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Peritoneal metastasis in gastric cancer is associated with rapid disease progression. Hyperthermic intraoperative peritoneal chemotherapy (HIPEC) done immediately after cytoreductive surgery (CRS) has become an important treatment for peritoneal metastasis in gastric cancer patients. However, different treatment options for HIPEC exist with potential influence on survival rates and prognosis in patients, exist. These treatment options include open or closed abdomen technique, perfusion solution, number of catheters, temperature, duration, and drug regimens. This paper aims to provide more evidence on standardization of HIPEC treatment options and technologies by systematically reviewing different drug regimens and technical approaches. The study included 2 randomized controlled trials, 3 phase I/II clinical trials, 2 prospective cohort studies, and 34 retrospective cohort studies, involving 1511 patients. The most common HIPEC option is to dissolve 50-75 mg/m2 of Cisplatin and 30-40 mg/m2 of Mitomycin C in 3-4 L saline solution at 42-43â. After gastrointestinal anastomosis, 2-3 catheters are used in the HIPEC system with a perfusion flow rate of 500 ml/min. The duration is 60-90 minutes. Anastomotic leakage was low in studies where HIPEC was performed after gastrointestinal anastomosis. The utilization of open HIPEC and a two-drug regimen resulted in improved overall survival rates. The future development of HIPEC aims to enhance tumor-specific therapy by optimizing various aspects, such as identifying the safest and most effective chemotherapy regimens, refining patient selection criteria, and improving perioperative care.
Subject(s)
Cytoreduction Surgical Procedures , Hyperthermic Intraperitoneal Chemotherapy , Peritoneal Neoplasms , Stomach Neoplasms , Humans , Cisplatin/administration & dosage , Cisplatin/therapeutic use , Combined Modality Therapy , Cytoreduction Surgical Procedures/methods , Hyperthermia, Induced/methods , Hyperthermic Intraperitoneal Chemotherapy/methods , Mitomycin/administration & dosage , Mitomycin/therapeutic use , Peritoneal Neoplasms/secondary , Peritoneal Neoplasms/therapy , Peritoneal Neoplasms/drug therapy , Stomach Neoplasms/therapyABSTRACT
We report the picosecond spin current generation from the interface between a heavy metal and a vicinal antiferromagnet insulator Cr_{2}O_{3} by laser pulses at room temperature and zero magnetic field. It is converted into a detectable terahertz emission in the heavy metal via the inverse spin Hall effect. The vicinal interfaces are apparently the source of the picosecond spin current, as evidenced by the proportional terahertz signals to the vicinal angle. We attribute the origin of the spin current to the transient magnetic moment generated by an interfacial nonlinear magnetic-dipole difference-frequency generation. We propose a model based on the in-plane inversion symmetry breaking to quantitatively explain the terahertz intensity with respect to the angles of the laser polarization and the film azimuth. Our work opens new opportunities in antiferromagnetic and ultrafast spintronics by considering symmetry breaking.
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OBJECTIVE: The aim of the study was to investigate the safety and antiviral efficacy of a Chinese multiherb extract-based tincture (GWK) on a population of patients with high-risk human papilloma (hrHPV) infections and hrHPV-caused cervical low-grade squamous intraepithelial lesions (LSILs). PATIENTS AND METHODS: Patients with persistent hrHPV infection were enrolled in Group A, including A1 subjects, who received the intervention, and A2 subjects, who received the control. Patients with hrHPV infection causing cervical LSIL were enrolled in Group B, which included B1 subjects, who received the intervention, and B2 subjects, who served as the control. For Groups A1 and B1, hrHPV was tested at 3 months (M3) and 6 months (M6) after the intervention. The side effects were also analyzed. RESULTS: At baseline (D0), a total of 99 patients were enrolled in Group A, with 50 subjects in Group A1 and 49 subjects in Group A2. A total of 91 patients were enrolled in Group B, with 45 subjects in Group B1 and 46 subjects in Group B2. There was no significant difference in the characteristics, including average age, age stratification, and HPV genotype. At M6, both Group A1 and Group B1 had a higher hrHPV clearance rate than the control group (A1/A2: 80.0% vs. 20.4%; B1/B2: 64.4% vs. 15.2%, p<0.001). At M6, the effective rates of Group A1 and Group B1 were 84% (42/50) and 68.9% (31/45), respectively. The side effect rates of Groups A1 and B1 were 11.5% (6/52) and 11.1% (5/45), respectively. Most adverse reactions involved local discomfort, including vulvar erythema, vulvar itch, increased vaginal discharge, cervical bleeding, and mild pain in the lower abdomen. Univariate logistic regression analysis showed that the intervention had an OR of 12 (95% CI 4.431-32.50) for clearing persistent HPV infection (p<0.001). For cervical LSIL, the intervention had an OR of 10.1 for clearing persistent HPV infection (95% CI 3.68-27.7) (p<0.001). CONCLUSIONS: The results of this study suggest that the Chinese multiherb extract-based tincture GWK is safe and well tolerated. Furthermore, this preliminary study showed that this Chinese multiherb extract-based tincture is helpful for promoting HPV clearance in cases of persistent HPV and HPV-induced LSIL.
