Pub Date : 2020-01-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.01.008
F. Lian, Yongkang Sun, Shengfei Tang
Objective To analyze the role of thyroid imaging reporting and data system(TI-RADS), contrast-enhanced ultrasound(CEUS), fine needle aspiration cytology (FNAC) and tumor proliferation related genes in the early diagnosis of thyroid micro-papillary carcinoma(PTMC) and risk assessment of early metastasis. Methods From May 2018 to May 2019, a total of 140 patients with Thyroid micronodules for surgical resection and pathological diagnosis of benign or malignant into the Seventh People′s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine for the retrospective study.There were 90 cases in benign group and 50 cases in malignant group.The levels of TI-RADS, CEUS enhancement mode, peak intensity (PI) and cyclin D1 (CCND1), cell nuclear Proliferating Antigen (PCNA) and vascular endothelial growth factor (VEGF) were compared between malignant and benign groups, VEGF) mRNA expression level.The positive rate of FNAC, TNM stage, capsule invasion and lymph node metastasis were evaluated. Results The percentage of class four and more by TI-RADS grade in malignant group was significantly more than benign group((92.0% (46/50) vs.5.6% (5/90), χ2=103.718, P<0.001), more early low enhancement by CEUS(86.0%(43/50) VS.6.7%(6/90), χ2=91.328, P<0.001) and PI value higher than benign group, too((6.79±1.88) VS.(5.32±1.46), t=4.968, P=0.008). The positive rate of FNAC in malignant group was 92.0% (46/50). FNAC was positive in 42 cases of TNM stage, 9 cases of capsule invasion and 6 cases of lymph node metastasis.The pathological positive rate after resection was 50 cases of TNM stage, 10 cases of capsule invasion and 6 cases of lymph node metastasis.The expression of CCND1, PCNA and VEGF mRNA in malignant group was significantly higher than that in benign group((0.5624±0.134) VS.(0.213±0.097), t=15.639, P<0.001; (0.453±0.126) VS.(0.186±0.056), t=20.253, P<0.001; (0.633±0.159) VS.(0.252±0.097), t=31.265, P<0.001). Conclusion Ultrasound-guided FNAC is used to determine TNM staging, capsule invasion and lymph node metastasis, CCND1, PCNA and VEGF expression level, contrast-enhanced mode and peak intensity value measured by quantitative evaluation software have good accuracy for early diagnosis of PTMC, and are consistent with the pathological results of hand surgery. Key words: Thyroid micro-papillary carcinoma; Thyroid Imaging Reporting and Data System; Contrast-enhanced ultrasound; Fine needle aspiration cytology
目的分析甲状腺影像学报告与数据系统(TI-RADS)、超声造影(CEUS)、细针穿刺细胞学(FNAC)及肿瘤增殖相关基因在甲状腺微乳头状癌(PTMC)早期诊断及早期转移风险评估中的作用。方法2018年5月至2019年5月，对140例经手术切除并病理诊断为良性或恶性的甲状腺微结节患者送入上海中医药大学附属第七人民医院进行回顾性研究。良性组90例，恶性组50例。比较恶性组与良性组TI-RADS、CEUS增强模式、峰值强度(PI)及细胞周期蛋白D1 (CCND1)、细胞核增殖抗原(PCNA)、血管内皮生长因子(VEGF) mRNA表达水平。观察FNAC阳性率、TNM分期、包膜浸润及淋巴结转移情况。结果恶性组TI-RADS分级4级及以上比例明显高于良性组(92.0%(46/50)比5.6% (5/90)，χ2=103.718, P<0.001)，早期超声造影低增强比例明显高于良性组(86.0%(43/50)比6.7%(6/90)，χ2=91.328, P<0.001)， PI值也高于良性组((6.79±1.88)比(5.32±1.46)，t=4.968, P=0.008)。恶性组FNAC阳性率为92.0%(46/50)。TNM期42例FNAC阳性，9例包膜浸润，6例淋巴结转移。术后病理阳性率TNM期50例，包膜侵袭10例，淋巴结转移6例。恶性组CCND1、PCNA、VEGF mRNA表达量显著高于良性组((0.5624±0.134)∶(0.213±0.097)，t=15.639, P<0.001;(0.453±0.126)和(0.186±0.056),t = 20.253, P < 0.001;(0.633±0.159)和(0.252±0.097),t = 31.265, P < 0.001)。结论超声引导下FNAC检测TNM分期、包膜浸润及淋巴结转移，定量评价软件测定的CCND1、PCNA、VEGF表达水平、对比增强模式及峰值强度值对PTMC早期诊断具有较好的准确性，且与手部手术病理结果一致。关键词:甲状腺微乳头状癌;甲状腺影像报告与数据系统;对比度增强超声;细针吸细胞学检查
{"title":"Diagnosed values of fine needle aspiration combined with contrast-enhanced ultrasonography in the diagnosis of early thyroid microcarcinoma","authors":"F. Lian, Yongkang Sun, Shengfei Tang","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.01.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.01.008","url":null,"abstract":"Objective To analyze the role of thyroid imaging reporting and data system(TI-RADS), contrast-enhanced ultrasound(CEUS), fine needle aspiration cytology (FNAC) and tumor proliferation related genes in the early diagnosis of thyroid micro-papillary carcinoma(PTMC) and risk assessment of early metastasis. Methods From May 2018 to May 2019, a total of 140 patients with Thyroid micronodules for surgical resection and pathological diagnosis of benign or malignant into the Seventh People′s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine for the retrospective study.There were 90 cases in benign group and 50 cases in malignant group.The levels of TI-RADS, CEUS enhancement mode, peak intensity (PI) and cyclin D1 (CCND1), cell nuclear Proliferating Antigen (PCNA) and vascular endothelial growth factor (VEGF) were compared between malignant and benign groups, VEGF) mRNA expression level.The positive rate of FNAC, TNM stage, capsule invasion and lymph node metastasis were evaluated. Results The percentage of class four and more by TI-RADS grade in malignant group was significantly more than benign group((92.0% (46/50) vs.5.6% (5/90), χ2=103.718, P<0.001), more early low enhancement by CEUS(86.0%(43/50) VS.6.7%(6/90), χ2=91.328, P<0.001) and PI value higher than benign group, too((6.79±1.88) VS.