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1.
Article in Chinese | WPRIM | ID: wpr-908436

ABSTRACT

Objective:To investigate the diagnosis and treatment of emergency inguinal hernia.Methods:The retrospective cross-sectional study was conducted. The clinical data of 236 patients with emergency inguinal hernia who were admitted to the First Affiliated Hospital of Soochow University from January 2015 to May 2020 were collected. There were 194 males and 42 females, aged (69±30)years. Hospitalized patients received routine blood biochemistry test and imaging examinations for evaluation of characteristics of hernia contents and intestinal obstruction. Manual reduction and surgical treatment were selected according to the conditions of patients. Observation indicators: (1) treatment; (2) follow-up. Follow-up using outpatient examination and telephone interview was performed to detect hernia recurrence and late-onset mesh infection up to August 2020. Measurement data were described as M (range) or M ( P25, P75), and comparison between groups was analyzed using the Wilcoxon rank sum test. Count data were represented as absolute numbers, and comparison between groups was done using the chi-square test. Results:(1) Treatment: of the 236 patients, 106 cases had successful manual reduction, 124 cases underwent emergency operation, 6 cases refused surgery. ① For 106 cases with successful manual reduction (including 4 cases guided by B-ultrasonography), the manual reduction time was 5 minutes (2 minutes,7 minutes). Ninety-three of 106 patients underwent selective operation after manual reduction, including 89 cases with indirect hernia, 2 cases with direct hernia and 2 cases with compound hernia. The time to selective operation was 3 days(2 days,5 days) after manual reduction. Patients underwent mesh repair, of which the operation time, volume of intraoperative blood loss, time to postoperative first flatus, duration of postoperative hospital stay were 44 minutes (29 minutes, 66 minutes),10 mL(5 mL,20 mL), 1 day(1 day,2 days), 1 day(1 day,2 days), respectively. Eleven patients didn't undergo selective operation. Two patients with abdominal pain and fever after manual reduction were diagnosed with perforation of intestine by emergency surgical exploration, and then underwent partial intestinal resection combined with high ligation of hernial sac. ② There were 93 of 124 patients undergoing emergency operation with indirect hernia, 18 cases with femoral hernia, 6 cases with obturator hernia, 6 cases with compound hernia and 1 case with direct hernia. There were 54 of 124 patients undergoing open operation, including 21 cases with Bassini surgery, 18 cases with Lichtenstein surgery, 9 cases with Mc Vay surgery, 6 cases with high ligation of hernia sac. There were 70 patients undergoing laparoscopic operation, including 57 cases with laparoscopic transperitoneal preperitoneal hernia repair (TAPP), 10 cases with laparoscopic explora-tion + tissue repair and 3 cases with laparoscopic exploration + closure of inner inguinal ring. The operation time, volume of intraoperative blood loss, time to postoperative first flatus, cases with short-term postoperative complications were 60 minutes (50 minutes,76 minutes), 20 mL(14 mL,30 mL), 2 days(1 day,2 days), 15 cases for patients undergoing open surgery, respectively. The above indicators were 56 minutes (47 minutes,77 minutes), 20 mL(10 mL,25 mL), 2 days(1 day,2 days), 21 cases for patients under-going laparoscopic surgery. There was no significant difference in the above indicators between the two groups ( Z=?0.88, ?1.37, ?1.56, χ2=0.07, P>0.05). Cases with intraoperative placement of mesh and duration of hospital stay were 18 cases and 5 days(3 days,8 days) for patients undergoing open surgery, versus 57 cases and 3 days(2 days,5 days) for patients undergoing laparoscopic surgery, showing significant differences between the two groups ( χ2=29.50, Z=?4.32, P<0.05). (2) Follow-up: of 236 patients, 192 were followed up for 2?60 months, with a median follow-up time of 19 months. Seven patients had recurrence of hernia after emergency operation, including 3 with high ligation of the hernia sac, 2 with Bassini surgery, 1 with Lichtenstein surgery, and 1 with laparoscopic exploration + closure of inner inguinal ring. One patient with late-onset mesh infection after Lichtenstein surgery was improved after mesh removal. No long-term complications such as hernia recurrence or late-onset mesh infection occurred to the 184 patients. Conclusions:Emergency inguinal hernia had different state of illness, manual reduction is suitable for partial patients with incarceration. Surgery is the first choice, and the surgical procedure needs to be individually selected.

