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1.
Zhonghua Xin Xue Guan Bing Za Zhi ; 51(1): 58-65, 2023 Jan 24.
Artigo em Chinês | MEDLINE | ID: mdl-36655243

RESUMO

Objective: To explore the current situation of fetal heart defects in Yunnan Province and surrounding high altitude areas and the social factors affecting pregnancy outcome. Methods: This is a retrospective study. Pregnant woman who underwent fetal echocardiography and diagnosed as fetal cardiac defects in Yunnan Fuwai Cardiovascular Hospital from June 2017 to January 2021 were included. According to the clinical prognostic risk scoring system and grading criteria of fetal cardiac birth defects, the cases were divided into grade Ⅰ to Ⅳ. The disease distribution and proportion of each prognostic grade, pregnancy outcomes were analyzed and compared. The cases were divided into continued pregnancy group and terminated pregnancy group according to pregnancy outcome. The social factors that may affect the selection of pregnancy outcomes were analyzed by multivariate logistic regression analysis. Results: A total of 4 929 fetal echocardiography examination data were collected, and 4 464 cases (90.57%) were from Yunnan Province and surrounding high altitude areas. 2 166 cases of heart defects were finally analyzed, including 998 cases of congenital heart disease (CHD), 93 cases of cardiac tumors, cardiomyopathy and arrhythmia, 1 075 cases of foramen ovale, ductus arteriosus abnormalities and normal variations. The pregnant women were (29.2±5.0) years old with (25.6±3.8) gestational weeks. The number of cases with prognostic grade from Ⅰ to Ⅳ was 1 037 (47.88%), 620 (28.62%), 314 (14.50%), and 44 (2.03%), respectively. And 151 cases (6.97%) were not classified. The cases of normal variation and thin aortic arch development accounted for 42.66% (924/2 166), 5.22% (113/2 166), respectively. The top 3 diseases of grade Ⅱ were ventricular septal defect, coarctation of aorta and mild-moderate pulmonary stenosis, respectively, and their distribution was 11.63% (252/2 166), 3.92% (85/2 166) and 2.35% (51/2 166) respectively in all cases of heart defects, and 25.25% (252/998), 8.52% (85/998) and 5.11% (51/998) respectively in cases of CHD. Among the cases rated as grade Ⅲ and Ⅳ, most of them were complicated congenital heart disease, and the disease types are scattered. The more common cases in grade Ⅲ were complete transposition of great arteries (accounting for 2.40% (52/2 166) of all cases with heart defects, 5.21% (52/998) of all cases with CHD) and pulmonary artery occlusion (type Ⅰ to Ⅲ) with ventricular septal defect (accounting for 2.17% (47/2 166) of all cases with heart defects, and 4.71% (47/998) of all cases with CHD). In grade Ⅳ, single ventricle (0.74% (16/2 166) of all cases with heart defects, 1.60% (16/998) of all cases with CHD) and left ventricular dysplasia syndrome (0.65% (14/2 166) of all cases with heart defects, 1.40% (14/998) of all cases with CHD) are more common. A total of 1 084 cases were successfully followed up, and 675 cases were born, 392 cases were terminated, spontaneous abortion occurred in 17 cases. The proportion of terminated pregnancy cases was significantly increased from grade Ⅰ to Ⅳ, accounting for 5.24% (21/401), 27.78% (70/252), 89.54% (214/239) and 95.56% (43/45), respectively. Among the terminated pregnancy cases, those with grade Ⅲ accounted for the highest proportion (54.59% (214/392)). The distribution of terminated pregnancy cases was mainly complex congenital malformations or diseases with very poor prognosis (pregnancy outcome grade Ⅲ and Ⅳ), and proportion of terminated pregnancy with pregnancy outcome grade Ⅰ and Ⅱ cases (normal variation or good prognosis) accounted for 5.36% (21/392) and 17.86% (70/392), respectively. The results of multivariate logistic regression analysis showed that pregnant women with low education (high school and below: OR=2.73, 95%CI 1.26-5.93, P<0.001; illiteracy: OR=3.27, 95%CI 1.29-7.10, P<0.001) and low family income (Annual income<100 000 yuan: OR=2.47, 95%CI 1.69-5.12, P<0.001) were more likely to choose termination of pregnancy in case of fetal heart defect. Conclusion: In Yunnan province and the surrounding high altitude areas, the disease distribution of fetal heart defect is mainly simple or low-risk disease, but the complex malformation, especially the disease with poor pregnancy outcome, accounts for a relative high proportion. Pregnancy termination also occurs in some cases with good pregnancy outcome. The education level and family income of pregnant women may affect their choice of pregnancy outcome in case of fetal heart defect.


