ABSTRACT
【Objective】 To construct a nomogram survival prediction model for patients with locally advanced renal cell carcinoma based on SEER database (n=7893), so as to provide reference for future prognosis study. 【Methods】 Case data were downloaded from the SEER database, and divided into the experimental group and validation group with a ratio of 7∶3 by simple randomization.The clinical information was analyzed, independent risk factors influencing prognosis were screened, and the overall survival (OS) and tumor-specific survival (CSS) were mapped.Model performance was evaluated using consistency index, area under the receiver operating characteristic curve (AUC), internal and external validation, and calibration curves. 【Results】 Patients’ age, tumor size, disease progression tpye, TNM stage, number of positive lymph nodes, marital status and pathological type were significantly correlated with OS and CSS (P<0.01).Based on the above predictors, the internal verification AUC of the 1-, 3- and 5- year OS nomogram model was 0.809, 0.721 and 0.715, respectively.The internal validation AUC of the nomogram model for 1-, 3- and 5- year CSS was 0.802, 0.745 and 0.735, respectively.The external validation AUC of the OS nomogram model was 0.792, 0.628 and 0.620 at 1, 3 and 5 years, respectively, and the external validation AUC of CSS was 0.943, 0.803 and 0.737 at 1.3 and 5 years, respectively, showing good model differentiation and accuracy. 【Conclusion】 The prediction performance of the nomogram model is good, and it can provide reference for individualized treatment.
ABSTRACT
@#Diabetic kidney disease (DKD) is one of the main complications of diabetes, and also the leading cause of the end-stage renal disease (ESRD).The main clinical manifestations are albuminuria and decreased glomerular filtration rate.DKD seriously affects the quality of life of sufferers and places a huge financial burden on them. Traditional Chinese medicine (TCM) has accumulated rich experience in treating DKD.This paper analyzed and summarized the recent treatment of DKD with traditional Chinese medicine from three aspects: active ingredients of TCM, TCM pairs and TCM prescriptions, so as to provide new ideas for the majority of researchers in experimental research.
ABSTRACT
Objective @# To investigate the effect and mechanism of miR⁃145 ⁃3p on mitophagy in 1 ⁃methyl⁃4 ⁃pheny⁃lpyridiniumion ( MPP + ) Ⅳinduced Parkinson ′ s disease ( PD) cell model . @*Methods @# Human neuroblastoma cells SH⁃SY5Y) were divided into control group , model group , mimics group , calmodulin⁃dependent protein kinase kinaseβ (CaMkkβ) inhibitor ( STO⁃609) group , mimics + STO⁃609 group , cyclic adenosine monophosphate response element⁃binding protein (CREB) inhibitor (KG⁃501) group , mimics + KG⁃501 group and STO⁃609 + KG⁃501 group . Cell apoptosis was detected by flow cytometry , autophagosome structure was observed by transmission electron microscopy , and apoptosis , autophagy and CaMkkβ/adenylate activated protein kinase ( AMPK) /CREB pathway related protein expression were detected by Western blot . @*Results @#Compared with control group , the apoptosis rate , Bcl⁃2 ⁃associated X protein (Bax) , cysteine proteinase⁃3 (Caspase⁃3) and microtubule⁃associated protein light chain 3 ⁃I (LC3 ⁃ Ⅰ ) protein expression levels in model group increased (P < 0. 01) , and the autophagosome structure decreased . The protein levels of B cell lymphoma⁃2 (Bcl⁃2) , autophagy gene (Beclin⁃1) , microtubule⁃associated protein light chain 3 ⁃ Ⅱ ( LC3 ⁃ Ⅱ ) , phosphorylated calmodulin⁃dependent protein kinase kinaseβ(p⁃CaMkkβ) , phosphorylated cadenylate activated protein kinase ( p⁃AMPK) , and phosphorylated cyclic adenosine monophosphate response element⁃binding protein ( p⁃CREB) decreased ( P < 0. 01) . Compared with model group , the apoptosis rate , Bax , Caspase⁃3 and LC3 ⁃ Ⅰ protein expression levels in mimics group decreased (P <0. 