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1.
Article in Chinese | WPRIM | ID: wpr-936369

ABSTRACT

OBJECTIVE@#To propose a nonlocal spectral similarity-induced material decomposition network (NSSD-Net) to reduce the correlation noise in the low-dose spectral CT decomposed images.@*METHODS@#We first built a model-driven iterative decomposition model for dual-energy CT, optimized the objective function solving process using the iterative shrinking threshold algorithm (ISTA), and cast the ISTA decomposition model into the deep learning network. We then developed a novel cost function based on the nonlocal spectral similarity to constrain the training process. To validate the decomposition performance, we established a material decomposition dataset by real patient dual-energy CT data. The NSSD-Net was compared with two traditional model-driven material decomposition methods, one data-based material decomposition method and one data-model coupling-driven material decomposition supervised learning method.@*RESULTS@#The quantitative results showed that compared with the two traditional methods, the NSSD-Net method obtained the highest PNSR values (31.383 and 31.444) and SSIM values (0.970 and 0.963) and the lowest RMSE values (2.901 and 1.633). Compared with the datamodel coupling-driven supervised decomposition method, the NSSD-Net method obtained the highest SSIM values on water and bone decomposed results. The results of subjective image quality assessment by clinical experts showed that the NSSD-Net achieved the highest image quality assessment scores on water and bone basis material (8.625 and 8.250), showing significant differences from the other 4 decomposition methods (P < 0.001).@*CONCLUSION@#The proposed method can achieve high-precision material decomposition and avoid training data quality issues and model unexplainable issues.


Subject(s)
Algorithms , Humans , Image Processing, Computer-Assisted/methods , Phantoms, Imaging , Signal-To-Noise Ratio , Tomography, X-Ray Computed/methods , Water
2.
Article in Chinese | WPRIM | ID: wpr-936138

ABSTRACT

OBJECTIVE@#To summarize and analyze the clinical characteristics of children with basal ganglia germinoma and to improve the level of early clinical diagnosis.@*METHODS@#The clinical data of children diagnosed with basal ganglia germinoma admitted to the Pediatric Surgery Ward of Peking University First Hospital from January 2013 to December 2020 were retrospectively analyzed, and descriptive statistics were used to analyze the clinical characteristics of children with basal ganglia germinoma.@*RESULTS@#A total of 30 patients were included in the study, 28 were male, 2 were female, the mean age at onset was (9.7±2.2) years, the median disease duration was 7 months, 27 had unilateral disease, and 3 had bilateral disease. The clinical manifestations were decreased limb muscle strength, cognitive function disorders, polydipsia, precocious puberty, intracranial hypertension, dysphonia and swallowing dysfunction. The serum and cerebrospinal fluid tumor marker alpha-fetoprotein (AFP) were normal in the 30 patients, and the serum and cerebrospinal fluid tumor marker β-human chorionic gonadotropin (β-HCG) were normal in 8 patients.The serum β-HCG was normal in 11 patients but the cerebrospinal fluid β-HCG was slightly elevated, and the serum and cerebrospinal fluid β-HCG were slightly elevated in 11 patients. A total of 33 lesions with irregular shapes were found by imaging examination, including 15 (45.5%) patchy lesions, 10 (30.3%) patchy lesions, and 8 (24.2%) round-like high-density lesions. Tumors showed obvious high-density shadows on computed tomography (CT) scan. Magnetic resonance imaging (MRI) scan of the tumors showed low or isointensity on T1WI and isointensity on T2WI, accompanied by mild peritumoral edema, hemispheric atrophy, cerebral peduncle atrophy, calcification, cystic degeneration, ventricular dilatation and wallerian degeneration. On contrast-enhanced scans, the tumor showed no enhancement or heterogeneous enhancement.@*CONCLUSION@#The main age of onset of germ cell tumors in the basal ganglia in children is about 10 years old, and males are absolutely dominant. The clinical features and imaging manifestations have certain characteristics. With both combined, the early diagnosis of germ cell tumors in the basal ganglia can be improved.


Subject(s)
Atrophy/pathology , Basal Ganglia/pathology , Biomarkers, Tumor , Brain Neoplasms/diagnostic imaging , Child , Chorionic Gonadotropin, beta Subunit, Human , Female , Germinoma/pathology , Humans , Magnetic Resonance Imaging , Male , Neoplasms, Germ Cell and Embryonal , Retrospective Studies
3.
International Eye Science ; (12): 1741-1744, 2022.
Article in Chinese | WPRIM | ID: wpr-942853

