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BACKGROUND: The surgical Apgar score (SAS) quantifying three intraoperative indexes has been confirmed to be significantly associated with postoperative morbidity and prognosis in many surgical specialties. However, there are great limitations in its application for esophageal cancer (EC). This study aimed to assess the predictive capability of esophagectomy SAS (eSAS) in determining postoperative morbidity and overall survival (OS) in EC patients who had undergone neoadjuvant therapy. METHODS: A retrospective evaluation was conducted on a cohort of 221 patients in which surgery- and tumor-related data were extracted and analyzed. Major morbidity was defined as complications meeting the criteria of Clavien-Dindo classification III or higher during hospitalization. Univariate and multivariate analyses were performed to identify potential risk factors for major morbidity. Kaplan-Meier analysis was utilized to calculate the OS and relapse-free survival (RFS). RESULTS: The results exhibited that eSAS demonstrated potential predictive value for postoperative morbidity with an optimal cutoff value of 6. The eSAS and diabetes mellitus were two independent risk factors for the major morbidity; however, no correlation between the eSAS and the OS or RFS was detected. CONCLUSION: The eSAS could be used as a predictor of major morbidity, while it was not correlated with OS and RFS.
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Neoplasias Esofágicas , Esofagectomia , Humanos , Recém-Nascido , Esofagectomia/efeitos adversos , Esofagectomia/métodos , Estudos Retrospectivos , Índice de Apgar , Terapia Neoadjuvante/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Esofágicas/tratamento farmacológico , Neoplasias Esofágicas/cirurgia , Neoplasias Esofágicas/complicaçõesRESUMO
Background: The emergence of immune checkpoint inhibitors (ICIs) has brought about a paradigm shift in the treatment landscape of non-small cell lung cancer (NSCLC). Despite the promising long-term survival outcomes and optimization of pathological complete response (cPR) demonstrated by various studies such as Impower010 and Checkmate-816, the effectiveness of neoadjuvant immunotherapy in advanced resectable NSCLC remains a subject of debate. Although previous research has explored the connection between the efficacy of neoadjuvant therapy and surgical-related safety, limited studies have specifically investigated the surgical-related safety of neoadjuvant immunotherapy. Therefore, our study aims to assess the efficacy and surgical-related safety of neoadjuvant immunotherapy in advanced resectable non-small cell lung cancer. Method: We conducted a retrospective study on a cohort of 93 patients with stage IIIA-IIIC NSCLC who underwent neoadjuvant therapy and surgical resection. Among them, 53 patients received neoadjuvant immunotherapy, 18 patients underwent neoadjuvant chemotherapy while the remaining 22 underwent neoadjuvant targeted therapy. The patients were separated into further groups according to their pathological type. Data analyses were performed using Mann-Whitney U test, chi-square test. Results: All patients were categorized into six distinct groups. Notably, the neoadjuvant immunotherapy squamous carcinoma group exhibited a favorable edge over the neoadjuvant targeted squamous carcinoma group concerning the duration of drainage tube indwelling and the extent of lymph node dissection. Furthermore, the neoadjuvant immunotherapy adenocarcinoma group outperformed neoadjuvant targeted therapy adenocarcinoma counterpart in terms of achieving complete pathological response (cPR). Simultaneously, the neoadjuvant immunotherapy adenocarcinoma group surpassed the neoadjuvant chemotherapy adenocarcinoma group in the incidence of hydrothorax. Nevertheless, no statistically significant disparities were noted between the neoadjuvant immunotherapy squamous carcinoma group and the neoadjuvant chemotherapy carcinoma group. Conclusion: Regarding surgical outcomes, neoadjuvant immunotherapy conferred notable advantages compared to conventional neoadjuvant chemotherapy and neoadjuvant targeted therapy for patients diagnosed with adenocarcinoma. In the case of squamous carcinoma, neoadjuvant immunotherapy exhibited superiority over neoadjuvant targeted therapy, although additional evidence is required to conclusively establish its precedence over neoadjuvant chemotherapy.