(5.32±1.46), t=4.968, P=0.008). The positive rate of FNAC in malignant group was 92.0% (46/50). FNAC was positive in 42 cases of TNM stage, 9 cases of capsule invasion and 6 cases of lymph node metastasis.The pathological positive rate after resection was 50 cases of TNM stage, 10 cases of capsule invasion and 6 cases of lymph node metastasis.The expression of CCND1, PCNA and VEGF mRNA in malignant group was significantly higher than that in benign group((0.5624±0.134) VS.(0.213±0.097), t=15.639, P<0.001; (0.453±0.126) VS.(0.186±0.056), t=20.253, P<0.001; (0.633±0.159) VS.(0.252±0.097), t=31.265, P<0.001). Conclusion Ultrasound-guided FNAC is used to determine TNM staging, capsule invasion and lymph node metastasis, CCND1, PCNA and VEGF expression level, contrast-enhanced mode and peak intensity value measured by quantitative evaluation software have good accuracy for early diagnosis of PTMC, and are consistent with the pathological results of hand surgery. Key words: Thyroid micro-papillary carcinoma; Thyroid Imaging Reporting and Data System; Contrast-enhanced ultrasound; Fine needle aspiration cytology","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"162 1","pages":"31-35"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69920917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.01.013
Z. Xin, Shen Zhan, Lihong Zhang
Objective To explore the relationship between high sensitivity C-reactive protein (hs-CRP) and vascular access failure in hemodialysis patients. Methods From July 2017 to June 2018, 105 patients with regular hemodialysis were selected from the blood purification center of Beijing Haidian hospital.According to the presence or absence of VAF, the patients were divided into two groups: VAF+ group and VAF - group.The difference of hs CRP level between the two groups was compared. Results During the 12-month follow-up, 17 patients had more than one event of vascular failure.The total protein level of VAF+ group was significantly lower than that of VAF-Group((65.61±4.01) g/L and( 68.98±5.66) g/L, P=0.021). The male proportion of VAF+ group was lower than that of VAF-group (29.41% vs 53.41%, P=0.07), but the difference was not statistically significant.There was no significant difference in the annual change level of hs CRP between VAF + group and VAF Group((0.33±5.49) mg/L and(0.57±4.45) mg/L, P=0.840). The level of total protein was the independent protective factor of VAF(OR=0.889, 95%CI 0.797-0.991, P=0.034). The level of hs CRP was not significantly correlated with vascular access events(OR=1.018, 95%CI 0.926-1.119, P=0.713). Conclusion There is no correlation between hs CRP and VAF.The exact mechanism of inflammation in intimal hyperplasia needs further study. Key words: Hemodialysis; Hypersensitive C-reactive protein; Vascular access failure; Total protein
{"title":"Relationship between serum high sensitive C-reactive protein and vascular dysfunction in hemodialysis patients","authors":"Z. Xin, Shen Zhan, Lihong Zhang","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.01.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.01.013","url":null,"abstract":"Objective To explore the relationship between high sensitivity C-reactive protein (hs-CRP) and vascular access failure in hemodialysis patients. Methods From July 2017 to June 2018, 105 patients with regular hemodialysis were selected from the blood purification center of Beijing Haidian hospital.According to the presence or absence of VAF, the patients were divided into two groups: VAF+ group and VAF - group.The difference of hs CRP level between the two groups was compared. Results During the 12-month follow-up, 17 patients had more than one event of vascular failure.The total protein level of VAF+ group was significantly lower than that of VAF-Group((65.61±4.01) g/L and( 68.98±5.66) g/L, P=0.021). The male proportion of VAF+ group was lower than that of VAF-group (29.41% vs 53.41%, P=0.07), but the difference was not statistically significant.There was no significant difference in the annual change level of hs CRP between VAF + group and VAF Group((0.33±5.49) mg/L and(0.57±4.45) mg/L, P=0.840). The level of total protein was the independent protective factor of VAF(OR=0.889, 95%CI 0.797-0.991, P=0.034). The level of hs CRP was not significantly correlated with vascular access events(OR=1.018, 95%CI 0.926-1.119, P=0.713). Conclusion There is no correlation between hs CRP and VAF.The exact mechanism of inflammation in intimal hyperplasia needs further study. Key words: Hemodialysis; Hypersensitive C-reactive protein; Vascular access failure; Total protein","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"24 1","pages":"56-60"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69921372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.01.003