Subject(s)
Drugs, Chinese Herbal , Papillomavirus Infections , Female , Humans , China , Drugs, Chinese Herbal/administration & dosage , Drugs, Chinese Herbal/adverse effects , Drugs, Chinese Herbal/therapeutic use , East Asian People , Papillomaviridae/drug effects , Papillomaviridae/genetics , Papillomavirus Infections/complications , Papillomavirus Infections/drug therapy , Papillomavirus Infections/virology , Plant Extracts/administration & dosage , Plant Extracts/adverse effects , Plant Extracts/therapeutic use , Prospective Studies , Uterine Cervical Dysplasia/drug therapy , Uterine Cervical Dysplasia/pathology , Uterine Cervical Dysplasia/virology , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/virology , Vaginal SmearsABSTRACT
OBJECTIVE: Coronavirus disease 2019 (COVID-19) was first discovered in December 2019, and since then rapidly spread worldwide. Our study aimed to investigate the early indicators of death in patients suffering from severe and critical COVID-19. PATIENTS AND METHODS: A retrospective cohort study was conducted on patients with severe and critical COVID-19, admitted to the Seventh Hospital of Wuhan. Clinical information was collected from electronic medical records according to standardized data collection tables. Patients were divided into non-survival and survival groups based on the disease outcome. Using univariate and multivariate logistic regression analysis, and calculating odds ratios (OR) and 95% confidence intervals (CI), independent risk factors for death in severe and critically ill COVID-19 patients were identified. RESULTS: The median age of 162 patients (57.4% males) was 67.5 years old. Patients in the non-survival group had significantly higher white blood cell count, decreased lymphocyte count, anemia and thrombocytopenia compared to patients in the survival group (p < 0.05). A 28-day mortality rate of the study cohort was 31.5%. Multivariate logistic regression analysis showed that underlying heart disease, lymphocyte count < 1.0 × 109/L, glomerular filtration rate < 66, lactate > 2.2 mmol/L, higher Sequential Organ Failure Assessment (SOFA) score, lower oxygenation index (OR 1.748; 95% CI 1.024-2.984; p=0.041) and higher "multi-lobar infiltration, hypo lymphocytosis, bacterial co-infection, smoking history, hypertension and age" (MuLBSTA) score (OR 1.601; 95% CI 1.062-2.415; p=0.025) were risk factors associated with death in patients with severe and critical COVID-19. CONCLUSIONS: Underlying heart disease, lymphocyte count, glomerular filtration rate, lactate, oxygenation index, SOFA score, and MuLBSTA score were associated with the risk of death in severe and critical COVID-19 patients.
