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Objective To investigate the effect of glucocorticoids on the prognosis and inflammatory markers of patients with acute severe pancreatitis(SAP).Methods A retrospective collection was performed for SAP patients diagnosed and treated in the Department of General Hepatobiliary Surgery,the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2020 to January 2023.SAP patients were divided into GC group and non-GC(NGC)group according to whether they used glucocorticoids(GC)or not.The two groups were compared with general data,inflammatory markers[neutrophil-lymphocyte ratio(NLR),monocyte-lymphocyte ratio(MLR),platelet-lymphocyte ratio(PLR),systemic inflammatory index(SII)and C-reactive protein-albumin ratio(CAR)],clinical events[continuous renal replacement therapy(CRRT),vasoactive drugs,ICU stay,total length of stay and survival)],and complications(organ failure,electrolyte imbalances,gastrointestinal bleeding and infection).Kaplan-Meier curve analysis of the relationship between GC and death in SAP patients.Logistic regression was used to explore the relationship between GC and death and organ failure.Results A total of 84 patients with SAP,40 in the GC group and 44 in the NGC group were included in the study.After treatment,NLR,MLR,PLR,SII and CAR in the GC group were significantly lower than those in the NGC group(P<0.05).There were no statistically significant differences between the GC and NGC groups in CRRT treatment,vasoactive drug use,surgery,ICU stay,total length of stay,electrolyte imbalance,gastrointestinal bleeding,pancreatic pseudocyst,abscess formation,pancreatic encephalopathy,and infectious complications(P>0.05);The mortality rate and organ failure incidence of patients in the GC group were significantly lower than those in the NGC group(P<0.05).The results of multivariate regression showed that the use of GC was an independent protective factor for death[OR=0.243,95% CI(0.062,0.948),P=0.042]and organ failure[OR=0.401,95% CI(0.165,0.976),P=0.044]in SAP patients.Conclusion GC can reduce the mortality rate and organ failure rate of SAP patients without increasing the incidence of additional complications,and has a high safety profile.
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<p><b>OBJECTIVE</b>To explore the effects of Rhizoma Polygoni Cuspidati and Ramulus Cinnamomi compatibility (PR) on uric acid metabolism and the expression of urinary neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in rats with hyperuricemia.</p><p><b>METHODS</b>Seventy male Sprague Dawley (SD) rats were randomly divided into 7 groups with 10 rats per group, including the normal group, model group, allopurinol group, benzbromarone group and PR groups at 3 doses (3.5, 7, 14 g/kg). Except the normal group, rats of the other groups were intragastrically administered 100 mg/kg hypoxanthine and 250 mg/kg ethambutol, and subcutaneously injected with 200 mg/kg potassium oxonate. All rats were continuously modeled for 17 days, and gavaged with corresponding drugs. The rats of the normal and model groups were gavaged with saline, once a day, for 2 weeks. The levels of serum uric acid (SUA), blood urea nitrogen (BUN) and creatinine (Cr) were determined. In addition, the contents of NGAL and KIM-1 in urine and the mRNA and protein expressions of xanthine oxidase (XOD) in liver of hyperuricemia rats were measured by reverse transcription polymerase chain reaction (RT-PCR) and Western blot, respectively. Moreover, the pathological changes of kidney were analyzed by hematoxylin and eosin (HE) stain method.</p><p><b>RESULTS</b>Compared with the normal group, the levels of SUA, BUN, NGAL and KIM-1 and the expressions of hepatic XOD mRNA and protein in the hyperuricemia rats were increased signifificantly (P<0.01). PR signifificantly decreased the levels of SUA, BUN, NGAL and KIM-1 and down-regulated the mRNA and protein expressions of hepatic XOD (P<0.05 or P<0.01). In addition, the pathological changes of kidney were signifificantly suppressed by oral administration of PR.</p><p><b>CONCLUSIONS</b>PR ameliorated uric acid metabolism and protected renal function, the underlying mechanism was mediated by decreasing the levels of SUA, BUN, NGAL and KIM-1, inhibiting the expression of hepatic XOD and ameliorating the pathological change of kidney.</p>
摘要
Objective To observe the effects of the drug pair of Rhizoma Polygoni Cuspidati ( Huzhang) and Ramulus Cinnamomi ( Guizhi) on the Toll-like receptor 4 mediated myeloid differentiation factor 88 ( TLRs/MyD88) signaling pathway of rats with acute gouty arthritis induced by monosodium sodium urate (MSU) , so as to explore its therapeutic mechanism. Methods Forty-eight male SD rats were divided into normal group, modele group, blank plasmid group, positive plasmid group, Huzhang- Guizhi herb-pair (7 g/kg) group, and Huzhang-Guizhi herb-pair ( 7 g/kg) siRNA group, 8 rats in each group. The normal group, plasmid groups and model group were given physiological saline, and the left groups were given the corresponding drug by intragastric administration for 10 continuous days ( once daily ) . On the seventh day of intragastric gavage, acute gouty arthritis were induced by injection of MSU into the rat ankle joint, and normal group was injected with the samevolume of normal saline. Positive plasmid group and Huzhang-Guizhi herb-pair siRNA group were injected with the constructed siRNA-TLR4 plasmid targeting TLR4 gene ( TLR4-siRNA) to inhibit the in-vivo TLR4 gene expression. Pathological changes of the synovial tissues were detected, the contents of peripheral blood tumor necrosis factor alpha ( TNF-α) and interleukin 1 beta ( IL-1β) were detected by double antibody sandwich method, and the mRNA and protein expression levels of TLR4, MyD88, TNF receptor-associated factor 6 ( TRAF-6) in