RÉSUMÉ
Objective:To summarize the relevant evidence for prevention and management of stoma prolapse in patients with enterostomy, so as to provide reference for the clinical prevention and management of stoma prolapse measures.Methods:According to the evidence-based resource "6S" evidence pyramid model, systematically searched about the evidence of enterostomy patients prolapse prevention and management in UpToDate, BMJ best practice, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, CNKI, Wanfang database,VIP Database, SinoMed,etc. The search time limit was from 30 January 2017 to 30 May 2023, 2 researchers independently evaluated the quality of the literature, selected and extracted the evidence.Results:A total of ten articles were included, including one clinical decision, five guidelines, one expert consensus, one evidence, one systematic review, one position statement. Through analysis, 20 best evidences were identified, including perioperative evaluation, preoperative colostomy site marking, reducing abdominal pressure, enterostomy prolapse nursing, health education and the follow-up.Conclusions:Best evidence summary for the prevention and care of stoma prolapse in enterostomy patients provides evidence-based reference for clinical application. Nurses should carefully select and apply evidence in combination with clinical situations and patients′ wishes, so as to develop a personalised stoma prolapse prevention and management programme for patients with enterostomy.
RÉSUMÉ
With the deepening of China's medical reform, people's demand for health is growing, which promotes the construction of "new medicine" and puts forward higher requirements for the cultivation and education of medical students. Undergraduate medical education is a crucial period for the growth of medical students, and how to do a good job in undergraduate teaching under the background of "new medicine" is currently a research hotspot. The clinical teaching stage is an important period for medical students to fully understand clinical disciplines and cultivate their understanding of specialties. Therefore, we should explore new teaching methods and means to adapt to the needs of the new era. In the context of "new medicine", the medical-engineering fusion diagnosis and treatment technology has become an important trend in the clinical diagnosis and treatment of oncology. In order to adapt to this change, clinical teaching and teaching management in oncology also need new exploration and research. Taking the clinical teaching of oncology as an example, this article discusses how to cultivate medical students' thinking of medical-engineering fusion.
RÉSUMÉ
Objective@#To investigate the current status and relationship between loneliness and negative emotional symptoms among first generation college students in the family, so as to provide reference for improving mental health of this population.@*Methods@#A convenience sampling method was used to select 3 017 college students from 10 colleges and universities in Guangdong Province and Yunnan Province, China, in May 2023. Questionnaires were administered to the students, and the Depression Anxiety Stress Scale (DASS-21) and the short form of the University of California at Los Angeles Loneliness Scale (ULS-6) were employed.@*Results@#The total ULS-6 score of first generation college students in the family was (12.38±4.16), while the score of non first generation college students in the family was (11.89±4.38), with a statistically significant difference ( t=2.79, P <0.05). The total DASS-21 score of first generation college students in the family was (71.13±26.97), while the score of non first generation college students in the family was (70.20±26.66), with a statistically significant difference ( t=2.69, P <0.05). Among the first generation college students in the family, male students experienced more DASS-21 score (77.55±29.36) than female students (70.43±25.03)( t =5.79, P <0.05). Urban students (12.00±4.15, 70.34±25.68) reported lower levels of loneliness score and DASS- 21 score than rural students (12.62±4.15, 74.93±27.63), and the depression subscale scores showed statistically significant differences among students with different professional achievement rankings ( t/F =-3.42, -3.94, 4.25, P <0.05). There was a positive correlation between loneliness, depression, anxiety, pressure and DASS-21 scales of first generation college students in the family ( r=0.64, 0.62, 0.64, 0.66, P <0.01). The linear regression analysis results showed a positive correlation between loneliness and all dimensions and total scores of the DASS-21, explaining 44% of the variance in negative emotional symptoms.@*Conclusions@#A positive correlation is found between loneliness and negative emotional symptoms among first generation college students in the family. Improving the loneliness of the first generation college students in the family can reduce their negative emotional symptoms and improve their mental health level.