Subject(s)
COVID-19 , Heart Diseases , Male , Humans , Aged , Female , Retrospective Studies , Lactic Acid , Blood Gas AnalysisABSTRACT
Objective: To analyze the association between sleep duration and cognitive function of the elderly in six provinces of China. Methods: Based on the cross-sectional survey data of the elderly from the Healthy Ageing Assessment Cohort Study in 2019, 4 644 participants' sociodemographic and economic indicators, lifestyle, prevalence of major chronic diseases, and sleep status, including night-time sleep duration, daytime sleep duration and insomnia, were collected by questionnaires. Cognitive function was evaluated by the Mini-Mental State Examination. Multivariate logistic regression was used to analyze the association between night-time sleep duration, daytime sleep duration and cognitive function. Results: The mean age of 4 644 respondents was (72.3±5.7) years, and 2 111 of them were males (45.5%). The mean total daily sleep time of the elderly was (7.9±1.9) hours, and the proportion of those who slept less than 7.0, 7.0-8.9 and≥9.0 hours was 24.1% (1 119), 42.1% (1 954) and 33.8% (1 571), respectively. The mean sleep time at night was (6.9±1.7) hours. About 23.7% (1 102) of the elderly did not sleep during the day, and the mean duration of the elderly who slept during the day was (78±51) minutes. Among the elderly with insomnia, 47.9% were still satisfied with their sleep quality. The mean value of MMSE score of 4 644 respondents was (24.5±5.3), and the cognitive impairment rate was 28.3% (1 316). The results of multivariate logistic regression model analysis showed that the OR (95%CI) value of the risk of cognitive impairment in older people who did not sleep, slept for 31 to 60 minutes and slept more than one hour was 1.473 (1.139 to 1.904), 1.277 (1.001 to 1.629) and 1.496 (1.160 to 1.928), respectively, compared with those who slept for 1 to 30 minutes during the daytime. Compared with those who slept for 7.0â8.9 hours at night, the OR (95%CI) value of the risk of cognitive impairment in older people who slept more than 9.0 hours was 1.239 (1.011 to 1.519). Conclusion: The cognitive function is related to sleep duration in the Chinese elderly.
Subject(s)
Sleep Initiation and Maintenance Disorders , Sleep Wake Disorders , Male , Humans , Aged , Female , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/complications , Cross-Sectional Studies , Cohort Studies , Sleep , Cognition , China/epidemiologyABSTRACT
The scanning of bridge surface roughness by the test vehicle is a coupled and non-stationary problem since the bridge deflection caused by vehicles will inevitably enter into the vehicle response. To this end, a two-step procedure is proposed to retrieve the bridge surface profile from the noise-contaminated responses of a two-axle vehicle moving over bridges. Central to this is the elimination of the bridge deflection from the estimated unknown input to the test vehicle system. First, the extended Kalman filter with unknown inputs (EKF-UI) algorithm is extended to formulating the state-space equations for the moving vehicle over the bridge. Analytical recursive solutions are derived for the improved vehicle states and the unknown input vector consisting of the vehicle-bridge contact displacement and surface profile. Second, the correlation between the cumulated contact residuals and contact displacements for the two axles is approximately defined by using the vehicle's parameters and location on the bridge. Then, the surface profile is retrieved from the unknown input by removing the roughness-free contact (bridge) displacement, calculated with no prior knowledge of bridge properties. The efficacy of the proposed procedure was validated by the finite element method and demonstrated in the parametric study for various properties of the system. It is confirmed that the retrieved bridge surface profile is in excellent agreement with the original (assumed). For practical use, the vehicle is suggested to run at a not-too-high speed or in a too noisy environment. The proposed technique is robust with regard to vehicle mass and bridge damping.
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The clinical data of 22 patients with giant renal hamartoma in Zhejiang Provincial People's Hospital who underwent robot-assisted laparoscopic nephron-sparing surgery from October 2014 to January 2020 were retrospectively analyzed. All the patients successfully completed the operation. The operation time and renal artery occlusion time was (179±34) min and (19.8±2.5) min, respectively. The intraoperative blood loss was (117±62) ml, and the postoperative hospital stay was (9.0±1.5) d. All cases were confirmed as renal angiomyolipoma by postoperative pathology. No urine leakage, postoperative bleeding and other complications occurred. Postoperative telephone follow-up was performed for 6 to 52 months, and no tumor recurrence on the surgical side was reported.