2.
Article in Chinese | WPRIM | ID: wpr-912761

ABSTRACT

Objective:To investigate the psychological stress and related factors of community medical staff in Shanghai during infectious public health emergencies.Methods:Random cluster sampling, questionnaires combining general demographic information, self-rating anxiety scale(SAS), self-rating depression scale(SDS)and yale-brown obsessive compulsive scale(YB)were administrated to investigate the psychological stress of medical staff from 20 community healthcare centers in 10 Shanghai districts.Results:A total of 696 valid questionnaires were collected. 17.36% of the staff had SAS scores exceeding the boundary value. Nurses, staff with per capita monthly family income<5 000 yuan, or with below-average family relations presented higher SAS scores. 28.19% of the staff had SDS scores exceeding the boundary value. Staff with 5-10 years seniority, nurses, with per capita monthly family income<5 000 yuan, and with poor family relations presented higher SDS scores. 6.68% of the staff had YB score≥16. Nurses presented a higher YB score.Conclusions:Some community healthcare center staff experienced psychological stress during public health emergencies.Factors associated with psychological stress, such as 5-10 years′ seniority, nurses, per capita monthly family income<5 000 yuan, below-average or poor family relations, deserve more attention in order to prevent from or alleviate harmful psychological stress.

3.
Article in Chinese | WPRIM | ID: wpr-911697

ABSTRACT

Objective:To explore the clinical efficacy of aspirin plus low molecule heparin for pancreatic thrombosis during simultaneous pancreas and kidney transplantation (SPK).Methods:A total of 129 patients aged 18 years or higher underwent SPK between September 2016 and March 2020.They were divided retrospectively into two groups of aspirin ( n=60) and heparin ( n=69) according to different anticoagulant regimens.The aspirin group received only aspirin 100 mg/d at Day 1 post-operation.The heparin group received subcutaneous injection of enoxaparin 2 000 AxaIU daily for 7 days and followed by aspirin and clopidogrel.Outcomes and complication rates were compared between two groups. Results:All operations were successful without any mortality.In aspirin group, there were 5 cases of pancreatic thrombosis and one patient underwent pancreatectomy.There was no pancreatic thrombosis in heparin group ( P=0.014). There were 8 cases of intestinal anastomotic bleeding in aspirin group and 19 cases in heparin group.Statistically significant inter-group difference existed ( P=0.048). However, no significant inter-group difference existed in delayed recovery or rejection. Conclusions:Heparin anticoagulation can significantly lower the incidence of pancreatic thrombosis after SPK.Despite a higher incidence of intestinal anastomotic bleeding, no serious complication occurs after conservative meaures.

4.
Clinical Medicine of China ; (12): 243-249, 2021.
Article in Chinese | WPRIM | ID: wpr-884160

ABSTRACT

Objective:To investigate the electrocardiographic characteristics of left and right ventricles origin of premature ventricular contractions(PVCs) during V3 transition of precordial leads, right ventricular outflow tract (RVOT) anterior septum and right coronary sinus (RCC), and RVOT middle-posterior septum and left coronary sinus (LCC).Methods:From January 2017 to September 2019, 91 patients with ventricular extrasystole of outflow tract who had V3 transition in precordial lead and had successful radiofrequency ablation in RVOT anterior septum, middle posterior septum, LCC and RCC were selected for retrospective case control study.The electrocardiography measurements of PVCs were compared between the anteroseptal RVOT group and RCC group, as well as the middle-posterior septal RVOT group and the LCC group, respectively.The measurements included the R-wave amplitude in lead Ⅰ, Ⅱ, Ⅲ and aVF, R amplitude ratio in leads Ⅲ to Ⅱ, Q-wave amplitude in lead aVL and aVR, Q amplitude ratio in leads aVL to aVR, R-wave and S-wave amplitude from leads V1 to V3, the V2S/V3R index, the transition zone index, and the V2 transition ratio.Results:Thirty-six cases originated from the anteroseptal RVOT, and 11 from the LCC.Lead I R-wave amplitude in anterior septal RVOT was higher than LCC group((0.22±0.25) mV vs.(-0.17±0.33) mV; P=0.003). R-wave amplitude in lead Ⅱ was lower than that in the LCC group((1.59±0.35) mV vs.(1.76±0.27) mV; P=0.035). R-wave amplitude in lead aVF was lower compared with the LCC group((1.53±0.35) mV vs.(1.78±0.39) mV; P=0.050). The V2S/V3R index showed a significant difference between these two groups(1.99±0.66 vs.0.76±0.38; P<0.001). The V2 transition ratio also appeared a significant difference between the two groups(0.69±0.43 vs.1.05±0.35; P=0.005). PVCs arose from the middle-posterior septal RVOT in 32 cases, and from the RCC in 12 cases.Compared with RCC group, lead Ⅰ R-wave amplitude showed lower ((0.25±0.31) mV vs.(0.57±0.12) mV; P<0.001); R amplitude ratio in leads Ⅲ to Ⅱ higher (0.89±0.14 vs.0.72±0.18; P=0.002); Q amplitude in lead aVL((0.72±0.24) mV vs.(0.51±0.16) mV; P=0.002)higher, and Q amplitude ratio in leads aVL to aVR higher in the middle-posterior septal RVOT(0.76±0.23 vs.0.50±0.21; P=0.002). Conclusion:Among the cases with lead V3 transition, PVCs originated from the anteroseptal RVOT show significantly different R wave in lead Ⅰ, Ⅱ, aVF, V2S/V3R index, and the V2 transition ratio compared with those from the LCC.The PVCs from the middle-posterior septal RVOT and the RCC have different R wave in lead Ⅰ, R amplitude ratio in leads Ⅱ and Ⅲ, Q amplitude ratio in leads aVL and aVR.Combined with its different characteristics, it can help to identify the origin of left and right ventricles.

