditional group, 1 case of postoperative bleeding in the endoscope group, the difference between the two was statistically significant (χ2=4.365, P=0.037); 5 cases of incision infection in the traditional group, none in the endoscope group, and the difference was statistically significant (P=0.012); 4 cases of numbness convulsions in the traditional group, none in the endoscope group, and there was statistical significance (P=0.028); 87 cases of satisfaction in the traditional group, and 134 cases of satisfaction in the endoscope group, and the difference was statistically significant (χ2=6.825, P=0.009).@*Conclusions@#Transthoracic endoscopic thyroid surgery has fewer complications in thyroid surgery and quicker postoperative recovery. It is worthy of widespread promotion, but the specific implementation plan needs to be further optimized.

15.
Article in Chinese | WPRIM | ID: wpr-799859

ABSTRACT

Objective@#To explore the glycemic control of newly-diagnosed type 2 diabetes with different levels of baseline body mass index (BMI) after 6 months treatment under the standardized metabolic disease management model.@*Methods@#(1) 163 patients of newly-diagnosed type 2 diabetes were divided into normal weight (BMI 18.5-23.9 kg/m2), overweight (BMI 24.0-27.9 kg/m2), and obese (BMI≥28 kg/m2) groups according to baseline BMI, the blood glucose and lipids levels were compared among 3 groups. (2) The blood glucose levels were compared among 3 groups after 6 months of standardized management. (3) The overweight and obese patients were divided into group weight loss≥5% and group weight loss<5% or weight gain in 6 months. The blood glucose levels were compared.@*Results@#(1) At baseline, overweight and obese groups had higher homeostasis model assessment for insulin resistance and lower high density lipoprotein-cholesterol compared with normal weight group. (2) After 6 months of treatment, HbA1C and HbA1C reduction showed no difference among 3 groups (normal, overweight and obese) after adjusted by baseline HbA1C. The rate of HbA1C<7% among 3 groups were 77.78%, 83.95%, and 80.43% (P>0.05). (3) After 6 months of treatment, 32.28% overweight and obese patients lost weight by ≥ 5%, while HbA1Cand HbA1Creduction showed no difference between 2 groups (weight loss≥5% and weight gain or weight loss<5%) after adjusted by baseline HbA1C. Both groups achieved good glycemic control [(6.27±1.38 vs 6.43±0.66)%], but have no significantly(P>0.05). Group weight loss≥5% had better glucose control (92.68% vs 77.91%, P<0.05).@*Conclusions@#As BMI increased, insulin resistance and lipid disorders were more serious in newly-diagnosed type 2 diabetes. After 6 months of standardized metabolic management, newly-diagnosed type 2 diabetes with different baseline BMI and weight changes both achieved good glycemic control. In addition, patients losing weight equal to or more than 5% achieved higher attainment of HbA1C targets.

16.
Article in Chinese | WPRIM | ID: wpr-824708

ABSTRACT

Objective To explore the glycemic control of newly-diagnosed type 2 diabetes with different levels of baseline body mass index ( BMI ) after 6 months treatment under the standardized metabolic disease management model. Methods ( 1) 163 patients of newly-diagnosed type 2 diabetes were divided into normal weight (BMI 18.5-23.9 kg/m2), overweight (BMI 24.0-27.9 kg/m2), and obese (BMI≥28 kg/m2) groups according to baseline BMI, the blood glucose and lipids levels were compared among 3 groups. ( 2) The blood glucose levels were compared among 3 groups after 6 months of standardized management. ( 3) The overweight and obese patients were divided into group weight loss≥5%and group weight loss<5% or weight gain in 6 months. The blood glucose levels were compared. Results ( 1) At baseline, overweight and obese groups had higher homeostasis model assessment for insulin resistance and lower high density lipoprotein-cholesterol compared with normal weight group. ( 2) After 6 months of treatment, HbA1C and HbA1C reduction showed no difference among 3 groups ( normal, overweight and obese) after adjusted by baseline HbA1C. The rate of HbA1C<7%among 3 groups were 77.78%, 83.95%, and 80.43%(P>0.05). (3) After 6 months of treatment, 32.28% overweight and obese patients lost weight by ≥5%, while HbA1C and HbA1C reduction showed no difference between 2 groups ( weight loss≥5%and weight gain or weight loss<5%) after adjusted by baseline HbA1C. Both groups achieved good glycemic control [(6.27±1.38 vs 6.43±0.66)%], but have no significantly(P>0.05). Group weight loss≥5% had better glucose control (92.68% vs 77.91%, P<0.05) . Conclusions As BMI increased, insulin resistance and lipid disorders were more serious in newly-diagnosed type 2 diabetes. After 6 months of standardized metabolic management, newly-diagnosed type 2 diabetes with different baseline BMI and weight changes both achieved good glycemic control. In addition, patients losing weight equal to or more than 5%achieved higher attainment of HbA1C targets.