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ABSTRACT Introduction The standing long jump consists of four parts: pre-swing, take-off, flying, and landing. Objective Analyze the influence of gymnastics game fitness on standing long jump. Methods Eight kindergartens in a city were selected and divided into experimental and control groups. The children in the experimental group were intervened in gymnastics and game fitness modules. Each module was intervened in a rolling cycle in the morning and afternoon outdoor activities of children from June 1, 2021, to March 31, 2010, for nine months. Results During the intervention period, there was no significant difference between the experimental group and the control group (P > 0.05), but there was a significant difference between the experimental group and the girls before and after the experimental intervention (P < 0.05), while the difference between boys was not statistically significant, indicating that the range of ankle movement of girls was slightly more affected than boys during the fitness intervention. Conclusion With the increase in age and training time, the change range of joint angles of older children in the experimental group is significantly higher than that in the control group. Level of evidence II; Therapeutic studies - investigation of treatment results.
RESUMO Introdução O salto em distância horizontal consiste em quatro partes: corrida de aproximação, impulsão, voo e queda. Objetivo Estudar a influência da ginástica no salto em distância horizontal. Métodos Oito jardins de infância em uma cidade foram selecionados e divididos em um grupo experimental e um grupo de controle. As crianças do grupo experimental atuaram nos módulos de ginástica e de condicionamento físico. Cada módulo foi submetido a um ciclo contínuo de atividades ao ar livre de manhã e à tarde de atividades infantis, de 1º de junho de 2021 a 31 de março de 2010, por um total de 9 meses. Resultados Durante o período de intervenção, não houve diferença significativa entre o grupo experimental e o grupo controle (P > 0,05), mas houve diferença significativa entre o grupo experimental e as meninas antes e depois da intervenção experimental (P < 0,05), enquanto a diferença entre os meninos não foi estatisticamente significativa, indicando que a amplitude do movimento do tornozelo das meninas foi ligeiramente mais afetada do que a dos meninos durante a intervenção de condicionamento físico. Conclusão Com o aumento da idade e do tempo de treinamento, a faixa de variação do ângulo de articulação das crianças mais velhas no grupo experimental foi significativamente maior do que a do grupo de controle. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción El salto de longitud horizontal consta de cuatro partes: carrera de aproximación, impulsión, vuelo y caída. Objetivo Analizar la influencia de la gimnasia en el salto de longitud de pie. Métodos Se seleccionaron ocho guarderías de una ciudad y se dividieron en un grupo experimental y otro de control. Los niños del grupo experimental realizaron módulos de gimnasia y fitness. Cada módulo intervino en un ciclo continuo de actividades al aire libre por la mañana y por la tarde desde el 1 de junio de 2021 hasta el 31 de marzo de 2010, durante nueve meses. Resultados Durante el período de intervención, no hubo diferencias significativas entre el grupo experimental y el grupo de control (P > 0,05), pero sí entre el grupo experimental y las chicas antes y después de la intervención experimental (P < 0,05), mientras que la diferencia entre los chicos no fue estadísticamente significativa, lo que indica que la amplitud de movimiento del tobillo de las chicas se vio ligeramente más afectada que la de los chicos durante la intervención de acondicionamiento físico. Conclusión Al aumentar la edad y el tiempo de entrenamiento, el rango de variación de los ángulos articulares de los niños mayores del grupo experimental es significativamente mayor que el del grupo de control. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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To investigate the clinical diagnostic value of ultrasonographic superb micro‐vascular imaging ( SM I) for abdominal branch arteries′involvement in Stanford B aortic dissection ( AD ) . Methods A total of 34 AD patients underwent conventional ultrasound ,SMI and CTA . The characteristics of the ultrasonographic images of branch artery involvement including coeliac artery ,superior mesenteric artery ,left and right renal artery were analyzed . T he diagnostic performance of conventional ultrasound and SM I were compared and CT A was used as the reference standard . Results Among the 34 patients with AD ,according to the ultrasonographic images′characteristics ,136 branch arteries were categorized into four classes :Class Ⅰ (81/136) ,branch artery perfusion supplied from the aortic true lumen ; Class Ⅱ ( 27/136) , dissection extending into the branch ; Class Ⅲ ( 16/136 ) ,branch artery perfusion supplied from the aortic false lumen ; Class Ⅳ ( 12/136) ,branch artery perfusion supplied from the aortic true and false lumens . T he diagnostic accordance rate of the conventional ultrasound and SM I were 76 .5% ( 104/136 ) and 92 .6%( 126/136) and had significant differences ( P <0 .001) . Conclusions SMI can be used to evaluate branch artery involvement in AD patients w hich will guide the practice of pre‐operation and post‐operation .
