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2.
Zhonghua Bing Li Xue Za Zhi ; 49(4): 343-347, 2020 Apr 08.
Artigo em Chinês | MEDLINE | ID: mdl-32268671

RESUMO

Objective: To investigate the clinicopathological characteristics of gastric adenocarcinoma of the fundic gland(GA-FG). Methods: A total of 6 patients with GA-FG admitted from January 2014 to May 2019 were identified at Shanghai Songjiang District Central Hospital.Analyzed endoscopic findings, pathological characteristics and immunohistochemical staining of the lesions and reviewed relevant literatures. Results: Among the 6 patients, 3 were male, 3 were female, and the mean age was 66 years. The most common clinical presentation was epigastric discomfort. Gastroscopic examination revealed an elevated or flat lesion in the body of the stomach, with a diameter of 0.4 to 1.0 cm. Histopathologically, they mainly composed of main cells, but there were also scattered parietal cells, arranged in an irregular tubular or cord-like structure, and formed anastomosis branches. The tumor cells were immunohistochemically positive for MUC6 and pepsinogen 1. Conclusions: GA-FG is a rare variant of well-differentiated adenocarcinoma. It is important to understand its clinical features and histological morphology for more accurate diagnosis.


Assuntos
Adenocarcinoma , Neoplasias Gástricas , Idoso , China , Feminino , Fundo Gástrico , Mucosa Gástrica , Humanos , Masculino
3.
Zhonghua Jie He He Hu Xi Za Zhi ; 43(4): 356-361, 2020 Apr 12.
Artigo em Chinês | MEDLINE | ID: mdl-32294818

RESUMO

Objective: To explore the prevalence risk factors of Beijing genotype Mycobacterium tuberculosis (MTB) in Beijing and its correlation with second-line anti tuberculosis drug resistance. Methods: A total of 1 140 clinical MTB positive strains were collected from various districts in Beijing, and the drug sensitivity was detected by proportion method. Beijing genotype and non Beijing genotype MTB were identified by the method of Spoligotyping. Using SPSS 22.0 statistical software, chi square test or Fisher exact probability test was used to analyze the experimental data. Results: Among 1 140 MTB clinical isolates, 941 (82.5%) were Beijing genotype MTB, 199 were non Beijing genotype MTB. There were 663 males (70.5%) in Beijing genotype and 124 males (62.3%) in non Beijing genotype strains. There were significant differences in the proportion of males between the two genotypes [P=0.021, OR (95% CI):1.442 (1.048-1.985)]. There were 441 floating population (46.9%) in Beijing genotype MTB and 78 floating population (39.2%) in non Beijing genotype MTB. There was a significant difference in the proportion of floating population between the two genotypes [P=0.048,OR (95%CI):1.368(1.001-1.869)]. There were 129 patients (13.7%) aged 65 or older in Beijing genotype MTB, 40 patients (20.1%) aged 65 or older in non Beijing genotype MTB. The difference was statistically significant [P=0.021, or (95% CI): 0.631 (0.426-0.936)]. The resistance drug rates of Levofloxacin (Lfx), Amikacin (Am), Capreomycin (Cm), Para-aminosalicylic (PAS) in Beijing genotypes were 5.5% (52/941), 1.3% (12/941), 3.2% (30/941) and 3.0% (28/941), respectively, and those of non Beijing genotypes were 10.6% (21/199), 8.5% (17/199, 12.6% (25/199) and 11.6% (23/199), the difference was statistically significant (all P<0.05). There were 58 (6.2%) multidrug-resistant (MDR) strains in Beijing genotype MTB and 19 (9.5%) multidrug-resistant strains in non Beijing genotype. There was no significant difference in the proportion of MDR strains between Beijing genotype and non Beijing genotype (P>0.05). Conclusions: Beijing genotype MTB is widespread in Beijing and has a higher proportion in male population and floating population. Compared with non Beijing genotype, Beijing genotype MTB has a lower resistance rate to Lfx, Am, Cm and PAS, and there is no significant difference in the proportion of MDR-TB patients between the two genotypes.


Assuntos
Antituberculosos/uso terapêutico , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/genética , Tuberculose Resistente a Múltiplos Medicamentos/genética , Tuberculose Pulmonar/tratamento farmacológico , Idoso , Antituberculosos/farmacologia , China/epidemiologia , DNA Bacteriano/genética , Farmacorresistência Bacteriana Múltipla/genética , Genótipo , Humanos , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Prevalência , Tuberculose Pulmonar/epidemiologia
4.
Zhonghua Er Ke Za Zhi ; 58(3): 194-200, 2020 Mar 02.
Artigo em Chinês | MEDLINE | ID: mdl-32135590