5.
Article in Chinese | WPRIM | ID: wpr-882710

ABSTRACT

Objective:To investigate the causes, diagnosis and treatment of postoperative pulmonary changes in patients with thyroid cancer.Methods:Data of 378 patients with thyroid cancer surgery admitted from Oct. 1, 2019 to Jan. 31, 2020 were retrospectively analyzed. SPSS 23.0 statistical software was adopted to analyze the effect of gender, age, smoking history, BMI, operation way and the surgical approach on postoperative changes in the lungs. The two groups of counting data were compared using χ2 method. Results:Age, gender, smoking history and surgical approach had no significant influence on postoperative pulmonary change ( P>0.05) . Lung changes in patients receiving thyroid cancer plus lateral neck dissection were greater than those receiving radical thyroid cancer alone ( P=0.001) , and lung changes in patients receiving bilateral neck dissection were greater than those receiving unilateral neck dissection ( P=0.027) . The pulmonary changes in patients with underweight and obesity were greater than those in patients with normal weight and hyperreorganization ( P=0.019) . Conclusions:Lateral neck dissection and patients’ body mass index are important factors affecting the postoperative lung changes in thyroid cancer patients. Thyroid cancer patients undergoing lateral neck dissection should actively check their lung changes through chest radiographs after surgery, especially for lean and obese patients, and patients undergoing bilateral neck dissection.

6.
Article in Chinese | WPRIM | ID: wpr-879050

ABSTRACT

Chemical constituents from aerial parts of Glycyrrhiza uralensis were analyzed and identified using ultra-high performance liquid chromatography coupled with hybrid quadrupole-orbitrap mass spectrometry(UPLC-Q-Exactive Orbitrap-MS). The chromatographic column of Waters Acquity UPLC BEH-C_(18)(2.1 mm×100 mm, 1.7 μm) was adopted, with acetonitrile-water(0.5% formic acid) as mobile phase at a flow rate of 0.2 mL·min~(-1). Data was collected in positive and negative modes of electrospray ionization(ESI). A total of 55 compounds, including 42 flavonoids, 9 stilbenes, 2 coumarins, 1 lignin and 1 phenolic acid, which were characterized in the aerial parts of G. uralensis based on accurate molecular mass information of molecular and product ions provided by UPLC-Q-Exactive Orbitrap-MS based on comparison with standard substances and references. It is an effective and accurate method to provide chemical information of constituents in aerial parts of G. uralensis, and can provide a reference for further study on pharmacodynamic material basis and resources development and utilization.


Subject(s)
Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Glycyrrhiza uralensis , Mass Spectrometry , Plant Components, Aerial
7.
Article in Chinese | WPRIM | ID: wpr-878893

ABSTRACT

This study aims to investigate the potential mechanism of curcumin in mediating interleukin-6(IL-6)/signal transducer and activator of transcription 3(STAT3) signaling pathway to repair intestinal mucosal injury induced by 5-fluorouracil(5-FU) chemotherapy for colon cancer. SD rats were intraperitoneally injected with 60 mg·kg~(-1)·d~(-1) 5-FU for 4 days to establish a model of intestinal mucosal injury. Then the rats were randomly divided into model group(equal volume of normal saline), curcumin low, medium and high dose groups(50, 100, 200 mg·kg~(-1)), and normal SD rats were used as control group(equal volume of normal saline). Each group received gavage administration for 4 consecutive days, and the changes of body weight and feces were recorded every day. After administration, blood was collected from the heart, and jejunum tissues were collected. The levels of serum interleukin-1β(IL-1β) and tumor necrosis factor-α(TNF-α) were detected by ELISA, and at the same time, the concentration of Evans blue(EB) in jejunum was measured. Hematoxylin-eosin(HE) staining was used to observe the pathological state of jejunum, and the length of jejunum villi and the depth of crypt were measured. The positive expression levels of claudin, occludin and ZO-1 were detected by immunohistochemistry. Western blot was used to detect the protein expression of IL-6, p-STAT3, E-cadherin, vimentin and N-cadherin in jejunum tissues. The results showed that, curcumin significantly increased body weight and fecal weight(P<0.05 or P<0.01), decreased fecal score, EB concentration, IL-1β and TNF-α levels(P<0.05 or P<0.01) in rats. In addition, curcumin maintained the integrity of mucosal surface and villi structure of jejunum to a large extent, and reduced pathological changes in a dose-dependent manner. Meanwhile, curcumin could increase the positive expression of occludin, claudin and ZO-1(P<0.05 or P<0.01), repair intestinal barrier function, downregulate the protein expression of IL-6, p-STAT3, vimentin and N-cadherin in jejunum tissues(P<0.05 or P<0.01), and upregulate the protein expression of E-cadherin(P<0.05). Therefore, curcumin could repair the intestinal mucosal injury induced by 5-FU chemotherapy for colon cancer, and the mechanism may be related to the inhibition of IL-6/STAT3 signal and the inhibition of epithelial-mesenchymal transition(EMT) process.


