摘要
Objective:To investigate the incidence and treatment of gastric cancer in 16 medical centers in Tianjin from 2020 to 2021.Methods:The retrospective and descriptive study was conducted. The clinical data of 3 122 gastric cancer patients who underwent surgery in 16 medical centers, including Tianjin Medical University Cancer Institute & Hospital, et al, in Tianjin from 2020 to 2021 were collected. There were 2 112 males and 1 010 females, aged (64±11)years. Observation indicators: (1) general data of patients; (2) treatment situations; (3) postoperative complications. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were descri-bed as absolute numbers or percentages, and comparison between groups was conducted by the chi-square test. Results:(1) General data of patients. From 2020 to 2021, a total of 3 122 gastric cancer patients received surgeries in 16 medical centers in Tianjin, including 2 112 males and 1 010 females. There were 1 443 cases in 2020, including 976 males and 467 females, aged (63±11) years. There were 1 679 cases in 2021, including 1 136 males and 543 females, aged (65±11) years. Of the 3 122 pati-ents, cases in stage Ⅰ, Ⅱ, Ⅲ, Ⅳ were 696, 667, 1 466, 293, accounting for 22.293%(696/3 122), 21.365%(667/3 122), 46.957%(1 466/3 122), 9.385%(293/3 122), respectively. Cases with early gastric cancer, locally advanced gastric cancer, advanced gastric cancer account for 17.265%(539/3 122), 73.350%(2 290/3 122), 9.385%(293/3 122). There were 2 829 patients without distant metastasis and 293 patients with distant metastasis. For the 2 829 patients without distant metas-tasis, cases in stage T1, T2, T3, T4a, T4b accounted for 19.053%(539/2 829), 12.089%(342/2 829), 20.148%(570/2 829), 41.499%(1 174/2 829), 7.211%(204/2 829)respectively, cases in stage N0, N1, N2, N3 account for 37.328%(1 056/2 829), 16.331%(462/2 829), 15.836%(448/2 829), 30.505%(863/2 829). For the 293 advanced gastric cancer patients with distant metastasis, 190 cases had peri-toneal metastasis, 47 cases had lymph node metastasis, 27 cases had ovarian metastasis, 37 cases had liver metastasis, 14 cases had other metastasis (some patients had ≥2 distant metastases). (2) Treatment situations. ① For the 539 with early gastric cancer, cases undergoing endoscopic submu-cosal dissection, laparoscopic surgery, open surgery were 22, 150, 86 in 2020, versus 19, 212, 50 in 2021, showing a significant difference between them ( χ2=19.42, P<0.05). For the 498 patients with early gastric cancer who underwent laparoscopic or open surgery, cases undergoing open surgery including total gastrectomy, distal gastrectomy, proximal gastrectomy were 25, 81, 30, and cases undergoing laparoscopic surgery including total gastrectomy, distal gastrectomy, proximal gastrec-tomy were 18, 309, 35, respectively, showing a significant difference between them ( χ2=40.62, P<0.05). For the 2 290 patients with locally advanced gastric cancer, cases undergoing open surgery and laparoscopic surgery were 446 and 617 in 2020, versus 410 and 817 in 2021, showing a significant difference between them ( χ2=17.75, P<0.05). For the 2 290 patients with locally advanced gastric cancer, cases undergoing open surgery including total gastrectomy, distal gastrectomy, proxi-mal gastrectomy were 336, 377, 143, and cases undergoing laparoscopic surgery including total gastrectomy, distal gastrectomy, proximal gastrectomy were 377, 920, 137, respectively, showing a significant difference between them ( χ2=89.64, P<0.05). Of the 293 patients with advanced gastric cancer, 175 cases underwent surgeries due to hemorrhage, stenosis, perforation, 76 cases under-went surgery after chemotherapy, 42 cases underwent surgery directly. ② For 756 cases of 3 122 pati-ents undergoing total gastrectomy, 357 and 4 cases received open digestive tract reconstruction including Roux-en-Y and other anastomosis, versus 380 and 15 cases with laparoscopic digestive tract reconstruction including Roux-en-Y and other anastomosis, showing a significant difference between them ( χ2=5.57, P<0.05). For 1 687 cases undergoing distal gastrectomy, 84, 160, 158, 55 cases received open digestive tract reconstruction including Billroth