ABSTRACT

AIM: To investigate the influencing factors of disequilibrium refractive development in children aged 6-12 years old.METHODS: A total of 607 children with a mean age of 8.2±1.8 years old from two primary schools in Binhai New Area of Tianjin in December 2019 were selected by cluster sampling for optical biometry measurement(axial length and equivalent corneal power), cycloplegia refractive examination and questionnaire survey.RESULTS: The childrens'spherical equivalent was -0.11±1.63D, binocular spherical equivalent difference was -0.08±0.64D and absolute value of spherical equivalent difference was 0.41±0.49D. There were 56 children with anisometropia and 551 children without anisometropia. There was no difference in the absolute value of binocular corneal power difference between anisometropia and non-anisometropia group(0.30±0.34D vs 0.27±0.24D, P=0.430). But the absolute value of axial difference was significantly different(0.67±0.39mm vs 0.13±0.13mm, P=0.005). Multivariate linear regression analysis showed that weekly usage time of phones/computers, weekly close work hours, weekly visual fatigue times and habitual reading distance were the influencing factors of refractive imbalance development(the absolute value of binocular spherical equivalent difference). Habitual reading distance and handedness in writing are the influencing factors of the developmental bias of refractive imbalance(binocular spherical equivalent difference).CONCLUSION: Children aged 6-12 years old who spend more time on phones/computers, and have prolonged close work, more times of visual fatigue and close habitual reading distance may increase the degree of refractive imbalance. Children with right-handed handwriting and severe left or right head deviation have a deeper degree of myopia in the right eye than in the left eye.

4.
Journal of Clinical Hepatology ; (12): 1956-1961, 2022.
Article in Chinese | WPRIM | ID: wpr-942643

ABSTRACT

Ascites is the most common complication of decompensated liver cirrhosis. Recurrent massive ascites seriously affects the quality of life and prognosis of patients, and therefore, effective control of ascites is an important link in the treatment of liver cirrhosis. Based on the clinical reports in recent years, this article reviews the advances in the integrated traditional Chinese and Western medicine diagnosis of cirrhotic ascites, conventional Western medicine treatment such as salt restriction, diuresis, and albumin supplementation, and the application of transjugular intrahepatic portosystemic shunt, ascites pump, and liver transplantation in the treatment of refractory ascites. In addition, this article introduces the application of integrated traditional Chinese and Western medicine combining disease and syndrome with staged treatment and external treatment methods with traditional Chinese medicine characteristics, as well as the perspectives of future research including real-world study.

5.
Article in Chinese | WPRIM | ID: wpr-942361

ABSTRACT

Objective To investigate the epidemiological characteristics and identify the risk factors of Giardia lamblia infections among patients with colorectal cancer in Henan Province. Methods A cross-sectional study was performed for questionnaire surveys among colorectal cancer patients in Henan Cancer Hospital during the period from March to July, 2021. Patients’ stool samples were collected, and the triosephosphate isomerase (tpi) gene of G. lamblia was amplified in stool samples using nested PCR assay to characterize the parasite genotype. Univariate analysis and multivariate logistic regression analyses were employed to identify the risk factors of G. lamblia infections among colorectal cancer patients. Results A total of 307 colorectal cancer patients were investigated, including 176 males (57.3%) and 131 females (42.7%). PCR assay detected 8.1% [95% confidential interval (CI): (0.056, 0.117)] prevalence of G. lamblia infections among the study subjects, and there was no significant difference in the prevalence between men [9.1%, 95% CI: (0.057, 0.143)] and women [6.9%, 95% CI: (0.037, 0.125)] (χ2 = 0.495, P = 0.482). In addition, there was no age-specific prevalence of G. lamblia infections among the participants (χ2 = 1.534, P = 0.675). Multivariate logistic regression analysis identified use of septic tanks [odds ratio (OR) = 3.336, 95% CI: (1.201, 9.267)], daily use of well water [OR = 3.042, 95% CI: (1.093, 8.465)] and raising livestock [OR = 3.740, 95% CI: (1.154, 12.121)] as risk factors of G. lamblia infections among colorectal cancer patients, and the prevalence of abdominal pain was significantly greater in colorectal cancer patients with G. lamblia infections than in those without infections (P = 0.017). Among the 25 patients with G. lamblia infections, assemblage A was characterized in 24 (96.0%) cases and assemblage B in one case (4.0%). Conclusions The prevalence of G. lamblia is high among colorectal cancer patients in Henan Province, and assemblage A is the dominant genotype of G. lamblia. Use of septic tanks, daily use of well water and raising livestock are risk factors of G. lamblia infections among patients with colorectal cancer.

