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Objective:To study the change pattern of neck diameter and relevant factors in nasopharyngeal carcinoma (NPC) patients treated with helical tomotherapy, aiming to provide reference for clinical practice.Methods:Fifteen NPC patients treated with helical tomotherapy at Sun Yat-Sen University Cancer Center from November 2020 to February 2021 were enrolled in this study. The transverse diameters of NPC patients' neck contours and body weight of all patients during radiotherapy were recorded weekly. We used descriptive statistics to explore the distribution of transverse diameters of NPC patients' neck contours during radiotherapy. And Spearman correlation analysis was used to assess the association between weight loss and changes in neck contour transverse diameter.Results:During radiotherapy, the distribution of transverse diameters of NPC patients' neck contours was completely different from the initial values. Specifically, the transverse diameters were significantly reduced at the 4th week of the radiotherapy. Moreover, the reduction of transverse diameter of neck contour was highly correlated with the weight loss ( r=0.803, P<0.05), and moderately correlated with gender ( r=0.523, P<0.05). However, there was no statistical correlation between the alteration of neck diameter and age, TNM stage, and the mean dose of GTV nd-L, GTV nd-R, PTV nd-L and PTV nd-R (all P>0.05). Conclusions:The neck contours of NPC patients are altered regularly during helical tomotherapy, which are narrowed the most obviously in the 4th week. Extensive attention should be paid to the changes of neck contour during radiotherapy in clinical practice.
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Objective:To evaluate the prognostic value of thromboelastography maximum amplitude(MA)and arterial blood lactate levels for sepsis in elderly patients.Methods:A retrospective analysis was performed on clinical data of 63 sepsis patients(≥60 years old)admitted to the Intensive Care Unit(ICU)of Bethune Hospital of Shanxi Province from December 2018 to February 2020.MA values, white blood cell counts, lymphocyte counts, platelets, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores, sequential organ failure assessment(SOFA)scores, underlying diseases, body mass index, laboratory test results and other related treatments were analyzed.The subjects were divided into the survival group and the death group according to the 28-day survival outcome.Differences in MA, APACHE Ⅱ scores, SOFA scores and laboratory test results between the two groups were analyzed, and the correlations of MA with infection parameters and age were examined.Influencing factors of survival outcomes were analyzed using multivariate Logistic regression.The receiver operating characteristic curve(ROC)was used to calculate the prognostic value of MA and arterial lactate for sepsis in elderly patients.Results:The main sources of infections were pulmonary and abdominal(79.4%, 50/63)in 63 elderly patients with sepsis.The incidences of positive blood cultures and deaths were 15.9%(10/63)and 66.7%(42/63), respectively.There existed significant differences in lymphocyte counts, arterial lactate levels, MA and lengths of stay in the ICU between the survival group and the death group( t=3.847, 2.153, 2.745, -3.574, respectively, all P<0.05).MA was correlated with arterial lactate, SOFA score and survival outcome( r=-0.498, -0.506, and -0.358, respectively, all P<0.05).Multivariate Logistic regression analysis showed that MA and arterial lactate were independent factors for the survival outcome( OR=1.626, 0.766, all P<0.05).The area under the ROC curve(AUC, 95% CI)for the combination of MA and arterial lactate was larger than that of either MA or arterial lactate alone(0.89, range: 0.763-0.846; 0.58, range: 0.574-0.730; 0.77, range: 0.521-0.832; all P<0.05). Conclusions:The combination of thromboelastography maximum amplitude and lactate in arterial blood has important clinical value in assessing the prognosis of elderly patients with sepsis.