05 ) , and the autophagosome structure increased . The protein levels of Bcl⁃2 , Beclin⁃1 , LC3 ⁃ Ⅱ , p ⁃CaMkkβ , p ⁃AMPK , p ⁃CREB increased (P < 0. 05) . The trend of STO⁃609 group and KG⁃501 group was the same and opposite to mimics group . Compared with mimics group , the apoptosis rate , Bax , Caspase⁃3 and LC3 ⁃ Ⅰ protein expression levels in the mimics + STO⁃609 group and the mimics + KG⁃501 group increased (P < 0. 01) , and the autophagosome structure decreased . The protein levels of Bcl⁃2 , Beclin⁃1 , LC3 ⁃ Ⅱ , p ⁃CaMkkβ , p ⁃AMPK , p ⁃CREB protein levels decreased (P < 0. 01) . Compared with STO⁃609 group , the apoptosis rate , Bax , Caspase⁃3 and LC3 ⁃ Ⅰ pro⁃tein expression levels of STO⁃609 + KG⁃501 group increased ( P < 0. 01) , and the autophagosome structure decreased . The protein levels of Bcl⁃2 , Beclin⁃1 , LC3 ⁃ Ⅱ , p ⁃CaMkkβ , p ⁃AMPK and p ⁃CREB decreased ( P <0. 05) . @*Conclusion @# miR⁃145 ⁃3p can inhibit the apoptosis of MPP + Ⅳinduced PD cell model and promote mitophagy , and its mechanism may be related to the activation of the CaMkkβ/AMPK/CREB pathway .
ABSTRACT
OBJECTIVE@#To explore the effectiveness of the percutaneous parallel screw fixation via the posterolateral "safe zone" for Hawkins type Ⅰ-Ⅲ talar neck fractures.@*METHODS@#A retrospective analysis was conducted on the clinical data from 35 patients who met the selection criteria of talar neck fractures between January 2019 and June 2021. According to the surgical method, they were divided into a study group (14 cases, using percutaneous posterolateral "safe zone" parallel screw fixation) and a control group (21 cases, using traditional open reduction and anterior cross screw internal fixation). There was no significant difference in gender, age, affected side, Hawkins classification, and time from injury to operation between the two groups ( P>0.05). The operation time, bone healing time, complications, and Hawkins sign were recorded, and the improvement of pain and ankle-foot function were evaluated by visual analogue scale (VAS) score and American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score at last follow-up. The overall quality of life was assessed by the short form of 12-item health survey (SF-12), which was divided into physical and psychological scores; and the satisfaction of patients was evaluated by the 5-point Likert scale.@*RESULTS@#The operation time in the study group was significantly shorter than that in the control group ( P<0.05). All patients werefollowed up 13-35 months, with an average of 20.6 months; there was no significant difference in the follow-up time between the two groups ( P>0.05). The time of bone healing in the study group was shorter than that in the control group, and the positive rate of Hawkins sign (83.33%) was higher than that in the control group (33.33%), and the differences were significant ( P<0.05). In the control group, there were 2 cases of incision delayed healing, 7 cases of avascular necrosis of bone, 3 cases of joint degeneration, 1 case of bone nonunion, and 3 cases of internal fixation irritation; while in the study group, there were only 2 cases of joint degeneration, and there was a significant difference in the incidence of complications between the two groups ( P<0.05). At last follow-up, there was no significant difference in VAS score between the two groups ( P>0.05), but the SF-12 physical and psychological scores, AOFAS ankle and hindfoot scores, and patients' satisfaction in the study group were significantly better than those in the control group ( P<0.05).@*CONCLUSION@#The treatment of Hawkins type Ⅰ-Ⅲ talar neck fractures with percutaneous parallel screw fixation via the posterolateral "safe zone" can achieve better effectiveness than traditional open surgery, with the advantages of less trauma, fewer complications, faster recovery, and higher patient satisfaction.