Subject(s)
Animals , Colonic Neoplasms/drug therapy , Curcumin , Fluorouracil/toxicity , Interleukin-6/genetics , Intestinal Mucosa/metabolism , Rats , Rats, Sprague-Dawley , STAT3 Transcription Factor/metabolism , Signal Transduction
8.
Article in Chinese | WPRIM | ID: wpr-872352

ABSTRACT

Leading units of county medical alliance had difficulties in financial management and resource distribution after social medical insurance took the whole alliance as the payment subject. The authors summarized and analyzed the problems faced by the leading units of medical alliance in typical areas after the implementation of the overall payment, such as the high risk of fund overspending, the high risk of extra medical treatment, and the difficulty in the management of special funds. Then put forward some solutions, such as the unification of interests and responsibilities, the decentralization of medical insurance settlement rights, the refinement of medical insurance payment, and the pricing reform of primary medical services, so as to improve the medical insurance payment policy and promote the development of county medical alliance.

9.
Article in Chinese | WPRIM | ID: wpr-828657

ABSTRACT

OBJECTIVE@#To study the characteristics of pulmonary function in children with pertussis-like coughing caused by different pathogen infections.@*METHODS@#The data on etiology and tidal breathing pulmonary function were collected from 95 hospitalized infants and young children with pertussis-like coughing. The tidal breathing pulmonary function was compared between these children and 67 healthy children. According to the type of pathogen, the children with pertussis-like coughing were classified to 6 groups: pertussis (n=17), viral infection (n=23), tuberculosis infection (n=6), Mycoplasma infection (n=9), other bacterial infection (n=8), and unknown pathogen (n=32).@*RESULTS@#Among the 95 children with pertussis-like coughing, 15 (16%) had mild obstructive ventilatory dysfunction, 30 (32%) had moderate obstructive ventilatory dysfunction, and 22 (23%) had severe obstructive ventilatory dysfunction. Compared with the normal control group, the children with pertussis-like coughing had significant reductions in inspiratory-to-expiratory time ratio, ratio of time to peak tidal expiratory flow to total expiratory time (tPF%tE), and ratio of volume to peak tidal expiratory flow to total expiratory volume (vPF%vE) (P<0.05). The tuberculosis infection and Mycoplasma infection groups had a significantly lower tidal volume than the normal control group (P<0.05). All pathogen infection groups except the tuberculosis infection group had significantly lower tPF%tE and vPF%vE than the normal control group (P<0.05). The pertussis group had significantly lower tPF%tE and vPF%vE than the other infection groups (P<0.05).@*CONCLUSIONS@#Most of children with pertussis-like coughing have abnormal pulmonary functions. The children with Bordetella pertussis infection have the most severe pulmonary function impairment. Tidal breathing pulmonary function test may provide a reference for pathogen analysis of children with pertussis-like coughing.


Subject(s)
Child , Child, Preschool , Humans , Infant , Lung , Respiration , Respiratory Function Tests , Tidal Volume , Whooping Cough
10.
Journal of Experimental Hematology ; (6): 1210-1214, 2020.
Article in Chinese | WPRIM | ID: wpr-827138