RESUMO

Objective: To survey the children under 7 years of age in nine cities of China for a better understanding of the current situation of childhood stunting. Methods: According to a stratified cluster sampling design, a cross-sectional survey on children under 7 years of age was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to November in 2016. A total of 110 499 children were recruited. Height of children was evaluated using the growth standards for Chinese children (2009 edition) .Children with height less than the 3rd percentile of the growth standards were considered as stunting, and children with height between the 3rd and 10th percentiles of the growth standards were considered as relatively short stature. Chi-square test was used for comparison between data of boys and girls, urban and suburban, as well as among different ages and regions. Results: Totally 113 084 children under 7 years of age should be investigated and actually 110 499 children were investigated, with a rate of 97.7%. The prevalence of stunting was 1.9% (2 141/110 499) among all the children. The prevalence of stunting in urban children (1.6%, 904/55 524) was lower than that in suburban children (2.3%, 1 237/54 975, χ(2)=56.246, P<0.01). The gender difference in stunting prevalence was not statistically significant (1.9% (1 121/57 921) in boys and 1.9% (1 020/52 578) in girls, χ(2)=0.003, P=0.965). The prevalence of stunting decreased with age for children younger than 3 years, from 1.8% (312/17 080) in 0-<1 year of age group to 1.2% (168/13 740) in 2-<3 years of age group, but increased to 2.2% (240/11 073) at 6-<7 years group. Comparison among different regions showed that the stunting prevalence in southern region was higher than those in the central and northern regions (0.9% (193/20 374) in northern urban, 0.8% (154/18 486) in central urban, and 3.3% (557/16 664) in southern urban children), showing a statistical significance (χ(2)=437.736, P<0.01); 1.1% (241/21 924) in northern suburban, 1.4% (227/16 775) in central suburban and 4.7% (769/16 276) in southern suburban children, showing a statistical significance (χ(2)=646.533, P<0.01). In urban areas, the difference between the central and northern regions showed no statistical significance (χ(2)=1.429, P=0.232) and the stunting prevalence of central Chinese children was slightly higher than that of northern Chinese children in suburban areas (χ(2)=5.130, P=0.024). Among the nine cities, the stunting prevalence of Guangzhou (6.1%, 613/10 019) was higher than those of other cities (χ(2)=1 559.64, P<0.01). Among the stunting children, 78.4% (1 679/2 141) were classified as borderline or mild and only 7.2% (154/2 141) were classified as severe. The prevalence of relatively short stature was 5.2% (5 721/110 499). Conclusions: The prevalence of stunting among children under 7 years of age in nine cities of China is low and most of the stunting children were classified as mild; the prevalence of stunting in suburban children is higher than that in urban children; the gender difference show no statistical significance; and the prevalence of stunting in southern Chinese children is higher than those in central and northern Chinese children.


Assuntos
Estatura , Desenvolvimento Infantil , Transtornos do Crescimento/epidemiologia , Pequim , Estatura/fisiologia , Peso Corporal , Criança , Pré-Escolar , China/epidemiologia , Cidades/estatística & dados numéricos , Estudos Transversais , Feminino , Transtornos do Crescimento/diagnóstico , Humanos , Masculino , Prevalência , Inquéritos e Questionários
5.
Zhonghua Er Ke Za Zhi ; 58(3): 206-212, 2020 Mar 02.
Artigo em Chinês | MEDLINE | ID: mdl-32135592

RESUMO

Objective: To investigate the timing of permanent tooth emergence and its association with physical growth among children aged 4-7 years in 9 cities of China, and to analyze the trend of permanent teeth development. Methods: According to a stratified cluster sampling design, a cross-sectional survey on the timing of permanent tooth emergence children aged 4-7 years was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; Guangzhou, Fuzhou and Kunming in southern China) from June to October in 2015. A total of 37 973 children (19 035 boys and 18 938 girls) were recruited and were divided into different age groups (4.0-<4.5, 4.5-5.0, 5.0-5.5 and 6.0-<7.0 years of age). The situation of the exfoliation of primary teeth and the eruption of permanent teeth were investigated. Height and weight were measured using the standardized methods. Z-scores of physical growth indicators were calculated using the growth standards for Chinese children in 2009. Probit regression analysis was used to determine the median and percentile age of transition from deciduous to permanent teeth. Chi-square test was used for comparison of categorical data and t test was used for comparison of measurement data between boys and girls, urban and suburban as well as among different ages and regions. Meanwhile, the data from the national survey on physical growth and development of children under 7 years of age in 9 cities of China in 1995 were used to analyze the trends of the permanent teeth development. Results: The rate of transition from deciduous to permanent teeth in 37 973 children aged 4-7 years was higher with age, which was 0.6% (42/7 568) in 4.0-<4.5 years of age group, 30.3% (2 295/7 583) in 5.5-<6.0 years of age group, and 74.5% (5 680/7 627) in 6.0-<7.0 years of age group. The rates of transition from deciduous to permanent teeth in boys were all lower than those of girls except for children aged 4.0-<4.5 years (all P<0.01). The rate of transition from deciduous to permanent teeth in urban children was higher than that in suburban children for older than 5.5-6.0 years of age group in boys and older than 4.5-5.0 years of age group in girls, which was 74.2% (1 427/1 924) in urban boys aged 6.0-<7.0 years and 69.2% (1 305/1 885) in suburban boys aged 6.0-<7.0 years (χ(2)=11.446, P<0.01). The age of transition from deciduous to permanent teeth was 6.00 (95%CI: 5.98-6.01) years and the range of the 3-97 percentile was 4.88-7.11 years of age. The median permanent tooth emergence age of girls was lower than that of boys (5.94 vs. 6.06 years) and the median age of urban children was lower than that of suburban children (5.94 vs. 6.05 years). The median permanent tooth emergence age of southern Chinese children (6.05 years) was higher than that of northern (5.97 years) and central Chinese children (5.97 years). The weight for age Z-scores (WAZ), height for age Z-scores (HAZ) and body mass index for age Z-scores (BMIZ) of children with transition from deciduous to permanent teeth (0.35±1.17, 0.32±1.00, 0.23±1.16) were significantly higher than those of children without transition from deciduous to permanent teeth (0.03±1.13, 0.03±1.02, 0.04±1.13, t=20.81,21.67,12.09, all P<0.05). In comparison with the data in 1995, data in 2015 showed that the rate of transition from deciduous to permanent teeth was higher, for example, the rate of urban boys aged 6.0-<7.0 years group was 63.8% (1 146/1 796) in 1995, and increased to 74.2% (1 427/1 924) in 2015 (χ(2)=46.748, P<0.01). The median permanent tooth emergence age decreased by 0.24 years in 2015 as compared with that in 1995. Conclusions: The development of permanent teeth is earlier in girls than in boys, earlier in urban children than in suburban children and slightly delay in southern children than in central and northern Chinese children. In addition, the development of permanent teeth, which is related to the physical growth, slightly accelerate in China during the past 20 years.