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To explore the molecular mechanism underlying gastric carcinogenesis and progression by using gene expression profiling array together with bioinformatics. Lentivirus short hairpin RNA targeting STIL(ShSTIL)and scrambled sequence RNA(ShCon)were transduced into the gastric cancer cell line SGC-7901.RNA extraction,complementary DNA synthesis,construction of biotin-labelled amplified RNA probes,and hybridization with gene expression profile were consecutively performed.We collected corresponding data and analyzed differentially expressing genes(DEGs),followed by the analysis of gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)enrichment,transcription factor regulating network,and protein-protein interacting networks. Compared with ShCon,a total of 417 and 87 genes were respectively down-regulated and up-regulated,respectively,in the ShSTIL group(1 or <-1).GO and KEGG enrichment analysis indicated that genes regulated by STIL were localized in cytoplasm,extracellular exosome,Golgi apparatus and various biomembranes,and were implicated in the ubiquitin-mediated proteolysis,P53 signaling pathway,and pathways regulating pluripotency of stem cells.Evaluation on genes enriched in KEGG pathways,regulation of transcription factors,and protein-protein interacting network demonstrated that IGF1R,STUB1,SKP2,and FOXO1 were localized at the centre of the network and played a key role in the development and progression of gastric cancer. Through the protein-protein interactions,STIL may activate E3 ubiquitin ligase STUB1 or SKP2,promote the proteolysis of FOXO1-a transcription factor,regulate the expression of IGF1R,and thus promote gastric carcinogenesis and progression.
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Humanos , Biologia Computacional , Perfilação da Expressão Gênica , Ontologia Genética , Neoplasias Gástricas , Genética , TranscriptomaRESUMO
Objective To explore the association between carotid artery plaque and small dense low-density lipoprotein cholesterol(sdLDL-C)concentrations as well as the probability of sdLDL-C and sdLDL-C/LDL-C ratio as biomarkers of human carotid atherosclerotic plaque.Methods 174 subjects in physical examination center of An Zhen Hospital from November 2015 to February 2016 were enrolled one by one as a cross-sectional study.All subjects were divided into carotid IMT abnormal group(n=92)and control group(n=82)according to carotid ultrasound.According to the thickness of IMT characterized by carotid ultrasound,subjects were divided into the thickened IMT group(n=32), plaques group(n=60), and plaques group were divided into single plaque group(n=33)and multiple plaques group(n=27).Body Mass Index(BMI), fasting serum sdLDL-C, triglyceride(TG), LDL-C and high-density lipoprotein cholesterol(HDL-C)concentrations were measured.Pearson′s and Spearman correlation coefficient analyses and logistic regression analyses were used to examine the relationships between carotid atherosclerotic plaque,sdLDL-C values,and other clinical variables.Area under curve(AUC)was calculated to determine the diagnostic value of sdLDL-C and sdLDL-C/LDL-C ratio in subjects with carotid atherosclerotic plaque. Results Levels of sdLDL-C(1.02 ±0.42 vs.0.97 ±0.46 vs.0.61 ±0.29, F=21.07, P<0.001)and sdLDL-C /LDL-C(0.34 ±0.17 vs.0.34 ±0.17 vs.0.21 ±0.09,F=16.34,P<0.001)in the thickened IMT group and the plaques group were higher than those of the control group).Even in individuals considered to be at low LDL-C(<2.59 mmol/L)level,sdLDL-C(0.94 ±0.41 vs.0.56 ±0.25,t=4.00, P<0.01)and sdLDL-C/LDL-C ratio(0.43 ±0.19 vs.0.24 ±0.08,t=4.45,P<0.01)remained higher in the carotid abnormal group than those in the control group.Age and sdLDL-C were the independent risk factors of carotid artery plaque.AUC of receiver operator characteristic curve(ROC)for serum sdLDL-C and sdLDL-C/LDL-C ratio were 0.882(95% CI:0.819-0.945, P<0.01)and 0.830(95% CI:0.747-0.914,P<0.01)to determine the multiple carotid atherosclerotic plaque,and the cut-off level were 0.90 mmol/L(sensitivity,88.0%;specificity,79.3%)and 0.30(sensitivity,84.0%;specificity,74.5%). Conclusions Carotid atherosclerotic plaque has a close relationship with sdLDL-C concentrations.sdLDL-C and sdLDL-C/LDL-C ratio can be biomarkers when assessing subjects with a carotid atherosclerotic plaque.
