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Objective:To investigate the relationship between carotid atherosclerosis(CAS)and subclinical left ventricular(LV)dysfunction in type 2 diabetes mellitus patients with preserved LV ejection fraction(LVEF).Methods:A total of 120 patients with type 2 diabetes mellitus who had LVEF≥50% were selected in the Department of Endocrinology, the First Affiliated Hospital of Air Force Medical University from June 2021 to October 2021. The global longitudinal strain(GLS)was obtained by two-dimensional speckle tracking echocardiography(STE)to assess subclinical LV systolic function. The mitral ratio of peak early to late diastolic filling velocity(E/A), and mitral velocity to early diastolic velocity of the mitral annulus(E/E′)ratio were obtained by pulsed tissue Doppler echocardiography to assess LV diastolic function. Acrroding to bilateral carotid ultrasound examination, the subjects were divided into normal carotid arteries group( n=46) and CAS group( n=74). Demographics and biochemical parameters were compared between two groups. Binary logistic regression and Pearson correlation analysis were used to evaluate the relationship between CAS and subclinical LV dysfunction. Results:The CAS group had a higher proportion of men, older age, and a longer duration of diabetes than the normal carotid arteries group(all P<0.05). There was no difference in LVEF and GLS between the two groups [normal carotid arteries group vs CAS group, LVEF: (60.72±4.73)% vs(60.07±4.28)%; GLS: (18.24±3.72)% vs(17.81±3.47)%, respectively; both P>0.05]. However, compared with normal carotid arteries group, E/A ratio was decreased and E/E′ ratio was significantly increased in CAS group(both P<0.01). Pearson correlation analysis showed that GLS was not correlated with carotid plaque thickness and carotid intima-media thickness(CIMT; both P>0.05). By contrast, E/E′ ratio was positively correlated with carotid plaque thickness and CIMT(both P<0.05). Binary logistic regression analysis showed that GLS and E/E′ ratio were not associated with CAS( both P>0.05). However, decreased E/A ratio was significantly associated with the existence of CAS( OR=0.09, 95% CI 0.01-0.67, P=0.018). Conclusions:In type 2 diabetes mellitus patients without overt heart failure and with preserved LVEF, the occurrence of CAS is not associated with subclinical LV systolic impairment assessed by GLS, but is significantly associated with LV diastolic dysfunction, and is independent of traditional cardiovascular risk factors.
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Objective@#To explore the effect of guided half day education in rehabilitation of children with cerebral palsy.@*Methods@#100 children with cerebral palsy were selected and randomly divided into experimental group and control group according to the length of hospitalization, 50 cases in each group. The control group was given routine rehabilitation treatment and nursing, while the experimental group was given half-day education based on routine rehabilitation treatment and nursing. The changes of gross motor function (GMFM) and daily living activity (ADL) were observed and compared between the two groups before and 6 months after intervention.@*Results@#The GMFM scores of the experimental group before and after intervention were (41.85 ±4.26), (66.85 ±4.73) respectively, and those of the control group were (42.59±3.24), (56.59 ±3.63). There was no significant difference between the two groups (Z=1.33,12.17, P<0.05). The ADL scores of the experimental group before and after intervention were (40.43±9.78), (63.21±12.34), respectively. There were significant differences between the two groups (Z=0.51, 4.42, P < 0.05). After intervention, the scores of five single A, B, C, D and E areas of GMFM in the experimental group were (94.8 ± 18.2), (76.3 ± 16.5), (36.4±16.7), (30.4±14.5), (19.4 ± 15.2), respectively. The control group was (85.1±14.7), (58.5±13.6), (26.1±13.4), (18.3±12.3), (12.7±10.7). There were significant differences between the two groups (Z=2.55-5.89, P<0.05).@*Conclusion@#Guided half-day process teaching combined with routine rehabilitation treatment and nursing can improve the gross motor and self-care ability of children with cerebral palsy, and its effect is better than that of simple medical rehabilitation..
