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1.
Article in Chinese | WPRIM | ID: wpr-879417

ABSTRACT

OBJECTIVE@#To study the relationship between osteonecrosis of femoral head after internal fixation of femoral neck fracture and serum bone metabolism, vascular active factors, and analyze the risk factors.@*METHODS@#Total 150 patients with femoral neck fracture who underwent reduction and internal fixation from April 2016 to April 2019 were selected, including 83 males and 67 females. According to whether there was necrosis of femoral head after operation, they were divided into necrosis group(32 cases) and non necrosis group (118 cases). Before operation and 1, 3, 5 days after operation, the serum levels of beta-C terminal cross-linked telopeptides of typeⅠ collagen(β-CTX), N-telopeptide of typeⅠ procollagen(PINP), nitric oxide (NO), Endothelin-1 (ET-1) were measured. The clinical characteristics of the two groups were compared. The risk factors of postoperative femoral head necrosis were analyzed by logistic regression model. The value of serum indexes in predicting postoperative femoral head necrosis was analyzed by ROC curve.@*RESULTS@#There was no significant difference in the levels of serum PINP and β-CTX between necrotic group and non necrotic group before operation and 1, 3 and 5 days after operation(@*CONCLUSION@#The content of serum NO and ET-1 on the first day after operation can predict the necrosis of femoral head.


Subject(s)
Female , Femoral Neck Fractures/surgery , Femur Head , Femur Head Necrosis/etiology , Fracture Fixation, Internal/adverse effects , Humans , Male , Osteonecrosis , Retrospective Studies , Risk Factors
2.
Chinese Journal of Biotechnology ; (12): 1415-1424, 2021.
Article in Chinese | WPRIM | ID: wpr-878643

ABSTRACT

Coupling sugar is a kind of new sweetener which can substitute sucrose. It has a good application prospect in food, medicine and other fields because of its good coloration, water retention and anti caries. The purpose of this study was to find cheap and easily available donor and acceptor, and to optimize the preparation process of coupling sugar by using β-cyclodextrin glycosyltransferase from Bacilluscirculans 251. Using sucrose as acceptor, the factors of preparing coupling sugar was optimized, including enzyme dosage, starch types, temperature, pH, ratio of starch/sucrose, and cooperation of isoamylase and β-CGTase. When 105 g/L potato starch and 95 g/L sucrose was used as substrates, the yield of coupling sugar reached 88.4%, which was catalyzed by 13.5 U/g immobilized β-CGTase and 45.0 U/g isoamylase under the conditions of pH 5.5 and 40 °C for 21 h. In this study, isoamylase and β-CGTase were used to prepare coupling sugar innovatively. This method had obvious advantages in yield and cost, which laid both theoretical and experimental foundation for the industrial enzymatic preparation of coupling sugars.


Subject(s)
Glucosyltransferases , Hydrogen-Ion Concentration , Isoamylase , Starch
3.
Cancer Research and Clinic ; (6): 292-295, 2021.
Article in Chinese | WPRIM | ID: wpr-886051

ABSTRACT

Objective:To explore the application feasibility of modified sentinel lymph node biopsy (SLNB) for acral malignant melanoma.Methods:The data of 60 patients with acral malignant melanoma in the Affiliated Tumor Hospital of Xinjiang Medical University from January 2017 to January 2020 were retrospectively analyzed. According to the sentinel lymph node (SLN) detection method, they were divided into observation group (30 cases) and control group (30 cases). The observation group used contrast-enhanced ultrasound combined with subcutaneous injection of methylene blue around the wrist or ankle joint to detect SLN; the control group used peritumoral injection of methylene blue to detect SLN. The patients were regularly followed up to evaluate the postoperative effect. The detection number, detection rate, sensitivity, false negative rate and the size of SLN were compared between the two groups.Results:In the observation group, the detection rate of SLN was 100.0% (30/30), the sensitivity was 87.5% (7/8), and the false negative rate was 3.3% (1/30); in the control group, the detection rate of SLN was 83.3% (25/30), the sensitivity was 62.5% (5/8), and the false negative rate was 12.0% (3/25); the differences were statistically significant (all P < 0.05). The number of SLN detected in the observation group (3.5±1.2) was significantly more than that in the control group (2.0±1.1), and the difference was statistically significant ( t = 7.121, P < 0.05). The minimum long-axis diameter of SLN detected in the observation group was (5.4±2.2) mm (range, 1.5-12.3 mm), and that in the control group was (11.8±5.4) mm (range, 10.0-16.8 mm), the difference between the two groups was statistically significant ( t = 6.353, P < 0.05). Conclusion:The modified SLNB for acral malignant melanoma has a higher application value in the detection of acral SLN than the peritumoral injection method, and a higher accuracy rate can be obtained.