Assuntos
Cardiopatias Congênitas , Comunicação Interventricular , Gravidez , Feminino , Humanos , Adulto Jovem , Adulto , Estudos Retrospectivos , Altitude , China/epidemiologia , Cardiopatias Congênitas/diagnóstico por imagem , Ecocardiografia , Coração Fetal/diagnóstico por imagem
2.
Adv Mater ; : e2208800, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36692248

RESUMO

Weyl semimetal Td -MoTe2 has recently attracted much attention due to its intriguing electronic properties and potential applications in spintronic. Here, Fe intercalated Td -Fex MoTe2 single crystals (0

3.
Zhonghua Er Ke Za Zhi ; 61(1): 56-60, 2023 Jan 02.
Artigo em Chinês | MEDLINE | ID: mdl-36594122

RESUMO

Objective: To investigate the genetic and genomic profiling of juvenile myelomonocytic leukemia (JMML) and factors affecting its survival rate. Methods: Clinical characteristics, cytogenetics, molecular biology results and survival status of children with 27 JMML cases admitted to the Hematology Department of Children's Hospital, Capital Institute of Pediatrics from December 2012 to December 2021 were analyzed retrospectively, and the outcomes of the children were followed up. Kaplan-Meier method was used for survival analysis. Univariate analysis was used for analyzing factors affecting the overall survival (OS) rates of patients who received hematopoietic stem cell transplantation (HSCT). Log-Rank test was used for comparison of survival curves. Results: Among 27 JMML cases, there were 11 males and 16 females. The age of disease onset was 28 (11,52) months. There are 20 cases of normal karyotype, 4 cases of monosomy 7, 1 case of trisomy 8,1 case of 11q23 rearrangement and 1 case of complex karyotype. A total of 39 somatic mutations were detected.Those involved in RAS signal pathway were the highest (64%(25/39)), among which PTPN11 mutation was the most frequent (44% (11/25)). A total of 17 cases (63%) received HSCT, 8 cases (30%) did not receive HSCT, and 2 cases (7%) lost follow-up. For children receiving transplantation, the follow-up time after transplantation was 47 (11,57) months. The 1-year OS rate of high-risk transplantation group (17 cases) and high-risk non transplantation group (6 cases) was (88±8)% and (50±20)% respectively, with a statistically significant difference (χ2=5.01, P=0.025). The 5-year OS rate of the high-risk transplantation group was (75±11)%. The survival time of those who relapsed or progressed to acute myeloid leukemia after transplantation was significantly shorter than that of those who did not relapse (χ2=6.80, P=0.009). The OS rate of patients with or without PTPN11 mutation was (81±12) % and (67±19)% respectively (χ2=0.85, P=0.356). Conclusions: The main pathogenesis involved in JMML is gene mutation related to RAS signaling pathway, and the most common driver gene of mutation is PTPN11. Allogeneic HSCT can significantly improve the survival rate of high-risk JMML patients. The recurrence or progression after transplantation was related to poor prognosis.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Leucemia Mielomonocítica Juvenil , Masculino , Feminino , Criança , Humanos , Pré-Escolar , Leucemia Mielomonocítica Juvenil/genética , Leucemia Mielomonocítica Juvenil/terapia , Estudos Retrospectivos , Análise de Sobrevida , Mutação
4.
Zhonghua Wai Ke Za Zhi ; 61(3): 232-239, 2023 Jan 18.
Artigo em Chinês | MEDLINE | ID: mdl-36650970