Assuntos
Estatura/fisiologia , Erupção Dentária , Dente Decíduo , Peso Corporal , Criança , Pré-Escolar , China , Cidades , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários
6.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(2): 133-138, 2020 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-32074698

RESUMO

Objective: To analyze the trends of overweight and obesity of children and adolescents in 9 provinces of China from 1991 to 2015. Methods: A total of 14 888 children and adolescents aged 6-17 years with complete data were selected from the China Health and Nutrition Survey from 1991 to 2015. The definitions of overweight and obesity were defined using the international body mass index (BMI) cut-offs for child overweight and obesity established by the International Obesity Task Force in 2000 (hereinafter referred to as 'IOTF Standard'), the growth reference for school-aged children and adolescents established by the World Health Organization in 2007 (hereinafter referred to as 'WHO Standard'), the BMI cut-offs for screening overweight and obesity in Chinese children established by Li Hui et al. in 2009 (hereinafter referred to as 'Expert Standard'), and the screening thresholds for overweight and obesity in Chinese school-age children and adolescents released by the National Health and Family Planning Commission in 2018 (hereinafter referred to as 'Industry Standard'). Multivariable linear regression model was used to examine the trends in BMI values from 1991 to 2015, and multivariable logistic regression model was used to examine the trends in the prevalence of overweight and obesity from 1991 to 2015. Results: After adjusting for the age, sex and region, BMI values increased from 17.26 kg/m(2) in 1991 to 18.72 kg/m(2) in 2015 (P value for trend <0.001). The prevalence of overweight defined by the IOTF Standard, WHO Standard, Expert Standard, and Industry Standard increased from 4.06%, 5.37%, 5.16%, and 4.27% in 1991 to 13.58%, 16.23%, 13.30%, and 11.70% in 2015, respectively (all P values for trend <0.001), and the prevalence of obesity increased from 1.02%, 1.86%, 2.24%, and 2.41% in 1991 to 7.45%, 10.75%, 12.08%, and 12.74% in 2015, respectively (all P values for trend <0.001). Conclusion: The BMI values and prevalence of overweight and obesity increased significantly in Chinese children and adolescents from nine provinces from1991 to 2015.


Assuntos
Obesidade Pediátrica/epidemiologia , Adolescente , Índice de Massa Corporal , Criança , China/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência
7.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(2): 158-162, 2020 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-32074796

RESUMO

Objective: To investigate the safety and feasibility of proximal partial gastrectomy with Cheng's Giraffe esophagogastric reconstruction for the treatment of early Siewert II adenocarcinoma of esophagogastric junction (AEG). Methods: Indication of Cheng's Giraffe esophagogastric reconstruction: (1) Siewert II AEG or Siewert III AEG with diameter < 4 cm; (2) preoperative staging as cT1-2N0M0. A descriptive case series study was carried out. Clinical data of 34 patients with Siewert II AEG undergoing proximal partial gastrectomy and Cheng's Giraffe esophagogastric reconstruction at Department of Abdominal Surgery of Zhejiang Cancer Hospital and Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from February to July 2018 were retrospectively collected and analyzed, including 14 cases in IA stage, 11 cases in IIA stage and 8 cases in IIB stage. Brief procedure of Cheng's Giraffe esophagogastric reconstruction was as follows: Firstly, 12 cm long tubular stomach was formed by longitudinal incision 4 cm away from the great curvature of the stomach. Secondly, the gastric fundus and His angle were formed. Finally, the distance from His angle to esophagal-tubular gastric anastomosis should be more than 5 cm. The reflux disease questionare (RDQ) scores, radionuclide gastric emptying scintigraphy, and 24-hour multichannel intraluminal (MII)-pH monitoring technology were used to evaluate postoperative gastric emptying and gastroesophageal reflux. Result: All 34 patients successfully completed proximal partial gastrectomy with Cheng's Giraffe esophagogastric reconstruction, including 13 cases by open surgery and 21 cases by laparoscopic surgery. The operation time was (144.6±39.8) minutes, the blood loss during operation was (35.4±17.2) ml. No laparoscopic case was converted to open surgery and no postoperative complication was observed. The postoperative hospital stay was (8.4±2.5) days. The postoperative RDQ score was 4.4±3.1 one month after operation, and 3.3±2.5 six months after operation. Gastric-half emptying time was (67.0±21.5) minutes, and the residual ratio was (52.2±7.7)% in 1 hour, (36.4±3.1)% in 2 hours and (28.8±3.6)% in 3 hours at postoperative 1-month. The 24-hour MII-pH monitoring at postoperative 2-month revealed the frequency of acid reflux was (12.6±7.9) times, frequency of non-acid reflux was (19.6±9.7) times, DeMeester score was 5.8±2.9. Conclusion: Cheng's Giraffe esophagogastric reconstruction is safe and feasible in the treatment of Siewert type II AEG, and has good dynamic and anti-reflux effects.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias Esofágicas/cirurgia , Junção Esofagogástrica/cirurgia , Gastrectomia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Neoplasias Gástricas/cirurgia , Humanos , Estudos Retrospectivos , Resultado do Tratamento
8.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(2): 183-187, 2020 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-32074800