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Objective:To investigate the clinical features of pediatric patients with intracranial primary non-germinomatous germ cell tumors (NGGCT) and evaluate the treatment outcomes and prognostic factors of NGGCT.Methods:Clinical data of 40 children with NGGCT who were treated with radiotherapy (RT) at our department between November 2008 and June 2019 were retrospectively analyzed. Ninety percent of them received craniospinal irradiation (CSI). All children received platinum-based chemotherapy. Survival analysis was conducted using the Kaplan-Meier estimate. The prognostic factors were analyzed by log-rank test.Results:The primary sites were pineal gland, sellar / suprasellar region and basal ganglia. The median age of onset was 108 months (20-204 months). The median follow-up time was 33 months (8-131 months), and the 3-year and 5-year overall survival (OS) rates were 82.0%. The 3-year and 5-year progression-free survival (PFS) rates were 78.6% and 73.0%. Univariate analysis showed that increased alpha-fetoprotein (AFP) ( P=0.02), age at first diagnosis>10 years ( P=0.006), metastasis at first diagnosis ( P<0.001), and the pathological type (choriocarcinoma, yolk sac tumor and / or embryonal carcinoma) ( P=0.036) were independent adverse prognostic factors. Conclusions:Increased AFP, age>10 years at first diagnosis, tumor metastasis and pathological type were independent adverse prognostic factors of NGGCT. The overall prognosis of NGGCT children is worse than that of their counterparts with germinoma, and multidisciplinary intensive therapy is needed to improve survival.
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Objective:To investigate the correlation between serum calcitonin gene-related peptide (CGRP) and the culture outcome of in vitro fertilization embryo in male patients with infertility.Methods:In this study, the randomized samples from 25 male patients who received in vitro fertilization-embryo transfer (IVF-ET) in the 1st Affiliated Hospital of Fujian Medical University from June 2019 to October 2019 were analyzed by multiple linear stepwise regression, with some important clinical outcomes, such as the logarithmic conversion index of serum CGRP, fertilization method, masturbation difficulty, age, infertility duration, and prolactin, as independent variables, while total fertilization rate, normal fertilization rate, high quality embryo rate at day 3, blastocyst formation rate as dependent variables.Results:The Pearson correlation analysis showed that the D3 high-quality embryo rate was related to the normal sperm morphology rate in the primary infertility group ( r=0.537, P=0.048), the blastocyst formation rate was correlated with sperm density ( r=0.760, P=0.002), the CGRP logarithm was correlated with the total fertilization rate ( r=0.693, P=0.006). The logarithmic conversion index of serum CGRP was related to the total fertilization rate and normal fertilization rate in the secondary infertility group ( r=0.614, P=0.042 and r=0.611, P=0.046). In the secondary infertility group, there was a linear relationship between normal fertilization rate and total sperm count, serum CGRP log conversion, and sperm normal morphology rate, with standardized regression coefficients of 0.2, -0.729, and 6.8, respectively. Conclusion:Serum CGRP level, together with total sperm count and normal sperm morphology rate may affects normal fertilization rate in male patients with infertility.
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Objective:Based on the AAPM TG-263, a Content-Based Standardizing Nomenclatures (CBSN) was proposed to explore the feasibility of its standardization verification for organs at risk (OAR) of nasopharyngeal carcinoma (NPC).Methods:The radiotherapy structure files of 855 patients with nasopharyngeal carcinoma (NPC) receiving intensity-modulated radiotherapy (IMRT) from 2017 to 2019(15 of whom showed clinical anomalous structures) were retrospectively collected and processed. The Matlab self-developed software was used to obtain the image position, geometric features, first-order gray histogram, and the Gray-level Co-occurrence Matrix′s texture features of the OAR contour outlined by the doctor to establish the CBSN Location Verification model and CBSN Knowledge Library. Fisher discriminant analysis was employed to establish a CBSN OAR classification model, which was evaluated using self-validation, cross-validation, and external validation, respectively.Results:99%(69/70) of the simulated anomalous structures were outside the 90% reference range of the CBSN Knowledge Library and the characteristic parameters significantly differed among different OARs (all P<0.001). The accuracy rates of self-validation, cross-validation and external verification of the CBSN OAR classification model were 92.1%, 92.0% and 91.8%, respectively. Fourteen cases of clinical abnormal structures were successfully detected by CBSN with an accuracy rate of 93%(14/15). In the simulation test, the accuracy of the left and right location verification reached 100%, such as detecting the right eye lens named Len_L. Conclusion:CBSN can be used for OAR verification of NPC, providing reference for multi-center cooperation and standardized radiotherapy of NPC patients.