RESUMO

Objective: To examine the feasibility and surgical approach of removing type D trigeminal schwannoma through nasal cavity and nasal sinus under endoscope. Methods: Eleven patients with trigeminal schwannoma who were treated in the Department of Otorhinolaryngology, Qilu Hospital of Shandong University from December 2014 to August 2021 were analyzed retrospectively in this study. There were 7 males and 4 females, aged (47.5±13.5) years (range: 12 to 64 years). The neoplasm involved the pterygopalatine fossa, infratemporal fossa, ethmoidal sinus, sphenoid sinus, cavernous sinus, and middle cranial fossa. The size of tumors were between 1.6 cm×2.0 cm×2.0 cm and 5.7 cm×6.0 cm×6.0 cm. Under general anesthesia, the tumors were resected through the transpterygoid approach in 4 cases, through the prelacrimal recess approach in 4 cases, through the extended prelacrimal recess approach in 2 cases, and through the endoscopic medial maxillectomy approach in 1 case. The nasal endoscopy and imaging examination were conducted in 2 weeks, 3 months, 1 year and subsequent every year to detect whether neoplasm recurred or not, meanwhile, the main clinical symptoms were also closely observed during follow-up. Results: All the surgical procedures were performed under endonasal endoscope, including Gross total resection in 10 patients. The tumor of a 12-year-old patient was not resected completely due to huge tumor size and limited operation space. One patient was accompanied by two other schwannomas located in the occipital region and the ipsilateral parotid gland region originating from the zygomatic branch of the facial nerve, both of which were removed concurrently. After tumor resection, the dura mater of middle cranial fossa was directly exposed in the nasal sinus in 2 cases, including 1 case accompanied by cerebrospinal fluid leakage which was reconstructed by a free mucosal flap obtained from the middle turbinate, the other case was packed by the autologous fat to protect the dura mater. The operation time was 180 (160) minutes (range: 120 to 485 minutes). No complications and deaths were observed. No recurrence was observed in the 10 patients with total tumor resection during a 58 (68) months' (range: 10 to 90 months) follow-up. The symptoms No obvious change was observed in the facial appearance of all patients during the follow-up. Conclusion: Type D trigeminal schwannoma involving pterygopalatine fossa and infratemporal fossa can be removed safely through purely endoscopic endonasal approach by selecting the appropriate approach according to the size and involvement of the tumor.

5.
Phys Med Biol ; 68(2)2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36595320

RESUMO

Objective: Time-of-flight positron emission tomography (PET) is the next frontier in improving the effective sensitivity. To achieve superior timing for time-of-flight PET, combined with high detection efficiency and cost-effectiveness, we have studied the applicability of BaF2 in metascintillators driven by the timing of cross-luminescence photon production.Approach: Based on previous simulation studies of energy sharing and analytic multi-exponential scintillation pulse, as well as sensitivity characteristics, we have experimentally tested a pixel of 3 × 3 × 15 mm3 based on 300µm BGO and 300µm BaF2 layers. To harness the deep ultraviolet cross-luminescent light component, which carries improved timing, we use the FBK VUV SiPM. Metascintillator energy sharing is addressed through a double integration approach.Main results: We reach an energy resolution of 22%, comparable to an 18% resolution of simple BGO pixels using the same readout, through the optimized use of the integrals of the metascintillator pulse in energy sharing calculation. We measure the energy sharing extent of each pulse with a resolution of 25% and demonstrate that experimental and simulation results agree well. Based on the energy sharing, a timewalk correction is applied, exhibiting significant improvements for both the coincidence time resolution (CTR) and the shape of the timing histogram. We reach 242 ps CTR for the entire photopeak, while for a subset of 13% of the most shared events, the CTR value improves to 108 ps, comparable to the 3 × 3 × 5 mm3 LYSO:Ce:Ca reference crystal.Significance: While we are considering different ways to improve further these results, this proof-of-concept demonstrates the applicability of cross-luminescence for metascintillator designs through the application of VUV compatible SiPM coupling, and easily implementable digital algorithms. This is the first test of BaF2-based metascintillators of sufficient stoppng power to be included in a PET scanner, demonstrating the industrial applicability of such cross-luminescent metascintillators.