RESUMO

Objective: To evaluate the feasibility and short-term efficacy of a novel and simplified closure method developed by our team for the defect closure after endoscopic full-thickness resection (EFTR) for gastric submucosal tumors (SMT) in the gastric wall. Methods: A prospective single-arm clinical study was used. Inclusion criteria: (1) the lesion was located in the fundus or the greater curvature of the stomach, and was confirmed to originate from the muscularis propria layer; (2) the diameter of the tumor was ≤3.5 cm, and the tumor had no extensive adhesion to the peritoneal tissues and organs in extraperitoneal cavity; (3) the tumor had no malignant features under ultrasound endoscopy; (4) the patient agreed to participate in the study; (5) patients with severe complications were excluded. Based on the above criteria, 20 patients with gastric SMT at the Endoscopy Center of Zhongshan Hospital of Fudan University from January 2015 to March 2018 were enrolled in this study, including 5 males and 15 females with mean age of 61.1 (38 to 70) years. Grasping forceps-assisted endo-loop snare ligation device which is called "Shao-Mai" method was used to close the defect site. All the patients underwent EFTR and "Shao-Mai" method to perform defect closure. After successful tumor resection by EFTR, an endo-loop was anchored onto the edge of the gastric defect with grasping forceps assistance and closed tightly. The observation indicators included tumor size, en bloc resection, operation time, postoperative complications and hospital stay. The follow-up indicators included tumor residual, local recurrence, and metachronous lesions. Results: All the 20 lesions were located in the muscularis propria with a size of 0.5-3.5 (mean 1.4) cm. Three of them were located in the greater curvature of the mid-upper gastric body, 17 were located in the fundus. The endoscopic "Shao-Mai" closure was successfully performed after EFTR in all the 20 cases. Endoscope was used uniquely through the entire process, without laparoscopic assistance. The operative time was 20-100 (mean 43.8) minutes, while the "Shao-Mai" closure procedure took a range of 3-30 (mean 10.1) minutes. The en bloc resection rate was 100%. The pathological diagnosis included 17 gastrointestinal stromal tumors and 3 leiomyomas. No major complications occurred during or after surgery. All the patients were discharged 1-11 (mean 3.1) days after operation. The wounds of all the cases were healed completely six months after operation and only scar was observed without ulcer. No residual lesion, tumor recurrence or metastasis, leakage or fistula of digestive tract were found during the follow-up period of 15-54 (median 41) months. Conclusion: The endoscopic "Shao-Mai" closure method is a simplified novel way, which is feasible, effective, and safe for closing the gastric defect after EFTR.


Assuntos
Gastrectomia/métodos , Mucosa Gástrica/cirurgia , Gastroscopia , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Prospectivos , Resultado do Tratamento
9.
Artigo em Chinês | MEDLINE | ID: mdl-31954387

RESUMO

Objective: To investigate the effect of isosorbide mononitrate (ISMN) targeted nanoparticles on inflammatory factors of sinusitis by establishing a rabbit model of rhinosinusitis. Methods: Thirty healthy rabbits, male and female, weighing 2.5-3.5 kg, were randomly divided into 6 groups with 5 rabbits in each group. Group A was the control group. The model of rabbit sinusitis was established in group B to F, and CT was used to confirm the model was successful. After placing tubes into the maxillary sinus in the group C to F, saline, 45 mg/ml ISMN, 45 mg/ml ISMN nanoparticles and 45 mg/ml ISMN targeted nanoparticles were used to wash the maxillary sinus, respectively. Blood samples were collected from the ear vein of rabbits on day 7, 14, 21, 28, 35 and 42 after modeling respectively. Changes in the expression levels of inflammatory factors in rabbits during the modeling process and after drug washing were detected by ELISA. After the drug intervention, the maxillary sinus mucosa was taken for real-time quantitative PCR to detect the changes in the mRNA level of inflammatory factors. SPSS 22.0 software was used to process the data. Results: Rabbit model of sinusitis was successfully established. ELISA showed that after the action of ISMN targeted nanoparticles of 1 week (42th day after modeling), the levels of (interleukin, IL) 4, IL-8, IL-17A and interferon γ (IFN-γ) in the blood were lower compared with that of 35th day after modeling, the difference was statistically significant (5.57±1.20 vs 19.73±0.68, 66.41±11.87 vs 154.68±13.13, 17.96±1.87 vs 28.23±0.80, 53.56±5.66 vs 111.93±7.29, all P<0.05). Compared with the ISMN nanoparticles and ISMN, the ISMN targeted nanoparticles reduced the levels of IL-4, IL-8, IL-17A and IFN-γ more obviously, the differences were statistically significant (13.26±1.43 vs 8.81±1.33 vs 7.14±2.16, 89.47±17.80 vs 41.07±7.77 vs 15.84±3.72, 10.28±2.07 vs 3.06±1.62 vs 1.82±0.90, 62.16±6.18 vs 35.12±4.62 vs 27.89±10.18, all P<0.05). Real-Time PCR showed that after the flushing of ISMN targeted nanoparticles, the levels of IL-4, IL-8, IL-17A and IFN-γ mRNA were lowest compared with that of the model group, ISMN nanoparticles and ISMN group. Conclusion: ISMN targeted nanoparticles can reduce the level of inflammatory factors in rabbit sinusitis model.


Assuntos
Dinitrato de Isossorbida/uso terapêutico , Nanopartículas/uso terapêutico , Sinusite/sangue , Sinusite/tratamento farmacológico , Animais , Modelos Animais de Doenças , Feminino , Interferon gama/sangue , Interleucina-17/sangue , Interleucina-4/sangue , Interleucina-8/sangue , Masculino , Coelhos , Distribuição Aleatória
10.
Zhonghua Wai Ke Za Zhi ; 57(12): 912-916, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31826595