Subject(s)
Humans , Retrospective Studies , Quality of Life , Fractures, Bone/surgery , Fracture Fixation, Internal/methods , Bone Screws , Joint Dislocations , Treatment OutcomeABSTRACT
Objective:To observe the curative effects of triplane intra-articular osteotomy in the treatment of malunion of calcaneal intra-articular fracture.Methods:The 16 patients were retrospectively analyzed who had been admitted to Foot and Ankle Surgery Department, Honghui Hospital from January 2016 to December 2019 for malunion of calcaneal intra-articular fracture. They were 12 males and 4 females, with an average age of 43.4 years (from 31 to 58 years). The left side was affected in 10 cases and the right side in 6 cases. All malunions were type Yu Ⅱ (compressed bone fragments on the posterior articular surface) and treated with triplane intra-articular osteotomy. The curative effects were assessed by comparing the radiological parameters, American Orthopaedic Foot and Ankle Surgery Society (AOFAS) ankle-hindfoot score, pain visual analog scale (VAS) and psychological and physical scores in Health Survey 12-item Short Form (SF-12) between preoperation and the final follow-up.Results:All the patients were followed up for 20 to 60 months (average, 42.9 months); the bone healing time was 10 to 14 weeks (average, 11.5 weeks). At the final follow-up, their B?hler angle (25.7°±2.3°), Gissane angle (117.1°±5.8°), Meary angle (2.9°±1.3°), talocalcaneal angle (31.3°±3.0°), hindfoot alignment angle (3.9°±1.8°), ankle height [(82.3±2.6) mm], calcaneus height [(56.9±2.4) mm], calcaneus width [(41.4±2.1) mm], AOFAS ankle-hindfoot score [(82.3±7.3) points], median VAS score [3 (2, 3) points], SF-12 psychological score [(46.6±3.6) points], and SF-12 physiological score [(43.6±3.5) points] were significantly improved than the preoperative values [8.4°±2.7°, 137.5°±9.3°, 8.3°±4.3°, 24.6°±3.7°, -4.6°±3.2°, (76.1±3.1) mm, (53.8±3.0) mm, (50.2±2.2) mm, (51.9±7.7) points, 6 (6, 7) points, (37.5±3.8) points, and (31.0±2.6) points] (all P<0.01) Conclusion:In the treatment of type Yu Ⅱ malunion of calcaneal intra-articular fracture, triplane osteotomy can anatomically reduce the bone fragments of collapsed posterior articular surface, reshape the normal anatomy of the calcaneus, and preserve the subtalar joint, leading to positive short- and mid-term follow-up effects.
ABSTRACT
@#This study aimed to investigate the ameliorative effects of 60% ethanol elution fraction (ESMW) from Si Miao Wan on the hepatic lipid accumulation and its mechanism.TG kit, BODIPY fluorescence staining, QPCR, WB, oil red O staining, and AMPKα knockdown were used to detect the ability of ESMW to improve lipid accumulation in hepatocytes stimulated with free fatty acid.Furthermore, the effects of ESMW on the oral glucose tolerance, serum biochemical indexes, TG content in liver tissue, the expressions of mRNA and protein related to lipid metabolism in liver tissue were studied in mice fed with high fat diet to verify the mechanism of ESMW fraction on hepatic lipid accumulation.The results showed that ESMW inhibited lipid accumulation induced by free fatty acids by regulating AMPK signaling pathway, and that ESMW significantly improved the lipid metabolism of mice fed with high fat diet, with relation to AMPK signaling pathway.