6.
Article in Chinese | WPRIM | ID: wpr-941025

ABSTRACT

OBJECTIVE@#To express and purify the antigenic peptide of adeno-associated virus (AAV) capsid conserved regions in prokaryotic cells and prepare its rabbit polyclonal antibody.@*METHODS@#The DNA sequence encoding the conserved regions of AAV capsid protein was synthesized and cloned into the vector pET30a to obtain the plasmid pET30a-AAV-CR for prokaryotic expression and purification of the conserved peptides. Coomassie blue staining and Western blotting were used to identify the AAV conserved peptides. Japanese big ear white rabbits were immunized with AAV conserved region protein to prepare polyclonal antibody, with the rabbits injected with PBS as the control group. The antibody titer was determined with ELISA, and the performance of the antibody for recognizing capsid protein sequences of AAV1-AAV10 was assessed with Western blotting and immunofluorescence assay.@*RESULTS@#The plasmid pET30a-AAV-CR was successfully constructed, and a recombinant protein with a relative molecular mass of 17000 was obtained. The purified protein induced the production of antibodies against the conserved regions of AAV capsid in rabbits, and the titer of the purified antibodies reached 1:320 000. The antibodies were capable of recognizing a wide range of capsid protein sequences of AAV1-AAV10.@*CONCLUSION@#We successfully obtained the polyclonal antibodies against AAV capsid conserved region protein from rabbits, which facilitate future studies of AAV vector development and the biological functions of AAV.


Subject(s)
Animals , Antibodies , Capsid , Capsid Proteins/genetics , Dependovirus/genetics , Prokaryotic Cells , Rabbits , Recombinant Proteins/genetics
7.
Article in Chinese | WPRIM | ID: wpr-940833

ABSTRACT

ObjectiveTo investigate the mechanism of quercetin in regulating chondrocyte extracellular matrix metabolism and inflammatory response in knee osteoarthritis (KOA) from the perspective of autophagy. MethodChondrocytes were extracted and cultured, and the primary cells were identified by immunofluorescence staining with collagen Ⅱ. The chondrocytes induced by lipopolysaccharide (LPS) were divided into a control group (without any treatment), a model group (10 mg·L-1 LPS treatment for 48 h), and low-, medium-, and high-dose quercetin group (10 mg·L-1 LPS treatment for 48 h combined with 50, 100, and 150 mmol·L-1 quercetin for 24 h). The inhibitory effects of LPS (2.5, 5, 7.5, 10, 12.5 mg·L-1) on the proliferation of chondrocytes for different periods (24, 48, 72 h) were detected by cell counting kit-8 (CCK-8). The effects of quercetin (50, 100, 150, 200 mmol·L-1) on the LPS-induced proliferation of chondrocytes for different periods (12, 24, and 48 h) were investigated. The expression of microtubule-associated protein 1 light chain 3Ⅱ (LC3Ⅱ) and ubiquitin-binding protein p62 was detected by Western blot. LPS-induced chondrocytes were treated with 3-methyladenine (3-MA). The resultant cells were divided into a control group (without any treatment), a model group (10 mg·L-1 LPS), a quercetin group (model group + 100 mmol·L-1 quercetin), a 3-MA group (model group + 100 μmol·L-1 3-MA), and a 3-MA + quercetin group (model group + 100 μmol·L-1 3-MA + 100 mmol·L-1 quercetin, specifically, LPS for 48 h, 3-MA for 2 h, and then quercetin for 24 h). The content of interleukin (IL)-1β and tumor necrosis factor (TNF)-α was determined by enzyme-linked immunosorbent assay (ELISA). The protein expression of matrix metalloproteinase 13 (MMP-13) and tissue inhibitor of metalloproteinase 1 (TIMP1) was detected by Western blot. ResultCollagen Ⅱ immunofluorescence staining showed that the extracted cells were consistent with the characteristics of chondrocytes. As revealed by CCK-8, the optimum concentration of LPS was 10 mg·L-1 with an action time of 48 h, and the optimum concentration of quercetin was 100 mmol·L-1 with an action time of 24 h. Western blot results showed that compared with the control group, the model group showed decreased expression of LC3Ⅱ (P<0.01) and increased expression of p62 (P<0.01). The expression of LC3Ⅱ in the quercetin groups was higher than that in the control group (P<0.01), especially in the medium-dose quercetin group. The p62 expression in the quercetin groups was lower than that in the control group (P<0.01), especially in the medium-dose quercetin group. Compared with the control group, the model group showed increased expression of MMP-13 (P<0.05) and decreased expression of TIMP1 (P<0.01). Compared with the model group, the quercetin groups and the 3-MA + quercetin group showed decreased expression of MMP-13 (P<0.05, P<0.01), especially the quercetin groups, and increased expression of TIMP1 (P<0.01), especially the quercetin groups. Morphological changes in chondrocytes under the inverted microscope showed that quercetin could restore the morphology of damaged chondrocytes. CCK-8 showed that compared with the control group, the model group showed inhibited chondrocyte proliferation (P<0.01), and compared with the model group, the quercetin groups and the 3-MA + quercetin group showed promoted chondrocyte proliferation (P<0.01), especially the quercetin groups. ELISA results showed that IL-1β and TNF-α levels in the model group were higher than those in the control group (P<0.01), and the levels of IL-1β and TNF-α in the quercetin groups and the 3-MA + quercetin group were lower than those in the model group (P<0.05, P<0.01), and the decrease in the quercetin groups was the most significant. ConclusionQuercetin can promote LPS-induced chondrocyte proliferation, regulate chondrocyte extracellular matrix synthesis and metabolic balance, inhibit the inflammatory response, and restore chondrocyte function. The mechanism may be related to the activation of autophagy by quercetin.