RESUMO

Objective: To evaluate the role of multidisciplinary team (MDT) clinic in the diagnosis of pancreatic diseases and patient compliance with MDT advice in the current medical system. Methods: The study included 512 patients that had visited the pancreas-oriented MDT clinic of Zhongshan Hospital between May 2015 and May 2019.The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. Compliance was determined according to whether a patient received corresponding therapies or undergoing further checks or follow-ups. Results: Among the 512 patients that had visited the MDT clinic, 121 patients were referred due to undetermined diagnosis. Classified according to the final diagnosis, the rate of undetermined diagnosis in different disease categories from high to low in order was inflammatory diseases of the pancreas (75.0%, 24/32), other lesions of the pancreas (56.1%,23/41), pancreatic cystic lesions (19.1%,17/89), pancreatic carcinomas (18.3%,48/262) and pancreatic neuroendocrine neoplasms (pNEN)(10.2%,9/88). The MDT clinic made diagnosis to 68 patients directly with an accuracy of 89.7%. The rate of compliance in the entire cohort was 63.4%. The rate of compliance of patients from June 2017 to May 2019 (68.4%) was higher than that of patients from May 2015 to May 2017(59.6%). The compliance rate of patients in different disease categories from high to low in order was inflammatory diseases of the pancreas(84.4%, 27/32), pancreatic carcinomas (67.9%, 178/262), pNEN(60.2%,53/88), other lesions of the pancreas (56.1%,23/41), and pancreatic cystic lesions(49.4%, 44/89). The compliance rate of patients with different MDT advice from high to low in order was best supportive care(78.6%,22/28), antitumor approaches beyond surgery(71.6%,159/222), further tests(62.6%, 77/123), surgery(53.7%, 65/121) and follow-up(49.2%, 31/63). In patients suggested for surgery, the compliance rate of patients with carcinomas(67.4%, 33/49) was higher than patients with other kinds of neoplasms. Conclusions: MDT clinic could facilitate the diagnosis of pancreatic diseases conveniently and inexpensively. The overall compliance rate of MDT clinic patients is rather low, and patients with carcinomas have a relative high rate of compliance with the suggestion of surgery.


Assuntos
Ambulatório Hospitalar , Pancreatopatias/diagnóstico , Pancreatopatias/terapia , Cooperação do Paciente , China , Estudos de Coortes , Humanos , Neoplasias Pancreáticas/diagnóstico , Equipe de Assistência ao Paciente , Estudos Retrospectivos
11.
Zhonghua Fu Chan Ke Za Zhi ; 54(10): 654-659, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31648440

RESUMO

Objective: To explore the relationship between hemoglobin (Hb) level during the first trimester of pregnancy and gestational diabetes mellitus (GDM). Methods: A total of 1 276 participants, who underwent scheduled prenatal examination and normal singleton delivery at the Fifth People's Hospital of Shanghai and Hospital of Intergrated Chinese and Western Medicine in Minhang District, from January 2016 to May 2018 were included. There were 99 cases of GDM (GDM group) and 1 177 cases of normal (control group) pregnant women.Based on the serum Hb level during the first trimester of pregnancy, participants were divided into three groups, 236 cases of low Hb level group (Hb<110 g/L), 868 cases of normal Hb level group (110 g/L≤Hb<130 g/L), and 172 cases of high Hb level group (Hb≥130 g/L). Maternal clinical data were collected, including Hb level during the first trimester of pregnancy, three-point blood glucose (BG) of oral glucose tolerance test (OGTT) and fasting insulin during the second trimester of pregnancy. Homeostasis model assessment of insulin resistance index (HOMA-IR) and homeostasis model assessment of pancreatic ß cell function index (HOMA-ß) were used to evaluate insulin resistance and pancreatic ß cell function. Results: (1) Hb level during the first trimester of pregnancy in GDM group was significantly higher than that in control group [(123±10),(119±11) g/L, P<0.05]. There were no significant difference in gravidity, parity, index of liver and renal function (all P>0.05). (2) Pre-pregnancy body mass index (BMI), 1-hour BG and 2-hour BG of OGTT were significantly increased in the high Hb level group during the first trimester of pregnancy, which were (23±4) kg/m(2), (7.3±2.0) mmol/L, and (6.5±1.4) mmol/L (P<0.05), respectively. The pre-pregnancy BMI, 1-hour BG and 2-hour BG of the normal or low Hb level group were (22±3) kg/m(2), (6.7±1.6) mmol/L, (6.1±1.2) mmol/L; (22±3) kg/m(2), (6.5±1.5) mmol/L, (5.9±1.1) mmol/L, respectively. There were no statistically significant difference in levels of fasting blood glucose, fasting insulin, HOMA-IR and HOMA-ß within 3 groups (all P>0.05). (3) In the high Hb level group, prevalence of pregnancy overweight or obesity and GDM were the highest, which were 37.2%(64/172) and 15.1%(26/172), respectively; the differences were statistically significant (all P<0.05). (4) The serum Hb level in the first trimester was positively related with pre-pregnancy BMI (r=0.130, P<0.05), 1-hour BG (r=0.129, P<0.05), 2-hour BG (r=0.134, P<0.05), fasting insulin (r=0.096, P<0.05), and HOMA-IR (r=0.101, P<0.05).Logistic regression indicated that Hb≥130 g/L during the first trimester of pregnancy was an independent risk factor for GDM (OR=2.799, 95%CI: 1.186-6.604; P<0.05). Conclusion: The high level of Hb (Hb≥130 g/L) during the first trimester of pregnancy is associated with GDM.


Assuntos
Glicemia/análise , Diabetes Gestacional/diagnóstico , Intolerância à Glucose/diagnóstico , Teste de Tolerância a Glucose , Hemoglobinas/análise , Resistência à Insulina , Primeiro Trimestre da Gravidez/sangue , Adulto , Grupo com Ancestrais do Continente Asiático , Glicemia/metabolismo , Índice de Massa Corporal , China/epidemiologia , Diabetes Gestacional/sangue , Diabetes Gestacional/epidemiologia , Feminino , Humanos , Incidência , Gravidez , Fatores de Risco
12.
Zhonghua Er Ke Za Zhi ; 57(9): 680-685, 2019 Sep 02.
Artigo em Chinês | MEDLINE | ID: mdl-31530353