peripheral blood mononuclear cells of rats were detected by real-time fluorescence quantitative polymerase chain reaction ( PCR) and Western blot methods. The nuclear factor kappa B ( NF-κB) p65 immunoactivity was assayed by immunohistochemistry. Results Compared with the normal group, the model group had obvious hyperplasia of synovial cells and the inflammatory cell infiltration ( dominated by lymphcytes and monocytes) , and had amount of cellulose adhesive on the synovial membrane surface. Compared to the model group, positive plasmid group, Huzhang- Guizhi herb-pair group and Huzhang-Guizhi herb-pair siRNA group could obviously relieve the inflammatory cell infiltration, and improve synovial cell proliferation reaction. Compared to the normal group, serum levels of TNF-α and IL-1β, and the expression levels of TLR4, MyD88, TRAF-6 mRNA and protein in the peripheral blood mononuclear cells as well as the synovial NF-κB p65 ex pression in the model group were significantly increased ( P<0.01). Compared to the model group, positive plasmid group, Huzhang-Guizhi herb-pair group and Huzhang- Guizhi herb-pair siRNA group showed significant decrease in the levels of TNF-α, IL-1β, TLR4 MyD88, TRAF-6 and NF-κB p65 ( P<0.05 or P<0.01) . Conclusion Huzhang-Guizhi herb-pair can regulate the cytokines of the synovial membrane tissue in acute gouty arthritis rats, which may be related with its effect on inhibiting abnormal activation of TLR4-MyD88-NF-κB pathway in synovial tissue.
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Objective To explore the value of monitoring in vertebral and spinal cord operation by the real-time monitoring of the spinal cord in the process of operation.Methods Nineteen cases were included by the real-time monitoring of spinal cord in the process of operation.Japanese Orthopaedic Association(JOA) score was used to evaluate the clinical efficacy during following-up before and discharge after operation,6 months and 12 months after operation.Results Intraoperative ultrasound monitoring in the 19 patients had no symptom of spinal cord injury and other complications within the plant without loosening fracture occurred were bony fusion; the average JOA scores in the patients before operation,discharge after operation,6 months and 12 months after operation were 8.80±1.60,14.00±1.57,14.60±1.61 and 14.80±1.58,respectively.The improvement rate of JOA score for discharge after operation,6 months and 12 months after operation were individually 51.6%,61.3%,and 64.5%.The JOA score after operation was obviously higher than that before operation.The significant difference between the two groups was observed in the experiment (P<0.05).The cervical spinal canal sagittal diameter significantly increased after operation (mean sagittal diameter of the expansion of 6.6 mm),compared with that before the trial (P<0.05).Conclusion The real-time monitoring with ultrasonography during operation can identify the change of spinal cord and provide the image evidence of operative efficiency to avoid the injury in vertebral and spinal cord operation.
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<p><b>OBJECTIVE</b>To compare the manifestations of peripheral lung squamous cell carcinoma by CT dynamic enhancement with that of adenocarcinoma, and evaluate the difference of CT dynamic enhancement to distinguish peripheral lung squamous cell carcinomas from adenocarcinoma.</p><p><b>METHODS</b>Thirty peripheral lung squamous cell carcinomas and 40 adenocarcinomas were examined with dynamic contrasted CT, enhancement at various phases recorded, based on which the time-intensity curves were produced. The enhancement patterns were compared and analyzed.</p><p><b>RESULTS</b>There was no statistically significant difference in the enhancement degree and peak time between peripheral lung squamous cell carcinoma and adenocarcinoma (P > 0.05). The difference in enhancement pattern between these two different types of carcinoma was not statistically significant when the lesion was larger than 3 cm in diameter (P > 0.05), whereas it became statistically significant when the lesion is less than 3 cm (P < 0.05). Most of the squamous cell carcinoma showed heterogeneous enhancement or peripheral enhancement in the tumor zone, however, most of the adenocarcinomas had homogenous enhancement.</p><p><b>CONCLUSION</b>The maximum enhancement and the peak time are not helpful in differentiating peripheral lung squamous cell carcinoma from adenocarcinoma. When the lesion is less than 3 cm in diameter, the enhancement pattern of peripheral squamous cell carcinomas is different from that of adenocarcinoma.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma , Diagnostic Imaging , Pathology , Carcinoma, Squamous Cell , Diagnostic Imaging , Pathology , Lung Neoplasms , Diagnostic Imaging , Pathology , Radiographic Image Enhancement , Tomography, Spiral Computed , Methods摘要
Objective To study the effect and prognosis of percutaneous coronary intervention(PCI) for pa- tients with coronary artery disease(CAD).Methods Selected coronary angiography was performed in 31 patients with CAD.PTCA and stent implantation were performed in the patients of coronary stenosis(≥75 % in diameter). The effect and prngnosis of coronary interventionary therapy in patients were observed.Results The results of coro- nary angiongraphy suggested there were 18 patiens of coronary stenosis(≥75 % in diameter),PTCA and stent im- plantation were performed in 13 patients.Symptom was relieved greatly after the operation.There were 2 patients of coronary stenosis again,and 5 patients died.Conclusion Selected coronary angiography was an effective way to di- agnose CHD.The coronery interventioned therapy was not only effective in relieving symptom,but also in improving the quality of life of patients with CAD.