Assuntos
Luminescência , Fótons , Tomografia por Emissão de Pósitrons/métodos , Raios Ultravioleta , Algoritmos , Contagem de Cintilação/métodos
6.
Zhonghua Yan Ke Za Zhi ; 59(1): 44-49, 2023 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-36631057

RESUMO

Objective: To investigate the correlation of peripapillary hyper-reflective ovoid mass-like structures (PHOMS) in children and adolescents with myopia and its correlation factors. Methods: It was a cross-sectional study. From September 2021 to January 2022, myopic children and adolescents aged 6-16 years treated in Wuhan Central Hospital and Renmin Hospital of Wuhan University with a myopic spherical equivalent (SE) ≥0.5 D were consecutively included. All patients underwent best corrected visual acuity, refraction, intraocular pressure, slit lamp microscope, axial length, fundus photography and enhanced depth imaging optical coherence tomography (EDI-OCT) examination. EDI-OCT optic disc parameter measurements included diameter, degree of tilt and shift and PHOMS height. The patients were divided into PHOMS group and non-PHOMS group according to the presence or absence of PHOMS. According to the height of PHOMS, the patients were further divided into 3 subgroups: large (>400 µm), medium (200-400 µm) and small (<200 µm). The optic disc characteristics of the PHOMS group and the non-PHOMS group and each subgroup were observed, and the correlation factors of PHOMS were analyzed. Mann-Whitney U test, Kruskal-Wallis test, chi-square test, Logistic regression analysis and Kendall's tau-b correlation coefficient were used. Results: A total of 108 patients (108 eyes) were included, including 46 males (46 eyes) and 62 females (62 eyes). There were 70 eyes (64.8%) in the PHOMS group and 38 eyes (35.2%) in the non-PHOMS group. Small PHOMS can only be detected by EDI-OCT, while medium to large PHOMS showed blurred optic disc boundaries on fundoscopy images. Univariate Logistic regression analysis showed that PHOMS was associated with age (OR=1.36, 95%CI: 1.13-1.65, P=0.001) and myopic SE (OR=4.57, 95%CI: 2.51-8.32, P<0.001), axial length (OR=2.28, 95%CI: 1.37-3.82, P=0.002), optic disc tilt (OR=3.44, 95%CI: 2.09-5.66, P<0.001), optic disc shift (OR=0.95, 95%CI: 0.93-0.98, P<0.001) and optic disc diameter (OR=0.75, 95%CI: 0.58-0.95, P=0.019). Multivariate Logistic regression analysis showed that the higher the myopic SE (OR=3.01, 95%CI: 1.27-7.17, P=0.013) and the greater the tilt of the optic disc (OR=4.06,95%CI:1.99-8.29,P<0.001), the higher the risk of PHOMS. Kendall's tau-b correlation coefficient analysis showed that the height of PHOMS was negatively correlated with optic disc shift (r=-0.31, P<0.001). Conclusions: PHOMS can be found in a subset of myopic children. The fundus manifestations of PHOMS of different heights are slightly different. The large myopic SE and great optic disc tilt are risk factors of PHOMS, and their magnitudes correlate with the border tissue angle.