17.
International Journal of Surgery ; (12): 840-845, 2019.
Article in Chinese | WPRIM | ID: wpr-823538

ABSTRACT

Objective To explore the safety and effectiveness of transthoracic endoscopic thyroid surgery in thyroid surgery.Methods Retrospectively analyzed 230 patients with thyroid tumor aged from 19 to 71 years,including 67 males and 163 females,who were admitted to General minimally invasive surgery,First Affiliated Hospital of Henan University of Chinese Medicine from March 2018 to August 2019.All patients were divided into traditional operation group (n =95) and endoscopic group (n =135) according to the operation method.The general information of the two groups of patients before surgery,including the time of surgery and tumor removal,amount of bleeding during surgery,postoperative drainage and extubation time,were compared.And the hospital stay,hoarseness,postoperative bleeding,incision infection,numbness,twitching,satisfaction and other related indicators were calculated also.SPSS 22.0 software was used for statistical analysis.Normally distributed measurement data were expressed as Mean ± SD,and conparisons between groups were calculated by t test or x2 test.The non-normally distributed data were expressed as M(P25,P75) and were analyzed by the Mann-Whitney U test.Results Compared with the preoperative general data,the number of nodules in the traditional group was 3.00 (2.00,3.00),and the number of nodules in the endoscope group was 2.00 (1.00,3.00).The difference was statistically significant (Z =-4.461,P < 0.01).The maximum diameter of the tumor in the traditional group is 1.00 (1.00,2.00) cm,and the maximum diameter of the tumor in the endoscope group is 1.00 (1.00,2.00) cm.The two are statistically significant (Z =-2.041,P =0.041).There were no significant differences in age,gender,course of disease,nodule type,cystic change,nodule location,aspect ratio,nodule echo,nodular morphology,and nodular calcification (all P > 0.05).Comparison of intraoperative indicators,the operation time of the traditional group was shorter than that of the endoscope group [(67.51 ± 9.27) min vs (89.86 ± 10.32) min,t =11.462,P < 0.01];the tumor removal time of the traditional group was also shorter than that of the endoscope group [(28.37 ± 8.94) min vs (33.35 ± 7.39) min,t =5.456,P <0.01];the blood loss in the traditional group was significantly more than that in the endoscope group [(51.34 ± 3.26) ml vs (20.65 ± 5.89) ml,t =14.723,P <0.01].The recurrent laryngeal nerve was explored intraoperatively in both groups with a detection rate of 100%,the anesthesia was good in both groups,and the drainage tubes were indwelling in both groups.The drainage volume of the traditional group was significantly higher than that of the endoscope group [(135.76 ± 60.55) ml vs (69.12 ± 37.13) ml,t =10.805,P <0.01].The extubation time was longer in the traditional group than in the endoscope group [(5.54 ± 1.44) d vs (4.66 ± 1.55) d,t =2.384,P=0.023].In terms of hospitalization time,the traditional group was significantly longer than the endoscope group [(10.48 ± 5.37) d vs (7.25 ± 3.68) d,t =11.549,P < 0.01].There were 11 cases of hoarseness in the traditional group and 4 cases of hoarseness in the endoscope group,and there has statistically significant (x2 =6.790,P =0.009).There were 5 cases of postoperative bleeding in the traditional group,1 case of postoperative bleeding in the endoscope group,the difference between the two was statistically significant (x2 =4.365,P =0.037);5 cases of incision infection in the traditional group,none in the endoscope group,and the difference was statistically significant (P =0.012);4 cases of numbness convulsions in the traditional group,none in the endoscope group,and there was statistical significance (P =0.028);87 cases of satisfaction in the traditional group,and 134 cases of satisfaction in the endoscope group,and the difference was statistically significant (x2 =6.825,P =0.009).Conclusions Transthoracic endoscopic thyroid surgery has fewer complications in thyroid surgery and quicker postoperative recovery.It is worthy of widespread promotion,but the specific implementation plan needs to be further optimized.