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Objective To explore the effect of guided half day education in rehabilitation of children with cerebral palsy. Methods 100 children with cerebral palsy were selected and randomly divided into experimental group and control group according to the length of hospitalization, 50 cases in each group. The control group was given routine rehabilitation treatment and nursing, while the experimental group was given half-day education based on routine rehabilitation treatment and nursing. The changes of gross motor function (GMFM) and daily living activity (ADL) were observed and compared between the two groups before and 6 months after intervention. Results The GMFM scores of the experimental group before and after intervention were (41.85 ±4.26), (66.85 ±4.73) respectively, and those of the control group were (42.59±3.24), (56.59 ±3.63). There was no significant difference between the two groups (Z=1.33,12.17, P<0.05). The ADL scores of the experimental group before and after intervention were (40.43 ± 9.78), (63.21 ± 12.34), respectively. There were significant differences between the two groups (Z=0.51, 4.42, P<0.05). After intervention, the scores of five single A, B, C, D and E areas of GMFM in the experimental group were (94.8 ± 18.2), (76.3 ± 16.5), (36.4 ± 16.7), (30.4 ± 14.5), (19.4 ± 15.2), respectively. The control group was (85.1±14.7), (58.5±13.6), (26.1±13.4), (18.3±12.3), (12.7±10.7). There were significant differences between the two groups (Z=2.55-5.89, P<0.05). Conclusion Guided half-day process teaching combined with routine rehabilitation treatment and nursing can improve the gross motor and self-care ability of children with cerebral palsy, and its effect is better than that of simple medical rehabilitation..
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Objects:To investigate the current situation of interpersonal communication inpreparatory students in one Xinjiang medical college from the exchanges between students.Methods:Using self-developed questionnaire,a survey was conducted among 200 preparatory students and depth interviews were conducted for typical cases.Results:Preppies showed a strong willing of interpersonal communication.In the process of students' interaction,some features were presented as followings:pure motives but dissimilarity,narrow range of interactions,lack of interaction ability and the single form of social activities.Conclusion:Based on the above current situation of interpersonal communication in preparatory students,it should enhance the language application ability of preparatory stage,change the idea and attach importance to the education of humanistic quality in preparatory education and train preppy's expression and listening art.
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Objective:To investigate the effect of short term and intensive insulin pump on the blood lipid and glucose levels of patients with type 2 diabetes.Methods:76 patients with type 2 diabetes were selected and divided into two groups according to different administration.The control group (38 cases) was given routine insulin aspart treatment.The observation group (38 cases) was treated by insulin pump.The blood and lipid indexes and ADL score before treatment,at 1 week and 2 weeks after treatment were compared between two groups.Results:After treatment,the levels of FPG,HbAlc,TC,TG and LDL-C were lower than those before treatment and the level of HDL-C was increased in both groups.The levels ofFPG,HbAlc,TC,TG,LDL-C of observation group were lower than those of the control group,and the level of HDL-C of observation group was higher than that of control group (P<0.05).At 1 week,2 weeks after treatment,the ADL scores of both groups were significantly improved,and the ADL score of observation group was higher than that of the control group (P<0.05).Conclusion:Short term intensive insulin pump could significantly improve the blood glucose and lipid metabolism disorders in patients with type 2 diabetes,and improve the ability of daily life.
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Objective To analyze the clinical value of postoperative radiotherapy for node-positive middle thoracic esophageal squamous cell carcinoma ( TESCC ) and to modify the target volume .Methods A total of 286 patients with node-positive middle TESCC underwent radical surgery in Cancer Hospital, Chinese Academy of Medical Sciences, from 2004 to 2009.In addition, 90 of these patients received postoperative intensity-modulated radiotherapy.The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used for survival difference analysis.The Cox model was used for multivariate prognostic analysis.The chi-square test was used for comparing the recurrence between patients receiving different treatment modalities.Results The 5-year overall survival ( OS) rates of the surgery alone ( S) group and surgery plus postoperative radiotherapy ( S+R) group were 22.9%and 37.8%, respectively, and the median OS times were 23.2 and 34.7 months, respectively ( P=0.003) .For patients with 1 or 2 lymph node metastases (LNMs), the 5-year OS rates of the S group and S+R group were 27.3%and 44.8%, respectively ( P=0.017);for patients with more than 2 LNMs, the 5-year OS rates of the S group and S+R group were 16.7%and 25.0%, respectively (P=0.043).The peritoneal lymph node metastasis rates of N1 , N2 , and N3 patients in the S group were 2.9%, 10.9%, and 20.0%, respectively ( P=0.024) .The S+R group had a significantly lower mediastinal lymph node metastasis rate than the S group ( for patients with 1 or 2 LMNs:8.0%vs.35.3%, P=0.003;for patients with more than 2 LNMs, 10.0%vs.42.3%, P=0.001) , and had a prolonged recurrence time compared with the S group ( 25.1 vs.10.7 months, P=0.000) .However, for patients with more than 2 LNMs, the S+R group had a significantly higher hematogenous metastasis rate than the S group (46.7%vs.26.1%, P=0.039).Conclusions Patients with node-positive middle TESCC could benefit from postoperative radiotherapy.The target volume can be reduced for patients with 1 or 2 LNMs.Prospective studies are needed to examine whether it is more appropriate to reduce the radiotherapy dose than to reduce the target volume for patients with more than 2 LNMs.A high hematogenous metastasis rate warrants chemotherapy as an additional regimen.