ABSTRACT

OBJECTIVE@#To analyze the clinical efficacy and safety of rituximab therapy for patients with Epstein-Barr virus (EBV) positive diffuse large B-cell lymphoma (DLBCL), and to explore the factors influencing the clinical efficacy.@*METHODS@#According to therapeutic regimen, 66 patients with EBV-positive DLBCL were divided into two groups: CHOP group (32 cases) and R-CHOP group (CHOP+ rituximab, 34 cases). The clinical efficacy and the incidence of complication were compared between two groups. The clinical risk factors for the clinical efficacy in patients with EBV-positive DLBCL were confirmed by multivariate Logistic analysis.@*RESULTS@#Compared with CHOP group, the complete remission rate, partial remission rate and the overall effective rate in R-CHOP group all were high (P<0.05), moreover the disease progression rate in R-CHOP group were low (P<0.05). The occurrences rate of myelotoxicity, hepatic injury and gastrointestinal reaction were not statistically significantly different between two groups (P>0.05). Multivariate Logistic analysis showed that the Ann Arbor staging, IPI risk score and Ki-67 positive rate were independent risk factors for the clinical efficacy in patients with EBV-positive DLBCL (OR=2.689, P=0.038; OR=3.232, P=0.025; OR=2.919, P=0.023).@*CONCLUSION@#The clinical efficacy and safety of the therapy with rituximab on the patients with EBV-positive DLBCL are better. The poor Ann Arbor stage, high IPI risk score and the Ki-67 positive rate are factors affecting the clinical efficacy for the patients with EBV-positive DLBCL.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Cyclophosphamide , Therapeutic Uses , Doxorubicin , Therapeutic Uses , Herpesvirus 4, Human , Humans , Lymphoma, Large B-Cell, Diffuse , Drug Therapy , Prednisone , Therapeutic Uses , Rituximab , Therapeutic Uses , Treatment Outcome , Vincristine , Therapeutic Uses
11.
Article in Chinese | WPRIM | ID: wpr-781474

ABSTRACT

OBJECTIVE@#To investigate the proliferation, differentiation potential and autophagic mechanism HL-60 cells via ULK1 protein targeted by Haishengsu extracted from Tegillarca granosa.@*METHODS@#The HL-60 cells were divided into five groups: Haishengsu of 10,100,1000 mg/L-treated group, all-trans retinoic acid (ATRA) 5 μmol/L-treated group and control group. The cell proliferation rates were detected by MTT after culture 12,24,48 h and 72 h. The expression of differentiation and maturation markers CD11b and CD15 were detected by flow cytometry, and the expression of autophagy molecules ULK1 and LC-3 proteins were measured by Western blot.@*RESULTS@#After cultured for 48 and 72 h the cell proliferation rates of HL-60 in Haishengsu 100 and 1000 mg/L groups were significantly lower than those of ATRA 5 μmol/L group and Haishengsu 10 mg/L group and control group (P<0.05). After 72 h, the levels of CD11b, CD15, ULK1 and LC-3 expression of HL-60 cell in Haishengsu 100 and 1000 mg/L groups were higher than those in ATRA 5 μmol/L group, Haishengsu 10 mg/L group and control group (P<0.05). While the HL-60 cells in Haishengsu 10, 100 and 1000 mg/L group were treated with ULK1 protein inhibitor and after cultured for 72 h, the proliferation rate of HL-60 cell increased, levels of CD11b and CD15 expression decreased at the same time, and the levels of ULK1 and LC-3 proteins in HL-60 cells also decreased (P<0.05).@*CONCLUSION@#Haishengsu, which extracted from Tegillarca granosa, can induce HL-60 cell proliferation and differentiation by targeting ULK1 protein in a concentration and time dependent manner, its effective mochanism may be mediating autophagic activity, promoting cell differentiation and maturation.

12.
Article in English | WPRIM | ID: wpr-781415

ABSTRACT

Objective@#To evaluate the effects of incretin-based therapies on body weight as the primary outcome, as well as on body mass index (BMI) and waist circumference (WC) as secondary outcomes.@*Methods@#Databases including Medline, Embase, the Cochrane Library, and clinicaltrials.gov (www.clinicaltrials.gov) were searched for randomized controlled trials (RCTs). Standard pairwise meta-analysis and network meta-analysis (NMA) were both carried out. The risk of bias (ROB) tool recommended by the Cochrane handbook was used to assess the quality of studies. Subgroup analysis, sensitivity analysis, meta-regression, and quality evaluation based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were also performed.@*Results@#A total of 292 trials were included in this study. Compared with placebo, dipeptidyl-peptidase IV inhibitors (DPP-4Is) increased weight slightly by 0.31 kg [95% confidence interval ( ): 0.05, 0.58] and had negligible effects on BMI and WC. Compared with placebo, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) lowered weight, BMI, and WC by -1.34 kg (95% : -1.60, -1.09), -1.10 kg/m (95% : -1.42, -0.78), and -1.28 cm (95% : -1.69, -0.86), respectively.@*Conclusion@#GLP-1 RAs were more effective than DPP-4Is in lowering the three indicators. Overall, the effects of GLP-1 RAs on weight, BMI, and WC were favorable.