Subject(s)
Angiomyolipoma , Hamartoma , Kidney Neoplasms , Laparoscopy , Robotics , Angiomyolipoma/surgery , Hamartoma/surgery , Humans , Kidney Neoplasms/surgery , Neoplasm Recurrence, Local , Nephrectomy , Nephrons , Retrospective Studies , Treatment OutcomeABSTRACT
Objective: To explore the correlation between decreased cerebral perfusion measured from arterial spin labeling and cerebrovascular events in patients with bilateral moyamoya angiography (MMA). Methods: Twenty-seven consecutive cases with bilateral MMA, who were admitted to the neurosurgery department of Nanjing Drum Tower Hospital from April to November 2020, were included in this retrospective study. Among them, 10 were males and 17 were females, aged 35-66 (55±9) years. These patients all presented with unilateral cerebral hemisphere cerebral infarction or cerebral hemorrhage. The Wilcoxon paired signed-rank test was used to qualitatively analyze the differences in the Arterial Transit Artifact (ATA) of the bilateral cerebral hemispheres. The mean gray value, the kurtosis and skewness of gray distribution curve of bilateral cerebral hemispheres on cerebral blood flow (CBF) images with post labeling delay (PLD) of 1.5 s and 2.5 s were quantitative calculated. The relationship between ASL and cerebrovascular event was determined using binary logistics regression analysis. Results: No significant difference was observed in ATA between bilateral hemispheres on CBF images with PLDs of 1.5 s and 2.5 s (P>0.05). On the CBF images with a PLD of 1.5 s, the mean gray value of the cerebral hemisphere on the lesion side (17.50±5.88) was markly lower than that on the non-lesion side (20.80±5.51) (P<0.001), the kurtosis and skewness of gray distribution were significantly different between bilateral cerebral hemispheres (P<0.05);On the CBF images with a PLD of 2.5 s, the mean gray value and the skewness of the gray distribution on the lesion side of the cerebral hemisphere were statistically different from those on the non-lesion side (P<0.05), while the difference in kurtosis was not statistically significant between bilateral cerebral hemispheres (P>0.05). Multivariate regression analysis showed that the reduction of gray value on the side of the lesion was independently associated to the occurrence of the cerebrovascular events (ORPLD1.5=0.192, 95%CI:0.047-0.783;ORPLD2.5=0.175, 95%CI:0.050-0.615). Conclusion: The decreased perfusion detected by ASL is independently associated with cerebrovascular events in patients with MMA.
Subject(s)
Moyamoya Disease , Cerebrovascular Circulation , Female , Humans , Magnetic Resonance Imaging , Male , Moyamoya Disease/diagnostic imaging , Perfusion , Retrospective Studies , Spin LabelsABSTRACT
The Kibble-Zurek mechanism provides a unified theory to describe the universal scaling laws in the dynamics when a system is driven through a second-order quantum phase transition. However, for first-order quantum phase transitions, the Kibble-Zurek mechanism is usually not applicable. Here, we experimentally demonstrate and theoretically analyze a power-law scaling in the dynamics of a spin-1 condensate across a first-order quantum phase transition when a system is slowly driven from a polar phase to an antiferromagnetic phase. We show that this power-law scaling can be described by a generalized Kibble-Zurek mechanism. Furthermore, by experimentally measuring the spin population, we show the power-law scaling of the temporal onset of spin excitations with respect to the quench rate, which agrees well with our numerical simulation results. Our results open the door for further exploring the generalized Kibble-Zurek mechanism to understand the dynamics across first-order quantum phase transitions.
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Sclerostin, a natural hormone made in bone, suppresses bone formation. Sclerostin is also decreased by estrogen. Progesterone, estrogen's menstrual partner, stimulates bone formation. It is unclear whether progesterone influences sclerostin. This study showed that progesterone did not change sclerostin using serum remaining from a randomized progesterone hot flush therapy trial. INTRODUCTION: Progesterone and sclerostin are both endogenous hormones acting through osteoblast-origin cells and promote or suppress bone formation, respectively. Estradiol suppresses sclerostin, but progesterone, its menstrual cycle partner hormone, has unclear sclerostin relationships. We postulated that progesterone therapy would influence serum sclerostin levels. METHODS: We obtained sclerostin levels for an ethics-approved post hoc analysis. Fasting sclerostin was measured in all remaining sera from a previous 12-week randomized controlled trial (RCT) of oral micronized progesterone (progesterone) for menopausal (> 1 year after last flow) vasomotor symptoms (VMS). Women in the RCT took 300 mg progesterone at bedtime or placebo (1:1) in a trial showing progesterone significantly decreased VMS. RESULTS: Participants were healthy menopausal, primarily Caucasian (91.2%) community-dwelling women (± SD), 55.2 ± 4.6 years old with BMI 24.9 ± 2.9 kg/m2. The baseline sclerostin level in 60 women was 28.41 ± 10.47 pmol/L. Baseline sclerostin was not correlated with the run-in VMS score (r = 0.143, P = 0.294). Paired baseline and 12-week RCT data for 52 women showed serum sclerostin levels did not change related to experimental therapy (P = 0.504). Changes in final sclerostin values adjusted for baseline were progesterone (- 1.07 ± 7.96 pmol/L) and placebo (- 2.64 ± 8.70 pmol/L). In observational data (n = 60), baseline sclerostin levels correlated with the General Framingham Cardiovascular (CVD) Risk score (r = - 0.398, P = 0.003) and self-reported health by SF-36 quality of life instrument (QoL, r = - 0.331, P = 0.016). CONCLUSION: Physiological oral micronized progesterone did not stimulate nor suppress serum sclerostin levels based on post hoc analysis of RCT data. Exploratory results, however, showed sclerostin negatively correlated with CVD risk and QoL. ClinicalTrials.gov #NCT0146469.
