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Effect of ventricular premature catheter ablation on diastolic function in elderly patients 室性导管过早消融对老年患者舒张功能的影响
Pub Date : 2019-09-01 DOI: 10.3760/CMA.J.ISSN.1008-6315.2019.05.002
Chenglong Miao, Yanwei Wang, Lu Xu, Suyun Liu
Objective To observe whether catheter ablation for ventricular premature complexes (PVC) has an effect on ventricular diastolic function in elderly patients. Methods Elderly patients older than 65 years of age who underwent catheter ablation from March 2012 to May 2015 for idiopathic ventricular premature complexes were enrolled.Preoperative echocardiography was performed using E/e′ for left ventricular diastolic function and venous brain natriuretic peptide (BNP) levels were measured.All patients underwent catheter ablation under the guidance of a three-dimensional mapping system.Cardiac ultrasound and BNP levels were repeated 6 months after ablation, and 24-hour electrocardiogram was performed to confirm ventricular premature complexes. Results There were a total of 89 patients with idiopathic ventricular premature complexes (PVC) who underwent catheter ablation.81 cases were successed at 6 months, with a success rate of 91.0%.At 6 months after ablation, the E/e′ values were significantly lower ((15.3±5.2) vs (10.2±3.2), (P 0.05). Conclusion The number of premature ventricular beats is associated with left ventricular diastolic function, and ventricular premature catheter ablation can improve left ventricular diastolic function in elderly PVC patients. Key words: Ventricular premature complexes; Catheter ablation; Diastolic function; Brain natriuretic peptide; The aged
目的观察导管消融术治疗室性早衰(PVC)对老年患者心室舒张功能的影响。方法选取2012年3月至2015年5月因特发性室性早衰并发症行导管消融治疗的年龄大于65岁的老年患者。术前行超声心动图E/ E '检查左室舒张功能,测定静脉脑钠肽(BNP)水平。所有患者均在三维绘图系统的指导下行导管消融。消融后6个月复查心脏超声和BNP水平,24小时心电图确认心室过早复合物。结果89例特发性室性早衰(PVC)患者行导管消融治疗。6个月成功81例,成功率91.0%。消融后6个月,E/ E值明显降低(15.3±5.2)vs(10.2±3.2),P < 0.05。结论室性早搏次数与左室舒张功能有关,室性早搏导管消融可改善老年室性早搏患者左室舒张功能。关键词:心室过早复合物;导管消融;舒张功能;脑利钠肽;老年人
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引用次数: 0
Analysis of the efficacy of poly ADP-ribose polymerases inhibitor combined with chemotherapeutics in the treatment of triple negative breast cancer 聚ADP-核糖聚合酶抑制剂联合化疗药物治疗癌症三阴性疗效分析
Pub Date : 2019-09-01 DOI: 10.3760/CMA.J.ISSN.1008-6315.2019.05.009
Jinji Zhang, Zhonghui Li, Changzai Li, Lijun Meng, Xiu-li Zhang
Objective To investigate the effects of poly adenosine diphosphate ribose polymerase (PARP) inhibitor AG014699 on the proliferation of triple negative breast cancer (TNBC) cell line MDA-MB-231. Methods Cell proliferation and cytotoxicity test kit (CCK-8) was used to detect the proliferation of MDA-MB-231 cells in different concentrations of AG014699 (0.1, 1.0, 10.0, 20.0 and 40.0 mmol/L), DTX (10-9, 10-8, 10-7, 10-6 and 10-5 mol/L) and CBP (10-6, 10-5, 10-4 and 10-3 mol/L). Flow cytometry was used to detect cell apoptosis and cell cycle distribution. Results The effects of AG01469 at different concentrations (0.1, 1.0, 10.0, 20.0 and 40.0 μmol/L) on proliferation activity of MDA-MB-231 cells were(94.83±3.93)%, (79.42±5.52)%, (63.75±4.34)%, (38.97±8.42)%, (29.70±3.35)%, with statistically significant differences (F=75.54, P 0.05 at 10-9 concentration and P 0.05 at 10-6 concentration, P 1.15 when AG014699 was combined with 10-3 mmol/L CBP, which showed synergistic effect.When combined with other effective concentrations of DTX or CBP, the q value was between 0.85 and 1.15, showing additive effect. Conclusion PARP inhibitor AG014699 assisted DTX or CBP can inhibit the proliferation of TNBC cell line MDA-MB-231.By means of simple addition or systematic effect, it can inhibit the triple negative breast cancer. Key words: Triple negative breast cancer; Poly adenosine diphosphate ribose polymerase; Docetaxel; Carboplatin