Assuntos
Miopia , Disco Óptico , Masculino , Feminino , Humanos , Adolescente , Criança , Estudos Transversais , Miopia/diagnóstico , Refração Ocular , Fundo de Olho , Tomografia de Coerência Óptica
8.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 34(6): 626-629, 2023 Jan 05.
Artigo em Chinês | MEDLINE | ID: mdl-36642904

RESUMO

OBJECTIVE: To evaluate the effectiveness of a whole-process health education model among inpatients with ascites type of advanced schistosomiasis. METHODS: A "admission-hospitalization-discharge" whole-process health education model was created, 101 inpatients with ascites type of advanced schistosomiasis were given the whole-process health education. The scores of schistosomiasis control knowledge, attitudes towards schistosomiasis control and healthy behaviors, and awareness of schistosomiasis control knowledge, correct rate of attitudes towards schistosomiasis control and correct rate of healthy behaviors were compared among inpatients with ascites type of advanced schistosomiasis before and after implementation of the whole-process health education. RESULTS: The scores of schistosomiasis control knowledge, schistosomiasis control attitudes and healthy behaviors were all significantly higher among inpatients with ascites type of advanced schistosomiasis after implementation of the whole-process health education than before implementation (Z = -7.688, -3.576 and -4.328, all P values < 0.01). In addition, the awareness of schistosomiasis control knowledge increased from 54.3% to 82.7% (χ2 = 188.886, P < 0.01), and the correct rate of attitudes towards schistosomiasis control increased from 88.4% to 98.0% (χ2 = 22.001, P < 0.01), while the correct rate of healthy behaviors increased from 48.2% to 59.7% (χ2 = 11.767, P < 0.01). CONCLUSIONS: The whole-process health education model may remarkably improve the awareness of schistosomiasis control knowledge and promote the formation of positive attitudes towards schistosomiasis control and correct behaviors among inpatients with ascites type of advanced schistosomiasis, which is of great significance to facilitate patients' cure.


Assuntos
Ascite , Esquistossomose , Humanos , Pacientes Internados , Educação em Saúde , Hospitalização , Conhecimentos, Atitudes e Prática em Saúde
13.
Zhonghua Jie He He Hu Xi Za Zhi ; 46(1): 51-55, 2023 Jan 12.
Artigo em Chinês | MEDLINE | ID: mdl-36617929

RESUMO

We reported the manifestations, auxiliary examination, and treatment courses of a case of scimitar syndrome with pulmonary sequestration containing carcinoma. The clinical characteristics of scimitar syndrome with pulmonary sequestration, pulmonary sequestration containing carcinoma were summarized based on the data of this case and the related literatures before January 2022. Scimitar syndrome can coexist with ipsilateral pulmonary sequestration. Because sequestered lung tissue has a risk of malignant transformation, a cancer screening test is useful for early diagnosis and timely treatment.


Assuntos
Sequestro Broncopulmonar , Carcinoma , Neoplasias Pulmonares , Veias Pulmonares , Síndrome de Cimitarra , Humanos , Sequestro Broncopulmonar/complicações , Síndrome de Cimitarra/complicações , Pulmão , Neoplasias Pulmonares/complicações , Carcinoma/complicações
14.
Mol Biol Cell ; 34(2): rs1, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36475712

RESUMO

Tetrahymena thermophila harbors two functionally and physically distinct nuclei within a shared cytoplasm. During vegetative growth, the "cell cycles" of the diploid micronucleus and polyploid macronucleus are offset. Micronuclear S phase initiates just before cytokinesis and is completed in daughter cells before onset of macronuclear DNA replication. Mitotic micronuclear division occurs mid-cell cycle, while macronuclear amitosis is coupled to cell division. Here we report the first RNA-seq cell cycle analysis of a binucleated ciliated protozoan. RNA was isolated across 1.5 vegetative cell cycles, starting with a macronuclear G1 population synchronized by centrifugal elutriation. Using MetaCycle, 3244 of the 26,000+ predicted genes were shown to be cell cycle regulated. Proteins present in both nuclei exhibit a single mRNA peak that always precedes their macronuclear function. Nucleus-limited genes, including nucleoporins and importins, are expressed before their respective nucleus-specific role. Cyclin D and A/B gene family members exhibit different expression patterns that suggest nucleus-restricted roles. Periodically expressed genes cluster into seven cyclic patterns. Four clusters have known PANTHER gene ontology terms associated with G1/S and G2/M phase. We propose that these clusters encode known and novel factors that coordinate micro- and macronuclear-specific events such as mitosis, amitosis, DNA replication, and cell division.