Ⅰ anastomosis, Billroth Ⅱ + Braun anastomosis, Roux-en-Y anastomosis, uncut Roux-en-Y anastomosis, versus 154, 489, 417, 170 cases with laparoscopic digestive tract reconstruction including Billroth Ⅰ anastomosis, Billroth Ⅱ + Braun anastomosis, Roux-en-Y anastomosis, uncut Roux-en-Y anastomosis, showing a significant difference between them ( χ2=10.90, P<0.05) . Of the 539 patients with early gastric cancer, 65 cases had lymph node metastasis, in which 18 of 306 stage T1a cases had lymph node metastasis and 47 of 233 stage T1b cases had lymph node metastasis. The number of detected lymph nodes for the 2 290 patients with advanced gastric cancer was 31±15, including ≥16 for 2 059 cases and ≥30 for 1 276 cases. Of the 3 122 patients, cases with neoadjuvant therapy, complete response and incomplete response was 128, 13 and 115 in 2020, versus 250, 49 and 201 in 2021, showing a significant difference between them ( χ2=5.51, P<0.05). (3) Postoperative complications. Of the 3 122 patients, 746 cases had postoperative complications, with an incidence of 23.895%(746/3 122). There were 62 patients with grade 3 or more complications. Reoperation was conducted in 34 patients. There were 14 cases of postoperative death. The duration of postoperative hospital stay and hospital expense were (11±5)days and (98 114±46 598)yuan for the 3 122 patients, (26±14)days and (122 066±68 317)yuan for cases with complications, (40±21)days and (196 926±12 747)yuan for cases with grade 3 or more complications. Conclusion:Compared with 2020, cases undergoing laparoscopic surgery and distal gastrectomy for gastric cancer in Tianjin increases in 2021, and the digestive tract reconstruction also differs. The number of patients with neoadjuvant chemotherapy and complete response rate for advanced gastric cancer increases.
摘要
In order to explore the effect of peptidoglycan hydrolase on the viable cell counts of Bacillus amyloliquefaciens and the yield of alkaline protease, five peptidoglycan hydrolase genes (lytC, lytD, lytE, lytF and lytG) of B. amyloliquefaciens TCCC111018 were knocked out individually. The viable cell counts of the bacteria and their alkaline protease activities before and after gene deletion were determined. The viable cell counts of the knockout mutants BA ΔlytC and BA ΔlytE achieved 1.67×106 CFU/mL and 1.44×106 CFU/mL respectively after cultivation for 60 h, which were 32.5% and 14.3% higher than that of the control strain BA Δupp. Their alkaline protease activities reached 20 264 U/mL and 17 265 U/mL, respectively, which were 43.1% and 27.3% higher than that of the control strain. The results showed that deleting some of the peptidoglycan hydrolase genes effectively maintained the viable cell counts of bacteria and increased the activity of extracellular enzymes, which may provide a new idea for optimization of the microbial host for production of industrial enzymes.
Subject(s)
Bacillus amyloliquefaciens/genetics , Bacterial Proteins , Cell Count , Endopeptidases/genetics , N-Acetylmuramoyl-L-alanine Amidase/genetics摘要
Objective@#To explore the application value of matrix assisted laser desorption time of flight mass spectrometry (MALDI-TOF-MS) inproteomics of HBV-related liver cancer.@*Methods@#Thirty patients with HBV-related liver cancer, and 25 healthy volunteers were selected from January2018 to June 2018 in our hospital. The serum proteins of these participantswere captured by weak cation exchange (WCX) beads. MALDI-TOF-MS and related software were used to analyze the proteins, detect the marker of serum proteins in HBV-related liver cancer, establish the liver cancer diagnosis model and perform blind test.@*Results@#Totally 81 protein peaks were screened out, and 27 protein peaks had significant difference (P<0.05), of which 17 were up-regulated, 10 were down-regulated. Three differential protein peaks (M/Z 9179.55, 7789.00, 4097.00) were screened by BPS5.0 software to establish the model. Further blind test showed that the sensitivityand specificity of the protein peaks were 90.91% and 77.78%, respectively.@*Conclusions@#MALDI-TOF-MS provided an important basis for the diagnosis and treatment of HBV-related liver cancer.