目的探讨聚腺苷二磷酸核糖聚合酶(PARP)抑制剂AG014699对三阴性乳腺癌(TNBC)细胞株MDA-MB-231增殖的影响。方法采用细胞增殖及细胞毒性检测试剂盒(CCK-8)检测不同浓度AG014699(0.1、1.0、10.0、20.0和40.0 mmol/L)、DTX(10-9、10-8、10-7、10-6和10-5 mol/L)和CBP(10-6、10-5、10-4和10-3 mol/L)对MDA-MB-231细胞的增殖作用。流式细胞术检测细胞凋亡和细胞周期分布。结果不同浓度AG01469(0.1、1.0、10.0、20.0、40.0 μmol/L)对MDA-MB-231细胞增殖活性的影响分别为(94.83±3.93)%、(79.42±5.52)%、(63.75±4.34)%、(38.97±8.42)%、(29.70±3.35)%,差异有统计学意义(F=75.54, 10-9浓度P 0.05, 10-6浓度P 0.05, AG014699与10-3 mmol/L CBP联用P 1.15),具有协同作用。与其他DTX或CBP有效浓度联合时,q值在0.85 ~ 1.15之间,表现出加性效应。结论PARP抑制剂AG014699辅助DTX或CBP可抑制TNBC细胞株MDA-MB-231的增殖。通过简单加药或系统作用,均能抑制三阴性乳腺癌。关键词:三阴性乳腺癌;聚腺苷二磷酸核糖聚合酶;多西他赛;卡铂
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引用次数: 0
Clinical characteristics of early Parkinson′s disease patients with emotional apathy and its relationship with other non-motor symptoms 早期帕金森病患者情绪冷漠的临床特征及其与其他非运动症状的关系
Pub Date : 2019-09-01 DOI: 10.3760/CMA.J.ISSN.1008-6315.2019.05.011
Ke Liu, Qiang Li, Yanfang Hu, Lihua Xu, Shuangping Li, P. Hu
Objective To observe the characteristics of apathy in early Parkinson′s disease patients, analyze its relationship with other non-motor symptoms, and explore its impact on the quality of life. Methods Clinical data of 75 patients with Parkinson′s disease admitted to xingtai people′s hospital from August 2014 to August 2017 were selected.Unified Parkinson′s disease rating scale- III(UPDRS-III ), Modified apathy rating scale(MAES ), Montgomy-asberg Depression rating scale(MADRS ) and Simple mental state test(MMSE) were used to evaluate patients′ motor symptoms, indifference, depression and cognitive function.The relationship between apathy and other non-motor symptoms was analyzed by Parkinson′s disease non-motor symptom evaluation scale.Parkinson′s disease questionnaire-39(PDQ-39) was used to evaluate the quality of life.The patients were divided into the affective indifference group and the non-affective indifference group according to whether the patients were accompanied by affective indifference. Results 21.3%(16/75) of the patients were diagnosed with apathy.Emotional indifference group UPDRS score -Ⅲ (23.98±9.46), not apathy group(14.74±6.27). There was significant difference between the two groups (P<0.001). MMSE score of the indifferent group was (21.26±3.21), and that of the non-indifferent group was (26.57±3.42). There was significant difference between the two groups (P=0.038). PDQ-39 score of the emotionally indifferent group was (65.20±25.78), which was significantly higher than that of the non-emotionally indifferent group (34.86±25.42). There was significant difference between the two groups (P<0.001). In the comparison of Parkinson′s disease non-motor symptom evaluation scale, the fatigue symptom score of the emotionally indifferent group was (6.1±0.2) significantly higher than that of the non-indifferent group (2.3±0.7), and the difference was statistically significant (P=0.006). The score of lack of interest was (4.8±1.5) in the indifferent group and (1.3±0.8) in the non-indifferent group.The difference between the two groups was statistically significant (P=0.017). Conclusion Apathy has a high incidence in early Parkinson′s disease patients, often combined with fatigue and lack of interest symptoms.It has a serious impact on the quality of daily life in the future. Key words: Parkinson′s disease; Apathy; Unified Parkinson′s disease rating scale- III; Modified apathy evaluation scale; Montgomery-asberg depression rating scale; Mini-mental state examination; Non-motor symptom; Quality of life