Assuntos
Cilióforos , Tetrahymena thermophila , Tetrahymena , Tetrahymena thermophila/genética , Tetrahymena thermophila/metabolismo , Núcleo Celular/metabolismo , Ciclo Celular/genética , Mitose/genética , Perfilação da Expressão Gênica , Tetrahymena/genética
16.
Artigo em Inglês | MEDLINE | ID: mdl-36470682

RESUMO

AIMS: Accelerated hypofractionated radiotherapy is used at our institution for non-small cell lung cancer (NSCLC) patients not eligible for stereotactic body radiotherapy or chemoradiotherapy. The purpose of this study was to report clinical outcomes of delivering 60 Gy in 15 fractions for these patients. MATERIALS AND METHODS: All NSCLC patients who received 60 Gy in 15 fractions were reviewed. Outcomes of interest were local failure, regional failure, distant progression, overall survival and treatment-associated toxicities. RESULTS: In total, 111 patients were included. The median age was 78.8 years and most tumours were adenocarcinoma (n = 55, 49.6%). Sixty-five patients (58.6%) were N0. The cumulative incidence of local failure at 12 and 24 months in the N0 cohort was 5.2% and 14.2%, respectively, compared with 11.5% and 14.8% for N+ patients. Tumour size >35 mm predicted for local failure (hazard ratio 2.706, 95% confidence interval 1.002-7.307, P = 0.0494). Distant progression at 12 and 24 months in N0 patients was 13.7% and 24.3% compared with 24.6% and 33.5% in N+ patients. In N0 patients, larger tumour size was associated with increased risk of distant progression. The median overall survival was 38.1 months in N0 patients versus 31.7 months in N+ patients. The most common toxicity was radiation pneumonitis (n = 6, 6.4%). The incidence of any grade 3 toxicity was 10.3% at ≥1 year. There were no deaths or hospitalisations attributed to treatment. CONCLUSIONS: Accelerated hypofractionated radiotherapy is well tolerated and resulted in favourable clinical outcomes in various stages of NSCLC patients.

17.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 34(5): 484-492, 2022 Nov 14.
Artigo em Chinês | MEDLINE | ID: mdl-36464262

RESUMO

OBJECTIVE: To investigate the trends in the prevalence of soil-transmitted nematode infections and the spatio-temporal distribution characteristics of soil-transmitted nematodiasis in Sichuan Province from 2016 to 2021, so as to provide the evidence for formulating the soil-transmitted nematodiasis elimination strategy in Sichuan Province. METHODS: The soil-transmitted nematodiasis surveillance data in Sichuan Province from 2016 to 2021 were collected, and the epidemic trend of soil-transmitted nematode infections was identified. The distribution maps of soil-transmitted nematode infections in Sichuan Province were plotted to identify their spatial distribution characteristics. In addition, the spatial clusters of soil-transmitted nematode infections were detected using globa and local spatial autocorrelation analyses. RESULTS: The prevalence of soil-transmitted nematode infections appeared a decline with time in Sichuan Province from 2016 to 2021 (χ2= 400.24, P < 0.01). Global spatial autocorrelation analysis identified positive spatial autocorrelations in the prevalence of soil-transmitted nematode infections (Moran's I = 0.322, Z = 16.293, P < 0.01), hookworm infections (Moran's I = 0.425, Z = 21.290, P < 0.01), Ascaris lumbricoides infections (Moran's I = 0.102, Z = 5.782, P < 0.01) and Trichuris trichiura infections (Moran's I = 0.084, Z = 6.873, P < 0.01). Local spatial autocorrelation analysis showed that the high-high clusters of soil-transmitted nematode infections were mainly located in 37 counties (cities, districts) of Sichuan Province, and the high-high clusters of hookworm, A. lumbricoides and T. trichiura infections were mainly identified in 39 counties (cities, districts) in mountainous areas around Sichuan Basin and hilly areas, 9 counties (cities, districts) in mountainous areas in southwestern Sichuan Province, and 8 counties (cities, districts) in mountainous areas in southwestern Sichuan Province, respectively. CONCLUSIONS: The prevalence of soil-transmitted nematode infections appeared a tendency towards a decline in Sichuan Province from 2016 to 2021, which showed spatial clusters. The management of soil-transmitted nematodiasis requires to be reinforced in high-risk areas of Sichuan Province with adaptations to local epidemiological features.