8.
Article in Chinese | WPRIM | ID: wpr-940567

ABSTRACT

ObjectiveTo explore the mechanism of Tongbi Jiangu prescription (TBJG) in the treatment of knee osteoarthritis (KOA) based on network pharmacology and molecular docking,and further verify it by cell experiments. MethodThe active components and the corresponding targets of TBJG were screened out according to the traditional Chinese medicine systems pharmacology database and analysis platform(TCMSP). The targets of KOA were obtained from GeneCards,online mendelian inheritance in man(OMIM), and DrugBank. The common targets of active components of TBJG and KOA were the targets of TBJG against KOA. The active component-target network and protein-protein interaction (PPI) network were constructed by Cytoscape 3.7.2. STRING was used for PPI network analysis. DAVID was used for gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses. Key targets and core active components were selected for molecular docking by AutoDock. The results of network pharmacology were verified by cell experiments and the pharmacodynamic responses were observed. ResultThe prediction of network pharmacology showed that there were 111 active components of TBJG in the treatment of KOA. The core active components were quercetin,kaempferol, and β-sitosterol,and the key targets were interleukin-1β(IL-1β), matrix metalloproteinase-3 (MMP-3),and tumor necrosis factor-α (TNF-α). Biological processes (BP) in GO analysis mainly involved inflammatory response,response to lipopolysaccharide,apoptosis signaling pathway,and regulation of DNA activity in binding transcription factor. Cellular components (CC) included plasma membrane protein complex,RNA polymerase Ⅱ transcription factor complex,membrane raft,and serine/threonine protein kinase complex. Molecular functions (MF) were mainly enriched in cytokine receptor binding,nuclear receptor activity,protein domain specific binding,serine hydrolase activity,chemokine receptor binding,and activity of nitric oxide synthase regulator. As revealed by the KEGG analysis, the relevant signaling pathways were nuclear factor(NF)-κB, Janus kinase(JAK)/signal transducer and activator of transcription(STAT), and Wnt signaling pathways. Molecular docking results showed that the core active components had good binding activities with key targets. The experimental results showed that TBJG could down-regulate IL-1β, MMP-3,TNF-α, and NF-κB p65 expression levels (P<0.05),and up-regulated NF-κB inhibitor(IκB)-α(P<0.05). ConclusionThe mechanism of TBJG in the treatment of KOA lies in the application of active components such as quercetin,kaempferol, and β-sitosterol with IL-1β,MMP-3, and TNF-α as key targets through the NF-κB,JAK/STAT, and Wnt signaling pathways.

9.
Article in Chinese | WPRIM | ID: wpr-940468

ABSTRACT

Xiao Xumingtang in The Catalogue of Famous Ancient Classics (The First Batch) issued by the National Administration of Traditional Chinese Medicine is derived from the Important Prescriptions Worth a Thousand Gold for Emergency (Bei Ji Qian Jin Yao Fang) written by SUN Si-miao in the Tang dynasty. The present study systematically explored the origin, development, historical evolution, and clinical application of Xiao Xumingtang. As revealed by the results, Xiao Xumingtang as well as its analogues are primary prescriptions indicated for apoplexy before the Tang and Song dynasties and serve as the benchmark for the treatment of apoplexy. After the Song dynasty, due to the changes in the understanding of the pathogenesis of apoplexy and the limitations of the understanding of Xiao Xumingtang, its clinical application to apoplexy gradually decreased. In modern times, it has been re-recognized and applied, during which its clinical applications have undergone great changes. Its clinical applications are extensive, involving a variety of diseases related to the brain and nervous systems, such as stroke and its sequelae, peripheral facial paralysis, rheumatoid arthritis, hypertension, and other diseases related to the motor nervous system. Its primary indications are stroke and its sequelae, followed by peripheral facial paralysis. Other new indications are gradually found. This study is expected to provide references for the clinical application of Xiao Xumingtang and the transformation of new drugs.