目的观察早期帕金森病患者冷漠的特点,分析其与其他非运动症状的关系,探讨其对生活质量的影响。方法选取邢台市人民医院2014年8月至2017年8月收治的75例帕金森病患者的临床资料。采用统一帕金森病评定量表-Ⅲ(UPDRS-III)、改良冷漠评定量表(MAES)、Montgomy-asberg抑郁评定量表和简易精神状态测试(MMSE)评定患者的运动症状、冷漠、抑郁和认知功能。采用帕金森病非运动症状评定量表分析冷漠与其他非运动症状的关系。帕金森病问卷-39(PDQ-39)用于评估患者的生活质量。根据患者是否伴有情感冷漠,将患者分为情感冷漠组和非情感冷漠组。结果21.3%(16/75)的患者被诊断为冷漠。情感冷漠组UPDRS评分-Ⅲ(23.98±9.46)而非冷漠组(14.74±6.27),两组比较有显著性差异(P<0.001),两组间比较有显著性差异(P=0.038),情感冷漠组PDQ-39分为(65.20±25.78),两组比较有显著性差异(P<0.001)。在帕金森病非运动症状评定量表的比较中,情绪冷漠组的疲劳症状评分(6.1±0.2)显著高于非情绪冷漠组(2.3±0.7),差异有统计学意义(P=0.006)。无兴趣组为(4.8±1.5)分,无兴趣组(1.3±0.8)分。两组比较有统计学意义(P=0.017)。它对未来的日常生活质量有着严重的影响。关键词:帕金森病;冷漠;帕金森病统一评定量表-Ⅲ;改良冷漠评价量表;Montgomery-asberg抑郁症评定量表;小型精神状态检查;非运动症状;生活质量
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引用次数: 1
Analysis of serum gastric function and Helicobacter pylori infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps 胃增生性息肉和胃底腺息肉患者血清胃功能及幽门螺杆菌感染分析
Pub Date : 2019-09-01 DOI: 10.3760/CMA.J.ISSN.1008-6315.2019.05.017
Menglan Wang, Junlian Liu, Yanhong Wang, Rui Zhong, S. Fei
Objective To analyze the serum gastric function and Helicobacter pylori (HP) infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps. Methods From December 2017 to December 2018, 135 patients with gastric polyps and pathologically confirmed gastric hyperplastic polyps and gastric fundic gland polyps were enrolled in the hospital of Xuzhou Medical University.Among them, 68 patients with hyperplastic polyps, 67 cases of the gastric fundic gland polyps.Serum Hp antibodies (UreA, UreB, VacA, CagA antibodies) were qualitatively detected by immunoblotting.Eighty patients with chronic superficial gastritis were selected as the control group.Three groups of serum pepsinogen-I (PG-I), pepsinogen-Ⅱ (PG-Ⅱ), gastrin were detected by enzyme-linked immunosorbent assay (ELISA). Gastrin-17(G-17) and calculate PGⅠ and PGⅡ ratio(PGR). Results The levels of serum PGⅡ (13.13(8.15, 20.30) μg /L) and G17 (8.44(3.72, 27.17) pmol/L) in the gastric hyperplastic polyp group were higher than those in the control group (9.16(5.56, 15.14) μg/L and 1.83(0.87, 5.95) pmol/L) (P<0.05), and the PGR level was lower than the control group (P<0.05); serum PGI (120.12(86.72, 174.70) μg/L), PGII (11.92(7.27, 22.26) μg/L), G17 (5.68(1.79, 14.65) pmol/L) in the gastric fundic gland polyp group was higher than the control group ((101.32(79.17, 131.33) μg /L, 9.16(5.56, 15.14) μg /L, 1.83(0.87, 5.95) pmol/L)(P均<0.05)) (P<0.05); serum G17 (8.44(3.72, 27.17) pmol/L) level in gastric hyperplastic polyp group was higher than gastric fundus polyp group (5.68(1.79, 14.65) pmol/L) (P<0.05); Hp infection rate in gastric hyperplastic polyp group61.76%(42/68)was higher than that in the gastric fundic gland polyp group40.30%(27/67) (P<0.05), and type I Hp was the main one (P<0.05). The serum PGⅡ and G17 levels in the gastric hyperplastic polyp group were higher than those of Hp negative (all P<0.05). There were no significant differences in serum PGI, PGⅡ, G17, and PGR levels between the HP-positive and negative-positive