RÉSUMÉ
@#Hemodynamics plays a vital role in the development and progression of cardiovascular diseases, and is closely associated with changes in morphology and function. Reliable detection of hemodynamic changes is essential to improve treatment strategies and enhance patient prognosis. The combination of computational fluid dynamics with cardiovascular imaging technology has extended the accessibility of hemodynamics. This review provides a comprehensive summary of recent developments in the application of computational fluid dynamics for cardiovascular hemodynamic assessment and a succinct discussion for potential future development.
RÉSUMÉ
Objective@#The objective of this study was to present the real-world patients’ portrait, and the results of niraparib treatment in China. @*Methods@#This study included 142 patients treated with niraparib from 8 hospitals in China between December 2018 and September 2021. Patients’ characteristics were summarized. The efficacy and safety in first-line maintenance (1L-M), platinum-sensitive recurrence maintenance (PSR-M), and treatment for ovarian cancer were evaluated. Survival outcomes and the factors influencing progression-free survival (PFS) were estimated. @*Results@#The 93 patients received Niraparib as 1L-M, 31 as PSR-M and 18 as salvage. BRCA status was wild type or unknown in 87.3% of patients. With a median follow-up time of 8.7 months, the median PFS (mPFS) for 1L-M has not yet been reached, and the mPFS for PSR-M and salvage therapy was 10.5 and 5.7 months, respectively. Responses to last chemotherapy and cancer antigen 125 value before taking niraparib were 2 important factors affecting PFS among 1L and PSR patients. The 12.7% (18/142) of patients experienced grade ≥3 hematologic adverse events and 23.2% experienced dose adjustment. It was noteworthy that when the interval of chemotherapy and niraparib <21 days, the incidence of grade ≥3 adverse events increased significantly (p=0.0355). @*Conclusion@#Generally, niraparib was effective and well tolerated, which was consistent with the results of prospective trials. However, in real world, it was more inclined to use niraparib in late-line treatment without genetic testing.
RÉSUMÉ
Objective:To study the efficacy and safety of CT guided percutaneous transhepatic microwave ablation (PTPMWA) for primary liver cancer (PLC) in liver segment 9.Methods:A retrospective study was conducted on PLC patients between October 2013 and March 2019 at Dongguan People’s Hospital, Southern Medical University. Of 41 patients who entered into the study, there were 36 males and 5 females, with an average age of 59.1 years. These patients were diagnosed to have PLC in segment 9. The surgical related data and follow-up results were collected and analyzed.Results:All patients enrolled in the study completed the treatment procedure. CT scan was performed immediately after ablation which showed that the tumor areas to be completely covered by ablation. The duration of operation ranged from 45 to 260 (mean 91) min. The amount of bleeding during treatment was 1.0 to 5.0 (mean 1.4) ml. The complete response rate was 97.6% (40 patients) and the partial response rate was 2.4% (1 patient). The cumulative survival rates at 1, 2, 3, 4 and 5 years were 95.1%, 85.4%, 75.3%, 45.2% and 45.2%, respectively. Only 4 patients (9.8%) developed recurrence after treatment. The timings of recurrence were 1, 6, 13 and 67 months after treatment, respectively. The recurrent lesions were ablated again and complete response was obtained in all patients. There were no serious problems related to complications from ablation. The rate of postoperative complication was 7.3% (3 patients).Conclusion:PTPMWA is a novel treatment for patients with PLC in liver segment 9, the advantages of this treatment include good safety, high efficacy, low complications and local recurrence. The treatment is worthy of further future studies.