RESUMO

Objective: To investigate the status of the development of primary teeth and to identify the development patterns among infants and toddlers in nine cities of China in 2015. Methods: Healthy children aged 1-<36 months were investigated by across-sectional survey and retrospective studies, which was carried out in 9 cities (Beijing, Harbin and Xi'an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to October in 2015. Subjects (n=103 995) were divided into 14 age groups (1-<2, 2-<3, 3-<4, 4-<5, 5-<6, 6-<8, 8-<10, 10-<12, 12-<15, 15-<18, 18-<21, 21-<24, 24-<30, 30-<36 months). There were 150-200 boys and girls respectively in each group of urban and suburb areas in each city. The eruption status and the number of primary teeth were examined by the trained child health care physician or pediatrician on the spot. The timing of primary teeth eruption of children was retrospectively surveyed using a questionnaire. The prevalence of primary teeth was calculated and χ(2) test was used for comparison of categorical data. Probit regression analysis was used to determine the median and percentile age of eruption of primary teeth. Results: Totally 103 995 children aged 1-<36 months were investigated. There were 52 346 children in urban areas (boys 26 228, girls 26 118) and 51 649 children in suburb areas (boys 25 912, girls 25 737). The eruption rate of primary teeth in children under 2 years became higher with age and the difference among each age group was statistically significant (χ(2)=85 913.868, P<0.01), which was 0.3% (22/7 450) in 3-<4 months group, 43.0% (3 227/7 503) in 6-<8 months group and 99.9% (7 441/7 446) in 15-<18 months group. The eruption age of primary teeth was 6.6 months (95%CI: 6.5-6.7 months), and the range of the 3rd to 97th percentile was 4.1-10.6 months. The eruption ages of primary teeth in urban and suburb areas children were 6.6 months (95%CI: 6.5-6.7 months) and 6.6 months (95%CI: 6.5-6.7 months) respectively. The eruption age of primary teeth was earlier in boys (6.4 months, 95%CI: 6.3-6.5 months) than that in girls (6.7 months, 95%CI: 6.6-6.8 months). The median eruption age of primary teeth was earlier in northern China (6.2 months) than that in central (6.7 months) and southern China (6.9 months). The eruption rate of primary teeth became higher with age, showing that the median number of primary teeth was 2 in 8-<10 months group, 8 in 12-<15 months group and 20 in 30-<36 months group. Conclusions: The timing of eruption of primary teeth was similar between urban and suburb areas children and that of the boys was slightly earlier than that of the girls. There were slight differences among different regions in the eruption timing of primary teeth. The range of the 3rd to 97th percentile in the eruption age of primary teeth was 4.1-10.6 months and the number of primary teeth followed the regular development pattern with age.


Assuntos
Erupção Dentária , Dente Decíduo , Pré-Escolar , China , Cidades , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos
13.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(9): 944-946, 2019 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-31474079

RESUMO

To explore the mediating role of psychological resilience to childhood abuse and binge eating. This study assessed the childhood abuse, binge eating and psychological resilience of 3 453 middle school students in Harbin city, Heilongjiang Province. SPSS PROCESS macro program, combined with Bootstrap method, was employed to explore the mediating effect of psychological resilience. The incidence of middle school students experiencing at least one type of abuse in their childhood was 81.3% (2 807/3 453). Childhood abuse, psychological resilience and binge eating were all significantly different in terms of gender, household registration and whether they were only child (all P values<0.05). There was a significant positive correlation between childhood abuse and binge eating. Psychological resilience was negatively associated with childhood abuse and binge eating. Childhood abuse could not only directly predict the binge eating behavior of adolescents, but also could indirectly affect it via psychological resilience.


Assuntos
Maus-Tratos Infantis , Resiliência Psicológica , Adolescente , Bulimia/epidemiologia , Bulimia/psicologia , Criança , Maus-Tratos Infantis/psicologia , Comportamento Alimentar/psicologia , Feminino , Humanos , Masculino , Estudantes/psicologia , Estudantes/estatística & dados numéricos
14.
Eur Rev Med Pharmacol Sci ; 23(17): 7327-7337, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31539119

RESUMO

OBJECTIVE: Prostate cancer, one of the most common malignant tumors in urology, now has become a malignant disease that seriously threatens the health of men in China. Although there are a large number of clinical studies on the treatment of patients with prostate cancer, many patients have entered the advanced stage of diagnosis, and little is known about its pathogenesis. MATERIALS AND METHODS: We identified a series of ncRNA and TF by differential expression analysis, co-expression analysis, enrichment analysis, connectivity analysis, and hypergeometric test strategies for prostate cancer expression genomes. RESULTS: 53 modules related to prostate cancer PC-3 cells were obtained, involving module focusing of 4448 genes. Based on these modules, we predicted that miR-26a-5p, miR-130a-3p, miR-519d-3p, etc. have important regulatory effects on prostate cancer PC-3 cells. At the same time, a series of transcription factors (relating to RELA, SOX10, TP53, and TWIST2, etc.) were obtained and may play a key regulatory role in prostate cancer PC-3 cell-related modules. CONCLUSIONS: These results suggest that FENDRR in prostate cancer may reduce tumor invasion in prostate cancer PC-3 cells by targeting CSNK1E, which may have favourable effort to better understand the underlying pathogenesis of prostate cancer and provide a tough theoretical basis for further studying prostate cancer.