patients in the gastric fundus polyp group.The serum PGI and PGR levels in the hypertrophic polyp group were higher than those in the HPⅡ type (all P<0.05). There was no significant difference in the levels of serum PGⅠ, PGⅡ, G17, and PGR between the gastric fundic gland polyps group and the type Ⅱ. Conclusion Serum PG and G17 levels in patients with gastric hypertrophic polyps and gastric fundic gland polyps are higher than those in patients with chronic superficial gastritis.Patients with gastric hyperplastic polyps have higher HP infection rate and abnormal gastric function than gastric fundic gland polyps. Key words: Gastric hyperplastic polyp; Gastric fundus polyp; Helicobacter pylori; pepsinogen; Gastrin
目的分析胃增生性息肉和胃底腺息肉患者血清胃功能及幽门螺杆菌(HP)感染情况。方法2017年12月至2018年12月,徐州医科大学医院收治胃息肉及经病理证实的胃增生性息肉、胃底腺息肉135例,其中增生性息肉68例,胃底腺腺瘤67例。通过免疫印迹法对血清Hp抗体(UreA、UreB、VacA、CagA抗体)进行定性检测。选择80例慢性浅表性胃炎患者作为对照组。采用酶联免疫吸附法(ELISA)检测三组血清胃蛋白酶原-Ⅰ(PG-I)、胃蛋白酶原-Ⅱ(PG-Ⅱ)和胃泌素。Gastrin-17(G-17),计算PGⅠ和PGⅡ比值(PGR)。结果胃增生性息肉组血清PGⅡ(13.13(8.15,20.30)μg/L)和G17(8.44(3.72,27.17)pmol/L)高于对照组(9.16(5.56,15.14)μg/L和1.83(0.87,5.95)pmol/L)(P<0.05),PGR水平低于对照组(P<0.05);胃底腺息肉组血清PGI(120.12(86.72,174.70)μg/L)、PGII(11.92(7.27,22.26)μg/L)、G17(5.68(1.79,14.65)pmol/L)高于对照组(101.32(79.17,131.33)μg/L、9.16(5.56,15.14)μg/L和1.83(0.87,5.95)pmmol/L)(P均<0.05))(P<0.05);胃增生性息肉组血清G17(8.44(3.72,27.17)pmol/L)高于胃底息肉组(5.68(1.79,14.65)pmol/L)(P<0.05);胃增生性息肉组Hp感染率61.76%(42/68)高于胃底腺息肉组40.30%(27/67)(P<0.05),以Ⅰ型Hp为主(P<0.01),以及胃底息肉组HP阳性和阴性阳性患者之间的PGR水平。肥厚性息肉组血清PGI、PGR水平均高于HPⅡ型(P均<0.05),胃底腺息肉组与Ⅱ型组血清PGⅠ、PGⅡ、G17和PGR水平差异无统计学意义。结论胃肥厚性息肉和胃底腺息肉患者血清PG和G17水平高于慢性浅表性胃炎患者。胃增生性息肉患者HP感染率和胃功能异常均高于胃底腺息肉。关键词:胃增生性息肉;胃底息肉;幽门螺杆菌;胃蛋白酶原;胃泌素
{"title":"Analysis of serum gastric function and Helicobacter pylori infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps","authors":"Menglan Wang, Junlian Liu, Yanhong Wang, Rui Zhong, S. Fei","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.05.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.017","url":null,"abstract":"Objective \u0000To analyze the serum gastric function and Helicobacter pylori (HP) infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps. \u0000 \u0000 \u0000Methods \u0000From December 2017 to December 2018, 135 patients with gastric polyps and pathologically confirmed gastric hyperplastic polyps and gastric fundic gland polyps were enrolled in the hospital of Xuzhou Medical University.Among them, 68 patients with hyperplastic polyps, 67 cases of the gastric fundic gland polyps.Serum Hp antibodies (UreA, UreB, VacA, CagA antibodies) were qualitatively detected by immunoblotting.Eighty patients with chronic superficial gastritis were selected as the control group.Three groups of serum pepsinogen-I (PG-I), pepsinogen-Ⅱ (PG-Ⅱ), gastrin were detected by enzyme-linked immunosorbent assay (ELISA). Gastrin-17(G-17) and calculate PGⅠ and PGⅡ ratio(PGR). \u0000 \u0000 \u0000Results \u0000The levels of serum PGⅡ (13.13(8.15, 20.30) μg /L) and G17 (8.44(3.72, 27.17) pmol/L) in the gastric hyperplastic polyp group were higher than those in the control group (9.16(5.56, 15.14) μg/L and 1.83(0.87, 5.95) pmol/L) (P<0.05), and the PGR level was lower than the control group (P<0.05); serum PGI (120.12(86.72, 174.70) μg/L), PGII (11.92(7.27, 22.26) μg/L), G17 (5.68(1.79, 14.65) pmol/L) in the gastric fundic gland polyp group was higher than the control group ((101.32(79.17, 131.33) μg /L, 9.16(5.56, 15.14) μg /L, 1.83(0.87, 