RÉSUMÉ
Objective To explore the clinical features and risk factors of poor prognosis in neonatal necrotizing enterocolitis(NEC).Methods A retrospective study was carried out in the infants with NEC admitted to 6 cooperative hospitals in Guangdong Province between January 2005 and December 2014.The clinical features and risk factors of poor prognosis in preterm and full-term infants diagnosed NEC,early onset and late onset NEC were analyzed.Results A total of 449 cases who met the criteria were admitted during the study time.The mortality was 23.6％ (106/449 cases),of which the preterm group was 24.6％ (58/238 cases) while the full-term group was 22.7％ (48/211 cases),the early onset group was 22.1％ (45/204 cases) while the late onset group was 24.3％ (57/235 cases).The median number of NEC onset in preterm group was 11 d after birth while the number of the full-term group was 6 d.Full-term infants who diagnosed NEC were more likely to manifest themselves as abdominal distension (52.1％ vs.42.0％,x2 =4.597,P =0.032),vomiting(36.5％ vs.17.2％,x2 =21.428,P =0.000) and bloody stool(30.3％ vs.21.4％,x2 =4.653,P =0.031);but in the onset of NEC,preterm infants more likely to have feeding intolerance (21.0％ vs.12.8％,x2=5.309,P =0.021).The early onset group of full-term NEC was much common in twins or multiplets(9.4％ vs.1.1％,x2 =6.226,P =0.013),which rate of surgical therapy was much higher (41.0％ vs.27.0％,P =0.036) and the breast-feeding rate before NEC was lower than the late onset group(14.5％ vs.32.6％,x2 =9.500,P =0.002),the differences were statistically significant.The gestational age and birth weight were bigger in the early onset group of preterm NEC[(33.8 ±2.5) weeks vs.(32.2 ±2.8) weeks,t =4.261,P =0.000;(2.1 ±0.5) kg vs.(1.7 ± 0.5) kg,t =4.735,P =0.000)],but length of stay was shorter than the late onset group (18.0 d vs.26.5 d,P =0.000).Logistic regression analysis showed that the risk factors of poor prognosis of full-term NEC were shock,peritonitis and sepsis;while risk factors of poor prognosis of preterm NEC were small for gestational age infant,pulmonary hemorrhage,shock,intestinal perforation and sepsis;the risk factors of poor prognosis of the early onset group of full-term NEC was shock;while those of the late onset group were shock and peritonitis;the risk factors of poor prognosis in the early onset group of preterm NEC were shock and sepsis,while those in the late onset group were pulmonary hemorrhage,shock,intestinal perforation and sepsis.Conclusions Compared to the preterm NEC,the onset time of full-term NEC was earlier and the clinical manifestations were more typical.Early identification and management of shock,peritonitis,intestinal perforation,sepsis and pulmonary hemorrhage can reduce the risk of poor prognosis of neonate NEC.
RÉSUMÉ
Teaching rounds is an important part of clinical teaching practice,therefore,we established a demonstration team for teaching ward rounds.By formulating standard operation procedure for teaching rounds and encouraging innovation on teaching models,the team played a demonstration role in the clinical teaching rounds,which not only made up the shortcomings in teaching,but also improved the teaching level of clinical teachers and the quality of clinical training.
RÉSUMÉ
Teaching rounds is an important part of clinical teaching practice, therefore, we established a demonstration team for teaching ward rounds. By formulating standard operation procedure for teaching rounds and encouraging innovation on teaching models, the team played a demonstration role in the clinical teaching rounds, which not only made up the shortcomings in teaching, but also improved the teaching level of clinical teachers and the quality of clinical training.