15.
Zhonghua Er Ke Za Zhi ; 57(8): 614-619, 2019 Aug 02.
Artigo em Chinês | MEDLINE | ID: mdl-31352747

RESUMO

Objective: To explore the clinical manifestations, diagnosis, treatment and prognosis of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) . Methods: A retrospective study identified 91 patients diagnosed with ALCAPA at Shanghai Children's Medical Center from March 2010 to August 2017. According to the left ventricular ejection fraction (LVEF) at the time of consultation, patients were divided into the cardiac insufficiency group (n=54) and the normal cardiac function group (n=37). Clinical features (age of onset, clinical performance, etc) and auxiliary examinations (electrocardiogram, echocardiography, etc) between the two groups were compared using a t-test and a Chi-square test. Prognostic factors were analyzed by an ordered logistic regression and a Pearson correlation coefficient. Results: (1) The age of diagnosis of patients in the cardiac insufficiency group who were usually misdiagnosed as cardiomyopathy was (10.0±2.6) months (20/54) , whereas the age of diagnosis of patients in the normal cardiac function group who were usually misdiagnosed as valvular diseases was (40.0±7.8) months (4/37). According to the pathophysiological mechanism, forty of the 54 (74%) patients in the cardiac insufficiency group were infantile type, and 78% patients (29/37) in the normal cardiac function group were adult type. (2) Preoperative electrocardiogram showed the deep Q wave in lead I occurred more frequently in the cardiac insufficiency group than in the normal cardiac function group (28/54 vs. 11/37, χ(2)=4.388, P=0.036). (3) Twenty patients died in the cardiac insufficiency group including 12 patients who died from postoperative cardiac pump failure and 8 children who did not undergo surgery due to poor prognosis and died from other reasons. There was no death in the normal cardiac function group. (4) Preoperative LVEF was the unique risk factor affecting prognosis (F=16.872, P=0.005). The preoperative LVEF was significantly lower than the postoperative LVEF ((37±11)% vs. (45±14)%, t=3.614, P=0.001) in the cardiac insufficiency group. During the follow-up period, 6 patients in the cardiac insufficiency group still presented with postoperative cardiac dysfunction, and the patients in the normal cardiac function group still had normal cardiac function. Conclusions: Preoperative LVEF was the unique risk factor affecting prognosis of ALCAPA. Patients with infantile type ALCAPA and preoperative cardiac insufficiency should receive long-term follow-up treatment.


Assuntos
Síndrome de Bland-White-Garland , Anomalias dos Vasos Coronários/cirurgia , Assistência Perioperatória/métodos , Artéria Pulmonar/anormalidades , Adulto , Baixo Débito Cardíaco , Procedimentos Cirúrgicos Cardíacos , Criança , China , Eletrocardiografia , Humanos , Lactente , Insuficiência da Valva Mitral , Estudos Retrospectivos , Resultado do Tratamento , Função Ventricular Esquerda
16.
Eur Rev Med Pharmacol Sci ; 23(13): 5691-5698, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31298321

RESUMO

OBJECTIVE: Recent studies have discovered that long non-coding RNAs (lncRNAs) play an important role in the development of malignant tumors. The aim of this work was to investigate the exact role of lncRNA LINP1 in the development of Wilms' tumor and to explore the possible underlying mechanism. PATIENTS AND METHODS: The expression of lncRNA in non-homologous end joining pathway 1 (LINP1) in tissue samples of Wilms' tumor was detected by Real Time-quantitative Polymerase Chain Reaction (RT-qPCR). The relationship between the expression of lung cancer associated transcript 1 (LUCAT1) and patients' overall survival time was analyzed. Subsequent functional experiments were conducted to identify the changes in biological behaviors of Wilms' tumor cells after the gain or loss of LINP1. Moreover, the underlying mechanism of LINP1 function was explored. RESULTS: QRT-PCR results showed that LINP1 expression level in Wilms' tumor tissues was significantly higher than that of adjacent tissues. LINP1 expression was negatively associated with the overall survival time of patients with Wilms' tumor. Cell growth ability was markedly inhibited and promoted after down-regulation and overexpression of LINP1 in vitro, respectively. Moreover, after the loss and gain of LINP1 in vitro, cell migration and invasion abilities were remarkably repressed and promoted, respectively. Furthermore, the loss of LINP1 in vitro could significantly decrease the expressions of targeted proteins in the Wnt/ß-catenin signaling pathway. However, the expressions of targeted proteins in the Wnt/ß-catenin signaling pathway were remarkably up-regulated after over-expression of LINP1. CONCLUSIONS: LINP1 could enhance cell metastasis and proliferation via inducing the Wnt/ß-catenin signaling pathway. Our findings might provide a new prospect for the diagnosis and therapy of Wilms' tumor.

17.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(7): 686-691, 2019 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-31288338

RESUMO

Objective: To examine the association of joint effect of overweight (including obesity) and elevated blood pressure (BP) with left ventricular hypertrophy (LVH) in children. Methods: A convenient cluster sampling method was used to conduct a cross-sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 319 children aged 6-11 years old who had complete data on anthropometric indices and variables collected using a questionnaire were included in the study. LVH was defined as left ventricular mass index (LVMI) ≥90 th percentile for sex and age of this population. Based on weight status (yes vs. no) and elevated BP status (yes vs. no), all participants were divided into four subgroups (normal weight and normal BP, normal weight and elevated BP, overweight and normal BP, overweight and elevated BP). LVMI levels or prevalence of LVH across four subgroups were compared. The multivariate logistic regression model was used to examine the association of joint effect between overweight and elevated BP with LVH in children. Results: The age of children was (8.4±1.6) years, and boys accounted for 53.3% (n=703). There were significant differences in LVMI levels and prevalence of LVH across four subgroups (P<0.05); Children with both overweight and elevated BP (n=184) had the highest LVMI levels and prevalence of LVH [LVMI: (30.69±0.32) g/m(2.7); the prevalence of LVH: 24.46%]. After the adjustment for potential covariates, compared to children with both normal weight and normal BP (n=657), the risk of LVH in children with elevated BP alone (n=136) was not increased [OR (95%CI) was 0.89 (0.30-2.62)]. Children with overweight alone (n=342) [OR (95%CI) was 5.69(3.39-9.55)] and those with both overweight and elevated BP [OR (95%CI) was 9.45 (5.47-16.33)] were at higher risk of LVH. Conclusion: The joint effect between overweight and elevated BP could be highly correlated with LVH in children.