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Objective To study the clinical value of intraoperative epicardial echocardiography ( IEE) in assessing graft-left anterior descending artery ( LAD ) of off-pump coronary artery bypass grafting ( OPCABG) . Methods IEE was used to detecte graft vessels anastomosis in 53 patients with OPCABG-LAD . Two-dimensional grey ultrasound and color Doppler ultrasound was used to show whether there was abnormal echo in proximal and distal lumen , measuring diameter and rate of stenosis . Pulse Doppler ultrasound was used to observe the blood flow spectrum . Intraoperative transient blood flow meter (TTFM) was employed to measure the pulsatility index and flow volume . Results Among the 53 patients with OPCABG-LAD ,38 cases were left internal mammary artery graft (LIMA) ,15 cases were saphenous vein graft (GSV) . Pulsatility index and flow volume showed normal by TTFM . The detection rates of graft vessels-LAD anastomosis in proximal and distal segment were 100% using IEE , including 10 cases anastomotic plaques and 10 cases proximal plaques . Comparison of blood flow parameter of graft by IEE and TTFM in operation ,there was no significant difference in LIMA grafts ( P =0 .091) ,but the correlation was statistically significant ( r = 0 .809 , P < 0 .001 ) ;the difference in GSV grafts had no statistical significance ( P = 0 .821 ) ,but the correlation was statistically significant ( r = 0 .684 , P = 0 .005 ) . Conclusions IEE clearly displays the lumen of graft vessel and LAD ,and measures the hemodynamic indexes . It provides an intuitive ,accurate and convenient method for detecting the patency of the graft vessels during OPCABG .
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AIM:To investigate the effect of over-expression of peroxisome proliferator-activated receptor γ co-activator-1α (PGC-1α) on mitochondrial morphology and cell apoptosis in the cortical neurons with oxygen glucose depriva-tion/reoxygenation(OGD/R). METHODS:The whole gene sequence of PGC-1α was obtained from the cerebral cortex of C57BL/6 mice by RT-PCR and cloned into the eukaryotic expression vector pEGFP-N1. The pEGFP-N1-PGC-1α was iden-tified by PCR,and transfected into cortical neurons. The level of PGC-1α expression was identified by Western blot. The cortical neurons transfected with pEGFP-N1 and pEGFP-N1-PGC-1α vectors were treated with OGD/R. The mitochondrial mass,reactive oxygen species (ROS) and ATP production,cell apoptosis and changes of cleaved caspase-3 were detected by MitoTracker Red staining,flow cytometry,ATP metabolic assay kit and TUNEL. RESULTS:Over-expression of PGC-1α inhibited the decrease in mitochondrial biogenesis capacity and the ROS formation of OGD/R neurons(P<0.05),en-hanced the ability of ATP synthesis (P<0.01),inhibited neuronal apoptosis (P<0.01) and decreased the activation of caspase-3 (P<0.01). CONCLUSION:PGC-1α over-expression inhibits neuronal apoptosis with OGD/R treatment by promoting mitochondrial biogenesis,inhibiting the production of ROS and maintaining mitochondrial function. PGC-1α may be used as a target for the development of cerebral ischemia/reperfusion injury drugs.