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[ Abstract] Objective To investigate the clinical efficacy of preoperative three-dimensional radiotherapy (3DRT) with or without concurrent chemotherapy for esophageal carcinoma.Methods We retrospectively analyzed 103 esophageal carcinoma patients who received preoperative 3DRT with or without concurrent chemotherapy from 2004 to 2014 in Cancer Hospital CAMS.The median radiation dose was 40 Gy, and the TP or PF regimen was adopted for concurrent chemotherapy if needed.The overall survival (OS) and disease-free survival ( DFS) were calculated by the Kaplan-Meier method, and the survival difference and univariate prognostic analyses were performed by the log-rank test.The Cox proportional hazards model was used for multivariate prognostic analysis.Results The number of patients followed at 3-years was 54.The 3-year OS and DFS rates were 61.1% and 54.9%, respectively, for all patients.There were no significant differences between the 3DRT and concurrent chemoradiotherapy (CCRT) groups as to OS (P=0.876) and DFS (P=0.521).The rates of complete, partial, and minimal pathologic responses of the primary tumor were 48.0%, 40.2%, and 11.8%, respectively.There were significant differences in OS and DFS between the complete, partial, and minimal pathologic response groups (P=0.037 and 0.003). No significant difference in pathologic response rate was found between the 3DRT and CCRT groups (P=0.953).The lymph node metastasis rate was 26.5%, and this rate for the complete, partial, and minimal pathologic response groups was 14%, 30%, and 67%, respectively, with a significant difference between the three groups (P=0.001).The OS and DFS were significantly higher in patients without lymph node metastasis than in those with lymph node metastasis (P=0.034 and 0.020).The surgery-related mortality was 7.8% in all patients.Compared with the 3DRT group, the CCRT group had significantly higher incidence rates of leukopenia (P=0.002), neutropenia (P=0.023), radiation esophagitis (P=0.008), and radiation esophagitis ( P=0.023).Pathologic response of the primary tumor and weight loss before treatment were independent prognostic factors for OS and DFS (P=0.030,0.024 and P=0.003,0.042). Conclusions Preoperative 3DRT alone or with concurrent chemotherapy can result in a relatively high complete pathologic response rate, hence increasing the survival rate.Further randomized clinical trials are needed to confirm whether preoperative CCRT is better than 3DRT in improving survival without increasing the incidence of adverse reactions.