ABSTRACT
Objective: To investigate the effectiveness of tibialis posterior tendon transfer for foot drop secondary to peroneal nerve palsy. Methods: The clinical data of 21 patients with unilateral foot drop secondary to peroneal nerve palsy between October 2009 and September 2016 was retrospectively analyzed. There were 12 males and 9 females with an average age of 32.1 years (range, 23-47 years). The causes of peroneal nerve injury were iatrogenic injury in 7 cases, tibiofibular fractures combined with compartment syndrome in 5 cases, nerve exploration surgery after stab or cut injury in 3 cases, direct violence in 4 cases, and the fibular head fracture in 2 cases. The average time from injury to operation was 5.6 years (range, 2-8 years). There was 1 case of hallux valgus and 5 cases of toe flexion contracture. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot scores, Foot and Ankle Ability Measure (FAAM) scores, range of motion (ROM), and dorsiflexion strength of ankle joint were used to evaluated the ankle function. Radiographic evaluation for the changes of postoperative foot alignment included Meary angle, calcaneal pitch angle, and hindfoot alignment angle. Results: All incisions healed by first intention. All patients were followed up 18-42 months (mean, 30.2 months). The dorsiflexion strength of ankle joint recovered from grade 0 to grade 3-4 after operation. There was no patient with a postoperative flat foot deformity and claw toe during follow-up. There was no significant difference in Meary angle, calcaneal pitch angle, and hindfoot alignment angle between pre- and post-operation ( P>0.05). The AOFAS score, FAAM score, and ROM of dorsiflexion significantly improved at last follow-up when compared with preoperative values ( P<0.05); while there was no significant difference in ROM of plantar-flexion between pre- and post-operation ( t=4.239, P=0.158). There were significant differences in AOFAS score, FAAM score, and ROM of dorsiflexion between affected and healthy sides ( P<0.05); but no significant difference in ROM of plantar-flexion was found ( t=2.319, P=0.538). Conclusion: Tibialis posterior tendon transfer is an effective surgical option for foot drop secondary to peroneal nerve palsy. And no postoperative flat foot deformity occurred at short-term follow-up.
ABSTRACT
Objective: To compare the clinical and radiographic outcomes of bioabsorbable screw and metallic screw for Maisonneuve fracture. Methods: The clinical data of 68 patients of Maisonneuve fracture treated with open reduction and internal fixation between October 2012 and October 2016 were retrospectively analyzed. Metallic screw fixation was used in 37 cases (group A) and absorbable screw fixation was used in 31 cases (group B). There was no significant difference in age, gender, weight, operated side, cause of injury, time from injury to operation, and complications between the two groups ( P>0.05). At last follow-up, the tibiafibular clear space (TFCS), tibiafibular overlap (TFO), medial clear space (MCS), and syndesmotic malreduction rate were recorded. And the dorsiflexion and plantar-flexion range of motion, pain visual analogue scale (VAS) score, ankle and hind foot score of American Orthopaedic Foot and Ankle Society (AOFAS), and Olerud-Molander (OM) score were recorded. Results: All patients were followed up 25-43 months, with an average of 32.3 months. There was no significant difference in the operation time between the two groups ( t=1.229, P=0.282). All the fractures healed, and there was no significant difference in fracture healing time between the two groups ( t=1.367, P=0.413). At last follow-up, the syndesmotic malreduction rate of group A was 16.2% (6/37), showing no significant difference when compared with group B [6.2% (2/31)] ( χ2=1.549, P=0.213). There were 3 complications in group A, 1 was superficial wound infection, 1 was local heterotopic ossification due to failure to remove the screws in time, 1 was local heterotopic ossification of the screws; and there were 2 complications in group B, 1 was rejection and 1 was local heterotopic ossification of the screws. There was no significant difference in the incidence of complications between the two groups ( χ2=0.068, P=0.794). There was no significant difference in TFCS, MCS, TFO, ankle dorsiflexion and plantar-flexion range of motion, AOFAS score, OM score, and VAS score between the two groups at last follow-up ( P>0.05). Conclusion: Compared with metallic screw, absorbable screws provide adequate fixation and functional recovery with avoiding screw removal and lower syndesmotic malreduction.