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Objective:To study the pentraxin 3 (PTX3),hypersensitive c-reactive protein (the hs-CRP) and rheumatic heart disease ( RHD) correlation and significance .Methods:40 healthy people with the same period in hospital as contral ,and selected 76 cases hospitalized patients with rheumatic ( excluding artificial after valve replacement in patients with rheumatic ) , according to the Color Doppler Echocardiography and electrocardiogram ( ECG ) were divided into the atrial fibrillation rhythm group ( 48 cases ) and sinus rhythm group ( 28 cases ) combined valve lesion group ( 46 cases ) and single valve lesion group ( 30 cases ) using immune enhanced turbidimetric method to determine the hs-CRP, enzyme-linked immunosorbent ( ELISA ) method to detect the contents of PTX3.Results:①RHD group serum hs CRP and PTX 3 level obviously was higher than the control group ( P<0.01 );②the level of serum PTX3 rheumatic atrial fibrillation group was obviously higher than that of sinus rheumatic group ( P<0.01 ) , but the hs-CRP serum level of rheumatic atrial fibrillation group and sinus rheumatic group had no statistical difference ( P>0.05 );③PTX3 level and hs-CRP levels in combined valve lesion group were higher than in single valve disease group (P<0.05).Conclusion:PTX3 and hs-CRP persist in rheumatic heart disease , rheumatic valvular disease of the seriousness of the hs-elevated CRP and PTX3 concentration.PTX3 is one of the influence factors of rheumatic atrial fibrillation occurred ,PTX3 higher stability in rheumatic heart disease inflammatory response performance .
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Objective To develop europium (Ⅲ) [Eu (Ⅲ)] chelated microparticles for homogeneous immunoassay.Methods Anti-human PCT antibodies were labeled with Eu (Ⅲ) chelated nanoscale microparticles as the detection antibody,and another anti-human PCT antibody was labeled with biotin as the solid-phase antibody.Magnetic microspheres labeled with streptavidin were used to separate the complexes of Eu-IgM-PCT-IgM-Biotin.Results In the homogeneous immunoassay,the standard curve fit was not linear.The quadratic curve was Y =19170.12 + 75493.74X-26.00X2(r =0.9986).According to the standard curve,the limit of detection for PCT was 0.04 ng/ml.Conclusion The homogeneous immunoassay which uses Eu (Ⅲ) chelated microparticles is highly sensitive for detection of PCT recombinant antigens and may serve as a promising method to measure serum PCT levels in the future.
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BACKGROUND: The posterior anatomical locking plate has obtained excellent fixing performance in the treatment of complex fractures of the distal tibia; however, there are many drawbacks such as nail and plate broken, and the related rules are never reported. OBJECTIVE: To establish a finite element model of posterior anatomical locking plate for distal tibia and to provide references for its design and improvement. METHODS: The imaging data of a male patient aged 34 years old (body mass: 68 kg) with fracture on the left distal tibia were imported into Mimics16.01 software, and the proposed reconstruction parts were determined based on the default threshold of the software. The files were imported into the Ansys11.0 software, the distal tibial surface was fixed, and a force of 340 N was vertically loaded on the supine surface of the horizontal section of the large tibial shaft. RESULTS AND CONCLUSION: There was completely connected with the stepped surface of nut and screw thread portion in locking steel plate. The strain on the plate depended on the stress values. The posterior anatomical locking plate for distal tibia was more favorable for the fixation at the fracture site and could reduce the fixed plate and screws loosening, both of which could affect the fixed efficacy.