N. Huang, Hongjie Li, Jingjing Zhang, Beibei Xie, Ya-Yun Cheng
Objective To investigate the influencing factors of fertility outcome after laparoscopic conservative surgery for tubal pregnancy. Methods From October 2010 to October 2016, 253 cases of tubal pregnancy treated by laparoscopic conservative surgery in General Hospital of Jizhong energy Fengfeng Group Hospital were analyzed retrospectively.All patients were followed up from 24 to 36 months after operation to observe the intrauterine pregnancy.Logistic regression was used to analyze the influencing factors of intrauterine pregnancy. Results After 24-36 months follow-up, the patients were not contraception and pregnant under the guidance of doctors.Among the 253 cases, 182 (71.1%) were intrauterine pregnancy, 37 (14.6%) were ectopic pregnancy, and 34 (13.4%) were not pregnant.The results of logistic regression showed that high level of hCG, severe pelvic adhesions, obstruction of fallopian tube and history of ectopic pregnancy were the risk factors of intrauterine pregnancy (OR (95%CI) 1.982 (1.075-3.149), 2.410 (1.279-5.069), 2.485 (1.071-3.594), 5.071 (1.094-9.081), P<0.05 or P<0.01). Conclusion The reproductive outcome of laparoscopic conservative surgery for tubal pregnancy is influenced by many factors.The high level of hCG in preoperative blood, severe pelvic adhesions, obstruction of tubal and ectopic pregnancy history are the risk factors of postoperative pregnancy. Key words: Tubal pregnancy; Laparoscopy; Conservative surgery; Intrauterine pregnancy; Risk factors
{"title":"Analysis of the influencing factors of the outcome of laparoscopic conservative surgery in patients with tubal pregnancy","authors":"N. Huang, Hongjie Li, Jingjing Zhang, Beibei Xie, Ya-Yun Cheng","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.01.003","url":null,"abstract":"Objective To investigate the influencing factors of fertility outcome after laparoscopic conservative surgery for tubal pregnancy. Methods From October 2010 to October 2016, 253 cases of tubal pregnancy treated by laparoscopic conservative surgery in General Hospital of Jizhong energy Fengfeng Group Hospital were analyzed retrospectively.All patients were followed up from 24 to 36 months after operation to observe the intrauterine pregnancy.Logistic regression was used to analyze the influencing factors of intrauterine pregnancy. Results After 24-36 months follow-up, the patients were not contraception and pregnant under the guidance of doctors.Among the 253 cases, 182 (71.1%) were intrauterine pregnancy, 37 (14.6%) were ectopic pregnancy, and 34 (13.4%) were not pregnant.The results of logistic regression showed that high level of hCG, severe pelvic adhesions, obstruction of fallopian tube and history of ectopic pregnancy were the risk factors of intrauterine pregnancy (OR (95%CI) 1.982 (1.075-3.149), 2.410 (1.279-5.069), 2.485 (1.071-3.594), 5.071 (1.094-9.081), P<0.05 or P<0.01). Conclusion The reproductive outcome of laparoscopic conservative surgery for tubal pregnancy is influenced by many factors.The high level of hCG in preoperative blood, severe pelvic adhesions, obstruction of tubal and ectopic pregnancy history are the risk factors of postoperative pregnancy. Key words: Tubal pregnancy; Laparoscopy; Conservative surgery; Intrauterine pregnancy; Risk factors","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"36 1","pages":"9-12"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69920471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To investigate the efficacy and safety of magnesium aluminium carbonate, lansoprazole, amoxicillin and furazolidone in the treatment of Helicobacter pylori-related gastric ulcer. Methods From March 2016 to December 2017, 120 patients with HP related gastric ulcer who met the inclusion criteria were enrolled in the digestive department of Linxi Hospital of Kailuan general hospital.They were divided into observation group and control group with random number table method, 60 cases in each group.The control group was given lansoprazole+ amoxicillin+ furazolidone triple therapy.On this basis, the observation group was added with magnesium aluminum carbonate.The clinical efficacy, clearance rate of Helicobacter pylori, the level of VEGF and EGF in gastric juice were compared between the two groups. Results The total clinical effective rate of the observation group was 95.0% (57/60), which was significantly higher than that of the control group (83.3%) (50/60). The difference between the two groups was statistically significant (χ2=4.23, P 0.05). Conclusion The treatment of Helicobacter pylori related gastric ulcer with the combination of aluminum carbonate, lansoprazole, amoxicillin and furazolidone can obviously improve the clinical symptoms and promote the regeneration of ulcer mucosa. Key words: Helicobacter pylori; Gastric Ulcer; Magnesium aluminium carbonate; Lansoprazole; Amoxicillin; Furazolidone
