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BACKGROUND@#Invasive mucinous adenocarcinoma (IMA) was a rare and specific type of lung adenocarcinoma, which was often characterized by fewer lymphatic metastases. Therefore, it was difficult to evaluate the prognosis of these tumors based on the existing tumor-node-metastasis (TNM) staging. So, this study aimed to develop Nomograms to predict outcomes of patients with pathologic N0 in resected IMA.@*METHODS@#According to the inclusion criteria and exclusion criteria, IMA patients with pathologic N0 in The Affiliated Lihuili Hospital of Ningbo University (training cohort, n=78) and Ningbo No.2 Hospital (validation cohort, n=66) were reviewed between July 2012 and May 2017. The prognostic value of the clinicopathological features in the training cohort was analyzed and prognostic prediction models were established, and the performances of models were evaluated. Finally, the validation cohort data was put in for external validation.@*RESULTS@#Univariate analysis showed that pneumonic type, larger tumor size, mixed mucinous/non-mucinous component, and higher overall stage were significant influence factors of 5-year progression-free survival (PFS) and overall survival (OS). Multivariate analysis further indicated that type of imaging, tumor size, mucinous component were the independent prognostic factors for poor 5-year PFS and OS. Moreover, the 5-year PFS and OS rates were 62.82% and 75.64%, respectively. In subgroups, the survival analysis also showed that the pneumonic type and mixed mucinous/non-mucinous patients had significantly poorer 5-year PFS and OS compared with solitary type and pure mucinous patients, respectively. The C-index of Nomograms with 5-year PFS and OS were 0.815 (95%CI: 0.741-0.889) and 0.767 (95%CI: 0.669-0.865). The calibration curve and decision curve analysis (DCA) of both models showed good predictive performances in both cohorts.@*CONCLUSIONS@#The Nomograms based on clinicopathological characteristics in a certain extent, can be used as an effective prognostic tool for patients with pathologic N0 after IMA resection.
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Humanos , Prognóstico , Neoplasias Pulmonares/patologia , Adenocarcinoma Mucinoso/patologia , Adenocarcinoma de Pulmão/patologia , Estadiamento de Neoplasias , Pulmão/patologia , Estudos RetrospectivosRESUMO
Post-stroke depression (PSD) is a serious and common complication of stroke, which seriously affects the rehabilitation of stroke patients. To date, the pathogenesis of PSD is unclear and effective treatments remain unavailable. Here, we established a mouse model of PSD through photothrombosis-induced focal ischemia. By using a combination of brain imaging, transcriptome sequencing, and bioinformatics analysis, we found that the hippocampus of PSD mice had a significantly lower metabolic level than other brain regions. RNA sequencing revealed a significant reduction of miR34b-3p, which was expressed in hippocampal neurons and inhibited the translation of eukaryotic translation initiation factor 4E (eIF4E). Furthermore, silencing eIF4E inactivated microglia, inhibited neuroinflammation, and abolished the depression-like behaviors in PSD mice. Together, our data demonstrated that insufficient miR34b-3p after stroke cannot inhibit eIF4E translation, which causes PSD by the activation of microglia in the hippocampus. Therefore, miR34b-3p and eIF4E may serve as potential therapeutic targets for the treatment of PSD.