Subject(s)
Adaptor Proteins, Signal Transducing , Progesterone , Quality of Life , Adaptor Proteins, Signal Transducing/metabolism , Estradiol , Female , Hot Flashes/drug therapy , Humans , Menopause , Middle Aged , Progesterone/pharmacology , Progesterone/therapeutic useABSTRACT
Objective: To investigate the risk factors of prolonged postoperative length of stay (LOS) in patients with gastric cancer. Methods: A retrospective study was performed on 2033 patients who underwent curative surgery in Department of Pancreatic-gastric, Cancer Hospital, Chinese Academy of Medical Sciences. Eightieth percentile of postoperative hospital stay for all patients was taken as the cutoff, the patients were divided into the normal group (1 532 patients) and the extended group (501 patients). Logistic regression model was used to determine the risk factors related to prolonged postoperative LOS in gastric cancer. Results: A total of 417 cases with postoperative complications were recruited in extended group. The five highest complications accounting for prolonged LOS were: abdominal infection in 69 cases (13.77%), pleural effusion in 60 cases (11.98%), anastomotic leakage in 43 cases (8.58%), poor wound healing in 34 cases (6.79%), and bleeding in 25 cases (4.99%). Logistic regression analysis showed that age (OR=1.348, P=0.013), surgical procedure (OR=2.712, P<0.001), extent of resection (OR=2.035, P<0.001), degree of incision healing(OR=4.867, P<0.001), and perioperative blood transfusion (OR=1.711, P<0.001) were independent risk factors for prolonged postoperative LOS. Conclusions: The most common complication associated with prolonged postoperative LOS for gastric cancer patients is abdominal infection. Age, surgical procedure, extent of resection, degree of incision healing, and perioperative blood transfusion are the independent risk factors for prolonged postoperative LOS.
Subject(s)
Gastrectomy/adverse effects , Length of Stay , Stomach Neoplasms/surgery , Humans , Intraabdominal Infections/etiology , Postoperative Period , Retrospective Studies , Risk FactorsSubject(s)
Glycogen Phosphorylase, Muscle Form/genetics , Glycogen Storage Disease Type V , Hypokalemic Periodic Paralysis/diagnosis , Adult , Consanguinity , Creatine Kinase/blood , Diagnosis, Differential , Exercise Tolerance/physiology , Genetic Testing , Glycogen Storage Disease Type V/blood , Glycogen Storage Disease Type V/diagnosis , Glycogen Storage Disease Type V/genetics , Glycogen Storage Disease Type V/physiopathology , Humans , Male , Muscle Fatigue/genetics , Muscle Weakness/diagnosis , Muscle Weakness/etiology , Mutation, Missense , PedigreeABSTRACT
Dynamical quantum phase transitions are closely related to equilibrium quantum phase transitions for ground states. Here, we report an experimental observation of a dynamical quantum phase transition in a spinor condensate with correspondence in an excited state phase diagram, instead of the ground state one. We observe that the quench dynamics exhibits a nonanalytical change with respect to a parameter in the final Hamiltonian in the absence of a corresponding phase transition for the ground state there. We make a connection between this singular point and a phase transition point for the highest energy level in a subspace with zero spin magnetization of a Hamiltonian. We further show the existence of dynamical phase transitions for finite magnetization corresponding to the phase transition of the highest energy level in the subspace with the same magnetization. Our results open a door for using dynamical phase transitions as a tool to probe physics at higher energy eigenlevels of many-body Hamiltonians.
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OBJECTIVE: To elucidate the biological function of microRNA-300 (miRNA-300) in influencing the progression of non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: The relative level of miRNA-300 in NSCLC tissues and cells was determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The influences of miRNA-300 on the proliferative, migratory, and invasive potentials of A549 cells were assessed. The binding relationship between miRNA-300 and ETS1 was verified by the Dual-Luciferase Reporter Gene Assay. Finally, the regulatory effect of the interactive miRNA-300 and ETS1 on the progression of NSCLC was identified. RESULTS: MiRNA-300 was downregulated in NSCLC tissues and cells. The overexpression of miRNA-300 suppressed A549 cells to proliferate, migrate, and invade. MiRNA-300 could bind to ETS1 3'UTR and suppress its level in A549 cells. Notably, the knockdown of miRNA-300 could reverse the regulatory role of ETS1 in the cellular behaviors of NSCLC. CONCLUSIONS: MiRNA-300 suppresses NSCLC to proliferate, migrate, and invade by targeting ETS1.