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<p><b>OBJECTIVE</b>To explore the clinical efficacy of the chronic balloon expansion in urethral and vaginal reconstruction for high persistent cloaca.</p><p><b>METHODS</b>Clinical data of 21 children with high persistent cloaca undergoing chronic balloon expansion technique in Cangzhou Central Hospital and Capital Pediatric Institute from December 1996 to August 2014 were analyzed retrospectively. The balloon was continuously expand for 3 to 4 weeks. Balloon was filled with water, maintaining the internal pressure at 30 to 50 mmHg. When the diameter of the common channel was 3 cm, the plastic operations of bladder neck, urethra and vagina were performed.</p><p><b>RESULTS</b>All the 21 patients underwent primary posterior sagital urethro-vaginoplasty by using the expanded urogenital sinus. The average duration of expansion was (26.8±3.1) days and the average diameter of the urogenital sinus was increased up to (2.8±0.2) cm. Infection of urinary tract and common channel wall was not found. Histological examination demonstrated the expanded tissue consisted of a dense fibrous wall lined by a stratified squamous non-cornified epithelium, which was characterized by active cell mitoses and angiogenesis. Patients were followed up for 0.5 to 11.0 years. Efficacy was satisfactory, and no death occurred. After the operation, 9 cases reached grade I( urinary incontinence, 8 cases reached grade II( among the 17 cases with grade IIII( urinary incontinence. One patient had distal urethral dehiscence, and the secondary urethroplasty was employed six months after the operation. Urethral diameter of another 1 case dilated 9 years later, and a tighten urethral angioplasty was performed, then the urine dripping disappeared. All the children were not treated with vaginal dilatation.</p><p><b>CONCLUSION</b>Chronic balloon expansion allows the creation of adequate tissue similar in appearance and type to vagina and urethra, and provides a valuable surgical alternative for managing high persistent cloaca.</p>
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Femenino , Humanos , Enfermedad Crónica , Cloaca , Procedimientos de Cirugía Plástica , Estudios Retrospectivos , Uretra , VaginaRESUMEN
BACKGROUND:Bone nonunion may occur after limb trauma fracture. Internal fixation of implant is a common mode of repair, but fixation of different implants has different effects. OBJECTIVE:To explore the application value of different implant fixation in limb trauma of nonunion after femoral shaft fracture. METHODS:A retrospective analysis was performed on 72 cases of nonunion after femoral shaft fractures in Bozhou People’s Hospital from November 2012 to November 2013. They were divided into the observation group (36 cases) and control group (36 cases) according to the way of treatment, which were given interlocking intramedul ary nail and dynamic compression plate fixation. Length of incision, intraoperative blood transfusion volume, postoperative drainage volume, operation time, fracture healing time and functional recovery of knee joint were observed and compared between the two groups. RESULTS AND CONCLUSION:There was no statistical significance in operation time and length of the incision between the two groups (both P>0.05). Intraoperative amount of blood transfusion and postoperative drainage were significantly higher in the control group than in the observation group;the fracture healing time was significantly longer in the control group than in the observation group;infection rate in final fol ow-up was significantly higher in the control group than in the observation group (al P0.05), but above two scores were significantly higher in the observation group than in the control group in final fol ow-up (al P<0.05). These findings suggest that compared with the dynamic compression plate, interlocking intramedul ary nail in treatment of bone nonunion after femoral shaft fracture can obtain good effect, firm fixation, low infection rate, and is more in line with the physiological and biomechanical requirements.
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Objective Short-segment fixation is one of the most commonly used methods for the management of thoracolumbar vertebral fractures.In this study, we compared the clinical effects of short-segment fixation via and across the injured vertebrae in the treatment of thoracolumbar vertebral fractures . Methods We retrospectively analyzed 75 cases of thoracolumbar vertebral fractures treated by short-segment fixation, 39 via the injured vertebrae (group A) and 36 across the injured vertebrae (group B).We obtained the pre-and post-operative anterior vertebral body height ratio (AVBHr) and sagittal Cobb angle, operation time, and intraoperative blood loss, and compared them between the two groups of patients . Results Compared with the baseline, the AVBHr and the sagittal Cobb angle were significantly restored after surgery in both groups A ([56.32 ±12.53] vs [85.76 ±11.48]%and [20.41 ±5.73] vs [8.72 ±5.34]°, P0.05).The losses of the AVBHr and Cobb angle were (3.78 ±1.24)%and (2.25 ±1.06)°in group A, signifi-cantly lower than (6.69 ±2.52)% and (6.31 ±2.18)°in group B (P<0.05). Conclusion For thoracolumbar fractures, short-segment fixation either via or across the injured vertebrae can effective-ly improve the vertebral height and Cobb angle , but fixation via the injured vertebrae may achieve a better maintenance of correction .