RÉSUMÉ
Objective To evaluate the effect of non-invasive ventilator combined with compound ipratropium bromide inhalation in the acute exacerbation of chronic obstructive pulmonary disease. Methods 60 patients with acute exacerbation of chronic obstructive pulmonary disease were included in this study. Data were collected from March 2013 to March 2017. Participants were randomly and equally divided into observational group and control group. The control group was given routine treatment such as relieving cough and reducing sputum, anti-infection, etc. On the basis of control group, the observation group was given combined with non-invasive ventilator combined with compound ipratropium bromide inhalation therapy. The hospitalization time, APACHE Ⅱ score, tracheal intubation status of the two groups were compared and analyzed. Results The results showed that after different treatments there were 8 cases of tracheal intubation in the control group and 3 cases in the observation group, and the tracheal intubation rate was statistically different(P＜0. 05). In addition, there was no significant difference in partial pressure of oxygen, partial pressure of carbon dioxide and APACHE Ⅱ score between the two groups before treatment, while the difference was significant after treatment, and the length of hospitalization was also statistically significant (P＜0. 05). Conclusion In the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease, a non-invasive ventilator combined with compound ipratropium bromide on the basis of routine treatment can effectively shorten the hospital stay, improve the patient's oxygen partial pressure, and the overall treatment effect is significant, which deserve promotion.
RÉSUMÉ
Objective To study the composition of gut microbiome in neonates with severe bilinebinemia (serum total bilirubin ＞ 342 μmol/L),and to explore the relationship between gut microbiome and bilirubin brain injury.Methods A prospective study was conducted.The neonates with serum total bilirubin ＞ 342 μmol/L from September 2016 to March 2017 in Guangzhou Women and Children's Medical Center,Guangzhou Medical University,were enrolled in the study and 16S rDNA sequence analysis technology was used to detect the composition of gut microbiome in all subjects.According to the results of brain magnetic resonance imaging (MRI),brain stem auditory evoked potential (BAEP) and clinical manifestations,the subjects were divided into the brain injury group (26 cases) and no brain injury group (28 cases).The differences of the composition of gut microbiome between the 2 groups were compared,and the levels of unconjugated bilirubin in serum and cerebrospinal fluid were also compared.Results The level of unconjugated bilirubin in serum of the brain injury group was (463.51 ± 110.62) μmol/L,but in no brain injury group was(364.18 ±63.13) μmol/L,and there was significant difference between the 2 groups(t =4.090,P =0.000 1).The level of unconjugated bilirubin in the cerebrospinal fluid of the brain injury group was (9.53 ± 2.68) μmol/L,but in no brain injury group was (6.94 ± 2.31) μmol/L,and there was significant difference between the 2 groups (t =3.812,P =0.000 3).There was no correlation between the level of unconjugated bilirubin in the cerebrospinal fluid and serum between the 2 groups(r =0.137,0.081,all P ＞0.05).The abundance of gut microbiome in the brain injury group was lower than that in no brain injury group in genus level,among which Fusobacterium,Catabacter,Succinivibrio,Clostridium and Bacteroides were significantly different (all P ＜ 0.05).Conclusions The occurrence of bilirubin brain injury depends on the level of unconjugated bilirubin in serum cerebrospinal fluid,but it may be more directly dependent on the level of bilirubin in the cerebrospinal fluid.The diversity of gut microbiome in neonates with bilirubin brain injury was significantly lower than that in no brain injury group.The level of unconjugated bilirubin in cerebrospinal fluid may be related to the different blood-brain barrier permeability caused by different composition of gut microbiome.