Subject(s)
Carcinoma, Non-Small-Cell Lung/metabolism , Lung Neoplasms/metabolism , MicroRNAs/metabolism , Proto-Oncogene Protein c-ets-1/metabolism , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/pathology , Cell Movement , Cell Proliferation , Cells, Cultured , Humans , Lung Neoplasms/genetics , Lung Neoplasms/pathology , MicroRNAs/genetics , Proto-Oncogene Protein c-ets-1/geneticsABSTRACT
Objective: To explore the effect of ambient fine particulate matters (PM(2.5)) exposure on nasal oxidative stress level in patients with allergic rhinitis (AR). Methods: A panel of sixty AR patients was recruited as subjects. Four repeated measurements were carried out from June 2017 to January 2018. Nasal irrigation solution was collected and examined for malondialdehyde (MDA) and superoxide dismutase (SOD). Monitoring data of atmospheric pollutants and meteorological factors during measurement periods were also collected. Time activity pattern combined with micro-environment monitoring method was used to evaluate PM(2.5) exposure. Mixed effect model was applied to analyze the relationship between PM(2.5) exposure concentration and oxidative stress level. Results: 49 subjects accomplished the four repeated measurements, and the mean±SD of their age was (36.7±8.4) years old. The median of MDA and SOD in four measurement periods was 3.70, 3.70, 5.58, 6.24 nmol/ml, and 105.50, 102.50, 95.00, 96.50 U/ml. The concentration of PM(2.5) exposure in four measurement periods was (40.0±2.7), (41.5±2.5), (52.3±5.9) and (74.7±4.9) µg/m(3), respectively. Results of single pollutant mixed effect model analysis showed that 0-, 1-, 2-, 3-day lag concentrations of PM(2.5) was significantly positively associated with MDA, about ß (95%CI) estimated as 0.24 (0.17, 0.30), 0.34 (0.27, 0.41), 0.32 (0.20, 0.44) and 0.33 (0.23, 0.43), respectively. 0-, 1-, 2-day concentrations of PM(2.5) was significantly negatively associated with SOD, about ß (95%CI) estimated as -0.99 (-1.66, -0.31), -1.35 (-2.08, -0.62) and -0.94 (-1.80, -0.07), respectively. Multivariate analysis found that lag 1-day concentration of PM(2.5) was still significantly associated with MDA and SOD after controlling for temperature, age and other influencing factors. For a 10 µg/m(3) increase of PM(2.5) concentration, MDA increased 0.26 (95%CI: 0.18, 0.33) nmol/ml, and SOD decreased 0.87 (95%CI: 0.21, 1.53) U/ml. Conclusion: Our results suggested that PM(2.5) exposure can aggravate the nasal oxidative stress response of AR patients.
Subject(s)
Environmental Exposure/adverse effects , Oxidative Stress , Particulate Matter/toxicity , Rhinitis, Allergic/therapy , Adult , China , Cities , Humans , Middle AgedABSTRACT
Objective: To discuss the effect and safety of continuous pumping for home enteral nutrition after esophagectomy. Methods: The current study retrospectively analyzed the esophageal cancer patients who underwent transthoracic esophagectomy between January 2017 and November 2017 at First Department of Thoracic Surgery, Peking University Cancer Hospital and Institute. There were totally 108 cases, including 88 males and 20 females, with an average age of 62 years. The patients were divided into pump feeding group (n=56) and traditional tube feeding group (n=52). The postoperative short-term safety, weight maintenance, enteral nutrition tolerance and nutritional support complete rate of the 2 groups were compared by χ(2) test, Fisher exact test and t test, respectively. Results: Compared with traditional tube feeding group, the patient safety in pumping feeding group was significantly better, with complications within 2 months after discharge were 11/52 and 4/56 respectively (χ(2)=2.393, P=0.035); the weight maintenance was significantly better, the weight loss within 4 weeks after discharge were 3.90 kg and 0.13 kg, respectively (t=7.720, P=0.000); the general enteral complications were significantly lower (26/52 vs. 5/56, χ(2)=22.225, P=0.000), the nutritional support complete rate was significantly higher (23/52 vs. 55/56, χ(2)=39.167, P=0.000). Conclusions: Continuous pump feeding enteral nutrition support after discharge postoperatively could help improve patient safety after discharge, which is better for weight maintenance of the patients. Pump feeding could also enhance tolerability of tube feeding and ensure the effective accomplishment of nutritional support.