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<p><b>OBJECTIVE</b>Video-assisted thoracoscopic (VATS) esophagectomy has been performed for more than 10 years in China. However, compared with the conventional esophagectomy via right thoracotomy, whether VATS esophagectomy has more advantages or not in the lymph node (LN) dissection and prevention of perioperative complications is still controversial and deserves to be further investigated. The aim of this study was to explore whether there are significant differences in this issue between the two surgical modalities or not.</p><p><b>METHODS</b>The results of lymph node dissection and perioperative complications as well as other parameters in the patients treated by VATS esophagectomy and those by conventional esophagectomy via right thoracotomy at our department from May 1, 2009 to July 30, 2013 were compared using SPSS 16.0 in order to investigate whether there was any significant difference between these two treatment modalities in the learning curve stage of VATS esophagectomy.</p><p><b>RESULTS</b>One hundred and twenty-nine cases underwent VATS esophagectomy between May 1, 2009 and July 30, 2013, and another part 129 cases with the same preoperative cTNM stage treated by conventional esopahgectomy via right thoracotomy were selected in order to compare the results of lymph node dissection and perioperative complications as well as other parameters between those two groups of patients. There were no significant differences in the sex, age, lesion locations and cTNM stage between these two groups. The total LN metastatic rate in the VATS esophagectomy group was 35.7% and that of the conventional esophagectomy group was 37.2% (P > 0.05). The total average number of dissected lymph nodes was 12.1 vs. 16.2 (P < 0.001). The average dissected LN stations was 3.2 vs. 3.6 (P = 0.038). The total average number of dissected LN along the left recurrent laryngeal nerve was 2.0 vs. 3.7 (P = 0.012). The total average number of dissected LN along the right recurrent laryngeal nerve was 2.9 vs. 3.4 (P = 0.231). However, there was no significant difference in the total average number of dissected LN in the other thoracic LN stations, and in the perioperative complications between the two groups. The total postoperative complication rate was 41.1% in the VATS group versus 42.6% in the conventional group (P = 0.801). The cardiopulmonary complication rate was 25.6% vs. 27.1% (P = 0.777). The death rate was the same in the two groups (0.8%). The VATS group had less blood infusion (23.2% vs. 41.8%, P = 0.001) and shorter hospital stay (15.9 days vs. 19.2 days, P = 0.049) but longer operating time (161.3 min vs. 127.8 min, P < 0.01).</p><p><b>CONCLUSIONS</b>In the learning curve stage of VATS esophagectomy, compared with the conventional esophagectomy, less LN number and stations can be dissected in the VATS group due to un-skillful VATS manipulation, especially it is more difficult in the LN dissection along the left recurrent laryngeal nerve. Therefore, it is more suitable to select patients with early esophageal cancer without obvious enlarged lymph nodes for VATS esophagectomy in the learning curve stage.</p>
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Humanos , China , Neoplasias Esofágicas , Patología , Cirugía General , Esofagectomía , Métodos , Curva de Aprendizaje , Tiempo de Internación , Escisión del Ganglio Linfático , Métodos , Ganglios Linfáticos , Tempo Operativo , Complicaciones Posoperatorias , Epidemiología , Nervio Laríngeo Recurrente , Cirugía Torácica Asistida por Video , ToracotomíaRESUMEN
<p><b>OBJECTIVE</b>The aim of this study was to detect the plasma concentration of OLC1 (overexpressed in lung cancer 1) protein as a potential cancer biomarker, and evaluating its clinical application value in the diagnosis of non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>We prepared OLC1 antibody with OLC1 full length protein, in 5-6-week old Bal B/c mice. Each mouse was immunized four times at a dose of 15-30 µg antigen protein, and the interval between two consecutive immunizations was two weeks. Antibody screening was made by ELISA and Western blot, and a double antibody sandwich ELISA kit was developed. We used this established ELISA kit to detect the plasma concentration of OLC1 protein in 281 NSCLC patients and 92 gender- and age-matched healthy controls. Area under the receiver operating characteristic curve (AUC) was used to evaluate the detection efficacy of OLC1.</p><p><b>RESULTS</b>We obtained 11 OLC1 monoclonal antibodies and successfully established the ELISA kit to detect the plasma concentration of OLC1 with a detection range from 1.95 ng/ml to 62.50 ng/ml. OLC1 concentration in the case group (124.69 ng/ml) was significantly higher than that in the control group (67.07 ng/ml, P < 0.001). In the scenario of distinguishing NSCLC from control group, AUC result was 0.69. When the cut-off was set at 67.72 ng/ml, the sensitivity and specificity was 84.4% and 51.1%, respectively. In term of distinguishing early lung cancer (IA) from normal controls, the AUC, sensitivity and specificity were 0.68, 77.8% and 54.4%, respectively.</p><p><b>CONCLUSION</b>The plasma concentration of OLC1 protein is significantly elevated in NSCLC patients. OLC1 may be as a potential cancer biomarker applied in clinical diagnosis.</p>
