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Objective To analyze the clinical characteristics and treatment of clostridium difficile infection(CDI)in children.Methods The clinical data of 159 children with CDI admitted to the Department of Gastroenterology and Hepatology,Shanghai Children's Hospital,School of Medicine,Shanghai Jiao Tong University from September 2014 to October 2022 were retrospectively analyzed.All ini-tial CDI patients were divided into vancomycin treatment group and metronidazole treatment group according to different treatment meth-ods,Children with recurrent CDI(RCDI)were divided into two groups according to vancomycin or FMT treatment.Results A total of 159 children with initial CDI were included,including 93 males and 66 females,the age of these children was 4.3(1.7,8.0)years.109 children(68.55%)were treated with metronidazole,and 50 children(31.45%)were treated with vancomycin.Recurrence occurred in 51 children after antibiotic treatment,37 children(33.94%)of them treated with metronidazole,and 14 children(28.00%)of them treated with vancomycin,there was no significant difference(P>0.05).Among RCDI children,21 cases were treated with vancomycin and 30 were treated with FMT.The cure rate of FMT was 90.00%,and the cure rate of vancomycin was 57.14%.The cure rate of FMT was significantly higher than that of vancomycin.There were no serious adverse events reported after two months of FMT treatment.Conclusion Metronidazole can be used as the drug of choice for initial CDI in children.The cure rate of FMT for RCDI is superior to vancomycin treatment.
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Objective@#Accumulating evidence has shown that aberrant alternative splicing events are closely associated with the onset and development of cancer. However, whether genetic variants-associated alternative splicing is linked to risk of endometrial cancer remains largely uncertain. @*Methods@#We identified single nucleotide polymorphisms (SNPs) locates in the splicing number trait locus (sQTL) of endometrial cancer using the CancerSplicing QTL database. In parallel with bioinformatics analysis, we conducted a case-control study comprising 2,000 cases and 2,013 controls to assess the association between identified SNP which possesses mRNA splicing function and endometrial cancer susceptibility. Furthermore, we used the Kaplan-Meier Plotter, The Human Protein Atlas, SPNR, and Spliceman2 databases for sQTL and differential gene expression analyses to identify the genetic variant which most potentially influence the risk of endometrial cancer through alternative splicing to reveal the potential mechanism by which candidate SNPs regulate the risk of endometrial cancer. @*Results@#The results indicated that SNP rs7128029 A
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ObjectiveTo explore the occupational needs of hand injury patients and the effects of activity-based analysis and occupation-based interventions. MethodsFrom January, 2021 to June, 2022, 212 patients who accepted occupational therapy for wrist-hand injury in Rehabilitation Center of the First Affiliated Hospital of Nanjing Medical University were interviewed using Canadian Occupational Performance Measure (COPM) to collect the activities that they wanted to do, needed to do, were expected to do, but unable to do. Two senior occupational therapists conducted the activity analysis of the summarized needs, identified occupational components, designed a purposeful occupation-based intervention program, and evaluated the performance and satisfaction using COPM. ResultsA cumulative total of 84 occupational needs were proposed, covering five major domains: work, basic activities of daily living, instrumental activities of daily living, leisure and sleep. The activities mostly impaired involved using computer (8.28%), using chopsticks (6.42%), wringing towels (6.25%), travelling on transport (4.90%) and lifting heavy objects (4.73%). The performance and satisfaction improved after treatment (t > 16.572, P < 0.001). ConclusionThe occupational needs are culturally specific for local hand injury patients; the use of an activity-based analysis and occupation-based intervention is effective on meeting the occupational needs.