RÉSUMÉ
Objective To investigate the effect of curcumin on brain glucose metabolism in rat models of intracerebral hemorrhage ( ICH), and evaluate the therapeutic effect of curcumin. Methods Twenty-four healthy adult male SD rats were randomly divided into 4 groups ( 6 rats/group) by simple random sampling method:normal group ( group A) , ICH+curcumin group ( group B) , ICH +vehicle group ( group C) , and sham operated group (group D). ICH model was made by injecting collagenase (2 μl) into the right cau-date nucleus of rat. 18F-FDG with a dose of (17.8±0.4) MBq was injected through caudal vein at 6 h, 24 h, 48 h, 3 d, 5 d, 7 d, 14 d after the model was built successfully. 18F-FDG microPET/CT was performed 30 min post injection at each time point. ROI in the hematoma and peri-hematoma brain tissue was drawn, and its volume and SUVmean were measured and analyzed. Meanwhile, each rat was evaluated by neurological severi-ty scores ( NSS) . Analysis of variance for repeated measurement data and Pearson correlation analysis were used. Results NSS in group B were lower than those in group C from 6 h to 5 d (F=183.26, P<0. 01). MicroPET/CT showed decreased glucose uptake in the hematoma and peri-hematoma brain tissue after cere-bral hemorrhage. In group B, the 18 F-FDG uptake in peri-hematoma brain tissue of ICH decreased after 6 h, and reached the minimum at 24 h (1.20±0.08), and then increased. The glucose metabolism in group B was significantly lower than that in group D at each time point (F=7306.74, P<0.01), and significantly higher than that in group C ( F=471.50, P<0.01) . SUVmean within ROI had a significantly negative correla-tion with both ROI volume and NSS in group B at each time point( r values:-0.672 and -0.727, both P<0. 05) . Conclusions MicroPET/CT might visualize decreased glucose uptake of hematoma and peri-hema-toma brain tissue after cerebral hemorrhage. Curcumin might have a neuroprotective effect on ICH, and im-prove the glucose uptake in hematoma and peri-hematoma brain tissue.
RÉSUMÉ
Objective To investigate the effect of curcumin on brain glucose metabolism in rat models of intracerebral hemorrhage ( ICH), and evaluate the therapeutic effect of curcumin. Methods Twenty-four healthy adult male SD rats were randomly divided into 4 groups ( 6 rats/group) by simple random sampling method:normal group ( group A) , ICH+curcumin group ( group B) , ICH +vehicle group ( group C) , and sham operated group (group D). ICH model was made by injecting collagenase (2 μl) into the right cau-date nucleus of rat. 18F-FDG with a dose of (17.8±0.4) MBq was injected through caudal vein at 6 h, 24 h, 48 h, 3 d, 5 d, 7 d, 14 d after the model was built successfully. 18F-FDG microPET/CT was performed 30 min post injection at each time point. ROI in the hematoma and peri-hematoma brain tissue was drawn, and its volume and SUVmean were measured and analyzed. Meanwhile, each rat was evaluated by neurological severi-ty scores ( NSS) . Analysis of variance for repeated measurement data and Pearson correlation analysis were used. Results NSS in group B were lower than those in group C from 6 h to 5 d (F=183.26, P<0. 01). MicroPET/CT showed decreased glucose uptake in the hematoma and peri-hematoma brain tissue after cere-bral hemorrhage. In group B, the 18 F-FDG uptake in peri-hematoma brain tissue of ICH decreased after 6 h, and reached the minimum at 24 h (1.20±0.08), and then increased. The glucose metabolism in group B was significantly lower than that in group D at each time point (F=7306.74, P<0.01), and significantly higher than that in group C ( F=471.50, P<0.01) . SUVmean within ROI had a significantly negative correla-tion with both ROI volume and NSS in group B at each time point( r values:-0.672 and -0.727, both P<0. 05) . Conclusions MicroPET/CT might visualize decreased glucose uptake of hematoma and peri-hema-toma brain tissue after cerebral hemorrhage. Curcumin might have a neuroprotective effect on ICH, and im-prove the glucose uptake in hematoma and peri-hematoma brain tissue.