18.
Article in Chinese | WPRIM | ID: wpr-706309

ABSTRACT

Objective To investigate the impact of spatial distribution of emphysema on pulmonary function and clinical severity in patients with chronic obstructive pulmonary disease (COPD).Methods Chest MSCT was performed in 84 patients with COPD.The percentage of low attenuation areas were automatically calculated for each lobe with the COPD analysis software.The correlations between low-attenuation area percent(LAA%) of each lobe and the parameters of pulmonary function were analyzed.According to the pulmonary emphysema heterogeneity index,the patients were divided into non-emphysema group and emphysema group,and the latter were divided into the predominantly upper lobe subgroup and the predominantly lower-lobe subgroup.The differences of pulmonary function parameters between the 2 groups and clinical severity between the 2 subgroups in emphysema group were compared.Results LAA% of each lobe was negatively correlated with single breath carbon monoxide diffusing capacity to predicted value ratio (DLcoSB%pred).Except for the right middle lobe,LAA% of the remaining lobes were negatively correlated with forced expiratory volume in one second/forced vital capacity (FEV1/FVC) and FEV1%pred,while positively correlated with resonance frequency (Fres).The differences of pulmonary function parameters between the 2 groups were statistically significant (all P < 0.05).The differences of FEV1%pred and FEV1/FVC between the 2 subgroups in emphysema group were statistically significant (all P <0.05),and the differences of Fres and DLcoSB%pred between the 2 subgroups were not statistically significant (all P>0.05).The difference of clinical severity between the 2 subgroups was statistically significant (x2 =4.17,P=0.041).Conclusion The spatial distribution of pulmonary emphysema affects pulmonary function and clinical severity in COPD patients.The patients with the predominantly lower-lobe emphysema are relatively worse in lung function,and more serious in the clinical severity.

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Chongqing Medicine ; (36): 783-785, 2018.
Article in Chinese | WPRIM | ID: wpr-691871

ABSTRACT

Objective To explore the distribution proportion of peripheral blood HLA-DR-CD33+ CD14-CD11b+ myeloidderived suppressor cells (MDSC) in the patients with nasopharyngeal carcinoma(NPC) to provide a beneficial guidance for NPC immunotherapy.Methods Forty-five NPC patients and 20 healthy volunteers as the healthy control group were selected.The peripheral blood sample was collected before the first time chemotherapy and on 7 d after the second cycle induction chemotherapy,meanwhile the peripheral blood sample was collected in the healthy control group;then HLA-DR-CD33+ CD14-CD11b+ MDSC were detected by the flow cytometry.Results The peripheral blood MDSC ratio of NPC patients was significantly higher than that of healthy control group(P<0.05).With the NPC stage Ⅱ,Ⅲ and Ⅳ increase,the peripheral blood MDSC ratio was gradually increased (P<0.05).The MDSC ratio of NPC patients with three different pathological types of keratin type squamous carcinoma,differentiated and undifferentiated type non-keratin type squamous carcinoma was significant higher than that of healthy control group(P<0.05).The peripheral blood MDSC ration also had statistical difference among the NPC patients with 3 kinds of different pathological type(P<0.05).The peripheral blood MDSC ratio in NPC patients with different stages was significantly decreased after 2-cycle induction chemotherapy (P < 0.05),but its ratio level was still higher than that of the healthy control group.Conclusion The peripheral blood HLA-DR-CD33+ CD14-CD11b+ MDSC ratio in the NPC patients is significantly increased,suggesting that which may be related with NPC immune escape and is worth further study.