10.
Article in Chinese | WPRIM | ID: wpr-940199

ABSTRACT

The depressive state, as an emotional disorder, has common symptoms of lack of interest, self-denial, unresponsiveness, unwillingness to communicate, and even extreme misanthropy or suicidal tendency. The depressive state involves a variety of diseases, such as depression, post-stroke depression, postpartum depression, irritable bowel syndrome, major depression, and schizophrenia, which affects the treatment effect and prognosis of the disease, seriously reduces the quality of life and increases the economic burden of patients. At present, the mechanism of depressive state is complex, and the pathophysiological mechanism is unclear. The mechanism of depressive state may be related to abnormal expression of monoamine neurotransmitters, neuronal damage, changes in transduction pathways, hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, release of inflammatory cytokines, etc. An increasing number of studies in recent years have confirmed that the occurrence of depression is closely related to intestinal flora disorder, and they interact with each other. Traditional Chinese medicine (TCM) is effective in preventing and treating depressive state with few adverse reactions and a low recurrence rate. TCM also has the effect of regulating the homeostasis of intestinal flora. At the same time, intestinal flora affects the absorption and efficacy of active components of Chinese medicine through metabolic transformation. With the development of microecology, in-depth studies are conducted on the effect of intestinal flora on the occurrence and development of depressive state and brain-gut axis. Intestinal flora has become another potential target for the study of TCM treating depressive state. Starting from the theory and clinical practice of TCM, this paper summarized the mechanism of TCM in treating depressive state by Chinese medicine monomers, compound prescriptions, and acupuncture based on the theory of intestinal flora in recent years. This paper provided information for the profound study of the pathogenesis of depressive state and the scientific connotation of TCM in treating depressive state and ideas for the systematic exploration of the microbiological basis of symptom changes.

11.
Article in Chinese | WPRIM | ID: wpr-940167

ABSTRACT

The depressive state, as an emotional disorder, has common symptoms of lack of interest, self-denial, unresponsiveness, unwillingness to communicate, and even extreme misanthropy or suicidal tendency. The depressive state involves a variety of diseases, such as depression, post-stroke depression, postpartum depression, irritable bowel syndrome, major depression, and schizophrenia, which affects the treatment effect and prognosis of the disease, seriously reduces the quality of life and increases the economic burden of patients. At present, the mechanism of depressive state is complex, and the pathophysiological mechanism is unclear. The mechanism of depressive state may be related to abnormal expression of monoamine neurotransmitters, neuronal damage, changes in transduction pathways, hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, release of inflammatory cytokines, etc. An increasing number of studies in recent years have confirmed that the occurrence of depression is closely related to intestinal flora disorder, and they interact with each other. Traditional Chinese medicine (TCM) is effective in preventing and treating depressive state with few adverse reactions and a low recurrence rate. TCM also has the effect of regulating the homeostasis of intestinal flora. At the same time, intestinal flora affects the absorption and efficacy of active components of Chinese medicine through metabolic transformation. With the development of microecology, in-depth studies are conducted on the effect of intestinal flora on the occurrence and development of depressive state and brain-gut axis. Intestinal flora has become another potential target for the study of TCM treating depressive state. Starting from the theory and clinical practice of TCM, this paper summarized the mechanism of TCM in treating depressive state by Chinese medicine monomers, compound prescriptions, and acupuncture based on the theory of intestinal flora in recent years. This paper provided information for the profound study of the pathogenesis of depressive state and the scientific connotation of TCM in treating depressive state and ideas for the systematic exploration of the microbiological basis of symptom changes.

12.
Acta Pharmaceutica Sinica ; (12): 2334-2341, 2022.
Article in Chinese | WPRIM | ID: wpr-937038

ABSTRACT

Huachansu is a traditional Chinese medicine widely used in the clinic for cancer therapy, while the underlying mechanism is not fully clarified. This study was to investigate the targets and mechanisms of cinobufagin (CBG), an active component of Huachansu, in terms of blocking mitosis of cancer cells. Propidium iodide (PI) DNA staining was used to analyze the effect of CBG on cell cycle. The effect of CBG on mitosis of cancer cells was examined by α-tubulin and pericentrin staining after synchronization by a double thymidine block. Tubulin turbidity, tubulin polymerization and α‍-tubulin immunofluorescence assays were used to evaluate the effect of CBG on microtubule polymerization. CRISPR/Cas9 gene-editing technology was used to knockout microtubule-severing protein Katanin regulatory subunit B1 (KATNB1) in HCT116 cells, and the inhibitory effect of CBG on wild-type cells and knockout cells was measured by CCK-8. The engagement of CBG with KATNB1 was measured by CETSA and DARTS assays. The effect of CBG on KATNB1 protein and mRNA level was examined by Western blot and real-time PCR, respectively. Our data showed that CBG arrested HCT116 cell cycle at the G2/M phase, disrupted mitosis and induced centriole overduplication. CBG significantly inhibited tubulin polymerization in vitro and in vivo. The cytotoxicity of CBG inhibition on HCT116 was significantly attenuated upon KATNB1 depletion. Moreover, CBG bound to KATNB1 and decreased its protein level, while mutated KATNB1 weakened this effect. In conclusion, CBG inhibited microtubule polymerization via targeting KATNB1, thereby disrupting mitosis in cancer cells.