{"title":"Efficacy and safety evaluation of magnesium aluminate, lansoprazole, amoxicillin and furazolidone in the treatment of Helicobacter pylori-related gastric ulcer","authors":"Hongwei Liu, Yujie Huang, Jianying Yang, Guocun Peng, Shao-min Song, Liyun Wang","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.01.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.01.006","url":null,"abstract":"Objective To investigate the efficacy and safety of magnesium aluminium carbonate, lansoprazole, amoxicillin and furazolidone in the treatment of Helicobacter pylori-related gastric ulcer. Methods From March 2016 to December 2017, 120 patients with HP related gastric ulcer who met the inclusion criteria were enrolled in the digestive department of Linxi Hospital of Kailuan general hospital.They were divided into observation group and control group with random number table method, 60 cases in each group.The control group was given lansoprazole+ amoxicillin+ furazolidone triple therapy.On this basis, the observation group was added with magnesium aluminum carbonate.The clinical efficacy, clearance rate of Helicobacter pylori, the level of VEGF and EGF in gastric juice were compared between the two groups. Results The total clinical effective rate of the observation group was 95.0% (57/60), which was significantly higher than that of the control group (83.3%) (50/60). The difference between the two groups was statistically significant (χ2=4.23, P 0.05). Conclusion The treatment of Helicobacter pylori related gastric ulcer with the combination of aluminum carbonate, lansoprazole, amoxicillin and furazolidone can obviously improve the clinical symptoms and promote the regeneration of ulcer mucosa. Key words: Helicobacter pylori; Gastric Ulcer; Magnesium aluminium carbonate; Lansoprazole; Amoxicillin; Furazolidone","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"36 1","pages":"22-27"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69921277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.01.012
Yi Zhao, Y. Liu, Yin-ying Xue, Shangyu Chen
Objective To explore the relationship between the change of blood cholesterol and prognosis in patients with sepsis. Methods The clinical data of 236 patients with sepsis (observation group) admitted to Nanjing Hospital Affiliated to Nanjing Medical University from February 2014 to December 2018 were analyzed retrospectively.The general clinical data, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) of the two groups were compared with 236 patients without sepsis in the same period as the control group, high density lipoprotein cholesterol (HDL-C) and other biochemical indexes; sepsis patients were divided into survival group and death group according to the prognosis, and the related factors affecting the prognosis were analyzed by multi factor Logistic regression. Results The survival rate of sepsis patients was 60.6% (143/236), the mortality rate was 39.4% (93/236), 143 cases in survival group and 93 cases in death group.Compared with control group, the levels of serum TC ((2.51±1.20) mmo/L vs.(3.42±1.33) mmo/L, t=6.385) and HDL-C ((1.62±0.91) mmo/L vs.(2.53±0.79) mmo/L, t=5.526) in observation group were significantly lower (all P 0.05). In observation group, the patients in death group were older than those of the survival group ((75.4±10.3) years vs.(64.3±16.0) years, t=4.984, P<0.05), serum creatinine (SCr) was higher than that of survival group((252.3±65.2) μmol/L vs.(168.3±47.8) μmol/L, t=5.604, P<0.05), the levels of serum TC ((2.20±1.46) mmo/L vs.(2.91±1.12) mmo/L, t=6.157, P<0.05), HDL-C ((1.41±0.51) mmo/L vs.(1.95±0.65) mmo/L, t=5.090, P<0.05) and LDL-C ((1.71±0.67) mmo/L vs.(2.02±0.84) mmo/L, t=4.525, P<0.05) were significantly lower than those of survival group.Logistic regression analysis showed that age was the risk factor of death in sepsis patients (OR=1.035, 95%CI 1.012-1.049, P=0.008), and TC was the protective factor on the prognosis of sepsis patients (OR=0.748, 95%CI 0.693-0.822, P=0.015). Conclusion TC and HDL-C were significantly decreased in sepsis patients, while those who died were further decreased than those who survived.As a protective factor TC can be an effective biochemical index to evaluate the prognosis of patients with sepsis. Key words: Sepsis; Cholesterol; Prognosis; Age