4.
Article in Chinese | WPRIM | ID: wpr-885806

ABSTRACT

Objective:To explore the efficacy of total sternotomy or partial sternotomy for the treatment of isolated plasmacytoma of the sternum, and the feasibility of the chest wall reconstruction using 3D printed polyether ether ketone(PEEK) implants.Methods:In this study, a total of 6 patients with isolated plasmacytoma of sternum was enrolled, including 5 males and 1 female, aged (57.7±9.4) years old (42-71 years old). All patients received total sternotomy or partial sternotomy, and the chest wall was reconstructed using 3D-printed PEEK implant. The perioperative data and demographic characteristics of the patients were collected for statistical analysis.Results:All patients in this study had isolated plasmacytoma of sternum. Chest wall defects with mean area of (102.7±18.8)cm 2 were anatomically repaired using 3D-printed PEEK implants. No postoperative complications such as abnormal respiration was found. All 6 patients were discharged from hospital successfully, and no complications during the perioperative period were found. During the average follow-up period of(31.2±15.4)months, no implant fracture, displacement, rejection and other phenomena occurred, and no recurrence, metastasis or death occurred in postoperative patients. Conclusion:Total or partial sternotomy was an effective treatment for isolated sternum plasmocytoma . The chest wall reconstruction using 3D-printed PEEK implant was a reliable clinical treatment method.

5.
Article in Chinese | WPRIM | ID: wpr-885717

ABSTRACT

Objective:To investigate the clinicopathological features of gastric adenocarcinoma of fundic gland type (GA-FG).Methods:A total of 12 patients, including 7 cases treated with endoscopic submucosal dissection (ESD), were diagnosed as having GA-FG in Nanjing Drum Tower Hospital from January 2018 to August 2019. Morphological changes were analyzed by reviewing endoscopic and pathological results. Patients were followed up after definitive diagnosis.Results:The clinical symptoms of patients with GA-FG were nonspecific. No Helicobacter pylori infection was identified. The lesions were found in the non-atrophic gastric mucosa of the upper 1/3 portion in 10 cases and middle 1/3 portion in 2 cases. Endoscopically, the most common features were whitish color (9 cases), and all lesions diameter≤1 cm. Their macroscopic types were classified as 0-Ⅰ (2 cases), 0-Ⅱa (9 cases) and 0-Ⅱc (1 case) respectively. All lesions had sharp boundary, with branching dilated blood vessels on the surface. Five in 7 cases who were treated with ESD showed submucosal invasion. Immunohistochemically, 9 cases were classified as the chief cell type , 3 as the mixed type, 11 MUC6 positive, 4 MUC5AC positive, 2 MUC2 positive, and 3 CD10 positive. P53 was detected in all 12 cases, and 9 cases had low Ki-67 staining index (<10%). The mean time of follow-up was 11 months, and 11 patients survived. Conclusion:GA-FG should be taken into consideration when the polyps are found in the upper part of the stomach, with whitish color, and branch dilated blood vessels on the surface. Excellent clinical outcomes can be achieved for GA-FG patients with ESD.

6.
Article in Chinese | WPRIM | ID: wpr-885705

ABSTRACT

Objective:To evaluate the short-type single balloon enteroscope (SBE) to endoscopic retrograde cholangiopancreatography (ERCP) in patients with Roux-en-Y anastomosis.Methods:Data of 10 patients with Roux-en-Y anastomosis who received short-type SBE assisting ERCP (14 times of ERCP, the short-type SBE group) from May 2019 to September 2019 and 55 patients who received conventional SBE assisting ERCP (87 times of ERCP, the conventional SBE group) from March 2016 to April 2019 were collected in Nanjing Drum Tower Hospital. Success rates and mean time of reaching the blind loop, diagnosis and treatment success rates, procedure time and complication incidence in the two groups were compared.Results:The mean time to reach the blind loop was significantly shorter in short-type SBE group than that in the conventional SBE group (17.1 min VS 23.4 min, P = 0.04). There were no significant differences in success rates of reaching the blind loop[100.0%(14/14) VS 95.4%(83/87)], the success rates of diagnosis and treatment[both 100.0% (14/14) VS 100.0% (83/83)], the mean procedure time (62.6 min VS 64.3 min) or complication incidence [21.4%(3/14) VS 16.1% (14/83) ] between the two groups (all P>0.05). Conclusion:ERCP assisted by either type of SBE is safe and effective in patients with Roux-en-Y anastomosis. However, short-type SBE is faster to reach the blind loop because of its unique design and easier manipulation.