ABSTRACT
@#Six steroidal saponins were isolated from the n-butanol extract of 90% ethanol extract of the aerial parts of Paris polyphylla var. yunnanensis by silica gel for column chromatography, MCI column chromatography and preparative high performance liquid chromatography (HPLC). According to the physicochemical properties and spectral data, they were identified as 26-O-β-D-glucopyranosyl-kryptogenin-3-O-α-L-rhamnopyranosyl-(1→4)-α-L-rhamnopyranosy-(1→4)-[α-L-rhamnopyranosyl-(1→2)]-β-D-glucopyranoside (1), dioseptemloside G (2), polyphylloside III (3), chonglouoside SL-19 (4), protodioscin (5), chonglouoside SL-5 (6). Among these, compound 1 was a new compound, and compound 2 was obtained from Paris plants for the first time. The platelet aggregation activities and cytotoxicities of the above compounds were evaluated. The results showed that none of the isolated compounds showed significant platelet aggregation activity; compound 2 and 4 exhibited strong cytotoxicity against human colon adenocarcinoma cell line HT29.
ABSTRACT
Objective To compare the outcomes of surgical treatment of ankle fracture with or without repair of deltoid ligament(DL) rupture.Methods Between March 2009 and December 2015,75 patients were treated surgically at Department of Foot and Ankle Surgery,Honghui Hospital for ankle fracture with DL rupture.Of them,the DL rupture was repaired in 20(repair group) and not in 54(non-repair group).The 2 groups were compared in terms of pre- and post-operative medial clear space(MCS),rate of radiological MCS malreduction(MCS>5mm),rate of surgical failure,the American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score and visual analogue scale(VAS).The outcomes of AO/OTA types B and C were also compared between the 2 groups.Results The 2 groups were compatible due to insignificant differences in their preoperative general data and follow-up time(46.9±22.5 months versus 56.3±23.9 months)(P>0.05).The MCSs after operation(3.3±0.3 mm) and at the last follow-up(3.2±0.3mm) in the repair group were significantly shorter than those in the non-repair group(3.8±1.0mm and 3.8±1.2mm)(P<0.05).The rate of radiological MCS malreduction in the repair group(0) was significantly lower than that in the non-repair group(20.4%)(P<0.05).There were no significant differences between the 2 group in rate of surgical failure(0 versus 7.4%),AOFAS ankle-hindfoot score(88.0±5.8 versus 85.9±8.7) or VAS(1.2±0.8 versus 1.6±1.6)(P>0.05).The rate of radiological MCS malreduction for AO/OTA type C ankle fracture in the non-repair group was significantly higher than those for AO/OTA types B and C in the repair group and AO/OTA type B in the non-repair group(P<0.05).Conclusion Surgical repair of the DL rupture may help decrease the rate of postoperative MCS malreduction,especially for AO/OTA type C ankle fractures.
ABSTRACT
Objective To investigate the clinical value of gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery on patients with cholecystolithiasis. Methods A retrospective study was performed on data of 15 patients with cholecystolithiasis,who underwent gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery from April 2018 to July 2018. The operative data,including situation of operation,operative time,intraoperative hemorrhage,and postoperative complications were recorded. Results The procedure was performed successfully in all patients with a mean operative time of 108±12 min (ranged from 92-129 min). The intraoperative hemorrhage was 10-30 mL. Eight patients suffered from slight right upper abdominal pain,and 7 patients felt slight pain in umbilical a week after surgery. No fever,incision infection,umbilical hemia,peritonitis,and ascites were reported. The clear-liquid diet was recommended for one day after operation,and postoperative activity was allowed since the second day after operation. All patients were discharged on the fourth or fifth day,and all recovered to their normal life at one week after discharge. Follow-up showed that the scar was small and hidden in umbilical without visible incision after one month. Ultrasonic examination results showed that gallbladder contractile function worked perfectly in four patients and no gallbladder stone was found after three months. Conclusion Gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery is a safe and effective option for patients with cholecystolithiasis,provides excellent cosmetic outcomes,and can be appropriately carried out under the strict control of surgical indications.