13.
Article in Chinese | WPRIM | ID: wpr-742717

ABSTRACT

Objective:To observe the effect of CoCl2on the cisplatin sensitivity of human ovarian cancer SKOV3cells, and to clarify the possible mechanism.Methods:The SKOV3cells were cultured in vitro and randomly divided into control group, CoCl2 group, cisplatin (DDP) group and CoCl2 combined with DDP (combination) group.The cells in CoCl2group were cultured in normal cell medium for 20hafter cultured in 200μmol·L-1 CoCl2for 4h, the cells in DDP group were cultured in normal cell medium containing 10mg·L-1 DDP for 24h, and the cells in combination group were cultured in 10mg·L-1 DDP for 20hafter cultured in 200μmol·L-1 CoCl2for 4h.The survival rates of SKOV3cells in various groups were detected by MTT method, and the positive expression intensities of hypoxia-inducible factor-1α (HIF-1α) and inducible nitric oxide synthase (iNOS) in the cells in various groups were detected by immunofluorescence method.Rhod 2-AM fluorescence probe was used to observe the levels of Ca2+in mitochondria in the cells in various groups.Western blotting method was used to observe the expression levels of cytochrome C (cyto C) , cysteinyl aspartase 3 (caspase 3) and cleaved cysteinyl aspartase 3 (cleaved caspase 3) .Muse○R apoptosis assay kit was used to detect the apoptotic rates of cells in various groups.Results:Compared with control group, the survival rate of the cells in CoCl2group had no significant change (P>0.05) , and the survival rates of the cells in DDP and combination groups were decreased (P<0.05) ;the survival rate in combination group was higher than that in DDP group (P<0.05) .Compared with control group, the positive expression intensities of HIF-1αin CoCl2and combination groups were increased (P<0.05) .Compared with control group, the positive expressions of iNOS in DDP and combination groups were increased (P<0.05) .The Ca2+levels in the cells in DDP group and combination groups were higher than that in control group (P<0.05) and the Ca2+level in DDP group was higher than that in combination group (P<0.05) .Compared with control group, the expression levels of cyto C, caspase 3and cleaved caspase 3proteins in the SKOV3cells in CoCl2group had no significant changes (P>0.05) , and the expression levels of cyto C, caspase 3and cleaved caspase 3in DDP group were increased significantly (P<0.05) ;compared with DDP group, they were lower than those in combination group (P<0.05) .Compared with control group, the apoptotic rate of SKOV3cells in DDP group was increased significantly (P<0.05) ;the apoptotic rate of SKOV3cells in combination group was lower than that in DDP group (P<0.05) .Conclusion:CoCl2can redece the mitochondrial apoptosis of human ovarian cancer SKOV3cells by inhibiting the DDP-induced enhancement of iNOS expression and decrease the sensitivity of SKOV3cells to cisplatin.

14.
Cancer Research and Clinic ; (6): 520-524, 2019.
Article in Chinese | WPRIM | ID: wpr-756790

ABSTRACT

Objective To investigate the significance of lymphocyte-to-monocyte ratio (LMR) in peripheral blood before the treatment in prognosis evaluation of patients with locally advanced cervical cancer. Methods The clinical and follow-up data of 128 patients with cervical cancer in stage Ⅱ B-Ⅳ A from July 2012 to February 2016 in the Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. The patients were divided into the high LMR group (>5.19, 58 cases) and the low LMR group (≤5.19, 70 cases) according to the optimal cutoff value of peripheral blood LMR. And the clinical characteristics and progression-free survival (PFS) time of the two groups were compared and analyzed. At the same time, the factors affecting the prognosis of patients with locally advanced cervical cancer were also discussed. Results The lymphocyte count (t = 5.211, P < 0.01), monocyte count (t = 6.282, P < 0.01), lymph node metastasis (χ 2 = 9.436, P = 0.002), tumor stage (χ 2 = 6.624, P = 0.010), squamous cell carcinoma antigen (SCCA) level (Z = 2.515, P = 0.012), carcinoembryonic antigen (CEA) level (Z = 3.232, P = 0.001), carbohydrate antigen199 (CA199) level (Z = 2.319, P = 0.020) of two groups had statistically significant differences. In addition, age (t = 0.291, P = 0.771), pathological type (χ 2 = 0.003, P = 0.957), treatment method (χ 2 = 0.728, P =0.394), CA125 level (Z = 0.089, P = 0.929), CA153 level (Z = 0.859, P = 0.390) of two groups had no statistically significant differences. The short-term total effective rate of patients with the high LMR [82.8%(48/58)] was higher than that of patients with the low LMR [61.4% (43/70)] (P = 0.008). The median PFS time in the high LMR group (36 months) was longer than that in the low LMR group (19 months) (HR = 0.1295, 95% CI 0.081-0.206, P < 0.01). The median PFS time of the squamous cell carcinoma and adenocarcinoma, clinical stage Ⅱ B and stage Ⅲ A-Ⅳ A of the patients in the high LMR group (36, 31, 36, 36 months, respectively) was longer than that in the low LMR group (20, 15, 20, 18 months, respectively), and the differences were statistically significant (all P < 0.05). Univariate analysis showed that monocyte > 0.37×109/L, LMR ≤5.19, SCCA >15.24 U/ml were correlated with the poor prognosis of patients (all P < 0.05). Multivariate analysis showed that LMR ≤5.19 was an independent risk factor affecting the prognosis of patients (HR = 2.006, 95% CI 1.017-3.957, P = 0.045). Conclusion The peripheral blood LMR before the treatment can reflect the survival prognosis of patients with locally advanced cervical cancer, and low LMR indicates poor prognosis.