5.95) pmol/L)(P均<0.05)) (P<0.05); serum G17 (8.44(3.72, 27.17) pmol/L) level in gastric hyperplastic polyp group was higher than gastric fundus polyp group (5.68(1.79, 14.65) pmol/L) (P<0.05); Hp infection rate in gastric hyperplastic polyp group61.76%(42/68)was higher than that in the gastric fundic gland polyp group40.30%(27/67) (P<0.05), and type I Hp was the main one (P<0.05). The serum PGⅡ and G17 levels in the gastric hyperplastic polyp group were higher than those of Hp negative (all P<0.05). There were no significant differences in serum PGI, PGⅡ, G17, and PGR levels between the HP-positive and negative-positive patients in the gastric fundus polyp group.The serum PGI and PGR levels in the hypertrophic polyp group were higher than those in the HPⅡ type (all P<0.05). There was no significant difference in the levels of serum PGⅠ, PGⅡ, G17, and PGR between the gastric fundic gland polyps group and the type Ⅱ. \u0000 \u0000 \u0000Conclusion \u0000Serum PG and G17 levels in patients with gastric hypertrophic polyps and gastric fundic gland polyps are higher than those in patients with chronic superficial gastritis.Patients with gastric hyperplastic polyps have higher HP infection rate and abnormal gastric function than gastric fundic gland polyps. \u0000 \u0000 \u0000Key words: \u0000Gastric hyperplastic polyp; Gastric fundus polyp; Helicobacter pylori; pepsinogen; Gastrin","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"35 1","pages":"459-463"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43661588","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}
引用次数: 0
The effect of biliary stent position on short-term and long-term outcomes of patients with low malignant obstructive jaundice after surgical treatment 胆道支架位置对低度恶性梗阻性黄疸术后近期和远期预后的影响
Pub Date : 2019-09-01 DOI: 10.3760/CMA.J.ISSN.1008-6315.2019.05.001
Fulei Gao, Xiangzhong Huang, Dongqing Ren, Feng Gao, Guo-Dong Yuan
Objective To explore the effect of the position of the biliary stents on the short-term and long-term effects of the patients with low malignant obstructive jaundice after treatment. Methods Seventy-eight patients with low-grade malignant obstructive jaundice diagnosed in Jiangyin Hospital Affiliated to Medical College of Southeast University who underwent biliary stenting were enrolled as the study object.According to the placement of the biliary stents, the stents were divided into the spanning group and the non-crossing group.The baseline data and related serological indexes were recorded, and the changes of jaundice between the two groups were compared by repeated measurements.All patients were followed up for 48 weeks.Multivariate Cox regression analysis was applied on the risk factors that might affect the prognosis of patients, and the degree of influence of various factors on the prognosis of patients was further evaluated. Results Repeated measures analysis showed that the biochemical indicators of the spanning group and the non-crossing group showed a significant downward trend and the difference was statistically significant (TBil: Fintra-group=9.392, Pintra-group =0.000; DBil: Fintra-group=7.581, Pintra-group=0.001). Among them, the total bilirubin (TBil) (Preoperative: (318.69±101.13) μmol/L, 1 week after surgery: (135.98±63.61) μmol/L, 2 weeks after surgery: (60.21±24.81) μmol/L) was lower than the non-crossing group preoperative: (309.07±109.97) μmol/L, 1 week after surgery: (158.87±66.92) μmol/L, 2 weeks after