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Objective To evaluate the level of clinical treatment in severe stable double COPD noninvasive positive pressure ventilation (BiPAP) + tiotropium + Symbicort regimen effect. Methods 210 patients with moderate to severe COPD patients as the research object, divided into group I, group II, group III, 1 BiPAP + group with tiotropium bromide in the treatment scheme, group II Implementation of tiotropium + Symbicort treatment group enabled BiPAP + tiotropium + Symbicort. Results Group comparison indexes of pulmonary function level and lung function indexes were found in the three groups after treatment showed a rising trend comparison between groups after treatment, the levels of the indicators of lung function showed the most significant increases in group I, group II indexes of pulmonary function approximation. In group 6-MWD group with the longest distance difference index (P<0.05), group II and group I but the difference between does not have statistical significance Conclusion BiPAP + tiotropium bromide + Cr is an effective treatment for moderate and severe stable COPD, which is beneficial to improve the quality of life of patients.
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Objective To investigate the effect of budesonide in the treatment of COPD and nursing intervention. Methods 200 cases of COPD patients in our hospital during the period from January 2015 to December 2016 as the object of this study, all patients were randomly divided into control group and study group, 100 patients in each group. The control group the patients using conventional methods of treatment, patients in the study group is to use budesonide treatment on the basis of conventional treatment, while giving appropriate nursing intervention were observed and compared. Results The study group patients in the treatment of lung function improvement after (P<0.05); the average hospitalization time and cough symptoms time were significantly better than the control group, and the difference is significant; the study group after nursing intervention, nursing satisfaction of patients was significantly higher than control group (P<0.05). Conclusion The use of budesonide and implement corresponding nursing intervention on the patients with COPD were treated with remarkable effect, the clinical symptoms of the patients were obviously relieved, can improve the patients' recovery and quality of life.
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Aim To assay the possible targets of adriamycin (ADM), screening ADM resistance related proteins.Methods The drug sensitivity of the cells was analyzed by IC50 assay;RT-PCR assay was used to detect the expression of genes in the cells;CMPK1 protein expression was tested by Western blot assay;the expression of CMPK1 in the cells was decreased by siRNA of CMPK1.Results Data from IC50 assay showed the sensitivity of cells transfected with CMPK1 was increased most(IC50 HEK293-CMPK /IC50 HEK293-Control=0.15, P<0.01), and the expression of CMPK1 protein in ADM resistant breast cells (MCF7/ADM) was lower than that in parent MCF7 cells (P<0.05).When the expression level of CMPK1 was decreased by CMPK1 siRNA, the sensitivity of MCF7 cells to ADM decreased (IC50 MCF7-siCMPK1/IC50MCF7-Control=3.6, P< 0.01), and the sensitivity of MCF7 cells to paclitaxel and gemcitabine also decreased.Conclusions CMPK1 was related to the multidrug resistance of cells, and the expression of CMPK1 was positively related to the sensitivity to drugs, which provides the possibility of CMPK1 as a target in the treatment of multidrug resistance.
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Objective To investigate the hospitalization cost,length of stay in hospital,and mortality in patients with pulmonary infection in a hospital,and evaluate the influencing factors,so as to provide scientific basis for mak-ing targeted infection control measures.Methods Medical records of patients with pulmonary infection between January 2011 and December 2012 were collected,the difference and influencing factors of hospitalization cost,aver-age length of stay,and prognosis among patients with different types of pulmonary infection were compared and an-alyzed by univariate analysis,multiple linear regression analysis,and logistic regression analysis.Results Of 10 431 patients with pulmonary infection,the average hospitalization cost was (29 081 .95 ± 38 682.92 )yuan (RMB),the median cost was 16 085.25 yuan(RMB),and the average length of stay was (15.93 ±20.54)d,the median was 13.00 d,a total of 828 patients died due to invalid treatment,mortality was 7.94%.There were signifi-cant differences in hospitalization cost,average length of stay among patients with different genders,ages,modes of payment,admission status of illness,types of pulmonary infection,and operation or not (all P <0.05),and the differences in mortality were also significant among patients of above characteristics except gender(all P <0.05 ). Influencing factors for hospitalization cost were as follows:length of stay,whether or not operated,modes of pay-ment,types of pulmonary infection(healthcare-associated pneumonia,HAP),age,gender,and so on,influencing factors for length of stay were whether or not operated and types of pulmonary infection,factors leading to death were admission condition, types of pulmonary infection (HAP ),and whether or not operated, and so on. Conclusion Control of healthcare-associated pulmonary infection is important for controlling hospitalization cost, shortening average length of stay,and improving survival rate of patients.