Assuntos
Hipertensão/epidemiologia , Hipertrofia Ventricular Esquerda/epidemiologia , Obesidade Pediátrica/epidemiologia , Criança , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino
18.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(7): 692-695, 2019 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-31288339

RESUMO

Objective: To examine the association of abnormal metabolic indexes and its clustering with carotid intima-media thickness (cIMT) in childhood. Methods: A convenient sampling method was used to conduct a cross-sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 240 children who had complete data of questionnaires, physical examinations, and blood biochemical tests were included for analysis. Covariance analysis was used to analyze the association of the single abnormal metabolic indices and its clustering with cIMT. The multivariable linear regression model was used to quantify the relationship between the number of abnormal metabolic indices and cIMT. Results: The age of 1 240 children was (8.9±1.5) years, and 657 boys accounted for 53.0%. The highest detection rate of abnormal metabolic indicators was found in abdominal obesity, accounting for 30.9% (203/657) of boys and 29.7% (173/583) girls respectively.The cIMT of boys and girls were (0.49±0.08) and (0.45±0.07) mm, respectively. After adjusting for sex, age, consumption of fruits, vegetables and carbonated drinks, sleep duration, screen time and physical activity, abdominal obesity, elevated blood pressure, total triglyceride and fasting glucose were associated with cIMT (all P values <0.001). Children with 0, 1, 2 and ≥3 abnormal metabolic indicators had cIMT values of (0.45±0.07), (0.48±0.08), (0.50±0.09) and (0.53±0.08) mm, respectively. That was, cIMT values increased with the number of abnormal metabolic indexes (P(trend)<0.001). Conclusion: Abdominal obesity, elevated blood pressure, total triglyceride, fasting glucose and clustering of the above factors are associated with cIMT.


Assuntos
Espessura Intima-Media Carotídea/estatística & dados numéricos , Doenças Metabólicas/epidemiologia , Criança , China/epidemiologia , Análise por Conglomerados , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco
19.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(7): 765-769, 2019 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-31357795

RESUMO

Objective: To understand the mortality and influencing factors on injecting drug users (IDUs) with HIV/AIDS, in Guizhou province, 1996-2015. Methods: A retrospective cohort study was conducted on IDUs with HIV/AIDS that were reported through national comprehensive HIV/AIDS information system, in Guizhou province during 1996-2015. Cox proportional hazard regression model was used to analyze the influencing factors on the mortality of HIV/AIDS. Results: A total of 3 958 cases of IDUs with HIV/AIDS were recruited in this study, with all-cause mortality rate of 44.01% (1 742/3 958) and total mortality rate of 7.80/100 person-years, respectively. The median survival time between diagnosis and death was 8.08 years. Mortality rate was 3.57/100 person-years in the group receiving antiretroviral therapy (ART). The mortality appeared to be 4.08/100 person-years in the group who were on methadone maintenance treatment (MMT). Data from the multiple regression analysis indicated that factors of gender, ethnicity, age when HIV/AIDS diagnosis was made, CD(4)(+)T lymphocyte (CD(4)) count at the first testing, ART and MMT were significantly associated with deaths among these people. The risk of death in females was 0.82 times (95%CI: 0.69-0.98) higher than that in males. The risk of deaths among the ethnic minority subjects was 1.39 times (95%CI: 1.21-1.60) higher than that of the Hans. The risk of death appeared to be 2.44 times higher (95%CI: 1.07-5.56) in the over-50-year of age group than in the <20 year-old group, when HIV/AIDS was diagnosed for the first time. The risk of death in CD(4) ≥500/µl group in the first time was 0.27 times (95%CI: 0.22-0.32) more than CD(4) <200/µl group in the firs time. The risk of death in cases who were treated with ART or MMT was 2.83 times (95%CI: 2.45-3.26) and 1.35 times (95%CI: 1.15-1.59) higher than those who did not receive any treatment, respectively. Conclusion: Higher risks on death seemed to be related to the following factors: being male, older age at the time of diagnosis, lower CD(4) at diagnosis, not on ART or MMT among the IDUs with HIV/AIDS in Guizhou province, between 1996-2015.


Assuntos
Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/mortalidade , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
20.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(7): 634-638, 2019 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-31302960

RESUMO

Objective: To evaluate the clinical value of dual channel dual curved endoscope in the endoscopic submucosal dissection (ESD) for gastric angle mucosal lesions. Methods: A descriptive cohort study was carried out. Clinicopathological data of 20 cases with gastric angle mucosal lesions undergoing ESD by dual channel dual curved endoscope in our center from October 2016 to August 2018 were collected and analyzed retrospectively. Inclusion criteria: (1) the lesion was located in the gastric angle confirmed by gastroscopy before ESD. (2) CT examination showed no distant metastasis. (3) pathological biopsy confirmed precancerous lesion or early cancerous lesion without submucosal invasion. (4) the whole operation was performed by the same endoscopist with ESD experience of about 2000 cases. Patients with previous ESD history of gastric angle and other serious diseases were excluded. The dual channel dual curved endoscopy (Olympus, GIF-2TQ260M) and other conventional endoscopic surgical instruments were used in all the cases. Complete tumor resection rate, pathological results, intraoperative and postoperative complications, operation time and hospitalization time were observed. Follow - up parameters included residual tumor, local recurrence and heterogeneous lesion. Results: Of 20 patients, 14 were male and 6 were female with an average of 55.6 years (range, 37 to 75). All the tumors located in gastric angle. Specimen size ranged from 1.2 to 5.5 (average 2.9) cm. Operation time ranged from 50 to 120 (average 85.8) minutes. Hospital stay ranged from 3 to 7 (average 5.1) days. The en bloc excision was performed successfully in all 20 cases. There was no perforation or bleeding during or after operation. Pathological results showed curative or nearly curative resection stage in all the cases. No tumor residual or recurrence was found during follow-up for 8 to 30 (average 18.5) months. Conclusion: Dual channel dual curved endoscope can provide good vision and easy control in removing the lesion completely and avoiding complications during the ESD procedure in gastric angle mucosal lesions with good long-term efficacy.


Assuntos
Ressecção Endoscópica de Mucosa/instrumentação , Mucosa Gástrica/cirurgia , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Biópsia , Estudos de Coortes , Endoscópios Gastrointestinais , Feminino , Mucosa Gástrica/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Gástricas/patologia
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