RÉSUMÉ
Objective@#To evaluate the clinical characteristics and prognosis of patients with mitral valve prolapse (MVP).@*Methods@#We retrospectively analyzed the clinical characteristics and prognosis of 148 MVP patients who underwent mitral valve surgery in Fuwai hospital from January 2012 to December 2015.The patients were divided into mucoid degeneration group (52 cases) and without mucoid degeneration group(19 cases) according to pathological examination of leaflets and chordate.@*Results@#The clinical symptoms of MVP patients included dyspnea (59.5%(88/148)), chest distress and pain (52.7%(78/148)), and palpitations (36.5% (54/148)). Mitral valve repair was performed in 144 cases (97.3%), and mitral valve replacement was performed in 4 cases (2.7%). Posterior leaflet prolapse was the most common form of MVP (68.9%, 102/148). Pathological examination revealed myxomatous degeneration in 73.2% patients (52/71), fibrosis in 8.5% patients (6/71), and fibrinoid necrosis in 8.5% patients (6/71). Patients with mucoid degeneration had less atrial fibrillation before surgery (5.8%(3/52) vs. 42.1%(8/19), P<0.01), smaller preoperative left atrium diameter ((43.2±6.5) mm vs. (48.2±8.9) mm, P<0.05), more posterior leaflet prolapse (94.2%(49/52) vs. 63.2%(12/19), P<0.01), redundant chordae (26.9%(14/52) vs. 0, P<0.05) and leaflet thickening (76.9%(40/52) vs. 52.6%(10/19), P<0.05) when compared with patients without mucoid degeneration.Echocardiography examination at the postoperative follow-up of 39.0(22.3, 57.0) months revealed smaller left atrium diameter((38.5±7.1) mm vs. (45.3±8.3) mm, P<0.01), left ventricular end-diastolic diameter ((48.9±6.2) mm vs. (57.5±7.6) mm, P<0.01), reduced left ventricular ejection fraction ((61.2±7.1)% vs. (65.1±6.2)%, P<0.01) and less moderate or severe mitral regurgitation (1.4%(2/148) vs. 100.0%(148/148), P<0.01) compared with the corresponding preoperative values.@*Conclusions@#Dyspnea is the main symptom, and mucoid degeneration characterized by redundant chordae and leaflet thickening are the main pathological features of MVP patients.The surgical treatment of MVP patients is related with satisfactory outcome results.
RÉSUMÉ
Objective To analyze the willingness and influencing factors for usage of pre-exposure prophylaxis(PrEP) among male students who have sex with men (MSM) in universities of Guangxi. Meth-ods 295 MSM students in universities were recruited by Snow-balling methods. Questionnaires were self-administered to collect social demographic information,AIDS related risky sexual behaviors and willingness for usage of PrEP. Logistic regression was employed for univariate and multivariate analysis. Results Of the 295 MSM,58(19.7%)had ever heard PrEP,265(89.8%) said that they would like to use PrEP. Multivari-ate logistic regression analysis showed that those who had found partners through friends ( OR=11.419,95%CI:1.363~95.641), those who would advise his friend to use PrEP ( OR=87.946,95%CI:13.660-566. 222),those who concerned the convenience to gain the medicine ( OR=119.652,95%CI:3.765-3802.184) and those who said that they could take medicine every day ( OR=88.245,95%CI:10.237-760.696) were more likely to accept PrEP. The subjects whose partners would be angry if they stick to use condoms( OR=0.106,95%CI:0.019-0.606),and those who suspected the effectiveness of drugs( OR=0.010,95%CI:0. 001-0.112) were less likely to accept PrEP. Conclusion The acceptability of PrEP is high in university students'MSM. The safety of drugs and the convenience to gain the medicine are the main influencing factors for usage of PrEP.Using of PrEP should be strengthened to the MSM.
RÉSUMÉ
Objective To evaluate the effect of comprehensive intervention on perioperative antimicrobial prophy-laxis in clean incision surgery in a hospital.Methods From 2011 ,clean incision surgery cases were performed com-prehensive intervention,antimicrobial use in 2011 -2013 were compared.Results A total of 5 945 cases of clean in-cision surgeries were investigated between 2011 and 2013,3 827 cases (64.37%)received prophylactic use of anti-microbial agents.Prophylactic antimicrobial usage rates in 2011 -2013 were 84.95%,69.99%,and 52.97% re-spectively(χ2 =380.94,P <0.001);the correct rates of medication time were 50.97%,79.99%,and 98.95% re-spectively(χ2 =827.02,P <0.001 );the percentages of prophylactic antimicrobial use ≤24 hours were 24.91 %, 39.96%,and 64.95% respectively(χ2 =422.55,P <0.001 );additional antimicrobial usage rates during surgery were 50.00%,60.00%,and 80.00% respectively(χ2 =59.47,P <0.001 ).Conclusion The implementation of comprehensive intervention measures can standardize antimicrobial use,reduce prophylactic antimicrobial usage rate,improve the correct rate of medication time,shorten the duration of antimicrobial use,and implement addition-al use of antimicrobial agents during surgery.