{"title":"Changes characteristics of serum cholesterol indicators in sepsis patients and its correlation with prognosis","authors":"Yi Zhao, Y. Liu, Yin-ying Xue, Shangyu Chen","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.01.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.01.012","url":null,"abstract":"Objective To explore the relationship between the change of blood cholesterol and prognosis in patients with sepsis. Methods The clinical data of 236 patients with sepsis (observation group) admitted to Nanjing Hospital Affiliated to Nanjing Medical University from February 2014 to December 2018 were analyzed retrospectively.The general clinical data, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) of the two groups were compared with 236 patients without sepsis in the same period as the control group, high density lipoprotein cholesterol (HDL-C) and other biochemical indexes; sepsis patients were divided into survival group and death group according to the prognosis, and the related factors affecting the prognosis were analyzed by multi factor Logistic regression. Results The survival rate of sepsis patients was 60.6% (143/236), the mortality rate was 39.4% (93/236), 143 cases in survival group and 93 cases in death group.Compared with control group, the levels of serum TC ((2.51±1.20) mmo/L vs.(3.42±1.33) mmo/L, t=6.385) and HDL-C ((1.62±0.91) mmo/L vs.(2.53±0.79) mmo/L, t=5.526) in observation group were significantly lower (all P 0.05). In observation group, the patients in death group were older than those of the survival group ((75.4±10.3) years vs.(64.3±16.0) years, t=4.984, P<0.05), serum creatinine (SCr) was higher than that of survival group((252.3±65.2) μmol/L vs.(168.3±47.8) μmol/L, t=5.604, P<0.05), the levels of serum TC ((2.20±1.46) mmo/L vs.(2.91±1.12) mmo/L, t=6.157, P<0.05), HDL-C ((1.41±0.51) mmo/L vs.(1.95±0.65) mmo/L, t=5.090, P<0.05) and LDL-C ((1.71±0.67) mmo/L vs.(2.02±0.84) mmo/L, t=4.525, P<0.05) were significantly lower than those of survival group.Logistic regression analysis showed that age was the risk factor of death in sepsis patients (OR=1.035, 95%CI 1.012-1.049, P=0.008), and TC was the protective factor on the prognosis of sepsis patients (OR=0.748, 95%CI 0.693-0.822, P=0.015). Conclusion TC and HDL-C were significantly decreased in sepsis patients, while those who died were further decreased than those who survived.As a protective factor TC can be an effective biochemical index to evaluate the prognosis of patients with sepsis. Key words: Sepsis; Cholesterol; Prognosis; Age","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"36 1","pages":"52-55"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69921306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.01.020
Q. Zhu, Yixia Zhu, Qi Sun
The acute ischemic stroke has become the first major disability and death disease in China.With the release of the results of five trials represented by the Dutch multicenter randomized clinical trials of intravascular treatment of acute ischemic stroke, mechanical thrombectomy has become the main means to treat the acute ischemic stroke caused by the occlusion of large intracranial vessels, ushering in a new era of mechanical thrombectomy for acute cerebral infarction.At present, the main devices of mechanical thrombectomy are Merci thrombectomy device, penumbra thrombectomy device, solitairetm fr stent, revive se stent, trevo stent and aperio ® stent.According to the location and conditions of vascular embolism, different types of thrombectomy devices should be selected, and different thrombectomy technologies, such as adapt technology, solumbra Technology, advance technology, save technology, swim technology, etc So as to improve the recanalization rate and reduce complications. Key words: Acute ischemic stroke; Mechanical thrombectomy; Devices; Technology
{"title":"Research progress on intravascular treatment for acute ischemic stroke","authors":"Q. Zhu, Yixia Zhu, Qi Sun","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.01.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.01.020","url":null,"abstract":"The acute ischemic stroke has become the first major disability and death disease in China.With the release of the results of five trials represented by the Dutch multicenter randomized clinical trials of intravascular treatment of acute ischemic stroke, mechanical thrombectomy has become the main means to treat the acute ischemic stroke caused by the occlusion of large intracranial vessels, ushering in a new era of mechanical thrombectomy for acute cerebral infarction.At present, the main devices of mechanical thrombectomy are Merci thrombectomy device, penumbra thrombectomy device, solitairetm fr stent, revive se stent, trevo stent and aperio ® stent.According to the location and conditions of vascular embolism, different types of thrombectomy devices should be selected, and different thrombectomy technologies, such as adapt technology, solumbra Technology, advance technology, save technology, swim technology, etc So as to improve the recanalization rate and reduce complications. Key words: Acute ischemic stroke; Mechanical thrombectomy; Devices; Technology","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"36 1","pages":"87-91"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69921634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.01.021
Gaoshang Wang, Xuebin Zhan