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Objective@#To explore the antimicrobial effect of berberine combined with vancomycin on isolated Clostridium difficile (CD) strains in vitro, in order to provide some new ideas for the treatment of CD-related diseases.@*Methods@#Thirty-five clinical isolated CD strains were selected for single or combined susceptibility tests of vancomycin (concentration range 0.062 5~4 mg/L) or berberine (concentration range 8~512 mg/L) to CD by agar dilution method , the drug sensitivity result of single and combined drugs were analysed.@*Results@#All 35 CD strains were sensitive to berberine and vancomycin, where the sensitivity ranges of berberine and vancomycin were 128 mg/L to 512 mg/L and 0.25 mg/L to 2 mg/L, respectively. The 50% minimum inhibitory concentration (MIC50) values were 512 mg/L and 0.25 mg/L, and the 90% minimum inhibitory concentration (MIC90) values were>512 mg/L and 1 mg/L, respectively. Different concentrations of berberine combined with 0.062 5-4 mg/L vancomycin respectively, the strongest synergistic effect was 128 mg/L berberine combined with 1 mg/L vancomycin (accounting for 5.71%), the strongest additive effect was 64 mg/L berberine combined with 0.5 mg/L vancomycin(accounting for 25.71%), the strongest irrelevant effect was 8 mg/L berberine combined with 0.0625 mg/L vancomycin (accounting for 97.14%), no antagonistic effect of berberine and vancomycin was found (χ2=9.85, P=0.003).@*Conclusions@#Berberine can increase the antimicrobial activity of vancomycin against CD, and has the synergistic value for clinical medication.
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Objective@#To understand the epidemic characteristics of group A rotavirus diarrhea in pediatric outpatients in Beijing.@*Methods@#Data of children with diarrhea and their stool specimens were collected from Beijing Friendship Hospital from May 2015 to May 2017; group A rotavirus detection kit (colloidal gold) was used for screening of group A rotavirus positive specimens. Reverse transcription-polymerase chain reaction (RT-PCR) was used to analyze the genotype distribution.@*Results@#Of the 1813 cases of children with diarrhea, 319 were positive for rotavirus A, accounting for 17.6%; Positive rate of 1-2 years old children was the highest (27.2%). Six months to 12 months age group and 2 ~-3 years of age group had the highest detection rate (17.5% and 16.7%, respectively). Minimum age of positive detection was 12 days, the highest age of positive detection was 12 years. In February, group A rotavirus had the highest positive proportion, 24.5%, and the lowest was seen in June, 1.2%. The most common genotype of Group A rotavirus was G9 P [8] (55.5%), G1P [8] (22.6%) and G3P [8] (9.7%).@*Conclusions@#Rotavirus is the common pathogens of diarrhea in children under the age of five years in Beijing, the main epidemic strains were of G9P [8] genotype, rotavirus diarrhea has obvious time-specific characteristics.
摘要
Objective To investigate the effect of quantifying health education on nurse teaching in cardiovascular department. Methods Totally 98 nursing college students practicing in cardio-vascular department were randomly divided into experimental group and control group . Method of quantifying health education was employed in experiment group while traditional education was used in control group;all patients were guided by health education. After the internship, two ques-tionnaires were used separately to evaluate the health education effects on nurse students and patients. SPSS 17.0 software was used for statistical processing. The measurement data were expressed as x±s; The mean between the groups was compared using t test; the enumeration data between the groups were com-pared using字2 test, the ranked data were compared using rank sum test. α=0.05 was taken as inspec-tion level. Results The health education cognitive scores were higher in experimental group than in control group (P<0.05). The health education ability scores, theoretic test scores, and operation test scores were higher in experimental group than in control group, with statistical differences (t=3.20, 2.10, 2.87; P=0.001, 0.032, 0.004). There were statistical differences in patients' cognition after receiving health education. (Z=13.435, 14.290, 12.901, 12.466, 12.168, 11.350; all P=0.000). Conclusions Quantification of health education can improve health education cognition and ability of nursing students in cardiovascular department, enhance the ef-fectiveness of clinical practice, and help patients master knowledge of health education.