7.
Article in Chinese | WPRIM | ID: wpr-885696

ABSTRACT

Objective:To evaluate the application value of small IT knife pre-cut in assistance to duodenal papillary cannulation compared with conventional guidewire cannulation.Methods:A retrospective analysis was performed on the data of 90 patients with choledocholithiasis including 52 patients with small IT knife pre-cut assisted intubation (small IT knife group) and 38 patients with conventional guidewire intubation (conventional group) in endoscopic retrograde cholangiopancreatography (ERCP) from May 2016 to July 2019 in the digestive endoscopy center of Nanjing Drum Tower Hospital. The basic data, curative effect and complications of the two groups were collected and compared.Results:There was statistically significant difference in gender composition between the small IT knife group and the conventional group ( χ2=5.679, P=0.017), but no significant difference in other baseline data between the two groups (all P>0.05). The median intubation time of the small IT knife group was significantly shorter than that of the conventional group (141.5 s VS 270.0 s, Z=1 268.0, P=0.022). There were no significant differences in the success rate of intubation [98.1% (51/52) VS 94.7% (36/38), χ2=0.760, P=0.571], the incidence of intraoperative bleeding [15.4% (8/52) VS 7.9% (3/38), χ2=1.148, P=0.345], postoperative pancreatitis [5.8% (3/52) VS 7.9% (3/38), χ2=0.159, P=0.694], and postoperative cholangitis [1.9% (1/52) VS 5.3% (2/38), χ2=0.760, P=0.571] between the two groups. No perforation occurred in the two groups. After stratifying according to the operator′s proficiency, the median intubation time was significantly different between the small IT knife expert group and the conventional expert group (116.0 s VS 258.0 s, Z=276.0, P=0.038), while there was no significant difference in the intubation time among other groups (all P>0.05). Conclusion:The small IT knife is safe and effective to pre-cut and assist intubation in ERCP, and it may shorten the intubation time.

8.
Article in Chinese | WPRIM | ID: wpr-885180

ABSTRACT

Objective:To analyze clinical and histopathological characteristics of infantile congenital melanocytic nevi (ICMN) .Methods:Clinical and pathological data were collected from 126 infants with confirmedly diagnosed congenital melanocytic nevi in Department of Dermatology, Xijing Hospital from January 2015 to January 2020, and were retrospectively analyzed. Chi-square test was used for comparisons of enumeration data.Results:Among the 126 patients with ICMN, 68 were males and 58 were females; 109 (86.5%) presented with skin lesions at birth; 73 (57.9%) were 2 - 3 years old at the first clinic visit. The skin lesions occurred on the head and face (76 cases, 60.3%) , trunk (24 cases, 19.1%) or extremities (26 cases, 20.6%) . There were 36 (28.6%) patients with small congenital nevi, 68 (54.0%) with M1-type medium-sized nevi, 13 (10.3%) with M2-type medium-sized nevi and 9 (7.1%) with giant nevi. Of 126 cases of ICMN, 121 (96.0%) had solitary lesions, 5 (4.0%) had multiple lesions, 44 (34.9%) had nevi with coarse hairs, 15 (11.9%) had nevi complicated by papules or hyperplastic nodules, and 6 (4.8%) had satellite lesions. Pathological subtypes included compound nevus (120 cases, 95.2%) , intradermal nevus (4 cases, 3.2%) , and junctional nevus (2 cases, 1.6%) . Under the microscope, the depth of the skin lesions was < 1 mm in 38 (30.1%) cases, 1 - 2 mm in 61 (48.4%) and > 2 mm in 25 (19.8%) , and 45 (35.7%) cases showed nevus cells infiltrating the subcutaneous fat layer or deeper tissues. Among the 126 ICMN lesions, common pathological features included nevus tissue maturation (100%, 2 cases of junctional nevi were excluded) , pigment granules in the stratum corneum (53 cases, 42.1%) , disordered/asymmetric distribution of nevus cells (80 cases, 63.5%) , scattered epidermal nevus cells (91 cases, 72.2%) , pagetoid spread of epidermal nevus cells (67 cases, 53.2%) , melanophages in the dermis (71 cases, 56.4%) , and nevus cells distributed along hair follicles/sebaceous glands (82 cases, 65.1%) . Special pathological features included nevus cells embedded in the vascular/lymphatic vessels (42 cases, 33.3%) , nevus cell lysis (45 cases, 35.7%) , fibromatous changes (25 cases, 19.8%) , involvement of the arrector pilli muscles (31 cases, 24.6%) , and mast cell infiltration (30 cases, 23.8%) . Pathological patterns of ICMN with different clinical features: the incidences of infiltration depth > 2 mm, pigment granules and columnar pigment granules in the stratum corneum were significantly higher in the giant nevi than in the small and medium-sized nevi ( χ2 = 7.93, 10.76, 5.89 respectively, all P < 0.05) ; the incidences of infiltration depth > 2 mm, epidermal spongiosis with scattered nevus cells, nevus cell nests distributed along the hair follicles/sebaceous glands, fibromatous changes and mast cell infiltration were significantly higher in the skin lesions with coarse hairs than in those without ( χ2 = 28.29, 8.11, 6.22, 7.92, 8.19 respectively, all P < 0.01) ; the incidences of pagetoid spread of epidermal nevus cells and atypical nevus cells were significantly higher in the skin lesions with papules/hyperplastic nodules than in those without papules/hyperplastic nodules ( χ2 = 4.92, 6.30 respectively, both P < 0.05) . Conclusions:The clinical and histopathological characteristics of ICMN are unique, and atypical nevus cells are common in ICMN. The diagnosis and treatment of ICMN need to be based on the combination of clinical and pathological characteristics.