Objective MicroRNAs (miRNAs) are endogenous short stranded RNAs with a length of about 22 NT, which are highly conserved and have no coding function.Mature miRNAs play a role by specifically binding to the 3′untranslated region of the target gene, degrading the mRNA of the gene or hindering its translation at the post transcriptional level, so as to negatively regulate the expression of the target gene and play a biological role.In recent years, the research of miRNAs in cardiovascular diseases is increasingly in-depth.A large number of evidences show that miRNAs play a role in the pathogenesis of many cardiovascular diseases, and will become a potential marker and new treatment target for the diagnosis and prognosis evaluation of cardiovascular diseases. Key words: MicroRNAs; Cardiovascular diseases; Biomarkers
{"title":"Research progress of microRNAs in cardiovascular diseases","authors":"Gaoshang Wang, Xuebin Zhan","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.01.021","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.01.021","url":null,"abstract":"Objective MicroRNAs (miRNAs) are endogenous short stranded RNAs with a length of about 22 NT, which are highly conserved and have no coding function.Mature miRNAs play a role by specifically binding to the 3′untranslated region of the target gene, degrading the mRNA of the gene or hindering its translation at the post transcriptional level, so as to negatively regulate the expression of the target gene and play a biological role.In recent years, the research of miRNAs in cardiovascular diseases is increasingly in-depth.A large number of evidences show that miRNAs play a role in the pathogenesis of many cardiovascular diseases, and will become a potential marker and new treatment target for the diagnosis and prognosis evaluation of cardiovascular diseases. Key words: MicroRNAs; Cardiovascular diseases; Biomarkers","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"43 1","pages":"92-96"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69921828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.01.015
Haitao Duan, Rui-sheng Xu, Yong Ma, Can-feng Wang, Hong-bin Fan
Objective To study the application value of nerve root decompression through posterior approach in minimally invasive surgery of lumbar disc herniation (LDH). Methods From June 2016 to June 2018, 80 patients with unilateral single segment LDH were selected and diagnosed in Yunnan Puer People′s Hospital.The patients were divided into control group and observation group according to the random number table method, 40 cases in each group.The control group was treated with posterior fenestration and nucleus pulposus extraction, and the observation group was treated with posterior neurolysis and decompression through 5.3 mm intervertebral foramen.The incision length, operation time, intraoperative blood loss and postoperative hospital stay were compared between the two groups.The visual analog scale (VAS) of pain before operation and 1, 2, 7 days after operation was compared.The Japanese Orthopedic Association (JOA) score and the Oswestry disability index (ODI) questionnaire score before operation and 1, 3, 12 months after operation were compared.The effect of lumbar function recovery 12 months after operation was compared. Results The incision length, operation time, days in-hospital after operation, and bleeding amount in observation group were (0.9±0.2) cm, (50.8±8.6) min, (16.5±5.9) ml, (4.3±0.5)d, and in control group were (4.6±0.8) cm, (72.3±15.2) min, (52.5±10.3) ml, (7.2±0.9)d.The differences between the two groups were statistically significant (t=8.625, 14.623, 32.625, 6.524, all P<0.001). The VAS scores of the observation group and the control group were (5.7±1.1), (3.3±0.6), (1.2±0.3), (0.5±0.1) and (5.5±1.2), (4.2±0.8), (1.9±0.4), (1.1±0.3) before and 1, 3 and 7 days after the operation, respectively.The differences 1, 3, 7 days after operation between the observation group and the control group were statistically significant (all P<0.05). The JOA scores of the observation group were (8.1±1.6), (19.3±4.2), (23.2±4.9), (25.8±5.2) before and 1, 3 and 12 months after operation, respectively, and those of the control group were (8.3±1.5), (15.2±3.3), (19.3±4.2), (20.6±5.5) after operation.The differences 1, 3, 12 months after operation between the observation group and the control group were statistically significant (all P<0.05). The ODI scores of the observation group were (43.7±10.6), (18.3±5.2), (10.2±3.9), (1.8±0.5) before and 1, 3 and 12 months after the operation, respectively, and those of the control group were (42.5±9.4), (25.2±5.3), (14.3±4.2), (4.6±0.9) after the operation.The differences 1, 3, 12 months after operation between the observation group and the control group were statistically significant (all P<0.05). The effective rate of the observation group was significantly higher than that of the control group (92.5%(30/40) vs.75.0%(37/40), χ2=4.501, all P=0.034). Conclusion It can bring less trauma and faster recovery with 5.3mm intervertebral endoscopy by posterior approach of nerve root decompression for L