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@#Objective To investigate the protective effect of atomized inhalation of nano-luteolin preparation on acute lung injury caused by extracorporeal circulation, and to explore the anti-inflammatory mechanism of luteolin, so as to provide study basis for clinical application. Methods Thirty male SD rats aged 5-6 weeks and weighting 160-190 g, were randomly divided into a preoperative baseline (BL) group, arteriovenous partial diversion (ECC) group, luteolin atomization pretreatment for 1 h group, 2 h group, and 3 h group by random number method, with 6 rats in each group. In the BL group, lung tissue samples were collected directly without any treatment. The ECC group received mechanical ventilation, and the whole body was heparinized after the jugular arteriovenous intubation. The flow was transferred for 30 minutes, followed by observation for 60 minutes, then lung tissue samples were collected. Subjects in the 1 h, 2 h and 3 h groups were placed in a small animal atomizer 1 h, 2 h and 3 h before flow transfer respectively, and the subsequent operation was the same as that in the ECC group. The inflammatory level of lung tissue was detected to evaluate the degree of pathological injury of lung tissue. Western blotting (WB) was used to detect the contents of p65, IKKα, IKKβ and IKKγ in the cytoplasm of lung tissue samples of each group. Results Compared with the ECC group, the levels of IL-6 and TNF-α in lung tissues and the degree of pathological injury in the 1 h, 2 h and 3 h groups decreased, and the difference between the 3 h group and the ECC group was statistically different (P<0.05). WB results showed that compared with the ECC group, the levels of p65 in lung tissue of the 1 h, 2 h and 3 h groups decreased; the levels of IKKβ in the lung tissue increased in the 1 h, 2 h and 3 h groups, and the difference of the 3 h group was statistically different from the ECC group (P<0.05). Conclusion Luteolin has a protective effect on acute lung injury induced by ECC, and atomization 3 h in advance has the best protective effect on lung. The mechanism plays a protective role in ECC-induced acute lung injury, may be through inhibition of IKKβ phosphorylation, thereby inhibiting the classical NF-κB signaling pathway.
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Objective To explore the clinical effect of Liuwei Dihuang decoction on thrombocytopenia(HIT)of liver and kidney yin deficiency in hemodialysis patients.Methods 84 hemodialysis patients with liver and kidney yin deficiency HIT were randomly divided into observation group and control group,with 42 cases in each group.The control group was treated with conventional western medicine,while the observation group was treated with Liuwei Dihuang decoction on the basis of the control group.The scores of liver and kidney yin deficiency syndrome before and after treatment and the curative effect of traditional Chinese medicine syndrome were compared between the two groups,and the platelet count(Plt),P-selectin level,HIT antibody before and after treatment,the platelet recovery time and clinical efficacy and adverse reactions of the two groups were also compared.Results After 1 month of treatment,the scores of liver and kidney yin deficiency syndrome in the two groups were both lower than those before treatment(P<0.05),which in the observation group was lower than that of the control group(P<0.05).The total effective rate of traditional Chinese medicine syndromes in the observation group(97.62%)was higher than that in the control group(P<0.05).After 14 d of treatment,the Plt of the two groups were both higher than those before treatment,while the levels of P-selectin and the positive rate of HIT antibody of the two groups were lower than those before treatment(P<0.05),and the Plt in the observation group was higher than that of the control group,the levels of P-selectin and the positive rate of HIT antibody in the observation group were lower than those in the control group(P<0.05).The platelet recovery time in the observation group was shorter than that in the control group(P<0.05),the total effective rate of clinical treatment in the observation group(95.24%)was higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion On the basis of conventional western medicine treatment,the addition of Liuwei Dihuang decoction to treat HIT of liver and kidney yin deficiency in hemodialysis patients can improve the clinical efficacy,reduce the clinical symptoms of patients,improve the level of Plt,shorten the recovery time of platelet,and reduce the level of P-selectin and the positive rate of HIT antibody,with good safety,which is worthy of clinical promotion.
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Clostridium difficile infection(CDI)is a global public health issue and one of the most common pathogenic infections in the community and hospitals, causing varying degrees of diarrhea and pseudomembranous colitis.The current CDI diagnosis is based on the detection of clostridium difficile(CD)associated toxins or toxin encoding genes in patients′ stool, but these traditional microbiological techniques have limitations that may delay disease diagnosis.In clinical and research, CD has a distinct odor "horse barn odor" , which is caused by the volatile organic compounds(VOCs). VOCs in human breath, blood, urine and feces have recently received increased attention as potential noninvasive diagnostic biomarkers for a wide range of diseases, including infectious diseases and digestive tract disorders.It was discovered that VOCs from CD, with their potential characteristic VOCs, contributed to the rapid diagnosis of CDI.In this paper, we review VOCs and their application in the rapid detection of CDI.