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Objective To investigate the impacts of health education on awareness of hyperglycemia,self-efficacy and serum level of blood glucose in patients with coronary heart disease (CHD).Methods Two hundred CHD patients were enrolled in this study and assigned to the normal blood glucose (NGT) group ( n =60),impaired glucose regulation (IGR) group ( n =50),and type 2 diabetes mellitus (T2DM) group (n =90).Health education programme was carried out before and after discharge from the hospital.Fasting plasma glucose (FPG),2 h postprandial blood glucose (2 hPG) and glycosylated hemoglobin ( HbA1c ) of each group were assessed at baseline and 3 or 6 months after the intervention.Chisquare or t test was used for data analysis.Results After the intervention,the awareness of hyperglycemia was significantly improved in each of three groups (NGT group:x2 values were 17.207,23.582,37.046,39.046,38.686,46.218,28.643,39.895,37.046 and 33.333,respectively,all P ＜ 0.05 ; IGR group:x2values were 31.723,23.529,23.389,27.542,21.091,27.307,20.219,38.235,24.669 and 26.475,respectively,all P ＜0.05; T2DM group:x2 values were 21.161,20.680,14.612,23.104,22.383,29.436,19.444,32.526,24.671 and 31.696,respectively,all P ＜ 0.05 ).Self-efficacy scores of symptom selfmanagement and common disease management were increased after the health education intervention (t values were 12.75 and 7.21,respectively,both P ＜ 0.05 ).At 3 or 6 months,the NGT group showed on significant change in FPG,2 h PG and HbAlc (F values were 2.35,1.97 and 2.01,respectively,all P ＞0.05) ; however,FPG,2 h PG and HbAlc of the IGR and T2DM group were significantly decreased ( IGRgroup:F values were 8.07,8.89,and 10.23,respectively,all P ＜ 0.05 ; T2DM group:F values were 12.35,11.56 and 8.99,respectively,all P ＜ 0.05 ).Conclusion Health education could improve the awareness of hyperglycemia,self-efficacy and glucose metabolism in patients with CHD.
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<p><b>OBJECTIVE</b>To identify differentially expressed genes between chronic phase and blast crisis in chronic myeloid leukemia, explore the mechanism and screen potential biomarkers of disease progression.</p><p><b>METHODS</b>The differences in the gene expression profiles of bone marrow mononuclear cells between chronic phase and blastic crisis were examined using DNA microarray. PANTHER database, Genomatix database and Bibliosphere software were used to analyze and predict the critical genes or transcription factors during disease progression. Some of the genes or transcription factors were selected for verification by semi-quantitative RT-PCR.</p><p><b>RESULTS</b>In blastic crisis, 68 of the 1176 tested genes were obviously up-regulated. Sixteen of these differential genes were selectively expressed in leukocyte membranes. CD40, CCR3, LGALS3, RGS3, CEACAM3 and the related transcription factors RAC1, CTNNB1, TP53, and NF-κB, all as the nodes of the entire regulatory network, were presumed to play key roles in disease progression. The results of RT-PCR were consistent with the microarray data and showed high expression of CEACAM3, RGS3, CTNNB1 and RAC1 in blastic crisis.</p><p><b>CONCLUSION</b>A group of genes have been identified to very likely play key roles or serve as biomarkers in the transition from the chronic phase to blastic crisis in chronic myeloid leukemia.</p>
Subject(s)
Humans , Blast Crisis , Genetics , Computational Biology , Gene Expression Profiling , Gene Expression Regulation, Leukemic , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Genetics , Oligonucleotide Array Sequence Analysis , Transcriptome摘要
<p><b>OBJECTIVE</b>To investigate the cytogenetic differences between children and adults with acute lymphoblastic leukemia (ALL) using eight-probe fluorescence in situ hybridization and karyotype analysis.</p><p><b>METHODS</b>Eight-probe (MYC, P16, E2A, TEL/AML1, BCR/ABL , MLL , IGH, and hyperdiploidy) fluorescence in situ hybridization and karyotype analysis were performed for 86 adults and 39 children with acute lymphoblastic leukemia.</p><p><b>RESULTS</b>Eight-probe fluorescence in situ hybridization showed significant differences in the positivity rate of TEL/AML1, BCR/ABL, and hyperdiploidy between adult patients and children with ALL. By karyotype analysis, the positivity rate of t(9;22) and hyperdiploidy differed significantly between the children and adult patients (P<0.05).</p><p><b>CONCLUSION</b>Adults and children with ALL have different expression profiles of the fusion genes. Eight-probe fluorescence in situ hybridization is time-saving, accurate and efficient in detecting common genetic abnormalities in ALL patients, and can be well complementary to karyotype analysis in clinical diagnosis of ALL.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Cytogenetics , In Situ Hybridization, Fluorescence , Methods , Karyotype , Karyotyping , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Diagnosis , Genetics摘要
To obtain non-pathogenic rabies virus glycoprotein(RV-G),we expressed RV-G in Saccaromyces Cerevisiae(S.cerevisiae).In our study,tat-G fusion gene was cloned into the expression vector pYes2.0,which allows expression of a foreign gene in the yeast cells under the control of GAl1 promoter.Transforma-tion was performed by using lithium-treated yeast cells and several Ura+-tranformants were isolated.Ac-cording to the relative mobility in SDS-PAGE,we know probably two forms(designated as yGI and yGⅡ) of RV-G analogues produced in S.cerevisiae,their molecular weights were estimated as 66 kD and 56 kD,respectively.On the other hand,there was a specific band about 56 kD shown in western blot result.Com-bining precursors’ achievements,we will draw a conclusion that trans-membrane domain(TD) and cyto-plasmic domain have a negative regulation on RV-G antigen immunogenicity in S.cerevisiae.