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Adulto , Animales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Anticuerpos Monoclonales , Biomarcadores de Tumor , Sangre , Western Blotting , Carcinoma de Pulmón de Células no Pequeñas , Sangre , Diagnóstico , Alergia e Inmunología , Detección Precoz del Cáncer , Métodos , Ensayo de Inmunoadsorción Enzimática , Neoplasias Pulmonares , Sangre , Diagnóstico , Alergia e Inmunología , Ratones Endogámicos BALB C , Proteínas Oncogénicas , Sangre , Alergia e Inmunología , Curva ROC , Sensibilidad y EspecificidadRESUMEN
<p><b>OBJECTIVE</b>To evaluate and compare the value of stair climbing tests and conventional pulmonary function tests in the prediction of postoperative cardiopulmonary complications in non-small cell lung cancer patients underwent surgery.</p><p><b>METHODS</b>From April 1, 2010 to Jan. 30, 2012, a total of 162 patients with thoracic carcinoma underwent stair climbing test (SCT) and conventional pulmonary function tests (PFT) preoperatively. The correlation of postoperative cardiopulmonary complications with the SCT and PFT parameters were analyzed retrospectively using chi-square test, independent sample t test and binary logistic regression analysis.</p><p><b>RESULTS</b>Of the 162 patients, 19 without operation were excluded, due to an advanced stage (9 cases), poor cardiopulmonary function (5 cases), rejecting operation (4 cases) and exploration alone (1 case). 143 cases were eligible and evaluated eventually. Forty-one of the 143 patients (28.7%) had postoperative cardiopulmonary complications, but no death occurred. The patients were stratified into groups based on the time of stair climbing 5 stories (18.36 m, t, <92 s, ≥ 92 s). Exercise oxygen desaturation (EOD) during the stair climbing test (<5%, ≥ 5%) and the difference between the pulse at resting state and the pulse at end of stair climbing test (ΔP, <55 beats/min, ≥ 55 beats/min), respectively. The rate of postoperative cardiopulmonary complications was significantly higher in the group with t ≥ 92 s, EOD ≥ 5% and ΔP < 55 beats/min (38.5%, 42.0% and 35.1%, respectively) than that in the group with t<92 s, EOD<5% and ΔP ≥ 55 beats/min (16.9%, 21.5% and 18.2%, respectively). Binary logistic regression analysis showed that postoperative cardiopulmonary complications were independently correlated with EOD and lung function which did not meet the requirement of the lung resection operation mode.</p><p><b>CONCLUSIONS</b>A symptom-limited stair climbing test is a safe, simple and low-cost method to evaluate the cardiopulmonary function preoperatively. It can predict the occurrence of postoperative cardiopulmonary complications in non-small cell lung cancer patients. Conventional pulmonary function tests and stair-climbing test can be recommended to be routinely performed in all patients with non-small cell lung cancer before thoracic surgery.</p>
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Humanos , Carcinoma de Pulmón de Células no Pequeñas , Cirugía General , Prueba de Esfuerzo , Neoplasias Pulmonares , Cirugía General , Complicaciones Posoperatorias , Diagnóstico , Pruebas de Función Respiratoria , Estudios RetrospectivosRESUMEN
<p><b>OBJECTIVE</b>To explore the pattern of lymph node metastasis and evaluate the modes and extent of mediastinal lymph node dissection in patients with ≤ 3 cm, clinical stage I primary non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Data of 270 eligible patients who underwent pulmonary resection with systematic lymph node dissection in our hospital between March 2012 and August 2013 were retrospectively analyzed in order to investigate the relationship between the clinicopathological features and lymph node metastatic patterns. Patients with multiple primary carcinomas or non-primary pulmonary malignancies and those who received any chemotherapy or radiotherapy or did not undergo systematic nodal dissection were excluded. The criteria of systematic nodal dissection included the removal of at least six lymph nodes from at least three mediastinal stations, one of which must be subcarinal. The data were analyzed and compared using Chi-square test.</p><p><b>RESULTS</b>The postoperative morbidity rate was 14.8% and no death occurred in this series. The imaging findings showed 34 cases of pure ground glass opacity lesions, 47 partial solid nodules, and 189 solid nodules. Apart from 34 p-GGO lesions, among the other 236 cases, ≤ 1 cm lesions were in 22 cases, 1 cm- ≤ 2 cm lesions in 138 cases, and >2 cm- ≤ 3 cm lesions in 76 cases based on radiologic findings. The pathological types included adenocarcinoma (n = 245), squamous cell carcinoma (n = 18) and other rare types (n = 7). The overall lymph node metastasis rate was 18.9% (51/270), and the incidence of lymph node involvement was 0(0/34) in cancers with p-GGO, 2.1% (1/47) in mixed solid nodules, 26.5% (50/189) in solid nodules, 18.2% (4/22) in nodules ≤ 1 cm, 14.5% (20/138) in 1 cm < nodules ≤ 2 cm, and 35.5% (27/76) in 2 cm < nodules ≤ 3 cm. The metastasis rates of non-specific tumor-draining region lymph nodes detected in the patients with positive and negative lobe-specific lymph node involvement were 20.0%-50.0% vs. 0-2.9% (P < 0.001).