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Objective:To investigate the protective effect and mechanism of miR-30c targeting Wnt/β-catenin signal on the proliferation and apoptosis of human retinal endothelial cells (HRECs) induced by high glucose.Methods:Human retinal endothelial cells (HRECs) were cultured and given normal concentration (control group) and high concentration glucose (high glucose group) respectively. According to the experimental design, miR-30c mimic, negative control (miR-NC), Wnt1 overexpression vector (pcDNA3.1-Wnt1) and empty vector (pcDNA3.1) were transfected respectively. RT-PCR was used to detect the expression level of miR-30c in each group. Western blot was used to detect the expression levels of Wnt1, β-catenin and GSK-3β protein in each group. The dual luciferase experiment verified the targeting relationship of miR-30c to Wnt1. Thiazole blue method was used to detect the proliferation activity of each group. Flow cytometry was employed to detect the level of apoptosis of each group of cells.Results:Compared with the control group, the expression of miR-30c in the high glucose group was significantly reduced [ (0.94±0.11) vs (0.32±0.06), P<0.001]; compared with the control group, the cell proliferation activity of the high glucose group was significantly reduced, and the apoptosis rate was significantly increased [ (0.75±0.08) vs (0.13±0.04), (3.53±0.29) % vs (14.89±0.94) %, P<0.001]; compared with the high glucose+miR-NC group, the cell proliferation activity of the high glucose+miR-30c group was significantly increased, and the apoptosis rate was reduced [ (0.14±0.04) vs (0.64±0.06), (14.14±0.86) % vs (6.28±0.45) %, P<0.001]; compared with the miR-NC group, the luciferase activity of the miR-30c group co-transfected with WT-Wnt1 was significantly reduced [ (0.97±0.09) vs (0.26±0.03), P<0.001]; compared with the control group, the protein expression of Wnt1, β-catenin and GSK-3β in the high glucose group were significantly increased [ (0.43±0.05) vs (1.02±0.09), (0.25±0.04) vs (0.82±0.10), (0.39±0.04) vs (0.76±0.11), P<0.001]; compared with the high glucose+miR-NC group, the protein expression of Wnt1, β-catenin and GSK-3β in the high glucose+miR-30c group were significantly reduced [ (1.04±0.10) vs (0.68±0.06), (0.79±0.09) vs (0.34±0.05), (0.74±0.12) vs (0.48±0.06), P<0.001]; compared with the high glucose+miR-30c group, the cell proliferation activity was significantly reduced in the high glucose+miR-30c+pcDNA3.1-Wnt1 group, and the apoptosis rate was significantly increased [ (0.66±0.07) vs (0.31±0.05), (4.26±0.57) % vs (9.75±0.85) %, P<0.001]. Conclusion:miR-30c may negatively regulate the Wnt/β-catenin signaling pathway, promote cell proliferation, and inhibit cell apoptosis induced by high glucose.
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Objective To analyze the current status of exercise and exercise self-efficacy (ESE) and its influencing factors in middle-aged and elderly patients with high blood pressure, and to provide a basis for the intervention of patients with hypertension in the community. Methods The stratified random sampling method was used to select 546 patients with hypertension who had received hypertension management for one year in the community. The general condition, exercise condition, and ESE scores were collected using survey questionnaires. Chi-square test was applied to analyze the difference of exercise efficacy score among different characteristic objects, and analysis of regression method was applied to analyze the influencing factors of exercise self-efficacy. Results A total of 546 people were surveyed in this study, of which 67.03% of hypertension patients participated in exercise. The main exercise program was walking healthily (87.43%). A total of 262 people (47.99%) had strong performance on ESE score, while 284 people (52.01%) had weak self-efficacy. The univariate unconditional logistic regression analysis found that there were significant differences in the distribution of educational level, family monthly income, years of hypertension, whether they received the guidance from family doctors, whether they exercised and whether they warmed up before exercise (P<0.05). The multivariate unconditional logistic regression analysis showed that educational level of junior high school and low average monthly household income were the risk factors affecting exercise efficacy, and the guidance of family doctors, exercise, and hypertension less than 5 years were the protective factors affecting exercise efficacy. Conclusion The exercise self-efficacy of middle-aged and elderly patients with hypertension in this community is at a medium level, and family doctors should carry out targeted interventions based on influencing factors to improve exercise self-management ability.