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Animais , Camundongos , Depressão , Fator de Iniciação 4E em Eucariotos/metabolismo , MicroRNAs/metabolismo , Neurônios/metabolismo , Acidente Vascular Cerebral/metabolismoRESUMO
<p><b>OBJECTIVE</b>To investigate the efficacy of single-hand four-needle suture with sled-shaped needle three-tail fixed stitch in closure of pesudohernia sac of direct hernia under transabdominal preperitoneal (TAPP) inguinal hernia repair.</p><p><b>METHODS</b>A randomized controlled trail was conducted on adult patients with unilateral direct inguinal hernia undergoing laparoscopic TAPP repair from January 2014 to January 2018 at the Sixth Affiliated Hospital of Sun Yat-sen University. A total of 156 patients were enrolled prospectively in the study and were randomly divided into single-hand four-needle suture group (trial group, 76 cases) and traditional tacking group (control group, 80 cases). In trial group, sled-shaped needle three-tail knot-free stitch was applied to the continuous four-needle suture. The sled-shaped needle three-tail fixed stitch was made as follows: straighten the tail of a 3-0, 1/2-circle looper VICRYL Rapide into a sled shape; use suture overlap method to make and tighten a single knot; thread the end of the needle into the single knot loop;knot two ends of the thread next to the first knot; tighten the second knot, leaving about 12 cm to the end of the needle;cut the end of the loop (leaving about 0.6 cm) and the other end of the thread(leaving about 1.5 cm). In the control group, a hernia repair tack was used to fix the pseudohernia sac on pectineal ligament. This study was approved by the Hospital Ethics Committee(approval number: L2014ZSLYEC-016). Operation time, pseudoherina sac closure time, hospitalization cost, morbidity of postoperative complication, VAS score and postoperative recurrence were compared between two groups.</p><p><b>RESULTS</b>All the patients completed operations successfully. There were no significant differences between trial group and control group in age [(60.2±0.4) years vs. (61.1±0.7) years)], gender (male ratio 93.4% vs. 92.5%), BMI [(25.1±0.2) kg/m vs. (24.9±0.2) kg/m ], defection area [(16.1±0.4) cm vs. (15.7±0.7) cm ] (all P > 0.05). As compared to control group, trial group had longer operative time[(34.2±1.9) minutes vs. (30.3±1.1) minutes, t=5.484, P=0.045], longer closure time of psudohernia sac [(4.2±0.5) minutes vs. (1.8±0.7) minutes, t=7.423, P=0.031], but lower VAS score (3.2±0.1 vs. 5.3±0.6, t=-3.186, P=0.015) and lower total cost [(9 897.3±104.4) yuan vs. (12 325.6±169.7) yuan, t=-3.972, P=0.023]. No severe complication and death were found in either groups intra-operatively and postoperatively. No mesh infection and relapse occurred during postoperative follow-up of 1-24 (12.0±1.2) months. During follow-up, seroma occurred in 2 cases (2.6%) of trial group and 3 cases (3.8%) of control group without significant difference (χ =1.284, P=0.799), and all were absorbed and disappeared within 30 days after local application of mirabilite.</p><p><b>CONCLUSION</b>Compared to tack fix method, single-hand four-needle suture with sled-shaped needle three-tail fixed stitch can effectively close pseudohernia sac, reduce hospitalization cost and ameliorate postoperative pain in TAPP repair, which is worth promotion.</p>
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Humanos , Masculino , Pessoa de Meia-Idade , Hérnia Inguinal , Cirurgia Geral , Herniorrafia , Métodos , Laparoscopia , Telas Cirúrgicas , Técnicas de Sutura , Suturas , Resultado do TratamentoRESUMO
Objective@#To investigate the effect of dietary control combined with different exercise modes on plasma vaspin, irisin, and metabolic parameters in patients with non-alcoholic fatty liver disease (NAFLD) through a randomized open parallel-controlled study.@*Methods@#The patients aged 30-65 years who visited Tianjin Third Central Hospital from January 2013 to December 2014 and were diagnosed with NAFLD by liver ultrasound and fat content determination were screening, and 474 patients were enrolled in this randomized controlled trial and divided into aerobic exercise group, resistance exercise group, and control group. All patients received dietary intervention. The three groups were compared in terms of biochemical parameters, fat content, NFS score, energy metabolic parameters, body composition index, and levels of vaspin and irisin at baseline and after 6 months of intervention. SPSS 19.0 was used for statistical analysis. The t-test, the Mann-Whitney U test, the chi-square test, and an analysis of variance were used for comparison between groups. The multiple imputation method was used for missing data, and the results were included in the intention-to-treat analysis.@*Results@#There were no significant differences in age, sex, anthropometrical parameters, and biochemical parameters between the three groups at baseline. Compared with dietary control alone, aerobic exercise and resistance exercise helped to achieve significant reductions in waist circumference, diastolic pressure, percentage of body fat, volatile fatty acid, fasting blood glucose, homeostasis model assessment of insulin resistance, triglyceride, low-density lipoprotein cholesterol, free fatty acid, uric acid, alanine aminotransferase, and liver fat content after 6 months of intervention (P < 0.05). The aerobic exercise group had a significant increase in non-protein respiratory quotient and significant reductions in body mass index and aspartate aminotransferase after intervention, as well as a significant increase in resting energy expenditure and significant reductions in abdominal fat ratio and total cholesterol after 6 months of resistance exercise (P < 0.05). The aerobic exercise group and the resistance exercise group had a significant reduction in vaspin and a significant increase in irisin after intervention (P < 0.05), and the resistance exercise group had significantly greater changes in these two adipokines than the aerobic exercise group (P < 0.05).@*Conclusion@#Exercise therapy is an effective method for the treatment of metabolism-associated diseases, and a combination of resistance and aerobic exercises is more reasonable and effective in clinical practice. As a relatively safe exercise mode, resistance exercise can also effectively improve the metabolic state of NAFLD patients.