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BACKGROUND: After reviewing the literature, the author found that most of the epidemiological data related to cancer pain was reported by physicians from the point of view of treatment, or of patients' response to the treatment. Although the nurses in oncology department are most direct participants in the cancer pain management, there is less investigation about the nurses' knowledge, attitudes to and skills of cancer pain management.OBJECTIVE: The purpose of this investigation was to provide information so as to suggest the nursing managers and educators in specifically propagating and disseminating the knowledge of cancer pain management.DESIGN: A sampled investigation.SETTING: Integrated Medicine Ward, College of Clinical Oncology,Peking University.PARTICIPANTS: The participants of this investigation were 128 nurses who took part in the National Tumor Care Academic Exchanges and Seminar Conference held in June 1998.METHODS: This investigation was carried out through a survey questionnaire and the questionnaire was designed on the basis of the Cancer Analgesics Questionnaire (for nurses use only) established by the Oncology Profession Committee of Chinese Nursing Association in 1993, furthermore,suggestions from experts were adopted.MAIN OUTCOME MEASURES:①The perception about "three-step analgesic ladder";②currently most commonly used analgesics in clinical;③assessment methods for cancer pain④knowledge of being addicted to analgesics⑤attitude of nursing staff to cancer pain management.RESULTS: The number of those who could correctly designate the relationship of three steps and pain intensity was 82(64.0% ). Only one person could correctly write down the contents of three steps analgesic ladder (0.7%) . Physician's orders for analgesics for cancer pain in the responders' hospitals were classified into the following types: temporary order:54.0%; when necessary, 38.0%; long-term order, 24.0%. But none of the nurses could mark correctly the range of mild, moderate and severe grade on the scale. Only 49.2% (63/128) of the nurses considered that "The pain scale should be determined according to the cancer patients' self-perception to the pain intensity(chief complaint)" . Among the responders, only 12.5% (16/128) of them accepted that "the incidence of addiction occurred as a result of analgesics used for pain control is less than 1% ". Only 26. 5% (34/128) of the responders could distinguish the concepts of tolerance, physical dependence, and addiction.CONCLUSION: From the results of the investigation, we can see that, the nursing professionals do not have sufficient knowledge about "three-step analgesic ladder". The popularization of related knowledge among nurses has been delayed severely. Nurses will obtain the knowledge of cancer pain management by clinical experience instead of in regular ways. The attitude of nursing personnel to cancer pain treatment is one of the important factors that affect the pain management. The frontline nurses should master the pharmacological characteristics of opioids so as to explain it to the patients and their relations distinctly. Nurses should bring into play a more powerful action in reducing the "addiction-phobia" due to their professional characteristics. We suggest that the latest new progress in cancer pain treatment should be incorporated into the normal textbooks on the management of cancer pain. We also propose that the methods of cancer pain treatment,contents of the principle of drug prescription be included in the training of a medical care personnel of oncology professional before entering into clinic.
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The results of this study showed that no deficiency of the spleen or kidney were seen in the normal control group animal. About 1/3 of the anemic -rat control group revealed, earlier or later, spleen deficiency, without kidney deficiency. For the group of rats with iron deficiency, deficiency of the kidney appeared after 17 days, with many rats suffered from spleen deficiency, in which 43 % of the animals changed from deficiency of the spleen to deficiency of both spleen -kidney or kidney deficiency alone. The difference between the iron -deficiency group and animic control group of spleen deficiency was that the serum iron was markedly lower in the former group, whereas the serum iron in the deficiency of both the kidney and spleen - kidney rats was even lower than the spleen deficiency group. When deficiency of the kidney was induced by iron deficiency, the abnormality in the membranous protein of RBC is even more serious. Conclusion: Iron might be one of the crucial biochemical basis of the relations between the kidney and spleen.