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Scutellariae Radix is a kind of traditional Chinese medicine, which has the functions of heat-clearing and damp-drying, purging fire and detoxifying, hemostasis and miscarriage prevention. Modern pharmacological studies show that Scutellariae Radix has various effects, such as anti-oxidation, anti-inflammatory, liver protection and antiviral microorganisms. By searching the documents in the past ten years, the author has found that Scutellariae Radix and its active components play an important role in protecting the liver. It can prevent and cure liver injuries caused by different reasons, including acute or chronic hepatitis, liver fibrosis and liver cancer. Among all kinds(chemical, immunological, alcoholic, nonalcoholic, viral, ischemia-reperfusion, etc.) of acute or chronic hepatitis, most studies are on CCl_4 induced chemical liver injury. Scutellariae Radix and its active components can significantly reduce the serum transaminase level in hepatitis animals, and reduce the degree of liver pathological damage. The mechanisms include antioxidant stress, anti-inflammatory, anti-apoptosis, inhibition of immunity, anti-virus and regulation of lipid metabolism, etc. Scutellariae Radix and its active components can significantly inhibit the activation of hepatic stellate cells and reduce extracellular matrix, and its anti-fibrosis mechanism involves antioxidation, anti-inflammatory, inducing apoptosis of hepatic stellate cells and so on. Whether in vivo or in vitro, Scutellariae Radix and its active components show a good anti-hepatocarcinoma effect, especially on hepatocarcinoma. Its prevention and treatment mechanisms for hepatocarcinoma mainly include blocking cancer cell cycle, inhibiting cancer cell metastasis, promoting cancer cell apoptosis and inducing autophagy. It can be seen that Scutellariae Radix has multiple functions and mechanisms in liver protection, and has a great development potential. Therefore, this paper reviews the prevention and treatment effects and mechanism of Scutellariae Radix and its components on different liver diseases, in order to provide reference for in-depth study, development and clinical application in the prevention and treatment of liver disease.
Sujets)
Animaux , Anti-inflammatoires , Médicaments issus de plantes chinoises , Flavonoïdes , Médecine traditionnelle chinoise , Scutellaria baicalensisRésumé
Objective:To investigate the effect of whole body vibration (WBV) on balance and walking ability after a stroke.Methods:Thirty stroke survivors were randomly divided into a control group ( n=15) and an experimental group ( n=15). Both groups received 30 minutes of routine rehabilitation training twice a day, 6 days a week for 2 weeks. The experimental group was additionally provided with 14 minutes of 10Hz WBV with an amplitude of 4mm every day during the 2 weeks. Before and after the intervention, balance was quantified using the front-behind inclination angle (F-BIA), the left-right inclination angle (L-RIA) and the single-leg stance time of the hemiplegic side (SSTHS). Walking efficiency was quantified using the 10 metre walk test (10MWT) and the 3 metre timed up-and-go test (3TUG). Results:There was a significant improvement in all of the measurements in both groups after the intervention, but the improvements in average L-RIA, SSTHS, 10 MWT and 3TUG results in the experimental group were significantly greater than those in the control group.Conclusions:Supplementing routine therapy with WBV can improve balance and walking ability after a stroke more effectively than routine therapy alone.
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Objective:To learn about the employment situation of community-dwelling spinal cord injury (SCI ) survivors in Jiangsu Province and the factors which influence it, aiming to put forward suggestions which can help them return to work.Methods:This cross-sectional observational study was based on a International Spinal Cord Injury (InSCI) community survey in Jiangsu Province using a questionnaire (InSCI questionnaire) devloped with the International Classification of Functioning, Disability and Health as the framework. Data were collected using the InSCI questionnaire. Data on sociodemographics, diseases, body functions, activities and participation, environmental factors, general health, well-being and so on were collected. Descriptive statistics were computed to analyze the respondents′ employment-related information. Correlation analysis and multiple linear regression were used to analyze factors influencing the employment of these community-dwelling SCI survivors.Results:From January to December of 2018, 726 completed questionnaires were collected-541 through telephone interviews, 152 via Internet links and 33 via face-to-face interviews. Logistic regression showed that residential patterns (odds ratio, OR=0.472), whether there was someone to take care of them at home or going out ( OR=0.405), age at the onset of injury ( OR=0.949), personal factors ( OR=1.068), activity and participation ( OR=1.034), and environmental factors ( OR=1.043) all influenced the respondents′ engaging in paid work. Conclusion:The employment rate of patients with spinal cord injury living in the community is low (22.8%). Comprehensive rehabilitation programs and adequate family and social support should be implemented to help them return to work.