9.
Article in Chinese | WPRIM | ID: wpr-885177

ABSTRACT

Objective:To analyze clinical and pathological features of 320 cases of Spitzoid tumors.Methods:Clinical and pathological data were collected from 320 patients with Spitzoid tumors in Department of Dermatology, Xijing Hospital from January 2005 to January 2020, and retrospectively analyzed.Results:The 320 patients included 141 males and 179 females, aged 0 - 65 (12.5 ± 11.7) years, and their course of disease ranged from 1 month to 30 years. Among them, there were 307 patients with Spitz nevi, 8 with atypical Spitz tumors and 5 with Spitzoid melanoma. Most skin lesions were solitary, and occurred on the head, face, trunk and limbs, with clear boundaries. Among the 307 patients with Spitz nevi, the skin lesions were mainly black (132 cases, 43.0%) and red (108 cases, 35.1%) in color, most of which were uniformly pigmented (262 cases, 85.3%) with smooth surfaces (272 cases, 88.6%) . There were several special clinical subtypes of Spitz nevi, including Spitz nevus arising in a nevus spilus (11 cases, 3.6%) , agminated Spitz nevus (11 cases, 3.6%) , disseminated Spitz nevus (6 cases, 2.0%) , nodular Spitz nevus (7 cases, 2.3%) and keloid-like Spitz nevus (1 case, 0.3%) . Characteristic histopathological manifestations of Spitz nevi included pagetoid spread of epidermal nevus cells (123 cases, 40.1%) , Kamino bodies at the dermo-epidermal junction (74 cases, 24.1%) , horizontal band-like distribution of nevus cells (177 cases, 57.8) , wedge-shaped distribution of nevus cells (118 cases, 38.4%) , fissures around nevus cell nests (177 cases, 57.8%) , physiological mitotic figures (117 cases, 38.1%) , and fine nuclear chromatin (307 cases, 100%) . According to the special histopathological manifestations, Spitz nevi were divided into pigmented epithelioid Spitz nevus (9 cases, 2.9%) , desmoplastic Spitz nevus (13 cases, 4.2%) , hemangiomatous Spitz nevus (8 cases, 2.6%) , verrucous Spitz nevus (12 cases, 3.9%) , mucoid Spitz nevus (10 cases, 3.3%) , halo-like Spitz nevus (4 cases, 1.3%) , etc. Among the 8 cases of atypical Spitz tumors, 4 skin lesions were black, 7 were uniformly pigmented, and 3 had rough surfaces; the characteristic pathological manifestations included mild to moderate atypia of cells, mitotic figures (2 - 6 cells/mm 2 in 7 cases) , and coarse nuclear chromatin (5 cases) . Among the 5 cases of Spitzoid melanoma, 3 had red skin lesions, 4 were non-uniformly pigmented, and 3 had rough surfaces; the characteristic pathological manifestations included pagetoid spread of melanocytes (3 cases) , non-polar infiltrating growth of immature tumor cells, pathological mitotic figures (3 cases, > 6 cells/mm 2) , coarse nuclear chromatin and obviously stained nuclear membrane. Conclusions:Spitzoid tumors are characterized by unique clinical and histopathological features. There are various clinical and pathological subtypes of Spitz nevi, and atypical Spitz tumors have clinical and pathological characteristics of both Spitz nevi and melanoma.

10.
Article in Chinese | WPRIM | ID: wpr-885175

ABSTRACT

Objective:To analyze clinical and pathological features of Reed nevi (pigmented spindle cell nevi) .Methods:The clinical and pathological data were collected from 26 patients with Reed nevi, who visited Department of Dermatology of Xijing Hospital from January 2015 to June 2019, and analyzed retrospectively.Results:Among the 26 patients, 15 were males, and 11 were females. Their average age of onset was 17.35 years, and median age of onset was 13.85 years. Reed nevi occurred predominantly on the lower limbs (12 cases) , followed by the face (6 cases) , upper limbs (5 cases) and trunk (3 cases) . All the skin lesions were black in color, and 7 cases presented with maculae, 19 with flat papules, 22 with quasi-circular skin lesions, and 4 with irregular skin lesions. The diameter of skin lesions ranged from 2 to 10 mm, and 23 cases had skin lesions with a diameter of ≤ 5 mm. As histopathological examination showed, pathological subtypes included junctional nevus (15 cases) and compound nevus (11 cases) ; melanocytes were spindle-shaped with obvious cytochromes in 26 cases; nevus cell nests merged with the surrounding epidermis in 4 cases, and obvious fissures were formed between nevus cell nests and the surrounding epidermis in 22 cases; no obvious cell atypia or mitotic figure was observed in any of the 26 cases, and Kamino bodies were observed in 6 cases. All the skin lesions were resected by surgery, and no recurrence was observed during the follow-up of 1 - 5 years.Conclusion:Reed nevi can manifest as irregular lesions, pagetoid distribution of spindle cells of various sizes can be observed histopathologically, and they need to be differentiated from melanoma.