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Objective To observe the clinical efficacy of grain-sized moxibustion at Yongquan (KI 1) plus electroacupuncture in treating lumbar intervertebral disc herniation (LIDH).Method Fifty LIDH patients were randomized into a treatment group and a control group, 25 cases in each group. The treatment group was intervened by grain-sized moxibustion plus electroacupuncture, while the control group was by dry electroacupuncture. The Visual Analogue Scale (VAS) and Japanese Orthopaedic Association (JOA) score were observed, and the clinical efficacies were compared.Result After treatment, the VAS and JOA scores were significantly different from that before treatment in both groups (P<0.01). After treatment, the VAS and JOA scores in the treatment group were significantly different from that in the control group (P<0.01,P<0.05). The recovery plus markedly-effective rate and total effective rate were respectively 72.0% and 96.0% in the treatment group, versus 52.0% and 80.0% in the control group, and there was a significant difference in comparing the recovery plus markedly-effective rate (P<0.01).Conclusion Grain-sized moxibustion at Yongquan (KI 1) plus electroacupuncture is an effective approach in treating LIDH.
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Radiotherapy is a treatment for cancer with undesired by-effects. In order to develop a new radiation protective agent that could reduce the by-effects, we tried to express and purify human cryptochrome 1 (hCRY1). The coding sequence of hCRY1 was inserted into prokaryotic expression plasmid pET28a(+), and this protein was purified from Escherichia coli BL21(DE3) after IPTG induction, ultrasonication, inclusion body dissolution, gradient dialysis, nickel column purification and ultrafiltration. The yield of hCRY1 in 1 L E. coli culture (LB medium) was about 10-15 mg. The radiation protective efficiency of hCRY1 was monitored by detecting X-ray-induced H2A.X foci in HaCaT cells. The results of immunofluorescence show that hCRY1 significantly reduces X-ray stimulated DNA damage response. The apoptosis of HaCaT cell was also detected, and the repression of H2A.X foci formation was not due to hCRY1's cytotoxity. All these data suggest a potential application of recombinant hCRY1 as a protective agent for radiotherapy.
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Humanos , Criptocromos , Escherichia coli , Plasmídeos , Protetores contra Radiação , Proteínas RecombinantesRESUMO
Objective To explore the inhibitory effects of lobaplatin and cisplatin and their regulation of apoptosis-related genes in ovarian cancer cells in nude mice.Methods SKOV3 cells were implanted into nude mice.In monotherapy treatment study,the nude mice bearing human SKOV3 cells were randomly divided into control,lobaplatin,and cisplatin groups,with 7 mice in each group.The mice in each group were received corresponding treatment.The volume of tumor and the weight of nude mice were measured three times per week,respectively.Tumor inhibitory rate was calculated.The protein expressions of bax and bcl-2 were detected by flow cytometry.Results The growth inhibitory rate was 47.2% in lobaplatin group and 42.8% in cisplatin group,without significant difference between two groups (P > 0.05).The expression of bcl-2 was decreased but the bax was increased in lobaplatin and ciaplatin groups compared to the control group.Conclusions Lobaplatin can significantly inhibit the growth of ovarian cancer cells,induce apoptosis by down-regulation of bcl-2 and up-regulation of bax.