RÉSUMÉ
Objective:To investigate the efficiency of CBCT in the diagnosis of impacted maxillary anterior teeth and the treatment effect of different guided eruption methods. Methods:34 impacted maxillary anterior teeth in 30 patients were examined by panoramic films and CBCT, the dental crowns, root, eruption space and other related items were measured and compared between 2 examinations. 20 cases were treated by closed guided eruption and traction( CGET) technique, 10 cases by circumferential supracrestal fibrotomy and exposed traction( CSF-EE) , results were compared. Results: CBCT was more effective than panoramic films in the revelation of tooth root bending, apical pore closure and eruption measurements(P<0. 05). 7-10 d after treatment 5 out off the 10 casses treated by CSF-EE showed different degrees of clinical crown elongation, poor gum appearance and low height of alveolar ridge as insufficient periodontal attachment. However, the treatment of CGET for 26 teeth (76. 47% of all cases) was highly successful and received very satisfactory re-sults, the rest 8 teeth (23. 53% of all cases) showed mediocre satisfaction. Conclusion: CBCT can accurately display the position, shape, relation with adjacent teeth of the impacted teeth. Closed guided eruption and traction is more effective for the treatment.
RÉSUMÉ
Objective To investigate the therapeutic effect of the new K+ channel blocker 4-aminopyridine-3-methanol (4-AP-3-MeOH) on chronic spinal cord injury in rats.Methods 18 adult male Sprague-Dawley rats were randomly divided equally into 3 groups as follows:4-AP-3-MeOH treatment group (A),normal saline control group (B) and sham operation group (C).T10 segment of spinal cord compression injury was applied in group A and group B.4 weeks later,the rats in group A were daily treated by injecting 4-AP-3-MeOH 1 μmol (1000 μmol/L× 1 ml) into the veins of the tails for 4 weeks.While the same volume of saline was administrated into the group B for 4 weeks.Lamina of vertebra of T10 was cut without spinal cord injury in the sham-operation group.After modeling,the locomotor functional recovery was assessed by using Basso Beattie Bresnahan (BBB) scores and inclined plane (IP) tests,and all rats were periodical inspected by the somatosensory evoked potential(SEP) and motor evoked potential(MEP) post-operatively.Results BBB scores of group A started to increase gradually and were higher than those of group B from the 6th week,but the 2 groups at each time point in BBB scores were less than group C.Until 8 weeks after surgery,the inclined-plated angles of group A and B did not show significantly difference,but the both groups were significantly lower compared with group C.Electrophysiology study found that the amplitude of SEP and MEP in group A was higher than group B from the fourth to 8 weeks,but less than in group C.Histological examination showed that the spinal cord of rats in group C were morphologically intact with a clear demarcation between the grey and white matter.The gray matter structures of rats in group A and B were gone and a big cavity appears in the center of the spinal cord injury,with varying degrees of demyelination in the white around.In addition,statistically significant differences were found in the percentage of residual myelin at the injury epicenter between group A and group B.Conclusion With a persistent demyelination change and poor motor function in chronic spinal cord injury,daily administration of 4-AP-3-MeOH can improve the sensory and motor functions.