11.
Article in Chinese | WPRIM | ID: wpr-885065

ABSTRACT

Postoperative surgical site infection (SSI) can lead to adverse clinical outcomes in patients, such as prolonged hospital stay, increased medical costs, and severe economic burden on patients and on society.In addition, it may also cause nosocomial cross-infection.Therefore, it has aroused the high attention of medical workers.The development of SSI is closely related to a variety of factors, including patient factors, such as blood glucose levels, smoking, systemic use of steroids, obesity and malnutrition, and perioperative related factors, such as long preoperative hospital stay, preoperative skin preparation and prophylactic use of antibiotics of patients, hand hygiene and asepsis principles of medical staff, operation-related factors, anesthetic management and operation related factors, operating room environment factors and postoperative factors.Through reading a large number of relevant literatures published in recent years and according to the work characteristics of anesthesiologists, the author summarized the influential factors and preventive measures for postoperative SSI for the reference of fellow doctors.

12.
Chinese Journal of Urology ; (12): 278-282, 2021.
Article in Chinese | WPRIM | ID: wpr-885004

ABSTRACT

Objective:To evaluate the clinical value of the holographic image and navigation in robotic assisted laparoscopic radical prostatectomy (RARP) .Methods:From Sept. 2020 to Dec. 2020, 5 patients diagnosed with prostate cancer in Beijing United Family Hospital were included in this study. The mean age was 57 years(38-69 years). Before the operation, the engineers established the holographic image based on the enhanced MRI images. The holographic images were used in pre-surgery planning. During the operation, the navigation was achieved by real time fusing holographic images with the robotic surgery endoscopic views. Some important structure such as prostate, bladder neck and the tumor could be observed and monitored in real time. The No.1 patient had high-risk prostate cancer, underwent RARP+ extended pelvic lymph node dissection; The No.2 patient had low-risk prostate cancer, underwent RARP, and the right side neurovascular bundle (NVB) was preserved; The No.3 patient had low-risk prostate cancer, underwent RARP, and the bilateral side NVB was preserved; The No.4 patient had low-risk prostate cancer, underwent RARP, and the right side NVB was preserved; The No.5 patient had high-risk prostate cancer, underwent RARP+ extended pelvic lymph node dissection, and the bilateral side NVB was preserved.Results:All the 5 cases surgeries were successful, no conversion to open surgery, the mean operation time was 161.7min (160-250min), the mean blood loss was 426.7 ml(60-1000 ml). The pathological results were pT 3bN 0 cM 0, pT 2aN 0 cM 0, pT 2aN 0 cM 0, pT 2aN 0 cM 0 and pT 3aN 1 cM 0, respectively. There was no over Clavien Dindo Ⅱ perioperative complications. 4 patient achieved continence when catheter removal. The PSA level and erectile function were monitored in the follow up. Conclusions:Holographic image navigation might have clinical value in RARP.

13.
Chinese Journal of Geriatrics ; (12): 319-322, 2021.
Article in Chinese | WPRIM | ID: wpr-884888

ABSTRACT

Objective:To examine the risk of long-term cognitive impairment in elderly prostate cancer patients aged 75 years and older undergoing androgen deprivation therapy(DAT), and to analyze the correlation between DAT and cognitive impairment.Methods:This was a retrospective cohort study.Elderly prostate cancer patients aged 75 years and older in the National Cancer Database(SEER)from 1996-2003 were included.According to whether ADT was received, patients were divided into the ADT group(n=82 514)and the control group(n=121 856). Baseline clinical data were compared between the two groups. Kaplan- Meier survival analysis and the Log- rank test were used to compare the incidence of cognitive impairment(dementia and Alzheimer's disease)between the two groups. Cox risk ratio regression analysis was used to assess the relationship between ADT and cognitive impairment. Results:A total of 204 370 patients were enrolled in this study.The mean age of patients was(79.2±4.6)years.Compared with the control group, the ADT group was older and had higher prostate specific antigen levels, higher proportions of poorly differentiated tumors, more complications and a higher proportion of patients receiving radiotherapy( P<0.05). During the follow-up of(12.1±3.3)years, a total of 41 661 cases of dementia were diagnosed, including 13 634 in the ADT group and 28 027 in the control group, and 28 945 cases of Alzheimer's disease were diagnosed, including 9 372 in the ADT group and 19 573 in the control group.Kaplan-Meier survival analysis and the log-rank test showed that the incidence of dementia in the ADT group was higher than that in the control group( χ2=8.10, P=0.004), and the incidence of Alzheimer's disease was also higher in the ADT group than in the control group( χ2=5.06, P=0.024). Cox regression analysis results showed that ADT significantly increased the risk of dementia( HR=1.71, 95% CI: 1.14-2.57, P=0.01)and Alzheimer's disease( HR=1.63, 95% CI: 1.08-2.46, P=0.02), compared with treatment that did not include ADT. Conclusions:The risk of dementia and Alzheimer's disease is increased in elderly prostate cancer patients aged 75 years and older after ADT.