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Objective To investigate the serum levels of PGⅠ,PGⅡ,TK1,TSGF and CEA,CA724 in gastric cancer and eval-uate the application value of combined detection the above tumor markers in diagnosis of gastric cancer.Methods The serum levels of TSGF were measured in 94 patients with gastric cancer and 85 healthy control by rate method.PGⅠ,PGⅡ,TK1 and CEA,CA724 were detected by electrochemiluminescence method.Results PGⅠand PGⅠ/PGⅡwere lower than healthy control in serum of patients with gastric cancer (both P0.05),and other tumor markers were all higher than healthy control (all P<0.05).The sensitivity of PGⅠ,PGⅠ/PGⅡ were better than TK1,CEA and CA724 (all P<0.05),the specificity of PGⅠ/PGⅡ,CEA were better than TSGF (both P<0.05),the accuracy of PGⅠ,PGⅠ/PGⅡ were better than CA724 and TSGF alone (all P<0.05).When combined TSGF,TK1 and PGⅠ/PGⅡ,PGⅠ,the sensitivity was better than combined PGⅠ/PGⅡand PGⅠ alone (P<0.05).Then when added CEA, CA724,this sensitivity improved up to 82.98%.Although the combined detection would show a lower specificity,it still keep high to 84.71%.Combined detection improved the accuracy in diagnosis of gastric cancer,up to 83.80%.In this re-search,There was no difference in sensitivity,specificity and accuracy between the group of PGⅠ+PGⅠ/PGⅡ+TSGF+TK1+CEA and the group of PGⅠ+PGⅠ/PGⅡ+TSGF+TK1+CEA+CA724.Conclusion Compared with CEA and CA724 popular used in clinic,PGⅠ/PGⅡand PGⅠshowed a better application value.The group of PGⅠ+PGⅠ/PGⅡ+TSGF+TK1+CEA showed the best sensitivity.Combined detection of serum levels of PGⅠ,PGⅠ/PGⅡ,TSGF,TK1 ,CEA can significantly raise the sensitivity and accuracy in diagnosis of gastric cancer.
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Objective To compare the advantages and values of several special staining methods of chondrocytes . Methods Twelve 7-day old healthy C57BL/6J mice were killed to obtain the cartilage tissue of the knee joint in order to isolate the chondrycytes .Type II collagen was used to assess the chondrocytes .Then the chondrocyte climbing slices were prepared.The materials were fixed, and HE staining, Safranin O-fast green staining, SA-β-gal staining and immunohistochemical staining of Type II collagen were performed and compared .Results HE staining showed clear morphology of the chondrocytes .The cell nuclei were stained blue and the cytoplasm was pink .Safranin O-fast green staining showed that the nuclei were pink and the cytoplasm green .SA-β-gal staining showed that the aging cells were green while the young cells were colorless .Immunohistochemical staining of type II collagen showed the distribution of type II collagen and they were stained brown while the cell nuclei were blue .Conclusions HE staining and safranin O-fast green staining can provide more information than the other staining techniques .SA-β-gal staining is useful in the analysis of aging chondrocytes .Immunohistochemical of type II collagen can be used to study type II collagen .
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Objective The aim of the study is to explore the efficacy of Carbamazepine with manual massage on grand mal epilepsy.Methods Using a prospective research method,the grand mal epilepsy patients were randomly divided into the experimental group(40 cases)and the control group(40 cases).The experimental group was given manual massage based on oral Carbamazepine treatment.The control group was given oral Carbamazepine treatment.The treatment effect was compared between two groups.Results The curative efficacy of the experimental group was 92.5%,higher than 80.0% of the control group.Conclusions Carbamazepine with manual massage for treatment of grand mal epilepsy can obviously improve curative efficacy,which is worthy of popularization and application.