</p><p><b>CONCLUSIONS</b>Usually NSCLC with p-GGO nodules has no lymph node metastasis, therefore, systematic nodal dissection may be not necessary. The larger the tumor size is, the higher the lymph node metastatic rate is for mixed or solid nodules. Intraoperative frozen-section examination of the lobe-specific lymph nodes should be performed routinely in patients with ≤ 2 cm stage I NSCLC, and systematic nodal dissection should be done if positive, but it may be not necessary if negative. However, the effectiveness of the systematic selective lymph node dissection still needs to be further confirmed.</p>
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Humanos , Carcinoma de Pulmón de Células no Pequeñas , Diagnóstico , Cirugía General , Escisión del Ganglio Linfático , Métodos , Ganglios Linfáticos , Cirugía General , Metástasis Linfática , Diagnóstico , Estadificación de Neoplasias , Estudios RetrospectivosRESUMEN
A facial allotransplanted patient presented hyperglycemia with blood glucose ranged 14. 3 -33. 3 mmol/L after receiving immunosuppressive drugs and glucocorticoids. To control the blood glucose level, the patient was treated with two subcutaneous doses of 10 U human neutral protamine hagedorn (NPH) insulin, and the fasting glucose level came down to 3. 6 - 9. 4 mmol/L. Then the continuous subcutaneous infusion of insulin aspart ( Novo Industri) was administrated (from 96 to 21 U/d) , and the fasting blood glucose levels were 3. 9 -4. 6 mmol/L. With oral administration of Metformin and Repaglinide, the fasting blood glucose was maintained to 4. 3 -5.9 mmol/L. With these medications, the blood glucose level of the patient was under good control and the acute and chronic complications of hyperglycemia were effectively prevented.
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Objective To explore the clinical curative effect of AF system combined vertebra re-duction and posterolateral bone fusion treatment thoracolumbar burst fracture .Methods Seventeen pa-tients with thoracolumbar burst fracture using period stage , according to the system of AF clinical symptoms and image data line pressure decreased , and the pressure or not to hurt inside the vertebral pedicle autoge-nous bone grafts are grain filling and vertebral posterolateral line between the axon , lamina around small joints and bone , and postoperative follow-up X-ray inspection regularly , observe internal fixation and verte-bral vertebral height and adjacent intervertebral space changes , or after fixation and reset lost .Results following up 13 months, vertebral body height restore and maintain good , bolt looseness and broken and ver-tebral body height complications such as lost were no found in 17 cases.Conclusion Treatments of Poste-rior fixation combined short stage AF vertebral body and posterolateral bone fusion on thoracolumbar burst fracture are not only rebuild the vertebral height , but also make the vertebral obtained after three pillars in stable, reduce the internal fixation and compressed vertebral again such complications .
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Microbial lipopeptides play an important role in apoptosis induction of tumor cells. However, there is little knowledge about the relationship between apoptosis induction and membrane fatty acids. The present study focused on the effects of lipopeptides produced by Bacillus subtilis HSO121 on Bcap-37 cell lines. 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl (MTT) colorimetric assay and surface tension measurements, showed that the critical micelle concentration (CMC) was a critical level for the inhibitory activity of lipopeptides on the growth of Bcap-37 cells. Under the CMC, the order of least to greatest cytotoxicity effect on cancer cell lines by lipopeptides is C(13)-lipopeptide < C(14)-lipopepitde < C(15)-lipopeptide. Above CMC, all lipopeptides directly exert cytolytic activity. The flow cytometric analysis and Hoechst33258 staining experiments confirmed the apoptosis of Bcap-37 cell lines induced by lipopeptides in a dose-dependent manner. This apoptosis was associated with a significant decrease of the unsaturated degree of the cellular fatty acids of Bcap-37 cell lines due to the changes in the cellular fatty acids composition induced by the lipopeptide treatment. These results indicated that disturbance of the cellular fatty acid composition of breast cancer cell lines were related to in the cell apoptosis. Furthermore, significant difference in IC(50) values of tumor cells and normal cell showed that the lipopeptide exerted selective cytotoxicity on the cancer cells. Thus HSO121 lipopeptides may have potential applications as an anticancer leads.