14.
Chinese Journal of Geriatrics ; (12): 112-115, 2021.
Article in Chinese | WPRIM | ID: wpr-884852

ABSTRACT

Objective:To investigate differences in serum uric acid levels between elderly patients with prostate cancer and patients with benign prostatic hyperplasia(BPH).Methods:A total of 300 prostate cancer patients admitted to the urology department of our hospital between Feb.2010 and Jun.2019 were retrospectively analyzed.During the same period, 240 BPH patients and 400 elderly men with normal prostate size were enrolled as the control group.Serum uric acid and prostate-specific antigen(PSA)levels, C-reactive protein(CRP), neutrophil count and lymphocyte count were determined.Serum uric acid concentrations were monitored in prostate cancer patients with different clinicopathological characteristics.Results:CRP and Neu/Lym levels were higher in the prostate cancer group than in the BPH and control groups( P<0.05). The serum uric acid level was (327.0±58.3)μmol/L in the prostate cancer group, lower than in the BPH group(375.2±68.4)μmol/L and the control group(377.8±73.2)μmol/L( F=55.69, P<0.001). Multivariable Logistic regression analysis indicated that serum uric acid was a protective factor for prostate cancer( OR=0.593, 95% CI: 0.542-0.718, P=0.004). There were significant differences in serum uric acid levels between prostate cancer patients with different ages and pathological grades( t=-4.63, F=12.73, P<0.001). However, serum uric acid levels were not significantly correlated with clinical staging or lymph node metastasis( F=-2.72 and 0.77, P=0.068 and 0.460). Conclusions:Compared with BPH patients and healthy males, serum uric acid levels are reduced and inflammatory markers are increased in prostate cancer patients, indicating that serum uric acid may be a risk factor for the occurrence and progression of prostate cancer in the elderly.

15.
Article in Chinese | WPRIM | ID: wpr-884797

ABSTRACT

Objective:To analyze the relationships between baseline percentage of pulmonary perfusion defect scores (PPDs%) and residual pulmonary hypertension after pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension (CTEPH) patients.Methods:A total of 37 CTEPH patients (21 males, 16 females, age (50±12) years) who had pre- and post-pulmonary endarterectomy ventilation/perfusion (V/Q) scans from January 2016 to January 2019 at Fuwai Hospital were retrospectively collected. Residual pulmonary hypertension was defined as post-surgery mean pulmonary artery pressure (mPAP) higher than 30 mmHg (1 mmHg=0.133 kPa). Semi-quantitative index PPDs% was calculated to represent the extent of impaired perfusion in the whole lung. Pre- and post-surgery pulmonary hemodynamic parameters including pulmonary arterial pressure and resistance and lung perfusion were compared. Factors that may be related residual pulmonary hypertension were analyzed using logistic regression analysis. Paired t test and independent-sample t test were also used. Results:Pulmonary endarterectomy significantly decreased mPAP ((50.22±11.72) vs (26.41±10.61) mmHg; t=12.599, P<0.001) and pulmonary vascular resistance((10.06±5.48) vs (2.89±1.58) Wood unit; t=8.086, P<0.001). The number of defected lung segments (13.79±2.11 vs 5.52±2.82; t=11.593, P<0.001) was significantly reduced. Patients who had residual pulmonary hypertension ( n=11) exhibited significantly higher PPDs% before the surgery compared to those who were without residual pulmonary hypertension ( n=26; (57.48±5.88)% vs (47.77±11.09)%; t=-3.458, P=0.002). Baseline PPDs% was an independent factor for predicting residual pulmonary hypertension after pulmonary endarterectomy (odds ratio ( OR)=1.106, 95% CI: 1.006-1.216, P=0.036). Conclusions:Pulmonary V/Q scan can assess the therapeutic effects of pulmonary endarterectomy. Extent of impaired lung perfusion assessed by V/Q scan is the influencing factor for post-surgery residual pulmonary hypertension.