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Objective To assay the plasma omentin level in patients of type 2 diabetes mellitus (T2DM) combined with non-alcoholic fatty liver disease (NAFLD) and investigate the relationship between plasma omentin level,glucose and lipid metabolism,insulin resistance and NAFLD.Methods The plasma omentin level was assayed by enzyme-linked immunosorbent assay(ELISA) in all subjects,including patients of T2DM controls with NAFLD (group A,50 cases),T2DM without NAFLD (group B,50 cases),simple with NAFLD(group C,51 cases) and normal controls (group D,49 cases).Meanwhile,blood glucose,glycosylated hemoglobin(HbA1c),lipids and insulin levels were also measured.Body mass index (BMI) and waist-to-hip ratio were evaluated.Insulin sensitivity was assessed by HOMA-IR.Results The plasma omentin level was (17.85 ±3.68),(13.89 ±10.68),(26.05 ±7.26) and (22.92 ±2.71)μg/L in group A,B,C and D respectively.The plasma omentin level of group A and group B was significantly lower than that of group C and group D(P < 0.05).The plasma omentin level of group A was higher than that of group B (P < 0.05).The plasma omentin level of group C was higher than that of group D (P< 0.05).Correlation analysis showed that the plasma omentin level was negatively correlated to weight,BMI,waist,triglyceride,fasting blood glucose,fasting insulin (FINS) and HOMA-IR (P <0.05 or <0.01),and positively correlated to high-density lipoprotein cholesterol (HDL-C)(P <0.01).Multiple stepwise regression analysis showed that BMI,HOMA-IR and FINS was independent variable of omentin.The concentration of omentin was 24.82 μ g/L which could predict the risk of NAFLD in people with normal glucose regulation.Conclusions The plasma omentin level is closely correlated with glucose,lipid metabolism and insulin resistance.Plasma omentin may play an important role in the pathogenesis of T2DM and NAFLD.
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@#Objective To investigate the effect of physical training combined with biofeedback therapy on pelvic floor dysfunction.Methods 35 patients with pelvic floor dysfunction and received physical training combine with biofeedback therapy were analyzed retrospectively.Results The outcome was well in 23 cases, very effective in 4 cases, effective in 3 cases, the total effective rate was 85.7%. Conclusion Physical training combine with biofeedback is an effective, simple, and painless procedure for pelvic floor dysfunction.
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ObjectiveTo learn the status quo of pre-job training,on-the-job training and the demands of training among community health service staff,and to provide evidence of continuing education.MethodsInvestigation was made by self-designed questionnaire in 335 community health service staff from ten service centers and seven service stations in four regions of Guangdong province.Results The rate of pre-job training and on-the-job training were lower than the training demands among community health service staff.The content of on-the-job training was varied and could meet the training needs.Training was maily done in superior hospitals and the main form of training was seminars and classroom teaching.ConclusionTraining efforts should be increased to meet the training demands.Training model should be innovated to improve the training effect.Hospital and community exchanges should be strengthened and the training system should be improved.
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ObjectiveTo explore activity characteristics of diverse autonomic nervous system of armymen with different mental quality levels during dread emotion processes.MethodsMental Quality Questionnaire of Armymen was used to select participants.The activities of the diverse autonomic nervous system of armymen withdifferent mental quality levels during dread emotion processes were discussed by physiological - psychological experiments.Results ( 1 ) Under neutral condition blood volume pulse (BPV) is greater in low mental quality group( ( -0.87 ±0.64)mm Hg) than in high( -0.28 ±0.24)mm Hg).(2) During dread emotion processes the normalized low frequency spectral component(LF) and skin conductance (SC) are greater in low mental quality group ( (6.54 ± 2.96) nU),(0.78 ± 0.11 ) umho) than in moderate ( ( 1.32 ± 1.25 ) nU,( (0.22 ± 0.15 ) umho) and high ((3.51 ±2.28 )nU,((0.30 ±0.12) umho).(3) During dread emotion processes the recovery time of HR and the average recovery time of skin conductance( SC ),skin temperature( ST),blood volume pulse(BVP) and HR are greater in low mental quality ( 61.58 ± 35.66 ) s,( 36.78 ± 18.58 ) s ) than in high ( ( 22.36 ± 6.87 ) s,(56.87 ± 23.98 ) s).(4) In emotional arousal,and low mental quality (0.88 ± 2.54 ) in neutral conditions change their arousal'was significantly greater than the middle (0.57 ± 2.88) and high psychological quality group (0.15 ± 1.87) ; Low mental quality group (2.17 ±2.39) under the conditions of pleasure in the dread was significantlygreater than the middle ( 1.87 ± 1.45 ) and high psychological quality group ( 1.24 ± 1.66).ConclusionThe findings indicate that armymen with low mental quality is more likely to show corresponding physiological arousal and alert status in face of the neutral or weak emotional stimuli.When facing dread emotional stimuli,they would show stronger physiological arousal mainly basing on the excitement of sympathetic nerve system,and such statuswould last much longer to bring about more fierce pain experience.