13.
Chinese Journal of Hepatology ; (12): 220-223, 2022.
Article in Chinese | WPRIM | ID: wpr-935930

ABSTRACT

Objective: To investigate the practicability and safety of transjugular liver biopsy (TJLB). Methods: Data of 53 cases with transjugular liver biopsy from June 2015 to June 2020 were collected. LABS-100 was used in all patients who underwent transjugular liver biopsy. Among them, 45 cases and eight were biopsied via hepatic vein and intrahepatic segment of the inferior vena cava. The surgical indications, related complications, and postoperative pathological diagnosis were analyzed and summarized. Results: TJLB was successful in all patients, with an average of 2.8 punctures per case. Satisfactory liver tissue and histopathological diagnosis was obtained in all patients. Two cases developed a cervical hematoma that was improved spontaneously, and one patient developed an intrahepatic hematoma that was improved after conservative treatment. Conclusion: TJLB is a practical and safe method for patients with contraindications to percutaneous liver biopsy.


Subject(s)
Biopsy/methods , Biopsy, Needle/methods , Humans , Jugular Veins , Liver Diseases/pathology
14.
Chinese Journal of Pediatrics ; (12): 462-465, 2022.
Article in Chinese | WPRIM | ID: wpr-935721

ABSTRACT

Objective: To investigate the clinical characteristics of systemic juvenile idiopathic arthritis combined with coronary artery dilatation. Methods: A retrospective analysis was performed on the clinical data, including clinical manifestations, blood routine, inflammatory factors, echocardiography, vascular ultrasound and CT angiography, treatment and outcomes, etc, of 5 cases with systemic juvenile idiopathic arthritis combined with coronary artery dilation admitted to Department of Rheumatology in the affiliated Children's Hospital of Capital Institute of Pediatrics from May 2019 to June 2021. Results: There were 2 males and 3 females among 5 cases. The onset age ranged from 7 months to 4 years 7 months.The diagnostic time ranged from 1.5 months to 3.0 months.Four cases were diagnosed as atypical Kawasaki disease. Three cases showed unilateral coronary artery dilation.Two cases showed bilateral coronary artery dilation.Four cases developed multiple organ injuries.Three cases developed macrophage activation syndrome.Three cases developed lung injury.Two cases developed pericardial effusion.One case developed pulmonary hypertension.As for treatment, 3 cases treated with methylprednisolone pulse therapy and methotrexate combined with cyclosporine, improved after the final application of biological agents, and have stopped prednisone. The other 2 cases were treated with adequate oral prednisone and gradually reduced, and methotrexate was added at the same time, 1 case relapsed in the process of reduction. No other vascular involvement was found in 5 cases. Coronary artery dilation recovered completely after 1 to 3 months of treatment. Conclusions: Systemic juvenile idiopathic arthritis combined with coronary artery dilatation has the clinical characteristics of small onset age, long diagnostic time, prone to multiple organ injuries. Corticosteroids and conventional immunosuppressive agents are not sensitive, and biological agents should be used as soon as possible.The prognosis of coronary artery dilation is good after timely treatment.


Subject(s)
Arthritis, Juvenile/drug therapy , Biological Factors/therapeutic use , Child , Coronary Aneurysm/etiology , Coronary Artery Disease/therapy , Dilatation , Dilatation, Pathologic , Female , Humans , Infant , Male , Methotrexate , Prednisone/therapeutic use , Retrospective Studies
15.
Article in Chinese | WPRIM | ID: wpr-934568

ABSTRACT

Digital reform serves as powerful driver for high-quality development of hospitals. Taking the problems existing in the decision-making mechanism of major issues as a breakthrough, a tertiary hospital used digital thinking to optimize the decision-making mechanism. The hospital took such means as optimizing the rules of procedure, strengthening the pre-decision assessment, clarifying the principle of " two initiatives" , improving the " No.1 issue" system, strengthening the linkage between the Party committee and meeting the president′s office meeting, and standardizing the supervision and implementation. By such means, the hospital successfully built a smart, efficient, coordinated, and closed-loop operation and management system, desirably strengthening the leadership and core role of the Party committee, enhancing the president′s overall management of business work, as well as improving the decision completion rate and feedback rate.