16.
Article in Chinese | WPRIM | ID: wpr-884782

ABSTRACT

Objective:To study the functional connectivity (FC) and metabolic effective connectivity (MEC) patterns of the default mode network (DMN) in healthy male adults based on a novel hybrid PET/MR system.Methods:Fifteen healthy male adults with median age of 29 years were recruited locally in Xi′an from January to May 2019. All subjects went through PET/MR scan to get the whole brain 18F-fluorodeoxyglucose (FDG) PET, resting-state functional MRI (fMRI) and magnetization prepared rapid gradient echo (MPRAGE) T 1 weighted imaging data. CONN18b and statistical parametric mapping (SPM) 12 softwares were used to analyze data. The voxel-wise FC and FDG metabolic data were extracted within 4 sub-networks of DMN, which included medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC) and bilateral lateral parietal (LP). The FC and MEC between 4 sub-networks were calculated based on merged resting-state fMRI and metabolic data, and analyzed by one-sample t test separately, with Bonferroni correction. Results:FC pathways were all significant within 4 sub-networks of DMN ( t values: 6.00-7.71, all P<0.008, Bonferroni corrected). Meanwhile, there were significant bi-directional MEC between MPFC and PCC(MPFC to PCC: t=10.03; PCC to MPFC: t=3.73, both P<0.004, Bonferroni corrected), as well as between bilateral LP (LP_L to LP_R: t=5.28; LP_R to LP_L: t=4.76, both P<0.004, Bonferroni corrected). There were significant uni-directional MEC from both MPFC and PCC to bilateral LP ( t values: 3.44-6.93, all P<0.004, Bonferroni corrected). Conclusions:Special FC and MEC patterns exist within DMN. The closely interrelated MPFC and PCC play more important roles in DMN, and they may mediate LP jointly. The novel integrated PET/MR system will bring new perspective on the organization of brain networks, which may deepen the comprehensive understanding of DMN.

17.
Article in Chinese | WPRIM | ID: wpr-884610

ABSTRACT

Objective:To study the efficacy of direct intrahepatic portosystemic shunt (DIPS) in treatment of Budd-Chiari syndrome (BCS).Methods:From January 1, 2015 to June 31, 2017, consecutive patients with BCS who were treated with DIPS at the Department of Interventional Therapy of Beijing Shijitan Hospital, the Liver Disease Research Center of Beijing Friendship Hospital and the General Surgery Department of Beijing Ditan Hospital were retrospectively analyzed. The symptoms, physical signs (including abdominal distension, ascites, pleural effusion, splenomegaly, hepatic encephalopathy) and perioperative laboratory results of these patients were collected and analyzed. Biochemical indicators including alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), and portal pressure gradient were compared before and 2 weeks after treatment. The patients were followed up for at least 3 years to assess their clinical symptoms, patency of shunt, oncological status and survival.Results:Of 67 patients with BCS who were included in the study, there were 45 males and 22 females, aged (38.12±23.22) years. The BCS classification of these patients were hepatic vein type ( n=65), including 62 patients with complete hepatic vein obstruction, 3 patients with hepatic vein occlusion due to thrombosis, and 2 patients with mixed hepatic vein and inferior vena cava occlusion. All 67 patients underwent DIPS with 93 stents being implanted. In addition, 43 patients underwent gastric coronary vein embolization, and 2 patients with mixed type of BCS underwent inferior vena cava stenting. The portal pressure gradient decreased from (22.17±9.16) mmHg (1 mmHg=0.133 kPa) to (9.87±4.75) mmHg, the difference was statistically significant ( P<0.05). Abdominal distension was relieved, at one month and ascites completely subsided in 3 months after operation. The liver congestion and swelling were obviously relieved. Comparison of patients 2 weeks after operation and before operation, ALT decreased from (65.28±27.75) U/L to (28.43±13.46)U/L, AST from (68.75±29.23) U/L to (26.92±13.33)U/L, TBil from (175.31±80.48)μmol/L to (45.08±26.54)μmol/L, DBil from (127.55±44.65)μmol/L to (35.12±10.77)μmol/L, and albumin increased from (31.56±7.22) g/L to (44.18±11.36)g/L, the difference was statistically significant (all P<0.05). All patients were followed up for at least 3 years. Shunt stenosis was detected in 5 patients (7.46%) with shunt expansion being performed, variceal bleeding in 2 patients (2.99%), ascites recurrence in 4 patients (5.97%) and hepatic encephalopathy in 2 patients (2.99%). No patients were diagnosed with hepatic cancer, and no patients died. Conclusion:DIPS was efficacious, safe and reliable to that BCS patients. It rapidly reduced portal venous pressure, relieved liver congestion, and restored liver morphology and liver function in these patients.

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Article in Chinese | WPRIM | ID: wpr-884548

ABSTRACT

Objective:To preliminarily evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for pulmonary oligometastatic tumors from head and neck carcinoma.Methods:Clinical data of 24 patients with pulmonary oligometastasis from head and neck carcinoma undergoing SBRT in Zhejiang Cancer Hospital from January 2014 to May 2019 were retrospectively analyzed. Survival analysis was performed by Kaplan- Meier method. Results:Among the 24 patients, 12 cases were diagnosed with nasopharyngeal origin and 12 cases of non-nasopharyngeal origin. A total of 34 pulmonary metastatic lesions were treated with SBRT. The median follow-up time was 19.5 months. Thirteen cases developed new lesions after SBRT, and 9 of them occurred within 1 year after SBRT treatment. The actual 1-year local control rate was 95%. The median progression-free survival was 15.2 months, and the 1-and 2-year progression-free survival were 59% and 46%, respectively. The 2-and 3-years overall survival rate at were 71% and 51% fter lung metastasis, respectively. Univariate analysis showed that the patients with primary lesions located in nasopharynx and disease-free interval of more than 1 year had survival advantage. No more than grade 3 radiation-induced injury was observed in the whole cohort after SBRT, and the incidence of mild radiation-induced injury was 13%.Conclusions:SBRT is safe and effective in the treatment of pulmonary oligometastatsis from head and neck carcinoma, and it may be more effective for patients with primary tumors located in nasopharynx.