目的探讨后路神经根减压术在微创腰椎间盘突出症手术中的应用价值。方法选取2016年6月~ 2018年6月云南省普洱人民医院收治的单侧单节段LDH患者80例。按随机数字表法将患者分为对照组和观察组，每组40例。对照组行后路开窗、髓核提取术，观察组行5.3 mm椎间孔后路神经松解减压术。比较两组手术切口长度、手术时间、术中出血量及术后住院时间。比较术前、术后1、2、7 d疼痛视觉模拟评分(VAS)。比较术前及术后1、3、12个月的日本骨科协会(JOA)评分和Oswestry残疾指数(ODI)问卷评分。比较两组术后12个月腰椎功能恢复情况。结果观察组切口长度、手术时间、术后住院天数、出血量分别为(0.9±0.2)cm、(50.8±8.6)min、(16.5±5.9)ml、(4.3±0.5)d，对照组分别为(4.6±0.8)cm、(72.3±15.2)min、(52.5±10.3)ml、(7.2±0.9)d。两组间差异有统计学意义(t=8.625、14.623、32.625、6.524,P均<0.001)。观察组与对照组术前、术后1、3、7 d VAS评分分别为(5.7±1.1)、(3.3±0.6)、(1.2±0.3)、(0.5±0.1)、(5.5±1.2)、(4.2±0.8)、(1.9±0.4)、(1.1±0.3)。观察组术后1、3、7 d与对照组比较，差异均有统计学意义(P<0.05)。观察组患者术前及术后1、3、12个月JOA评分分别为(8.1±1.6)分、(19.3±4.2)分、(23.2±4.9)分、(25.8±5.2)分，对照组患者术后JOA评分分别为(8.3±1.5)分、(15.2±3.3)分、(19.3±4.2)分、(20.6±5.5)分。观察组术后1、3、12个月与对照组比较，差异均有统计学意义(P<0.05)。观察组患者术前及术后1、3、12个月ODI评分分别为(43.7±10.6)分、(18.3±5.2)分、(10.2±3.9)分、(1.8±0.5)分，对照组患者术后ODI评分分别为(42.5±9.4)分、(25.2±5.3)分、(14.3±4.2)分、(4.6±0.9)分。观察组术后1、3、12个月与对照组比较，差异均有统计学意义(P<0.05)。观察组有效率显著高于对照组(92.5%(30/40)vs.75.0%(37/40)， χ2=4.501，均P=0.034)。结论5.3mm椎间内镜后路神经根减压术治疗LDH患者创伤小，恢复快，安全性和疗效较好。关键词:椎间内镜;神经根减压术;腰椎间盘突出;腰椎功能
{"title":"Safety and efficacy of 5.3 mm intervertebral endoscopy in minimally invasive technique for lumbar disc herniation","authors":"Haitao Duan, Rui-sheng Xu, Yong Ma, Can-feng Wang, Hong-bin Fan","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.01.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.01.015","url":null,"abstract":"Objective To study the application value of nerve root decompression through posterior approach in minimally invasive surgery of lumbar disc herniation (LDH). Methods From June 2016 to June 2018, 80 patients with unilateral single segment LDH were selected and diagnosed in Yunnan Puer People′s Hospital.The patients were divided into control group and observation group according to the random number table method, 40 cases in each group.The control group was treated with posterior fenestration and nucleus pulposus extraction, and the observation group was treated with posterior neurolysis and decompression through 5.3 mm intervertebral foramen.The incision length, operation time, intraoperative blood loss and postoperative hospital stay were compared between the two groups.The visual analog scale (VAS) of pain before operation and 1, 2, 7 days after operation was compared.The Japanese Orthopedic Association (JOA) score and the Oswestry disability index (ODI) questionnaire score before operation and 1, 3, 12 months after operation were compared.The effect of lumbar function recovery 12 months after operation was compared. Results The incision length, operation time, days in-hospital after operation, and bleeding amount in observation group were (0.9±0.2) cm, (50.8±8.6) min, (16.5±5.9) ml, (4.3±0.5)d, and in control group were (4.6±0.8) cm, (72.3±15.2) min, (52.5±10.3) ml, (7.2±0.9)d.The differences between the two groups were statistically significant (t=8.625, 14.623, 32.625, 6.524, all P<0.001). The VAS scores of the observation group and the control group were (5.7±1.1), (3.3±0.6), (1.2±0.3), (0.5±0.1) and (5.5±1.2), (4.2±0.8), (1.9±0.4), (1.1±0.3) before and 1, 3 and 7 days after the operation, respectively.The differences 1, 3, 7 days after operation between the observation group and the control group were statistically significant (all P<0.05). The JOA scores of the observation group were (8.1±1.6), (19.3±4.2), (23.2±4.9), (25.8±5.2) before and 1, 3 and 12 months after operation, respectively, and those of the control group were (8.3±1.5), (15.2±3.3), (19.3±4.2), (20.6±5.5) after operation.The differences 1, 3, 12 months after operation between the observation group and the control group were statistically significant (all P<0.05). The ODI scores of the observation group were (43.7±10.6), (18.3±5.2), (10.2±3.9), (1.8±0.5) before and 1, 3 and 12 months after the operation, respectively, and those of the control group were (42.5±9.4), (25.2±5.3), (14.3±4.2), (4.6±0.9) after the operation.The differences 1, 3, 12 months after operation between the observation group and the control group were statistically significant (all P<0.05). The effective rate of the observation group was significantly higher than that of the control group (92.5%(30/40) vs.75.0%(37/40), χ2=4.501, all P=0.034). Conclusion It can bring less trauma and faster recovery with 5.3mm intervertebral endoscopy by posterior approach of nerve root decompression for L","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"36 1","pages":"66-70"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69920986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.01.017
Jie Shi, Weiwei Tang, Mei-Juan Luo