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Objective To evaluate the effect of preoperative transarterial chemoembolization (TACE) for resectable hepatocellular carcinoma (HCC).Methods HCC patients undergoing up-front hepatectomy (group A) were compared with those receiving TACE before hepatectomy (group B).Results Tumor size decreased significantly after TACE (t =3.3 1,P =0.021).The rates of tumor encapsulation and liver adhesions were significantly more often seen in group B.There were fewer tumor-residual and more frequent necrosis in group B.Operative time in group B was longer (t =2.71 ,P =0.046).The average blood loss and complication rate were of no difference between the two groups.The occurrence of pleural effusion and intrahepatic recurrence rate in group A was higher than group B (x2 =3.85 ,P =0.031) (x2 =2.76,P =0.046).The overall survival rate from the second year postoperative in group B was higher than group A (x2 =3.37, P =0.043).Conclusions TACE could diminish tumor, advance encapsulation and reduce tumor-residual.Preoperative TACE does not improve 1-, 2-, and 3-year tumor-free survival rates but improve 1-, 2-, and 3-year overall survival rates.
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Objective To evaluate the short-term and long-term elinical effect of hepatectomy using Tissue-Link & Cusa,compared to the Pringle maneuver.Methods Clinical data of 87 HCC patients who had received hepatectomy by the Pringle's Maneuver (group A) or Tissue-Link & Cusa (group B) were retrospectively analyzed.Results The average amount of bleeding in Group A was more than group B (t =2.030,P =0.023).The time of operation in group A was shorter than group B (t =-2.896,P =0.006).The postoperative supplement of albumin in group A was more than group B,the level of serum total bilirubin on 7th day after operation was higher than group B (P < 0.05).There was no significant difference in postoperation complications and the time in hospital (P >0.05).The rate of incisional recurrence and the rate of metastasis in or out of the liver in group A were higher than group B (P =0.029,0.021,0.016).The 2-and 3-year tumor-free survival rates and the 3-year overall survival rates in group A were lower than that in group B (P =0.047,0.036,0.042).Conclusions Hepatectomy using Tissue-Link & Cusa is superior to the Pringle's maneuver for the treatment of primary hepatocellular carcinoma.It has a clear operative field,less operative bleeding,less damage to liver function and a lower relapse rate of incisional margin.
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Objective To analyze the short-term and long-term effectiveness of radiofrequency ablation combined with transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC).Methods The clinical data of 70 HCC patients who had received thermal ablation (group A) done or in combination with TACE (group B) were retrospectively analyzed.Results The rate of intrahepatic distant recurrence in group B (25 cases) was lower than that in group A (45 cases) (X2 =3.845,P =0.046) and the tumor-free survival rate was higher than group A (X2 =5.020,P =O.030).There were no differences in the local tumor progression rate (X2 =0.853,P =0.374) and overall survival (x2 =2.316,P =0.154) between two groups.Incidence of bone marrow suppression in group B was higher than that of group A (X2 =5.642,P =0.042).Major complications didn't occur in any group(X2 =2.016,P =0.183).The costs was higher(t =7.738,P <0.001) and the hospital stay was longer (t =5.921,P =0.003) in group B than group A.Conclusions Compared with ablation alone,combined therapy is able to reduce short-term recurrence,and improve tumor-free survival.Combine therapy is safe and effective method for small liver carcinoma.
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Objective To investigate the applied value of abnormalities of fetus with oligohydramnios in mid-pregnancy by anmioinfusion. Methods Fifty women with oligohydramnios diagnosed by ultrasonograph were analysed retrospectively. During the procedure 60-300 ml saline solution at 37 ℃ were infused into the amniotic cavity,made prenatal diagnosis at the same time necessarily. And examined the women to know whether the fetal anomaly existed or not after the amnioinfusion by the ultrasound. Results There were 15 cases with fetal anomaly, 8 cases with genitotirinary anomaly(2 cases associated with multiple organs anomaly), 1 case with single umbilical artery, 4 cases with chromosomal abnormality (2 cases associated with fetal growth restriction), 2 cases with pulmonary hypolasia. There was no significant difference in dilivery outcome between others and 35 cases with normal pregnant women (P >0.05). Conclusion Transabdominal amnioinfusion has double function on beth diagnosis and therapy for the oligohydramnios in the mid-pregnancy.