Assuntos
Ascaríase , Infecções por Nematoides , Humanos , Solo , Infecções por Nematoides/epidemiologia , Análise Espacial , China/epidemiologia
18.
Zhonghua Fu Chan Ke Za Zhi ; 57(11): 821-829, 2022 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-36456478

RESUMO

Objective: To investigate the application of sentinel lymph node biopsy (SLNB) in early-staged cervical cancer by laparoscopy. Methods: It was a prospective, single-arm, single-center clinical study. Seventy-eight cases of cervical cancer patients were collected from July 2015 to December 2018 at the Fourth Hospital of Hebei Medical University. All the patients were injected with tracer into the disease-free block of cervical tissue after anesthesia by the same surgeon who learned sentinel lymph node (SLN) mapping technique in Memorial Sloan-Kettering Cancer Center, and underwent SLN mapping followed by complete pelvic lymphadenectomy. Moreover, all the dissected lymph nodes were stained with hematoxylin eosin staining (HE) pathological examination. Besides, the negative SLN on hematoxylin-eosin staining were detected by immunohistochemistry cytokeratin staining micro-metastasis. To analyze the distribution, detection rate, false negative rate the sensitivity and negative predictive value of the SLN in early-staged cervical cancer by laparoscopy, and explore the value of SLN mapping in predicting the lymph nodes metastasis in early-staged cervical cancer. Results: The overall detection rate of SLN in cervical cancer was 99% (77/78), bilateral detection rate was 87% (68/78). The average of 12.4 lymph node (LN) and 3.6 SLN were dissected for each patients each side. SLN of cervical cancer were mainly distributed in the obturator space (61.5%, 343/558), followed by external iliac (23.5%, 131/558), common iliac (7.3%, 41/558), para-uterine (3.8%, 21/558), internal iliac (2.2%, 12/558), para abdominal aorta (1.1%, 6/558), and anterior sacral lymphatic drainage area (0.7%, 4/558). Fourteen cases of LN metastasis were found among all 78 cases. There were a total of 38 positive LN, including 26 SLN metastasis and 12 none sentinel LN metastasis. Through immunohistochemical staining and pathological ultra-staging, 1 SLN was found to be isolated tumor cells (ITC), and 5 SLNs were found to be micro-metastases (MIC), accounting for 23% (6/26) of positive SLN. SLN mapping with pathological ultra-staging improved the prediction of LN metastasis in cervical cancer (2/14). Metastatic SLN mainly distributed in the obturator space (65%, 17/26), peri-uterine region (12%, 3/26), common iliac region (15%, 4/26), and external iliac region (8%, 2/26). The consistency of the diagnosis of lymph node metastasis by SLN biopsy and postoperative retroperitoneal lymph node metastasis showed that the Kappa value was 1.000 (P<0.001), indicated that the metastasis status of SLN and retroperitoneal lymph node were completely consistent. The sensitivity, specificity, accuracy, false-negative rate, and negative predictive value of SLN biopsy in the diagnosis of lymph node metastasis were 100%, 100%, 100%, 0, and 100%, respectively. Conclusions: SLN in early-staged cervical cancer patients were mainly distributed in the obturator and external iliac space, pathalogical ultra-staging of SLN could improve the prediction of LN metastasis. Intraoperative SLN mapping is safe, feasible and could predict the state of retroperitoneal LN metastasis in early-staged cervical cancer. SLNB may replace systemic pelvic lymphadenectomy.