Subject(s)
Enteral Nutrition , Esophageal Neoplasms , Esophagectomy , Home Care Services , Esophageal Neoplasms/surgery , Female , Humans , Male , Middle Aged , Nutritional Support , Retrospective StudiesABSTRACT
Objective: To evaluate the value of (18)F-FDG PET/CT in predicting long-term survival of esophageal squamous cell carcinoma(ESCC) before initial treatment. Methods: A total of 167 ESCC patients were retrospectively analyzed who underwent surgery between January 2010 and December 2014 in prospective database of Peking University Cancer Hospital Thoracic Surgery Department One, all cases were included according to inclusion and exclusion criteria.The relationship between SUVmax of the primary tumor and patients' age, gender, tumor location, tumor differentiation, tumor regression grade as well as long term survival were compared. Results: The median follow-up time of the 167 cases was 46.9 months(ranging from 30.5 to 86.2 months), with 1 year and 3 years postoperatively being 95.1% and 68.4%, respectively.The SUVmax of the tumor was positively correlated with cT(P<0.01), cN(P=0.033), cTNM(P=0.002) and pTNM(P=0.003)of the tumor.Patients with SUVmax ≤6 obtained a survival significantly better compared with patients with SUVmax>6, the 3 years OS were 83.4 % vs 65.6% (P=0.02) , and DFS were 82.4% vs 55.4%(P=0.006), respectively.The multivariate regression analysis demonstrated that the SUVmax>6 before treatment was the independent prognostic factor for OS (HR=3, 95%CI 1.050-8.568) and DFS (HR=3.971, 95% CI 1.408-11.200) of the ESCC patients. Conclusions: The higher the (18)F-FDG PET/CT SUVmax of the ESCC primary tumor, the poorer survival of the patients. Therefore, SUVmax could be used as an indicator to predict long term survival of the ESCC patients before treatment.
Subject(s)
Esophageal Squamous Cell Carcinoma , Esophageal Neoplasms , Fluorodeoxyglucose F18 , Humans , Positron Emission Tomography Computed Tomography , Prognosis , Prospective Studies , Radiopharmaceuticals , Retrospective StudiesABSTRACT
Objective: To compare diary-reported trips and Global Positioning System (GPS) recording trips and identify the reasons for the discrepancies between two methods. Methods: The survey was conducted in Jiangning district in Nanjing city during July to September and November to December, 2015. Both the diary records and GPS method were used to investigate the travel behavior of 33 retired adults for 5 consecutive days. The GPS traces were display in Google Earth and then split into trips to compare with the diary records according to time and location. χ(2) test was used to analyze the influence of trip characteristics on misreporting rates of each method. Results: A total of 1 087 trips in the survey can be compared between the diary (n=909) and the GPS method (n=912). 7.3% (79/1 087) of the trips were only recorded by GPS method, and 11.8% (128/1 087) were only reported in the diary. Of the remaining 880 trips recorded by the both methods, 86.7% (763/880) matched each other, while 13.3% (117/880) did not. For the matched trips, the difference between the trip durations recorded by diary and GPS method was 2.0 (quartile was 6.0) minutes and the diary method overestimated about 25.0% trip durations when compared with the GPS method. The accuracy rates were 84.8%(903/1 065) and 86.9%(925/1 065) for diary and GPS method, respectively. Both methods were more likely to misreport the trip under 5 minutes. The misreporting rates of diary method for trips under 5 minutes were 6.8 times higher than trips over 30 minutes (21.7% vs 3.2%). The reporting accuracy was also significantly different among trips by different travel mode (P<0.05) for both methods, diary method had the lowest accuracy in reporting vehicles recorders (69.3%, 133/192), while GPS method was more accuracy in both biking (91.9%, 136/148) and vehicles recorders(89.6%, 172/192). The main reasons for misreporting by diary method were forgetting or unwilling to record and failing to record trips according to travel mode, while forgetting to carry GPS device, bad GPS signal and failing to locate the position were the main reasons for misreporting by GPS method. Conclusion: The majority of the trips reported in diary and GPS method are well consistent with each other. Both of the methods should be used simultaneously in the survey of time-activity pattern to improve the data quality.