16.
Article in Chinese | WPRIM | ID: wpr-934179

ABSTRACT

Objective:Anatomical study of the cross-donor flap pedicled with the peroneal artery and the discussion of the effect of clinical application, so as to describe a new method for the repair of large-area soft tissue defects in the foot and ankle.Methods:From June 2016 to August 2019, 12 specimens of adult lower limbs were studied. The popliteal arteries were perfused with perchloroethylene-ethyl acetate-lead oxide and red perchloroethylene-ethyl acetate. The origin, number, outer diameter, course and distribution of perforating branches of the peroneal artery were anatomically observed. The source, distribution and anastomosis of the skin nutrient vessels in the posterolateral area of the calf were also studied. Relationship of the blood supply between the peroneal arteries and veins and the nutritional vessels of the sural nerve were observed. In 9 patients, the peroneal artery and vein were designed as the pedicle of cross-donor flap in the repair of large soft tissue defects of foot and ankle. The patients were entered follow-up through outpatient visits and telephone interviews.Results:Among the 12 adult specimens of lower limbs, there were 65 perforating branches from the peroneal artery, 4-7 branches on each side, with an average of (5.41±1.00) branches. The diameter of the penetrating deep fascia was(1.07±0.36) mm. The perforator branches were mostly distributed in 3 sections of 4.0-11.0 cm, 16.0-21.0 cm and 24.0-27.0 cm away from the lateral malleolus, accounting for 48%, 24% and 17% of the total number of perforators, respectively. The outer diameters of the perforator vessels were (0.92±0.26)(0.56-1.68) mm, (1.32±0.38)(0.60-2.14) mm, and (0.98±0.28)(0.62-1.36) mm. The length of the pedicle of the perforator vessels were (3.91±0.96)(2.15-5.78) cm, (5.34±0.50)(4.01-5.85) cm, and (3.31±1.15)(2.16-5.66) cm. The perforating branches in the 3 sections appeared constantly. The diameter of the vessels was≥0.5 mm with an average length of at(4.19±1.16)(2.15-5.85) cm. The vascular network of the flap in the posterolateral area of the calf was mainly composed of subdermal vascular network and deep fascial vascular network. The deep fascia vascular network in the posterolateral area of the calf had 3 obvious longitudinal chains, including the medial sural neurotrophic vascular chain, the small saphenous vein-sural nerve communicating branch vascular chain and the lateral sural neurotrophic vascular chain, which took the nutrient blood supply from the perforating branches of the peroneal artery also formed a longitudinal and transverse anastomosis between the perforating branches of the peroneal artery. In the clinical trials performed on 9 patients, all soft tissue defects of foot and ankle were repaired. The composite tissue flap survived without infection or necrosis. The follow-up was lasted for 12 months to 3 years. The postoperative function and the donor site appearance were good and the patients walked normally. According to the American Orthopaedic Foot and Ankle Association(AOFAS) foot scoring standard, the function of affected feet were evaluated. Five patients were excellent and 4 were good.Conclusion:The cross-donor flaps pedicled with peroneal arteries and veins has sufficient blood supply and a large area. It provides a method for the repair of large-area soft tissue defects in the foot and ankle.

17.
Article in Chinese | WPRIM | ID: wpr-934106

ABSTRACT

Objective:To evaluate the safety and feasibility of double endoscopic bypass, namely endoscopic ultrasound-guided gastroenterostomy (EUS-GE) combined with endoscopic ultrasound-guided biliary drainage (EUS-BD), for malignant gastric outlet and biliary obstruction.Methods:A retrospective analysis was conducted on data of 10 patients with malignant gastric outlet and biliary obstruction who were not suitable for surgery or endoscopic retrograde cholangiopancreatography (ERCP) and treated by double endoscopic bypass in Nanjing Drum Tower Hospital from August 2017 to October 2020. The completion of therapy, clinical efficacy and post-procedure adverse events were analyzed.Results:Ten patients with different malignant cancer successfully underwent EUS-GE and EUS-BD, with procedure time of 60.5±22.3 min (30-100 min). There were no postoperative adverse events. EUS-GE was clinically successful in all 10 cases. Of the 10 EUS-BD cases, 9 were clinically successful, and 1 did not meet the criteria of clinical success. The median follow-up was 71 (37-120) days. None of the 10 patients had recurrent gastric outflow tract obstruction or biliary tract obstruction.Conclusion:Double endoscopic bypass is feasible and effective for patients with malignant gastric outlet and biliary obstruction and without surgery or ERCP opportunity.