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Humanos , Antineoplásicos , Química , Farmacología , Apoptosis , Bacillus subtilis , Ciclo Celular , Membrana Celular , Química , Metabolismo , Supervivencia Celular , Ácidos Grasos , Química , Metabolismo , Células HeLa , Lipopéptidos , Química , Farmacología , Ploidias , Células Tumorales CultivadasRESUMEN
Objective To evaluate the effect of computer-aided design of composite materials with epoxide acrylate maleic (E) and hydroxyapatite (H) in cranioplasty. Methods A total of 45 patients with cranium defects were treated with cranioplasty by using skull bone flaps made of composite materials including epoxide acrylate maleic (E) and hydroxyapatite (H) ,which was designed with computer aid according to individual requirements. The patients were followed up for 6-36 months. Results After cranioplasty with composite EH, there occurred subcutaneous fluid in one patient and mild bone collapse in one. The composite EH showed good histocompatibility, with no infection or rejection. Conclusion During cranioplasty, use of computer-aided design of composite EH takes advantages of good accuracy, short operation time, good biocompatibility and good clinical efficiency.
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Objective To investigate the effect of swimming exercise on insulin sensitivity and interleukin-1 beta(IL-1β)mRNA expression in muscle tissue of insulin-resistant (IR) rats induced by high-fat diet.Methods The IR rat model was induced by high-fat diet feeding for 10 weeks and assessed by hyperinsulinemic-euglycemic clamp technique (HEC). The rats were divided into the fllowing three groups: normal group without exercise, IR groups with and without swimming exercise. After 4 weeks swimming excersie, insulin sensitivity and serum IL-1β levels were measured.Results Glucose infusion rate (GIR) of the IR rats was significantly elevated than that of non-exercise IR rats (P<0.01). Moreover, serum IL-1β levels were reduced markedly in IR rats (P<0.01). Conclusion High-fat diet feeding can partly reverse IR of rats to normal value. Swimming exercise improves insulin sensitivity and reduces the levels of IL-1β in IR rats induced by high-fat diet.
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<p><b>BACKGROUND</b>With the improvement of the surgical and anesthetic techniques, there are increasing numbers of elderly surgical patients with lung cancer. The purpose of this study is to examine the prognostic factors of surgical resection in patients more than 70 years of age.</p><p><b>METHODS</b>Data were retrospectively analyzed from 192 patients aged ≥70 years who underwent lung cancer surgery. Of these patients, 48.4% were in stage I, 20.8% in stage II, 19.3% in stage III, and 2.1% in stage IV. Patient demographics were the following: 79.2% male and 20.8% female; 21.9% ≥75 years older; and 11.5% had significant co-morbidities. Tumor characteristics: squamous cell carcinoma 49.0%, adenocarcinoma 35.9%, adenosquamous carcinoma 8.3%, small cell lung cancer 4.7%, others 2.1%.</p><p><b>OPERATIONS</b>exploration 2.1%, wedge resection 8.3%, lobectomy 72.4%, more than lobectomy 12.5%, pneumonectomy 4.7%. Of these operations, 91.1% were radical surgery. The significance of prognostic factors was assessed by univariate and multivariate COX regression analyses.</p><p><b>RESULTS</b>The total 5-year survival rate was 33.5% in this series. Age, sex, symptom and co-morbidity had no impact on survival. Multivariable COX analysis demonstrated that incomplete resection (P=0.003), advanced surgical-pathological stage (P < 0.001) and other type of the tumor (P=0.016) were significant, independent, unfavorable prognostic determinants in patients.</p><p><b>CONCLUSIONS</b>Thoracic surgery is a safe and feasible approach in elderly patients with lung cancer. Every effort should be made to detect early stage patients who might benefit from surgical treatment. Lobectomy is still the ideal surgical option for elderly patients who are able to tolerate the procedure. More limited lung surgery may be an adequate alternative in patients with associated co-morbidities.</p>