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Aim To investigate the effect of mallotoxin (MTX) on LQT2 induced by E-4031 in isolated guinea pig hearts and ventricular myocytes.Methods The isolated guinea pig heart underwent retrograde perfusion using Langendorff technique.In order to determine the effects of different concentrations of MTX on QT/QTc interval,transmural dispersion of repolarization (TDR) and index of cardiac electrophysiological balance (iCEB) in the absence and presence of hERG channel blocker E-4031,the electrocardiogram of isolated guinea pig hearts was recorded using Biopac physiological record.Single ventricular myocytes were isolated from guinea pig heart by enzymatic dissociation.Effects of MTX on action potential duration (APD) in the absence and presence of E-4031 were recorded by current clamp mode using whole patch clamp technique.Results MTX shortened the QT interval,reduced TDR,and decreased iCEB in isolated guinea pig heart.MTX could reverse the prolongation of QT interval and the increased TDR induced by E4031.MTX shortened the action potential duration and decreased APDgo,APD60 and APD30 in isolated guinea pig ventricular myocytes.MTX could reverse the prolongation of action potential repolarization duration induced by E-4031.Conclusion MTX shortens QT interval,decreases TDR,reduces iCEB,as well as shortens APD,thus reversing LQT2 induced by E4031.
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Objective To design and manufacture a multifunctional cushion for venous thrombosis prevention of lower extremities, which can be also applied to the low extremities needing raising. Methods The cushion was made of anti-rust, low-weight, undeformable and easy-to-clean stainless material, which was composed of a pad and a massage apparatus. The pad had its height regulable from 16 to 30 cm and telescopic inclination from 30 to 70° to adapt the cushion to sizes of patients. There were 6 independent air chambers and tubular circulating pipes around the blanket wrapping the chambers so that extremity massage and temperature-controlled heating could be executed based on setting up pressure, time and temperature of the electromagnetic air and water pumps. Results The cushion simulated the functions of the muscle pump, which formed step-by-step-increasing pressure changes by driving the chambers to be inflated and discharged continuously to execute extremity massage, temperature-controlled heating etc. Conclusion The cushion gains advantages in flexible composition, patient comfort etc, solves the problems in fixing angle and height, constant time for pump inflation and discharge as well as temperature-controlled heating, and thus is worthy promoting clinically.
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One of the mechanisms of endometriosis-dysmenorrhea is closely related to the changes of pelvic anatomy and hemodynamics. TCM holds that cold-coagulation and blood-stasis that alternate and resist the cell palace is one of the main pathogenesis of dysmenorrheas.Dunhuang Liao Fengxu Shouruo Formula(P.3930),a precise and appropriate formulating prescription, plays an important role in activating blood, dispelling cold, tonifying qi and nourishing blood, which can warm the maridians and disperse cold, nourish blood and dissolve stasis and it achieves significant results. And in this prescription, the method of decocting herbs in mutton soup embodies the local characteristic of foodtherapy combined with medication of ancient Dunhuang medical prescriptions.
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Objective·To explore the value of applying CT/MRI image registration and fusion combined with 3D printing technique in pre-surgical planning of refractory pelvic tumors. Methods·A retrospective analysis was performed on the cases with refractory pelvic tumors admitted between March 2014 and December 2016 in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. CT/MRI examinations were performed as a routine pre-surgical procedure, and the resulting images were subject to rapid registration and fusion with the Medraw software in order to accurately determine the tumor boundaries and to be used as references in designing and making patient-specific tumor models, prostheses, and implants by 3D printing technique. Results·A total of 13 cases with refractory pelvic tumors were included in this study (8 cases of chondrosarcoma, 1 case of osteosarcoma with aneurysmal bone cyst, 1 case of dedifferentiated sarcoma, 1 case of fibrous connective tissue hyperplasia, 1 case of solitary fibrous tumor/hemangiopericytoma, and 1 case of metastatic squamous cell carcinoma) with an average age of (50.0±8.5) years. According to the Enneking classification,there were 2 cases in zone Ⅰ , 2 in zones Ⅰ + Ⅱ , 1 in zones Ⅱ + Ⅲ , 3 in zones Ⅰ + Ⅱ + Ⅲ , 1 in zones Ⅰ + Ⅱ + Ⅳ , 1 in zonesⅠ + Ⅱ + Ⅲ + Ⅳ , 1 in zones Ⅰ + Ⅳ , 1 in zones Ⅱ + Ⅳ , and 1 in zone Ⅳ. The mean maximal tumor diameter was (15.15±4.81) cm without implicating the pelvic blood vessels. Results from intraoperative frozen section at resection boundaries and the installation of prosthesis showed that the actual surgical procedure was consistent with the surgical planning based on the reported image fusion technique. Conclusion·CT/MRI image registration and fusion technique combined with 3D printing technique can accurately determine the resection boundary of pelvic tumors and assist in designing of individualized prosthesis model and surgical guide, which has a great value in pre-surgical planning and clinical treatment of refractory pelvic tumors.