18.
Article in Chinese | WPRIM | ID: wpr-934096

ABSTRACT

Objective:To analyze the clinicopathological characteristics of differentiated early cardia cancer and to evaluate the short-term and long-term efficacy of endoscopic submucosal dissection (ESD).Methods:A total of 329 patients (331 lesions) who underwent ESD at Nanjing Drum Tower Hospital from October 2014 to December 2019 and were pathologically confirmed as differentiated early cardia cancer were included in the study and followed up. The endoscopic and pathological data of patients were reviewed to analyze the clinicopathological characteristics of differentiated early cardia cancer. The short-term (including en bloc resection rate, curative resection rate and incidence of short-term complications) and long-term efficacy (including incidence of metachronous cancer, recurrence and distant metastasis, and overall survival rate) of ESD was evaluated.Results:The ratio of male to female in 329 patients with differentiated early cardia cancer was 4∶1, and their age was 65.69±8.02 years. Tumor diameter of ≤2.0 cm accounted for 65.9% (218/331). Most lesions were located on the posterior wall (50.5%, 167/331), followed by the minor curve (36.3%, 120/331). The endoscopic morphology of 0-Ⅱc type accounted for 49.5% (164/331). There were 69.8% (231/331) lesions confined to the mucosal layer. The en bloc resection rate was 100.0% (329/329), and the curative resection rate was 83.3% (274/329). Short-term complications occurred in 28 patients (8.5%). With a median follow-up time of 39 months, 11 patients (3.3%) developed metachronous cancer, 2 (0.6%) developed distant metastasis, and no recurrence occurred. Seven patients died, and the overall survival rate during the follow-up period was 97.9% (322/329). The survival rate of patients with curative resection and additional surgery was 100.0% (3/3), while that without additional surgery was 99.3% (269/271). The survival rate of patients with non-curative resection and additional surgery was 96.0% (24/25), and that without additional surgery was 86.7% (26/30).Conclusion:Most differentiated early cardia cancers are well-differentiated adenocarcinomas, with less than 2 cm in diameter at the time of diagnosis with a low rate of ulcer and vascular invasion. ESD is safe and effective for the treatment of differentiated early cardia cancer with a high rate of curative resection, fewer intraoperative and postoperative complications, low incidences of metachronous cancer, distant metastasis and recurrence, and a high overall survival rate. However, additional surgical treatment is recommended for patients with non-curative resection.

19.
Article in Chinese | WPRIM | ID: wpr-934091

ABSTRACT

Objective:To investigate the efficacy and safety of a new China-made direct visualization system of peroral cholangiopancreatography in the diagnosis and treatment of biliopancreatic diseases.Methods:Clinical data of 37 patients who underwent endoscopic examination through the direct visualization system of peroral cholangiopancreatography at Digestive Endoscopy Center of Nanjing Drum Tower Hospital from April 2020 to June 2021 were retrospectively analyzed. Technical success rate and complications were analyzed.Results:The examination was completed in 37 patients through the system. The technical success rate was 100.0%. The nature of biliary stricture was confirmed in 24 cases, presenece or absence of bleeding or residual stones in the bile duct was confirmed in 6 cases, neoplasm or residual stones in the pancreatic duct was determined in 2 cases, biliary stricture was passed assisted with visualized guidewire in 2 cases, and lithotripsy was performed assisted with biliary laser in 3 cases. Nine patients were pathologically diagnosed as having malignant biliary stricture, and 8 of them were confirmed malignant by the system. Drainage was performed in 34 cases after the examination. There were 3 cases of cholangitis, 4 cases of bacteremia and 2 cases of postoperative pancreatitis after the operation, which were relieved in a short time after conservative treatment. Bleeding occurred in 1 case which was improved after two times of endoscopic hemostasis.Conclusion:The new direct visualization system of peroral cholangiopancreatography is safe and effective in the diagnosis and treatment of biliopancreatic diseases.

20.
Article in Chinese | WPRIM | ID: wpr-934088

ABSTRACT

Clinical data of 26 patients with proton pump inhibitor dependent gastroesophageal reflux disease (GERD) who underwent anti-reflux mucosectomy (ARMS) in Nanjing Drum Tower Hospital from July 2017 to December 2020 were reviewed, and the GERD questionnaire (GERD-Q) score, the short-form reflux-qual (RQS) score, esophageal motility and 24 h esophageal pH parameters before and after ARMS were compared. With a median follow-up period of 18.4 months (6-27 months), 23 (88.5%) patients reported symptomatic improvement and 15 (57.7%) patients discontinued the use of proton pump inhibitors. After ARMS, the mean scores of GERD-Q (6.23 VS 13.19, P=0.004) and RQS (26.67 VS 10.98, P<0.001) were significantly improved, the mean DeMeester score (10.69 VS 53.15, P<0.001), the mean acid exposure time percentage (3.56% VS 9.92%, P<0.001) and the mean number of acid reflux episodes (36.9 VS 139.9, P=0.001) were lower, and the mean rest pressure at lower esophageal sphincter (LES) (25.19 mmHg VS 13.63 mmHg, P<0.001) and the mean distal contractile integral (1 819.15 mmHg·s·cm VS 1 007.67 mmHg·s·cm, P<0.001) were significantly increased compared with those before surgery. ARMS has significant short-term efficacy in the treatment of proton pump inhibitor dependent GERD, which can effectively improve reflux symptoms and life quality of patients, and strengthen the rest pressure of LES and peristalsis of the esophageal body.

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