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Objective To study the expression of CD62P and carbohydrate antigen 153 (CA153) in peripheral blood of patients with breast cancer, and to explore the value of CD62P and CA153 in the di-agnosis of breast cancer. Methods The CD62P ratio in peripheral blood of 60 patients with breast cancer ( breast cancer group) , 52 patients with breast fibroma ( fibroma group) and 25 healthy volunteers ( control group) was detected by flow cytometry ( FCM) . The serum CA153 level was detected by electro chemilumi-nescence ( ECLIA) , and the relationship between their expression levels and clinicopathological factors of breast cancer patients was analyzed. The sensitivity and specificity of serum CD62P, CA153 and their com-bination in the diagnosis of breast cancer were analyzed by receiver operating characteristic ( ROC) curve. Results ⑴ The expression levels of CD62P and CA153 in breast cancer group were significantly higher than those in fibroma group and control group (P<0. 05), but with no significant difference between fibro-ma group and control group (P>0. 05). ⑵The expression levels of CA153 and CD62P in peripheral blood of breast cancer group were correlated with clinical stage and lymphatic metastasis (all P<0. 05), and the expression levels of CA153 and CD62P were positively correlated (r=0. 514, P<0. 05). ⑶The sensitivity and specificity of combined detection of CD62P and CA153 for breast cancer were higher than those of single detection. Conclusions CD62P is highly expressed in peripheral blood of patients with breast cancer, which may be a new marker for the diagnosis of breast cancer.
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·AIM:To investigate the factors related to the decrease of corneal endothelial cell number after phacoemulsification in cataract patients. ·METHODS: We selected 98 patients (120 eyes) in Ophthalmic Center from July 2014 to July 2016 underwent phacoemulsification and they were retrospectively analyzed. According to the central corneal endothelial cell density before and 2mo after the operation, they were divided into serious loss group of 52 cases (67 eyes, density of central corneal endothelial cells loss rate no less than 12.3%),the general loss group of 46 cases (53 eyes, the density of central corneal endothelial cell loss rate <12.3%). Relevant indicators of general information, operation of the two groups were compared, the influence factors of non conditional Logistic regression analysis method was used to investigate the effect for corneal endothelial cell loss in cataract patients. ·RESULTS:Serious loss group and the general group on gender, rate with hypertension, rate with diabetes, rate with high blood lipids, with shallow anterior chamber, corneal diameter and suction time comparison, had no statistically significant differences (P > 0. 05). Nuclear hardness classification of Emery lens, ultrasonic power, ultrasonic emulsification time, age between groups were significantly different(P<0.05). By using Logistic analysis method, the results showed that increased Emery lens nucleus grading, ultrasonic energy, phacoemulsification time, age were independent risk factors for corneal endothelial cells after phacoemulsification (P<0.05). ·CONCLUSION: The main factors that influence the decrease of corneal endothelial cell number after phacoemulsification are Emery lens, higher grade of nucleus of lens, increase of ultrasonic energy, longer time of phacoemulsification and increased age.
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Objective Serine /threonine kinases (STK) and phosphatases (STP) regulate various physiological activities of prokaryotes by reversible phosphorylation of proteins .This paper aimed to study the effects of simultaneous deletion of the stk and stp1 genes on the biological characteristics and pathogenicity of streptococcus suis type 2, the Chinese virulent strain 05ZYH33. Methods The double mutant of the stk and stp1 genes of 05ZYH33 was constructed by homologous recombination .The biological characteristics of the wild strain 05ZYH33 and the mutant strain Δstk/stp1 were compared.The effects of the stk and stp1 deletion on bacterial virulence was analyzed using cell adhesion assay , anti-phagocytosis assay and the mouse model of infection . Results RT-PCR showed that the stk and stp1 genes were replaced by the spectinomycin resistance gene Spc r and the mutant strain was successfully constructed .Experi-ments of biological characterization revealed gradually increased value of 05ZYH33 and Δstk/stp1 at 2 hours after inoculation and a plateau period at 7 hours.The logarithmic phase of the mutant strain (A600≈0.4) was 1 hour later than that of the wild one , and the bacterial den-sity of the former was lower than that of the latter after the plateau pe -riod (0.8 vs 1.0).On the blood plates of 05ZYH33 and Δstk/stp1 were observed greyish, round, semitransparent, wet and smooth-sur-faced tiny bacterial colonies , around which there were hemolysis rings with no significant differences in colony morphology and hemolytic ac -tivity.In the experiment on pathogenicity , the mice of the 05ZYH33 group all died within 12 hours while 9 of the 30 mice in the Δstk/stp1 group died within 12 hours and all died within 24 hours. Conclusion The simultaneous deletion of the stk and stp1 genes may mainly affect the regulation of the proteins associated with bacte -rial proliferation and division.