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Objective To analyze the impact of comprehensive care on living conditions of hemophiliac patients in China.Methods Based on the managerial experience of the World Federation of Hemophilia(WFH) and China's national condition,we carried out comprehensive care on patients with hemophilia (PWH) in our center.Questionnaire surveys on living condition were conducted before and after intervention (in 2004 and 2016,respectively) to Beijing's permanent hemophiliacs.The results of questionnaires conducted in 2004 were settled as baseline data,and a comparative analysis was done between the baseline data and the results of surveys conducted in 2016 in the PWH who had received comprehensive care for at least 2 years.Results Totally 109 cases received baseline survey whereas 136 cases received questionnaires after intervention.Thirty-nine(28.7%) and 70(51.5%) patients conducted prophy-laxis or home treatment after receiving comprehensive care,respectively.There was significant difference (P<0.01)in terms of treatment timeliness.Similar results were found (P<0.01)in terms of times of bleeding per year,and there was significant improvement (P<0.01) on joint disorder after comprehensive care.Conclusion After receiving comprehensive care,PWH are more willing to accept and conduct prophylaxis and home treatment.The bleeding can be controlled more effectively,and the treatment can be given more timely.Meanwhile,PWH can receive more improvements in joint and walking function.
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One of the mechanisms of endometriosis-dysmenorrhea is closely related to the changes of pelvic anatomy and hemodynamics. TCM holds that cold-coagulation and blood-stasis that alternate and resist the cell palace is one of the main pathogenesis of dysmenorrheas.Dunhuang Liao Fengxu Shouruo Formula(P.3930),a precise and appropriate formulating prescription, plays an important role in activating blood, dispelling cold, tonifying qi and nourishing blood, which can warm the maridians and disperse cold, nourish blood and dissolve stasis and it achieves significant results. And in this prescription, the method of decocting herbs in mutton soup embodies the local characteristic of foodtherapy combined with medication of ancient Dunhuang medical prescriptions.
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Objective·To explore the value of applying CT/MRI image registration and fusion combined with 3D printing technique in pre-surgical planning of refractory pelvic tumors. Methods·A retrospective analysis was performed on the cases with refractory pelvic tumors admitted between March 2014 and December 2016 in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. CT/MRI examinations were performed as a routine pre-surgical procedure, and the resulting images were subject to rapid registration and fusion with the Medraw software in order to accurately determine the tumor boundaries and to be used as references in designing and making patient-specific tumor models, prostheses, and implants by 3D printing technique. Results·A total of 13 cases with refractory pelvic tumors were included in this study (8 cases of chondrosarcoma, 1 case of osteosarcoma with aneurysmal bone cyst, 1 case of dedifferentiated sarcoma, 1 case of fibrous connective tissue hyperplasia, 1 case of solitary fibrous tumor/hemangiopericytoma, and 1 case of metastatic squamous cell carcinoma) with an average age of (50.0±8.5) years. According to the Enneking classification,there were 2 cases in zone Ⅰ , 2 in zones Ⅰ + Ⅱ , 1 in zones Ⅱ + Ⅲ , 3 in zones Ⅰ + Ⅱ + Ⅲ , 1 in zones Ⅰ + Ⅱ + Ⅳ , 1 in zonesⅠ + Ⅱ + Ⅲ + Ⅳ , 1 in zones Ⅰ + Ⅳ , 1 in zones Ⅱ + Ⅳ , and 1 in zone Ⅳ. The mean maximal tumor diameter was (15.15±4.81) cm without implicating the pelvic blood vessels. Results from intraoperative frozen section at resection boundaries and the installation of prosthesis showed that the actual surgical procedure was consistent with the surgical planning based on the reported image fusion technique. Conclusion·CT/MRI image registration and fusion technique combined with 3D printing technique can accurately determine the resection boundary of pelvic tumors and assist in designing of individualized prosthesis model and surgical guide, which has a great value in pre-surgical planning and clinical treatment of refractory pelvic tumors.