Subject(s)
Air Pollution/statistics & numerical data , Data Collection/methods , Environmental Exposure/statistics & numerical data , Travel/psychology , Aged , Cities , Geographic Information Systems , Humans , Records , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To investigate the effect of caloric restriction (CR) on expressions of peroxisome proliferators-activated receptors (PPARs) and positive transcription elongation factor b (P-TEFb) (including cyclin-dependent kinase 9 (CDK9) and cyclin T1) protein in visceral adipose tissue of obese rats. MATERIALS AND METHODS: Obese rats were induced by high-fat diet for 8 weeks. Then they were divided into three groups: Model (n=5), 50% Calorie Restricted (50% CR, n=5), Intermittent Fasting (IF) (eight cycles of 3-d fasting and 3-d refeeding, n=6) for 8 weeks. Biochemical parameters were measured. Protein and mRNA expression of Cdk9, cyclin T1 and PPARs were qualified in visceral adipose tissue. RESULTS: A significant decline in fasting plasma glucose (FPG), homeostatic model assessment of insulin resistance (HOMA-IR), body weight, and visceral fat weight was observed in 50% CR group. The IF group exhibited a significant decrease in FPG, HOMA-IR, visceral fat weight. Both 50% CR and IF down-regulated mRNA and protein expression of PPARγ and Cdk9, cyclin T1 and up-regulated mRNA and protein expression of PPARß. CONCLUSIONS: These results suggest that the effects of 50% CR and IF on HOMA-IR, body weight, visceral fat weight, P-TEFb and PPARγ expression may be related to their protective potential on obesity.
Subject(s)
Caloric Restriction , Intra-Abdominal Fat/metabolism , Obesity/metabolism , Positive Transcriptional Elongation Factor B/metabolism , Animals , Body Weight , Diet, High-Fat , Fasting , Insulin Resistance , Male , PPAR gamma/genetics , RNA, Messenger/genetics , Rats , Rats, WistarABSTRACT
Objective: To summarize the initial experiences of applying sacral neuromodulation (SNM) for refractory interstitial cystitis/pelvic pain syndrome (IC/PPS). Methods: From January 2013 to August 2016, 26 patients with refractory IC/PPS (including 5 males and 21 females) treated with SNM were recruited in Beijing Chaoyang Hospital and Hebei Yanda Hospital in this retrospective study. The data before operation, after implantation of stage â tined lead, and during short-term follow-up after implantation of stage â ¡ implanted pulse generator (IPG) were compared in order to observe the improvement of relevant symptoms, and to summarize the effectiveness and safety of SNM for IC/PPS. Results: All the 26 patients received stage â tined lead implantation under local anesthesia, of whom 7 patients finally had the tined lead removed under local anesthesia because of poor testing effects. And 19 patients chose embedding of IPG at the end of stageâ , with the conversion rate from stage â to stage â ¡ being 73.1%. The mean follow-up time after stage â ¡ was 12.1 months. The data at the end of follow-up compared with those before treatment were: voiding frequency in 24 hours 24.3±9.6 vs 13.5±5.7, nocturia 4.6±2.2 vs 2.7±1.5, average voiding amount (109.4 ±45.3)vs(172.6±61.6) ml, O'leary-sant scale score 26.0±3.1 vs 17.0±3.8, quality of life (QOL) score 5.7±0.4 vs 3.3±1.3, sex rating 5.4±1.4 vs 2.9±1.6, and Numeric Pain Intensity Scale 8.4±1.7 vs 3.9±1.2 (all P<0.05). During the follow-up period for the 19 patients, 11 showed symptoms relieve without recurrence, 5 patients had slightly symptoms recurrence and 3 patients had severe recurrence of pelvic pain and frequent urination. About 42.1%(8/19) patients received reprogramming, the average reprogramming rate being 1.73/person. And 84.2% (16/19) patients had symptoms improvement greater than 50% after stage â ¡ IPG implantation. Conclusions: SNM is an effective, safe and minimally invasive procedure for refractory IC/PPS. IC/PPS is a good indication for SNM with a high conversion rate from stage â to stage â ¡. Patients should be followed up regularly after operation, and reprogramming should be arranged according to the degree of symptom improvement.