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In order to obtain enough fusion protein for developing preclinical studies of IFNbeta-HAS, we screened Pichia pastoris transformants expressing high-level protein by immunology method. The yield of IFNbeta-HSA was about 500 mg/L by fed-batch fermentation. The purity of IFNbeta-HSA reached 96% through the steps of ultrafiltration, Blue Sepharose FF, Ni2+-IMAC and DEAE Sepharose FF. Analysis of Western blotting showed that IFNbeta-HSA had the antigenicity of IFNbeta and HSA. The specific activity was about 1.96 x 10(7) IU/mg by standard survival activity test on WISH cells challenged with VSV virus. This study provided a method to produce IFNbeta-HSA.
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Humanos , Fermentação , Interferon beta , Genética , Pichia , Genética , Metabolismo , Proteínas Recombinantes de Fusão , Genética , Albumina Sérica , GenéticaRESUMO
BACKGROUND: Silver-matrix composite is usually used as a kind of electrical conductive matedal, which has excellent properties in electrical and heat conducting. MoS2, which used as a common solid lubricating material, has unique anti-frictional and lubricating properties in the process of wearing. Ag-MoS2 composites using in the area of electrical sliding wear were fabricated by adding MoS2 to the silver-matrix. OBJECTIVE: Ag-MoS2 composites with different content of MoS2 were produced to gain the mixture ratio for best properties by the experiments of mechanical and wear test. DESIGN, TIME AND SETTING: The controlled experiment was performed at the Department of Matedal Science and Engineering, Hefei University of Technology from April to May 2008. MATERIALS: Silver powder (Bengbu Gold and Silver Article Factory, China) and MoS2 powder (Sinopharm Chemical Reagent Co., Ltd., China) were used in this study. METHODS: Ag-MoS2 composites for five different contents were fabricated by powder metallurgy method, which included the processes of powder mixture, drying, initial pressure, sintering, and second pressure. MoS2 contents were the MoS2 composite of 12.0%, 13.5%, 15.0%, 16.5%, 18.0% silver- MoS2. MAIN OUTCOME MEASURES: Flexural strength was measured by versatility mechanical testing machine. The microstructures of the composites after sintering were observed by an optical microscope. The electrical sliding friction and wear properties were tested by the electrical wear test machine. The worn surfaces of the samples were observed by a scanning electron microscope. RESULTS: With the increase in MoS2, the flexural strength decreased, the resistivity increased, and the wear loss decreased first, and then increased, which comes the lowest point when the MoS2 content was 15%. CONCLUSION: When the content of MoS2 is 15%, the average properties was the best.
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Objective To evaluate a thrombolytic system of portal vein port-catheter kit (PC) in the treatment of portal vein thrombosis (PVT). Methods In this study, 42 PVT patients with liver cirrhosis and portal hypertension after splenectomy from 2005 to 2007 were divided into two groups. In group A (20 eases) thrombolysis was administered through the PC device. Urokinase at the dosage of 1000 U?kg-1?h-1 was given for a consecutive 3 -6 days through the PC, and then the therapy was converted to 100 AxaIU/kg of low molecular heparin twice a day for 7 days subcutaneously. In group B, the thrombolysis was performed on 22 patients through peripheral veins. The therapy was same as in group A except for that the urokinase dosage was doubled. The complete thrombolysis rate, the effective thrombolysis rate, the time of thrombolysis, the long-term recurrence rate and the incidence of complication were compared between the two groups. Results The complete thrombolysis rate and the effective thrombolysis rate in group A were 75%, 90% respectively, compared with that of 41%, 59% respectively in group B. The significant differences in the complete thrombolysis rate, the effective thrombolysis rate, the time of thrombolysis and the incidence of complication were found between the two groups, while the thrombolysis recurrence rate had no significant difference between the two groups. Conclusion PC regime is an effective and safe method for the treatment of portal vein thrombosis.
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@#目的探讨后外侧小切口行全髋置换术(THA)后患者康复护理。方法后外侧入路小切口患者45例48髋,经精心护理后与常规THA患者在手术切口、围手术期出血量、术后疼痛、住院天数、早期活动方面比较。结果在相同条件下,小切口手术患者减少围手术期出血量、术后疼痛、住院天数及术后早期康复快,缩短住院时间。结论康复护理有助于THA患者的恢复。