Objective Small cell neuroendocrine carcinoma of the ovary is a kind of ovarian cancer with a very low incidence.Its clinical manifestations are not obvious.The diagnosis should be based on the pathology and neuroendocrine indicators, and its primary nature should be determined.The main treatment is operation combined with platinum based chemotherapy.The survival period is related to clinical stage and treatment plan.The patient was hospitalized for 2 days because of the aggravation of abdominal distention and pain for half a year.The diagnosis of adnexal mass was confirmed by pathology.After three cycles of neoadjuvant chemotherapy (etoposide+ cisplatin), the patients underwent abdominal " total hysterectomy+ greater omentum resection+ appendectomy+ right pelvic wall peritoneal biopsy+ mesenteric biopsy" . After the operation, the patients received three cycles of EP chemotherapy, and they have been followed up for 15 months. Key words: Small cell carcinoma of ovary; Total hysterectomy with double appendages; omentum resection; Chemotherapy
{"title":"A case of small cell neuroendocrine carcinoma of ovary","authors":"Jie Shi, Weiwei Tang, Mei-Juan Luo","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.01.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.01.017","url":null,"abstract":"Objective Small cell neuroendocrine carcinoma of the ovary is a kind of ovarian cancer with a very low incidence.Its clinical manifestations are not obvious.The diagnosis should be based on the pathology and neuroendocrine indicators, and its primary nature should be determined.The main treatment is operation combined with platinum based chemotherapy.The survival period is related to clinical stage and treatment plan.The patient was hospitalized for 2 days because of the aggravation of abdominal distention and pain for half a year.The diagnosis of adnexal mass was confirmed by pathology.After three cycles of neoadjuvant chemotherapy (etoposide+ cisplatin), the patients underwent abdominal \" total hysterectomy+ greater omentum resection+ appendectomy+ right pelvic wall peritoneal biopsy+ mesenteric biopsy\" . After the operation, the patients received three cycles of EP chemotherapy, and they have been followed up for 15 months. Key words: Small cell carcinoma of ovary; Total hysterectomy with double appendages; omentum resection; Chemotherapy","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"36 1","pages":"76-79"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69921079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.3760/CMA.J.ISSN.1008-6315.2020.01.002
Jing Guo, Dan Yang, X. Fu, Dongqi Jia
Objective To investigate the clinical effect of cervical conization under cervical endoscopy in high-grade cervical intraepithelial neoplasia (CIN). Methods From June 2017 to June 2019, 100 patients with grade II and III CIN admitted to Harbin First Hospital were divided into control group and observation group with 50 cases in each group by random number table method.The control group was treated with traditional cervical cold knife conization, while the observation group was treated with cervical conization under endoscopy.To compare the therapeutic effects of two surgical methods. Results The incidence of positive margin were significantly lower than that in the control group(8%(4/50) and 18%(9/50)), and the difference was statistically significant (χ2=4.98, P 0.05). Conclusion The cervical conization through cervical canal endoscope can accurately locate the focus of high-grade CIN, with higher rate of lesion clearance, lower rate of lesion recurrence and complications. Key words: Conization of cervix; Endoscopy; Cervical intraepithelial neoplasia
{"title":"Analysis of the effect of cervical conization through cervical endoscopy in the treatment of High-grade cervical intraepithelial neoplasia","authors":"Jing Guo, Dan Yang, X. Fu, Dongqi Jia","doi":"10.3760/CMA.J.ISSN.1008-6315.2020.01.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2020.01.002","url":null,"abstract":"Objective To investigate the clinical effect of cervical conization under cervical endoscopy in high-grade cervical intraepithelial neoplasia (CIN). Methods From June 2017 to June 2019, 100 patients with grade II and III CIN admitted to Harbin First Hospital were divided into control group and observation group with 50 cases in each group by random number table method.The control group was treated with traditional cervical cold knife conization, while the observation group was treated with cervical conization under endoscopy.To compare the therapeutic effects of two surgical methods. Results The incidence of positive margin were significantly lower than that in the control group(8%(4/50) and 18%(9/50)), and the difference was statistically significant (χ2=4.98, P 0.05). Conclusion The cervical conization through cervical canal endoscope can accurately locate the focus of high-grade CIN, with higher rate of lesion clearance, lower rate of lesion recurrence and complications. Key words: Conization of cervix; Endoscopy; Cervical intraepithelial neoplasia","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"36 1","pages":"5-8"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69920892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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