ABSTRACT
Objective@#To investigate the clinical value of gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery on patients with cholecystolithiasis.@*Methods@#A retrospective study was performed on data of 15 patients with cholecystolithiasis, who underwent gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery from April 2018 to July 2018. The operative data, including situation of operation, operative time, intraoperative hemorrhage, and postoperative complications were recorded.@*Results@#The procedure was performed successfully in all patients with a mean operative time of 108±12 min (ranged from 92-129 min). The intraoperative hemorrhage was 10-30 mL. Eight patients suffered from slight right upper abdominal pain, and 7 patients felt slight pain in umbilical a week after surgery. No fever, incision infection, umbilical hemia, peritonitis, and ascites were reported. The clear-liquid diet was recommended for one day after operation, and postoperative activity was allowed since the second day after operation. All patients were discharged on the fourth or fifth day, and all recovered to their normal life at one week after discharge. Follow-up showed that the scar was small and hidden in umbilical without visible incision after one month. Ultrasonic examination results showed that gallbladder contractile function worked perfectly in four patients and no gallbladder stone was found after three months.@*Conclusion@#Gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery is a safe and effective option for patients with cholecystolithiasis, provides excellent cosmetic outcomes, and can be appropriately carried out under the strict control of surgical indications.
ABSTRACT
Objective To evaluate the efficacy of different methods of biliary stenting for intractable choledocholithiasis.Methods A total of 137 patients with intractable choledocholithiasis were randomly divided into 4 groups to receive different managements.The treatments included single biliary stent placement in group A (n=32),single stent placement plus oral medication in group B (n=35),double stents placement in group C (n=33) and double stents placements plus oral medication in group D (n=37).All biliary stents were placed via endoscopic retrograde cholangiopancreatography (ERCP).Oral medication included ursodeoxycholic acid and/or anethol trithione after the procedure.All patients were closely followed up.Results The size of stones in common bile duct (CBD) decreased in all cases at 3 months after stent placement,with most significant changes in groups C and D than in groups A and B (P<0.05).The stents kept unobstructed for a mean time of 7.6 months (3.5-20 months),with a significant difference between every 2 groups (P<0.05) and a longest duration time in group D.A second procedure of ERCP was performed in 72 patients (52.6%),with achievement of total choledocholithiasis clearance in 51 (84.7%).Hyperamylasemia (HA) occurred in 41 cases (29.9%),which were mainly observed in the groups C and D (P <0.05).Conclusion Biliary stent placement is a safe and effective palliative therapy for intractable choledocholithiasis,while double stents placements combined with pharmacotherapy is most effective.
ABSTRACT
10 U/ml was determined as positive value.Urinary NMP 22 protein was elevated in 22 cases.Bladder cancer was diagnosed in 11 cases.The sensitivity and specificity of the NMP 22 test were 100%(11/11) and 81%(46/57),respectively.Cystoscopy alone identified 35% of the cancers (4/11).Among 22 cases with elevated NMP 22,1 case was dignosized as bladder cancer during 1 year visit. Conclusions Urine NMP 22 is a new useful marker in early diagnosis of bladder cancer.
ABSTRACT
Objective To investigate the effect of Fangjifulingtang on preventing proliferation of glomerular mesangial cells and the expression of PAI-1, so as to provide experimental evidence for Fangjifulingtang to cure chronic kidney disease. Method Glomerular mesangial cells were cultured and TNF-? was used as a stimulation to make the cells proliferate. Then Fangjifulingtang was incubated together at different doses. Cell vitality were evaluated and qualified by MTT. Cell period were analysed by Flow CytoMeter (FCM). Secretion of PAI-1 expression was measured by ELISA. Results The proliferation of Glomerular mesangial cells was inhibited (P
ABSTRACT
Objective To evaluate the efficacy of endoscopic injection hemostasis and sequential application of sandostatin in treatment of Dieulafoy's lesion. Methods After diagnosis of Dieulafoy's lesion confirmed, endoscopic injection hemostasis(EIH) together with mixture hypertonic saline and epinephrine(HSE) was performed, and then sandostatin was given consecutively for 7 days. The control group included the patients who were not given sandostatin or given just for 1 to 2 days. Results The rates of recurrent bleeding and transfer into surgery in sandostatin group were significantly lower than those in control group,(12.5% and 6.3% versus 53.8% and 46.2% respectively, P