15.
Article in Chinese | WPRIM | ID: wpr-802336

ABSTRACT

Objective:To explore the mechanism of modified Xiaoyaosan on extracellular regulated protein kinase(ERK) signal transduction pathway of central dopamine receptor in hyperprolactinemia(HPRL)model rats by treating them with Shugan Jianpi as the core. Method:The 96 SD female rats were randomly divided into normal group, model group, Bromocriptine group (0.001 g·kg-1), modified Xiaoyaosan high, medium and low dose group(60,30,15 g·kg-1), dopamine D1 receptor(D1R) antagonist group (SCH23390, SCH23390+ modified Xiaoyaosan group, SCH23390+bromocriptine group), dopamine D2 receptor(D2R) antagonist group (haloperidol group, haloperidol+modified Xiaoyaosan group,haloperidol+bromocriptine group).HPRL rat model was established by pituitary transplanta-tion. After 30 days of administration, renin-angiotensinsystem Ras and Raf protein expressions in thypothalamus of rats were detected by Western blot, and mitogen-activated protein kinase (MAPK) kinase 1/2(MEK1/2)mRNA and extracellular signaling regulates kinase 1/2(ERK1/2) mRNA expressions in the hypothalamus of rats were detected by Real-time PCR.The microstructures of mitochondria in ovarian granulosa cells were observed by electron microscopy. Result:The Ras,Raf protein,MEK1/2 and ERK1/2 mRNA expression were significantly decreased in model group compared with normal group (PPPPConclusion:Modified Xiaoyaosan stimulates D2R, inhibits D1R, regulates ERK/MAPK signaling pathway.It also effectively improve the mitochondrial function of ovarian granulosa cells and promote follicular development.It is suggested that the modified Xiaoyaosan with a multi-target mechanism in treating HPRL.

16.
Article in Chinese | WPRIM | ID: wpr-755931

ABSTRACT

Objective To preliminarily explore the clinical efficacy of ipsilateral simultaneous pancreas and kidney transplantation (SPK) .Methods Ipsilateral SPK was performed in 40 patients from September 2016 to August 2018 .During a follow-up period of 6 to 29 months ,we summarized the efficacy and complications of the technique .Results Up to now ,38 patients achieved an exceelent clinical efficacy with no major surgical complications .However ,two patients died of severe pneumonia .The postoperative serum levels of creatinine at 3 ,6 ,12 ,24 months were 107 ,102 ,107 ,110 umol/L ;creatinine clearance rate 64 ,67 ,64 ,63 ml/min;fasting glucose 4 .6 ,5 .1 ,4 .6 ,5 .2 mmol/L ;glycated hemoglobin 4 .8% , 5 .4% ,4 .9% ,5 .2% respectively .And 1/2-year pancrea and kidney graft survival rates both were 92% . Complications included kidney graft rejection (n= 11) ,pancreas graft rejection (n= 12) ,simultaneous renal & pancreas graft rejection (n=6) ,renal graft DGF (n=1) ,pulmonary infection (n=14) ,urinary tract infections (n=18) ,gastrointestinal bleeding (n=10) diarrhea (n=6) ,splenic venous thrombosis (n=2) ,incomplete ureteric obstruction of renal allograft (n=3) ,urine leakage (n=1) and pancreas allograft dysfunction (n= 2) .There were no severe surgical complications .After aggressive interventions ,all postoperative complications were cured and none required excision of kidney or pancreas .Conclusions Ipsilateral SPK has definite therapeutic efficacy and it is worth wider popularization .

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Clinical Medicine of China ; (12): 392-396, 2019.
Article in Chinese | WPRIM | ID: wpr-754321

ABSTRACT

Objective To observe whether catheter ablation for ventricular premature complexes (PVC) has an effect on ventricular diastolic function in elderly patients.Methods Elderly patients older than 65 years of age who underwent catheter ablation from March 2012 to May 2015 for idiopathic ventricular premature complexes were enrolled.Preoperative echocardiography was performed using E/e′ for left ventricular diastolic function and venous brain natriuretic peptide (BNP) levels were measured.All patients underwent catheter ablation under the guidance of a three?dimensional mapping system.Cardiac ultrasound and BNP levels were repeated 6 months after ablation, and 24?hour electrocardiogram was performed to confirm ventricular premature complexes.Results There were a total of 89 patients with idiopathic ventricular premature complexes ( PVC) who underwent catheter ablation.81 cases were successed at 6 months,with a success rate of 91.0%.At 6 months after ablation,the E/e′ values were significantly lower ((15.3±5.2) vs ( 10.2± 3.2),( P<0.001)) and BNP levels were significantly lower (( 202.0 ± 23.2) pg/L vs (94±13.3) pg/L),(P<0.001).For the unsuccessful subgroup,there was no significant change in E/e′values (16.3±6.3 vs 15.2±5.6) and BNP levels ((223.0±26.8) pg/L vs (245.0±23.9) pg/L), (P>0.05).Conclusion The number of premature ventricular beats is associated with left ventricular diastolic function,and ventricular premature catheter ablation can improve left ventricular diastolic function in elderly PVC patients.