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<p><b>BACKGROUND</b>There have been few studies to evaluate the effects of helical CT on bladder tumor. This study was to evaluate the clinical applications of helical CT dynamic contrast-enhanced axial imaging, multiplanar reformation (MPR), three-dimensional (3D) reconstruction and virtual cystoscopy (CTVC) in bladder tumors.</p><p><b>METHODS</b>The precontrast and four-phase postcontrast helical CT scans were performed in 42 patients with bladder tumors confirmed by conventional cystoscopy and pathology. MPR, 3D and CTVC images were generated from the volumetric data of the excretory phase. The results were then compared with the findings of conventional cystoscopy and surgery in a double-blinded mode.</p><p><b>RESULTS</b>The sensitivity of the axial, 3D and CTVC images in detecting the bladder tumors were 90.8%, 76.9% and 95.4% respectively. The dynamic contrast-enhanced axial images could provide excellent intramural and extravesical information, and the accuracy in preoperative tumor staging was 87.7%. MPR could directly demonstrate the origin and extravesical invasions of the tumors and their relation to the ureter. 3D and CTVC images were useful for displaying the surface morphology of the tumor and the relationship between the tumor and the ureteric orifices, whereas CTVC could depict the tumors smaller than 5 mm that were not seen on the axial images.</p><p><b>CONCLUSIONS</b>The combination of axial, MPR, 3D and CTVC images with helical CT can provide comprehensive information on bladder tumor.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Cystoscopy , Imaging, Three-Dimensional , Tomography, Spiral Computed , Methods , Urinary Bladder Neoplasms , Diagnostic Imaging摘要
<p><b>OBJECTIVE</b>To evaluate the diagnostic effect of helical CT on bladder tumor.</p><p><b>METHODS</b>In 28 patients with bladder tumors which had been confirmed by conventional fiberoptic cystoscopy (FC) and pathology, precontrast and four-phase postcontrast helical CT scans were performed with multiple plane reconstruction (MPR), three dimensional (3D) reconstruction and CT virtual cystoscopy (CTVC) images constructed from the volumetric data of the excretory phase. The results were then compared with the findings of conventional fiberoptic cystoscopy and surgery through a double-blind manner.</p><p><b>RESULTS</b>The sensitivity of the helical CT axial, 3D and CTVC images in detecting bladder tumor were 92.3%, 76.9% and 96.2% respectively. The accuracy in preoperative tumor staging of helical CT was 83.0%. The axial images could provide excellent intramural and extravesical information, and MPR could directly show the origin and extravesical invasion of the tumor and its relation to the ureter. 3D and CTVC images were useful in displaying the surface morphology of the tumor and its relation with the ureteric orifices, whereas CTVC images could depict a tumor smaller than 5 mm that could not be visualized on the axial images.</p><p><b>CONCLUSION</b>Combining interpretation of axial, MPR, 3D and CTVC images, helical CT is able to provide comprehensive information for the diagnosis and treatment of bladder tumor.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Imaging, Three-Dimensional , Tomography, Spiral Computed , Tomography, X-Ray Computed , Urinary Bladder Neoplasms , Diagnostic Imaging摘要
Objective To investigate the value of whole-liver MR perfusion imaging(MRPI)for early detection of coagulative necrosis after percutaneous ethanol injection(PEI)in rabbit liver VX_2 tumors. Methods VX_2 tumor cell suspension was inoculated into rabbit liver and liver VX_2 tumors[diameter of (2.6?0.6)cm]were induced in 10 male rabbits.MR T_1 WI and T_2 WI were performed to monitor the development of the liver tumor on the 2~(nd)and 3~(rd)week after inoculation.Whole-liver MRPI was performed in the 10 rabbits with liver VX_2 tumors before and 6 days after PEI therapy(1.0 ml ethanol was injected into the most enhanced tumor region under CT guiding).Signal intensity(SI)values of untreated tumor parts and treated areas 6 days after PEI were recorded respectively.The steepest slope(SS)and bolus arrival time (TO)of SI-time curves were measured.The t-Student test was used in statistical analysis of the data.Results There was significant difference in MRPI data between untreated tumor parts[TO:(16.0?1.2)s and SS: 38.9?2.2]and treated areas[TO:(50.8?5.9)s and SS:6.0?1.2]6 days after PEI(t was 15.8 and -39.6 respectively,P