Assuntos
Laparoscopia , Linfonodo Sentinela , Neoplasias do Colo do Útero , Humanos , Feminino , Linfonodo Sentinela/cirurgia , Metástase Linfática , Neoplasias do Colo do Útero/cirurgia , Amarelo de Eosina-(YS) , Hematoxilina , Estudos Prospectivos
19.
Zhonghua Fu Chan Ke Za Zhi ; 57(11): 836-842, 2022 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-36456480

RESUMO

Objective: To compare oxytocin combined with ergometrine with oxytocin alone in terms of primary prophylaxis for postpartum hemorrhage (PPH) at the time of cesarean section (CS). Methods: This was a multicenter double-blind randomized controlled interventional study comparing ergometrine combined with oxytocin and oxytocin alone administered at CS. From December 2018 to November 2019, a total of 298 parturients were enrolled in 16 hospitals nationwide. They were randomly divided into experimental group (ergometrine intra-myometrial injection following oxytocin intravenously; 148 cases) and control group (oxytocin intra-myometrial injection following oxytocin intravenously; 150 cases) according to 1∶1 random allocation. The following indexes were compared between the two groups: (1) main index: blood loss 2 hours (h) after delivery; (2) secondary indicators: postpartum blood loss at 6 h and 24 h, placental retention time, incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution; (3) safety indicators: nausea, vomiting, dizziness and other adverse reactions, and blood pressure at each time point of administration. Results: (1) The blood loss at 2 h after delivery in the experimental group [(402±18) ml] was less than that in the control group [(505±18) ml], and the difference was statistically significant (P<0.05). (2) The blood loss at 6 h and 24 h after delivery in the experimental group were less than those in the control group, and the differences were statistically significant (all P<0.05). There were no significant differences between the two groups in the incidence of PPH, the proportion of additional use of uterine contraction drugs, hemostatic drugs or other hemostatic measures at 2 h and 24 h after delivery, the proportion requiring blood transfusion, and the proportion of prolonged hospital stay due to poor uterine involution (all P>0.05). (3) Adverse reactions occurred in 2 cases (1.4%, 2/148) in the experimental group and 1 case (0.7%, 1/150) in the control group. There was no significant difference between the two groups (P>0.05). The systolic blood pressure within 2.0 h and diastolic blood pressure within 1.5 h of drug administration in the experimental group were higher than those in the control group, and the differences were statistically significant (P<0.05), but the blood pressure of the two groups were in the normal range. Conclusion: The use of ergometrine injection in CS could reduce the amount of PPH, which is safe and feasible.


Assuntos
Hemostáticos , Hemorragia Pós-Parto , Gravidez , Feminino , Humanos , Hemorragia Pós-Parto/prevenção & controle , Ergonovina/uso terapêutico , Ocitocina/uso terapêutico , Cesárea , Placenta
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 43(10): 1666-1670, 2022 Oct 10.
Artigo em Chinês | MEDLINE | ID: mdl-36456501

RESUMO

Statistical graphics has a long history and is an important mean to present study design, analysis results and conclusions of medical research. A survey of statistical graphs of recent publications in Chinese and English academic journals shows that scientific and technical specifications of statistical graphics are still lacking. Based on the requirements of statistical graphics in prestigious medical journals (NEJM, Lancet, JAMA and The BMJ), this paper summarizes the technical requirements, key points of design of statistical graphs and practical conditions of common statistical graphs to provide reference for clinical researchers.


Assuntos
Pesquisa Biomédica , Humanos , Pesquisadores , Projetos de Pesquisa
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