20.
China Pharmacy ; (12): 223-228, 2018.
Article in Chinese | WPRIM | ID: wpr-704556

ABSTRACT

OBJECTIVE:To observe clinical efficacy and safety of Compound xiongshao capsules in the treatment of diabetic peripheral neuropathy (DPN).METHODS:A total of 97 DPN patients selected from our hospital during Jun.2015-Apr.2016 were divided into group A (compound xiongshao treatment group,46 cases) and control group (51 cases) according to random number table.The latter was divided into group B (epalrestat+beraprost sodium group,12 cases),group C (fursultiamine+mecobalamin group,12 cases) and group D (epalrestat group,27 cases) according to clinical symptoms and economic situation of patients.Four groups were given antidiabetic drugs for blood glucose control.Based on it,group A was additionally given Compound xiongshao capsules 0.9 g,tid;group B was additionally given Epalrestat tablets 50 mg,tid+Beraprost sodium tablets 40 μg,tid;group C was additionally given Fursultiamine tablets 50 mg,tid+Mecobalamin tablets 0.5 mg,rid;group D was additionally given Epalrestat tablets 50 mg,tid.All groups were treated for 6 months.Clinical efficacies were observed.TCSS scores,motor nerve conduction velocity (MCV),sensory nerve conduction velocity (SCV),incubation period and amplitude of median nerve and common peroneal nerve,the levels of hemorheology indexes,blood glucose,glycosylated hemoglobin,blood lipid,serum creatinine were compared before and after treatment.The occurrence of ADR was recorded.RESULTS:Total response rates of group A and B (82.61%,83.33%)were significantly higher than those of group C and D (33.33%,66.67%),total response rate of group D was significantly higher than that of group C,with statistical significance (P<0.05).Before treatment,there was no statistical significance in TCSS scores,MCV,SCV,incubation period and amplitude of median nerve,MCV and amplitude of common peroneal never,SCV,incubation period and amplitude of common peroneal never or whole blood high-shear viscosity among 4 groups (P>0.05).After treatment,TCSS scores of group A,B and D were decreased significantly compared to before treatment,and those of group A and B were lower than those of group C and D,with statistical significance (P<0.05).MCV,incubation period and amplitude of median nerve in group A and B,amplitude of median nerve in group C,MCV and amplitude of median nerve in group D were significantly better than before treatment;MCV,incubation period and amplitude of median nerve in group A and B were significantly better than group C and D,with statistical significance (P<0.05).MCV,incubation period and amplitude of common peroneal never in group A,B,C were significantly better than before treatment,MCV and amplitude of common peroneal never in group A,B were significantly better than group C,D;the improvement of incubation period of common peroneal never in group A,B,D were significantly better than group C,with statistical significance (P<0.05).SCV,incubation period and amplitude of median nerve,SCV and amplitude of common peroneal nerve in group A,B and D were significantly better than before treatment;SCV,incubation period and amplitude of median nerve,SCV and amplitude of common peroneal nerve in group A,SCV,incubation period and amplitude of median nerve and amplitude of common peroneal nerve in group B were significantly better than group C and D;SCV of median nerve in group D was significantly better than group C,with statistical significance (P<0.05).Whole blood high-shear viscosity of group A was decreased significantly compared to before treatment,and significantly lower than those of group B,C and D,with statistical significance (P<0.05).There was no statistical significance in total response rate and TCSS score between group A and B,and in the levels of blood glucose,glycosylated hemoglobin,blood lipid or serum creatinine among 4 groups (P>0.05).No obvious ADR was found in 4 groups.CONCLUSIONS:Compound xiongshao capsules shows significant therapeutic efficacy for DPN,and improves nerve conduction velocity,incubation period and amplitude of median nerve and common peroneal nerve,whole blood high-shear viscosity.Its effect is similar to that of epalrestat combined with beraprost sodium,and better than those of fursultiamine combined with mecobalamin,epalrestat alone.It does not affect the blood glucose,blood lipid and serum creatinine levels with good safety.

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