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Objective To analyze the impact of comprehensive care on living conditions of hemophiliac patients in China.Methods Based on the managerial experience of the World Federation of Hemophilia(WFH) and China's national condition,we carried out comprehensive care on patients with hemophilia (PWH) in our center.Questionnaire surveys on living condition were conducted before and after intervention (in 2004 and 2016,respectively) to Beijing's permanent hemophiliacs.The results of questionnaires conducted in 2004 were settled as baseline data,and a comparative analysis was done between the baseline data and the results of surveys conducted in 2016 in the PWH who had received comprehensive care for at least 2 years.Results Totally 109 cases received baseline survey whereas 136 cases received questionnaires after intervention.Thirty-nine(28.7%) and 70(51.5%) patients conducted prophy-laxis or home treatment after receiving comprehensive care,respectively.There was significant difference (P<0.01)in terms of treatment timeliness.Similar results were found (P<0.01)in terms of times of bleeding per year,and there was significant improvement (P<0.01) on joint disorder after comprehensive care.Conclusion After receiving comprehensive care,PWH are more willing to accept and conduct prophylaxis and home treatment.The bleeding can be controlled more effectively,and the treatment can be given more timely.Meanwhile,PWH can receive more improvements in joint and walking function.
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Objective:To explore the prognostic value for circulating monocyte subsets combining left ventricular ejection fraction (LVEF) in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods:STEMI patients admitted within 24 h of onset received PCI in Pingjin hospital heart center were enrolled.Flow cytometry (FCM) was used to examine 3 subsets of monocyte in peripheral blood as classical CD14++CD16-monocyte,intermediate CD14++CD16+ monocyte and non-classical CD14+CD16++ monocyte.The patients were followedup in 3 years for major adverse cardiac events (MACE) occurrence.The relationship between monocyte subsets,LVEF and MACE occurrence was studied by COX model analysis and MACE prediction model was established by ROC combining multivariate Logistic regression analysis.Results:There were 50/221 patients suffered from MACE during 3-year follow-up period.Compared with Non-MACE patients,MACE patients had the elder age (63.82±11.88) years vs (58.84±11.40) years,P=0.009;more diabetes mellitus (28.0% vs 18.7%),P<0.001;higher blood levels of LDL-C (2.77 mmol/L) vs (2.41 mmol/L),P=0.003 and CD14++CD16+ monocyte (47.17 cells/μl) vs (21.47 cells/μl),P<0.001;lower LVEF (52% vs 46%),P<0.001.Multivariate Cox analysis indicated that CD14++CD16+ (HR=2.211,95% CI 1.211-3.635,P=0.016) and LVEF (HR=2.014,95% CI 1.038-2.933,P=0.022) were the independent risk factors for MACE occurrence in STEMI patients.ROC combining multivariate Logistic regression analysis presented that MACE predictive value of CD14++CD16+ monocyte combining LVEF (AUC=0.744,95% CI 0.664-0.823,P<0.001) was higher than the single value of CD14++CD16+ monocyte (AUC=0.683,95% CI 0.598-0.768,P<0.001) and LVEF(AUC=0.640,95% CI 0.552-0.7291,P=0.003) respectively.Conclusion:Circulating level of CD14++CD16+ monocyte combining LVEF may predict MACE occurrence within 3 years in STEMI patients;it had potential value in clinical practice.