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@#AIM: To investigate the cause and the description of pathogenic characteristics of chronic infective keratitis in different age groups. <p>METHODS: Totally 89 patients(89 eyes)with chronic infective keratitis were diagnosed in our hospital from January 2015 to December 2017 were selected as the research objects and the cause of the disease and pathogenic characteristics of different age groups, including 13-32 years group(35 eyes in 35 patiens), 33-52 years group(28 eyes in 28 patiens)and 53-73 years group(26 eyes in 26 patiens), were retrospectively studied. <p>RESULTS: There were no significant differences in the etiological distribution of patients in the three groups(<i>P</i>=0.290). There was no significant difference in the distribution of microbial composition among the three groups(<i>χ</i><sup>2</sup>=0.258, <i>P</i>=1.000). The incidence of chronic infectious keratitis caused by fungal infection in the three groups was higher than that of other pathogenic microbes. In this study, 26 cases were positive in bacterial culture, including Staphylococcus epidermidis(50%), Pseudomonas aeruginosa(15%), Streptococcus salivarius(12%), Streptococcus pneumoniae(8%), Escherichia coli(8%)and Neisseria gonorrhoeae(8%). Pseudomonas aeruginosa and Staphylococcus epidermidis were the common bacterial strains in the positive culture results. In the cultivation of fungal strains 24 were positive cultures including Fusarium(46%), Aspergillus(17%), Alternaria(21%), Mycelium(no spore,4%), Penicillium(4%)and Curvularia(8%). Two strains of Fusarium spp. and Alternaria spp. were high of all patients. <p>CONCLUSION: There were no significant differences in the etiology of infectious keratitis among different age groups. Fungal infection is the main pathogen in the distribution of pathogens, the bacteria were mainly Streptococcus epidermidis in etiological features but in fungi, Fusarium dominates. So early prevention and prevention of infective keratitis should be strengthened and early treatment should be given.
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Objective To observe the effects of Ganlu Xiaodu Dan and its incomplete prescription on expressions of MiR-146a and TLR4 mRNA in RD cells infected by EV71. Methods With technique of cell culturing, Ganlu Xiaodu Dan therapy group, incomplete Qing prescription therapy group, incomplete Li prescription therapy group, normal cells control group, model control group and ribavirin control group were set, and tests for virus toxicity and medicine toxicity in cells were taken, then expressions of miRNA-146a and TLR4 mRNA in these RD cells 24 hours after intervention with medicine were detected. Results Compared with normal cells control group, miR-146a in mRNA model control group decreased and TLR4 mRNA increased. Compared with model control group, miR-146a mRNA in Ganlu Xiaodu Dan therapy group, incomplete Qing prescription therapy group and incomplete Li prescription therapy group all increased while TLR4 mRNA decreased, and differences between ribavirin control group and model control group were not significant. Compared with Ganlu Xiaodu Dan therapy group, both expressions of miR-146a and TLR4 mRNA in incomplete Qing prescription therapy group were lower; miR-146a increased and TLR4 mRNA decreased in incomplete Li prescription therapy group. Compared with incomplete Qing prescription therapy group, miR-146a mRNA in incomplete Li prescription therapy group increased, but expression of TLR4mRNA between them was not significant. Conclusion Ganlu Xiaodu Dan can regulate the immune reactions caused by infection of EV71 by increasing expression of miR-146a mRNA and reducing expression of TLR4 mRNA. There may be antagonism effect between incomplete Qing prescription and incomplete Li prescription.