18.
Chinese Journal of Epidemiology ; (12): 702-706, 2019.
Article in Chinese | WPRIM | ID: wpr-805457

ABSTRACT

A large amount of data has been accumulated in Chinese medical area. Problems as how to use big data to carry out randomized controlled trials have also been increasingly noteworthy. Through learning the successful experiences in conducting randomized controlled trials on big data from abroad, this article introduces the knowledge regarding sources of data, identification of research subjects and outcomes, interventions, methods of randomization and the implementation of informed consent, etc., all related to big data, hoping to shed light on studies of this kind, for the years to come in China.

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Organ Transplantation ; (6): 175-2019.
Article in Chinese | WPRIM | ID: wpr-780511

ABSTRACT

Objective To investigate the safety of young recipients undergoing living donor renal transplantation from elderly relative donors through long-term follow-up of the pathological changes. Methods According to the age of donors, 28 young recipients were divided into the observation group (n=14, elderly donors) and control group (n=14, young and middle-aged donors). The 7-year survival after renal transplantation, the serum creatinine (Scr) levels at various postoperative time points were compared between two groups. The chronic pathological injury scores of renal allograft biopsy at time-zero, postoperative 6-month and 7-year were compared between two groups. The expression levels of renal interstitial fibrosis indicators connective tissue growth factor (CTGF), transforming growth factor (TGF)-β, laminin (LN), fibronectin (FN), cell senescence indicators intercellular connexin (Cx)-43 and mammalian target of rapamycin (mTOR) at postoperative 6-month and 7-year were compared between two groups. Results The 7-year survival rates in the observation and control groups were 78.5% and 92.8% with no statistical significance (P > 0.05). In the observation and control groups, the levels of Scr were 190 and 160 μmol/L at the postoperative 7 d, and 170 and 125 μmol/L at postoperative 1 month. At each postoperative time point, the levels of Scr in the observation group were significantly higher than those in the control group (all P > 0.05). The total chronic pathological injury scores of renal transplant biopsy at time-zero in the observation group was significantly higher than that in the control group (P > 0.05), whereas the total chronic pathological injury scores at postoperative 7-year did not significantly differ between two groups (P > 0.05). Within either group, the total chronic pathological injury scores at postoperative 7-year was remarkably higher than those at time-zero and postoperative 6-month (both P < 0.05). The expression levels of CTGF, TGF-β, LN, FN, mTOR, Cx43 of renal transplant tissue at postoperative 7-year did not significantly differ between two groups (all P > 0.05). Conclusions The long-term follow-up outcomes demonstrate that the pathological changes of young recipients undergoing renal transplantation from elderly donors are similar to those from young and middle-aged donors. It is safe and feasible for young recipients to undergo renal transplantation from elderly donors in the pathological perspective.

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Organ Transplantation ; (6): 713-2019.
Article in Chinese | WPRIM | ID: wpr-780496

ABSTRACT

Objective To investigate the distribution characteristics of pathogenic bacteria in infectious donors from organ donation after citizen's death and preventive strategies for renal transplant recipients. Methods Clinical data of 412 donors and 803 recipients from organ donation after citizen's death were retrospectively analyzed. All donors underwent culture of airway secretions, urine, blood and renal lavage fluid. The incidence rate of infection, distribution and composition ratio of pathogenic bacteria of donors from organ donation after citizen's death were observed. The scores of all donors were evaluated according to the length of intensive care unit (ICU) stay for donors, the situation of abdominal trauma and the results of body fluid culture, etc. According to the score, the recipients received different infection prevention regimes. The incidence rate of donor-derived infection (DDI) and clinical prognosis of the recipients were analyzed. Results A total of 243 donors were diagnosed with infection in 412 donors from organ donation after citizen's death with an infection rate of 59.0%. In total, 456 strains of pathogenic bacteria were isolated, mainly derived from the airway secretions (71.7%). Gram-negative bacteria dominantly consisted of Klebsiella pneumoniae and acinetobacter baumannii. Gram-positive bacteria mainly included staphylococcus aureus and fungus mainly included yeast-type fungus. Three recipients (kidneys from 2 donors respectively) developed DDI with an incidence rate of 0.4%. Conclusions The infection rate of donors from organ donation after citizen's death is relatively high. It is effective to prevent the incidence of DDI by grading the risk of infection of donors and adopting rational preventive plan according to the score.

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