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Objective To investigate the potential association of Ghrelin(GHRL)gene polymorphisms susceptible to schizophrenia by case-control study.Methods Six hundred and thirty-four patients,six hundred and six healthy control subjects were recruited.Four SNPs rs696217,rs26802,rs27647 and rs26311 were detected by the polymerase chain reaction-based-restriction fragment length polymorphism analysis.Results No significant differences in genotype or allele frequencies of the four SNPs were observed between schizophrenic patients and healthy controls (Pvalues of genotype frequencies were 0.649,0.944,0.410,0.826;P values of allele frequencies were 0.773,0.992,0.301,0.723).However,seven haplotypes(GAAG,GAGC,GAGG,GCGC,GCGG,TAGC,TAGG)showed significant differences in frequency between schizophrenic and control groups(P values were 0.011,0.001,1.76×10-6,9.84×10-10,1.38×10-9,2.12×10-5,2.57×10-6).Conclusion These data suggest that the GHRL gene may not be associated with susceptibility to schizophrenia in the Chinese Han population.However,the haplotype of GA may be the susceptive factor of schizophrenia.
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Objective To explore influence of norm-setting three-stage rehabilitation training on hemiplegic stroke patients with movement and cognitive dysfunction. Methods A prospective randomized controlled study and stepwise linear regression analysis was carried out to investigate the early variation factors, which affected the integrated functional recovery of stroke patients. According to variation factors we established our norm-setting three-stage rehabilitation training program. 200 patients were randomly selected, according to the cerebral infarction and cerebral hemorrhage classification, and then randomly divided into the rehabilitation group and the control group with 100 patients in each group. All patients accepted general neurology routine nursing. The rehabilitation group was given an extra norm-setting three-stage rehabilitation training. The improvement of motor and cognitive function were observed. Results The early variation factors of integrated functional outcome were treatment programs, CNFD score, age, diabetes, SFMA score, smoking and the intensity of labor within six months since stroke onset. Movement and cognitive function of the rehabilitation group significantly improved than the control group as well as upon admission on the first, 3rd and 6th months since stroke onset. Conclusions The norm-setting three-stage rehabilitation training obviously promotes the improvement of motor and cognitive function at all stages.
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Objective To study the correlation between emotion regulation type and mental quality of young army men.Methods 487 young army men were measured with the Mental Quality Questionnaire of Army men and the questionnaire of army men's emotion regulation types.Results (1)Compared to soldiers,non-commissioned officers were tend to use affective-appeal((16.65±3.57)vs(15.65±3.45),t=2.08,P<0.05).The dimension of altective-appeal was significantly different in service age(F=2.85,P<0.05).The dimension of cognitive-focus had significantly difference between different education levels of soldiers(F=3.94.P<0.01).(2)The dimensions of cognitive-focus(t=4.41,P<0.01) and self-comfort(t=4.44.P<0.01) were significantly different in mental quality level.(3)There was a significant relationship between the army men's emotion regulation types and mental quality(P<0.05).Affective-appeal,behavior-restrain and self-comfort were significantly positive predictions of mental quality,meanwhile cognitive focus was negative.Conclusion There is a significant relationship between the army men's emotion regulation types and mental quality.
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Objective To study the influence of hierarchical model on the professional attitude and quality improvement of nurses and supply references for the apphcation of hierarchical model.Methods 310 nurses were divided into the control group(158 cases)and the practice group(152 cgses).The practice group adopted hierarchical model while the control group did not.Investigation was carried out in 15 aspects such as training requirement,choosing of nursing posts and departure intention,etc.Results The nursing teaching pest and nursing management post in the aspect of post requirement between the two groups had no statistical difference(P>0.05),but statistical difference existed in other items(P<0.05).In the aspect of training requirement evident difference existed in two groups(P<0.05).Conclusion Application of hierarchical model proved to be a pivotal method to improve the professional passion and loyalty of nurses.