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Objective To investigate the effect of diabetes on clinical efficacy of transcatheter arterial chemoembolization (TACE) in the treatment of non-viral hepatitis hepatocellular carcinoma (HCC). Methods Retrospectively analyzed the clinical data of 367 non-hepatitis virus HCC patients treated by TACE, included 153 diabetes mellitus cases (test group) and blood glucose of 214 patients was normal (control group). To assess the treatment effect after 1 month of TACE based on response evaluation criteria in solid tumors, include complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), and calculate the disease control rate. Through 6 to 75 months follow-up to observed long-term efficacy, record the time to progression (TTP) and overall survival (OS) time. Survival rate were analyzed using Kaplan-Meier method and Log-rank analysis by SPSS 16.0. The single-factor analysis was used to analyze variables which variables that differed were analyzed by Cox regression. Results The disease control rate of test group was 69.9%(107/153) and control group was 74.3%(159/214), the difference was no statistically significant (P=0.125). The median time to progression (mTTP) and median overall survival (mOS) of test group were 10.0 and 15.0 months;and the mTTP and mOS of control group were 14.0 and 19.0 months, the difference were statistically significant (P=0.023 and P= 0.026). Tumor diameter ≥4.5 cm, numbers of tumor ≥3, invasion of blood vessels, α-fetoprotein≥200 μg/L, Eastern Cooperative Oncology Group score and diabetes were risk factors for OS of HCC patients. Conclusion Diabetes is unfavorable factors for overall survival of non-hepatitis HCC tread by TACE.
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BACKGROUND: Clinical value of the nerve root sedimentation sign in patients with lumbar spinal stenosis (LSS) is still uncertain.OBJECTIVE: To investigate the positive rate and correlation of the nerve root sedimentation sign in patients with LSS.METHODS: Totally 281 patients complaining lumbago or low back pain underwent MRI examination in the Orthopedic Clinic or Ward of Jinshan Hospital of Fudan University, including 119 males and 162 females. The cross-sectional area and sagittal diameter of the spinal canal were measured, and the patients were then divided into two groups according to the presence and absence of LSS. Finally, the positive rate of nerve root sedimentation sign was compared.RESULTS AND CONCLUSION: (1) Grouping based on the presence and absence dural sac cross-sectional area stenosis: the positive rate of nerve root sedimentation sign in sever, non, and mild LSS patients was 91.4%, 39.6%,and 53.5%, respectively, and the difference was significant (P < 0.05), but the positive rate showed no significant difference between mild and moderate as well as moderate and severe LSS patients. (2) Grouping according to the presence and absence spinal canal sagittal diameter stenosis: there was a significant difference in the positive rate of nerve root sedimentation sign between non-LSS and LSS patients (44.3% vs. 76.1%, χ2=21.469, P=0.000). (3) Grouping based on the dural sac cross-sectional area combined with spinal canal sagittal diameter: the dural sac cross-sectional area < 120 mm2 or the spinal canal sagittal diameter < 10 mm indicating LSS, there was a significant difference in the positive rate of nerve root sedimentation sign between non-LSS and LSS patients (40.6% vs.80.6%,χ2=30.539, P=0.000). (4) These results indicate that the diagnosis value of nerve root sedimentation sign in LSS is still under discussion. Although a positive sedimentation sign exclusively and reliably occurs in patients with severe LSS, it is also higher in patients without LSS. It may be inappropriate to take nerve root sedimentation sign as a diagnostic tool, but when combined with dural sac cross-sectional area and sagittal canal subsidence, it will be of great significance for the diagnosis of LSS.
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Objective To explore the effect of diabetic liaison nurses on controlling blood sugar levels in patients with hyperglycemia in department other than endocrinology. Methods Four hundred diabetic patients with high blood sugar were selected from January to December, 2014 in department other than endocrinology. They were divided randomly into 2 groups equally:the control group and the observation group. The control group received traditional nursing care, while blood sugar management was carried out by diabetic liaison nurse in the observation group. Result Pre-discharge sugar metabolism in the observation group was significantly better than that in the control group (P<0.05). Conclusion The diabetic liaison nurses in other departments than the endocrinology department can help control blood sugar levels in patients with hyperglycemiain.
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The resistance to PBK-Akt-mTOR pathway inhibitors has close relationship to the negative feedback of its context-dependent signal pathways. According to our current understanding, the resistant mechanisms could be divided into the following basic conditions: related to FOXO and hormone receptor, MYC-dependence, β-catenin-dependence, JAK/STAT pathway-dependence, MAPK pathway-dependence and related to AXL. The emergence of drug resistance to PBK-Akt-mTOR pathway inhibitors has greatly limited their curative effect. The reported resistance mechanisms to PBK-Akt-mTOR pathway inhibitors to search for potential strategies for overcoming resistance by drug combination were summarized.