19.
Article in Chinese | WPRIM | ID: wpr-884540

ABSTRACT

Objective:To investigate the expression of miR-203a in bladder cancer (BC) cell lines (RT-112, T24, 5637, UM-UC-3) and evaluate the effects on BC cell proliferation and radiosensitivity.Methods:Mir-203a mimics, mir-203a inhibitor, CDK6 siRNA, CDK6 expression plasmid and corresponding negative controls were transfected into BC cells. Quantitative real-time PCR was used to detect the expression of miR-203a in BC cell lines and human bladder epithelial immortalized cell line (SV-HUC-1). CCK8 assay was used to investigate the regulation of miR-203a and cyclin-dependent kinases 6(CDK6) on the proliferation of BC cells. Colony formation assay was performed to assess the effect of miR-203a and CDK6 on the radiosensitivity of BC cells. The target gene of miR-203a was confirmed by luciferase reporter assay. The effect of miR-203a on CDK6 protein expression was detected by Western blot. Multi-group comparison was performed by one-way ANOVA and two-group comparison was conducted by t-test. Results:Compared with the SV-HUC-1 cells, the expression levels of miR-203a in RT-112, T24, 5637 and UM-UC-3 cells were significantly down-regulated (all P<0.05). Compared with NC group, overexpression of miR-203a significantly inhibited the proliferation of BC cells, whereas knockdown of miR-203a significantly promoted the proliferation of BC cells (both P<0.05). Compared with NC group, overexpression of miR-203a significantly increased the sensitivity of BC cells to radiotherapy, whereas knockdown of miR-203a significantly weakened the sensitivity of BC cells to radiotherapy (both P<0.05). CDK6 was the target of miR-203a. Compared with NC group, overexpression of miR-203a significantly down-regulated the expression level of CDK6 protein, whereas knockdown of miR-203a significantly up-regulated the expression level of CDK6 protein (both P<0.05). After overexpression of CDK6 in T24 and UM-UC-3 cells transfected with miR-203a mimics, the cell proliferation ability was significantly increased, whereas the sensitivity to radiotherapy was significantly decreased compared with mir-203a mimics (both P<0.05). After CDK6 was silenced in RT-112 and 5637 cells transfected with miR-203a inhibitor, the proliferation ability of cells was significantly decreased, whereas the sensitivity to radiotherapy was remarkably increased compared with miR-203a inhibitor group (both P<0.05). Conclusion:miR-203a can serves as a tumor suppressor gene to inhibit the proliferation of BC cells and enhance the radiosensitivity of BC cells.

20.
Article in Chinese | WPRIM | ID: wpr-884470

ABSTRACT

Objective:To investigate the feasibility, efficacy, and safety of CT- and bronchoscopy-guided 125I seed implantation in the treatment of central lung cancer complicated with atelectasis. Methods:Retrospective analysis was conducted on twenty-nine patients who were treated from May 2016 to Oct 2019 in the Second Hospital of Tianjin Medical University for central non-small-cell lung carcinoma complicated with pulmonary atelectasis that was inoperable due to medical reasons. 125I seeds were implanted into the trachea under the guidance of bronchoscopy first.The 125I seeds were then implanted into the hilum of the lungs by percutaneous puncture under the guidance of the CT and template.The seed activity was 18.5-29.6 MBq, and the prescription dose was 120 Gy.TPS planning and quality verification were performed before and after the operations.The rate of atelectasis recanalization, the satisfactory rate of dose verification, the improvement of dyspnea index, the survival time, and the adverse events during and after operation were observed. Results:All 29 patients with lung cancer complicated with atelectasis successfully completed the seed implantation, and the satisfactory rate of quality verification was 93.1%.The rate of atelectasis recanalization at 2, 6, 12, 18, and 24 months was 93.1%, 89.7%, 78.6%, 76.2%, and 60%, respectively.Their dyspnea and anoxia symptoms were significantly relieved in 5-28 months after treatment.The results showed that the patients′ dyspnea index was 2.8-0.8 before treatment and 1.4-0.9 after treatment.The median follow-up period was 20 months and median survival was 21 months.Adverse events associated with the radiation therapy included pneumothorax, hemoptysis, cough, fever, and particle displacement.No level-3 or more serious adverse events occurred.Conclusions:The CT- and bronchoscopy-guided 125I seed implantation is a safe and effective therapy option for the treatment of central non-small-cell lung carcinoma associated with atelectasis.It contributes to a high rate of local recanalization, and can rapidly improve clinical conditions and quality of life of the patients with few adverse reactions.

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