RÉSUMÉ
Objective To evaluate the efficacy and toxicity of the combination of oxaliplatin and S-1 in the treatment of patients with advanced breast cancer.Methods A total of 72 patients with advanced breast cancer after the treatment failuer of anthracycline and taxane were treated with oxaliplatin and S-1.The first day,they were given oxaliplatin,135 mg/m2,with the 5％ glucose injection 500 ml,the time of intravenous drip should be more than 2 hours.And the S-1 was taken after breakfast and dinner,the dose was 40-60 mg,and the time of duration was 2 weeks,then they had 7 days to rest.The cycle was 21 days.Every 2 cycles,we estimated the efficacy.Patients who were effective and stable kept that chemotherapy regimens,the maximum duration was 6 cycles.The efficacy and toxicities were evaluated after cycles of chemotherapy.Results Two cases (2.8％) had complete response (CR),26 cases (36.1％) had partial response (PR).The response rate (RR) was 38.9％ and the disease control rate (DCR) was 69.4％.The median progress free survival (PFS) was 7.7 months and the median overall survival (OS) was 12.3 months.Subgroup analysis showed that the OS of patients who belong to stage Ⅳ,had two or more metastases or with failure treatment after being treated with anthracycline and taxane was notably shorter than the patients who belong to stage Ⅲ C,only one metastasis,with effective treatment after being treated with anthracycline and taxane,and the differences were statistically significant (10.5 months vs.15.0 months,x2 =4.469,P =0.035;9.3 months vs.15.0 months,x2 =8.297,P=0.004;10.0 months vs.14.0 months,x2 =4.077,P=0.043).The main side effects were neutropenia (19.4％),nausea (8.3％) and nerve toxicity (2.8％),mainly 3-4 degree,and could be welltolerated.The others were diarrhea,impaired liver function,stomatitis,anemia and hand-foot syndrome,mainly 1-2 degree.Conclusion Oxaliplatin combined with S-1 is effective and tolerable in treatment of patients with advanced breast cancer,the adverse reactions can be tolerated.
RÉSUMÉ
Objective:To investigate procalcitonin and C-reactive protein levels in diarrheal patients who underwent irinotecan che-motherapy. Methods:Procalcitonin and C-reactive protein were detected among 85 diarrheal and 63 non-diarrheal patients after irinote-can chemotherapy. Results:According to WHO classification, patients without diarrhea are classified as grade 0, whereas patients with diarrhea can be classified as gradesⅠ-Ⅳ. In grades 0,Ⅰ,Ⅱ,Ⅲ, andⅣpatients, the levels of procalcitonin were 0.29 ± 0.17, 0.30 ± 0.18, 0.36 ± 0.20, 1.24 ± 0.22, and 2.15 ± 0.26 ng/mL on the second day, respectively. However, on the fourth day, the procalcitonin lev-els were 0.28 ± 0.15, 0.30 ± 0.14, 0.34 ± 0.18, 2.00 ± 0.22, and 2.40 ± 0.28 ng/mL, respectively. Moreover, in grades 0,Ⅰ,Ⅱ,Ⅲ, andⅣ, the levels of C-reactive protein were 6.06 ± 1.85, 6.12 ± 1.16, 6.20 ± 1.68, 22.62 ± 4.55, and 31.26 ± 5.23 mg/L on the second day, respectively. On the fourth day, the C-reactive protein levels were 5.80 ± 1.82, 5.94 ± 1.14, 6.15 ± 1.55, 30.52 ± 4.74, and 38.67 ± 5.68 mg/L, respectively. No significant difference was found between the procalcitonin and C-reactive protein levels of stagesⅠandⅡpa-tients (P>0.05), but a significant difference was found between stagesⅠ, andⅡpatients and stagesⅢandⅣpatients (P<0.05). Con-clusion: Monitoring levels of procalcitonin and C-reactive protein may be helpful in the early evaluation of the severity of diarrhea. This process has prognostic effect and can be used to assess whether patients have enterogenous bacterial infection. Monitoring the lev-els of these proteins has certain clinical value and can be used to guide early anti-infection therapy.