surgery: (75.91±20.46) μmol/L), and the difference was statistically significant (Finter-group=3.362, Pinter-group=0.041). The direct bilirubin (DBil) (Preoperative: (171.93±73.01) μmol/L, 1 week after surgery: (90.38±57.33) μmol/L, 2 weeks after surgery: (36.64±18.95) μmol/L) was lower than the non-crossing group (Preoperative: (174.53±82.74) μmol/L, 1 week after surgery: (107.85±49.07) μmol/L, 2 weeks after surgery: (37.87±14.55) μmol/L.The difference was statistically significant (Finter-group=6.284, Pinter-group=0.003). There was an interaction between the treatment regimen and treatment time (1 week after surgery and 2 weeks after surgery) (TBil: Finteraction=12.262, Pinteraction=0.000; DBil: Finteraction=10.254, Pinteraction=0.000). The results of the multi factor Cox proportional hazard model of the spanning group and the non-crossing group showed that the ALP, DBil, TBil and lymphatic metastasis of malignant tumor were the two independent risk factors that affect the prognosis.However, the pancreatic cancer, ALT and age in the spanning group across the ampulla also have a certain effect on the prognosis of the patients. Conclusion The effect of the placement of biliary stents across the Vater ampullary was more obvious in the short term on the decline of bilirubin.But in the long term, there was no significant difference in the prognosis of patients with biliary stenting position.ALP, TBil, DBil, a
目的探讨胆道支架位置对低恶性梗阻性黄疸患者治疗后近期和远期疗效的影响。方法选择在东南大学医学院附属江阴医院诊断为低度恶性梗阻性黄疸的78例胆道支架置入术患者为研究对象。根据胆道支架的放置情况,将支架分为跨越组和非跨越组。记录基线数据和相关血清学指标,并通过重复测量比较两组之间黄疸的变化。所有患者随访48周。对可能影响患者预后的危险因素进行多因素Cox回归分析,进一步评价各因素对患者预后的影响程度。结果复测分析显示,跨越组和非跨越组的生化指标呈显著下降趋势,差异有统计学意义(TBil:Fintra组=9.392,Pintra组=0.000;DBil:Finra组=7.581,Pintra集团=0.001),其中总胆红素(TBil)(术前:(318.69±101.13)μmol/L,术后1周:(135.98±63.61)μmol/L,术后2周:(60.21±24.81)μmol/L)低于非交叉组术前:(309.07±109.97)μmol/L,术前:(171.93±73.01)μmol/L,术后1周:(90.38±57.33)μmol/L;术后2周:(36.64±18.95)μmol/L,术后2周:(37.87±14.55)μmol/L,差异具有统计学意义(Finter组=6.284,Pinter组=0.003)。治疗方案和治疗时间(术后1周和术后2周有相互作用)(TBil:Finteract=12.262,Pinteract=0.000;DBil:Fininteract=10.254,Pinterct=0.000)跨越组和非跨越组的比例危险模型显示,ALP、DBil、TBil和恶性肿瘤淋巴结转移是影响预后的两个独立危险因素。但胰腺癌症、ALT和跨壶跨跨组年龄对患者的预后也有一定影响。结论经Vater壶腹放置胆道支架在短期内对胆红素下降的影响更为明显。但从长期来看,胆道支架置入术患者的预后没有显著差异。ALP、TBil、DBil和疾病分类都是影响两组患者预后的重要危险因素关键词:恶性梗阻性黄疸;胆道支架;壶腹;风险因素
{"title":"The effect of biliary stent position on short-term and long-term outcomes of patients with low malignant obstructive jaundice after surgical treatment","authors":"Fulei Gao, Xiangzhong Huang, Dongqing Ren, Feng Gao, Guo-Dong Yuan","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.05.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.05.001","url":null,"abstract":"Objective \u0000To explore the effect of the position of the biliary stents on the short-term and long-term effects of the patients with low malignant obstructive jaundice after treatment. \u0000 \u0000 \u0000Methods \u0000Seventy-eight patients with low-grade malignant obstructive jaundice diagnosed in Jiangyin Hospital Affiliated to Medical College of Southeast University who underwent biliary stenting were enrolled as the study object.According to the placement of the biliary stents, the stents were divided into the spanning group and the non-crossing group.The baseline data and related serological indexes were recorded, and the changes of jaundice between the two groups were compared by repeated measurements.All patients were followed up for 48 weeks.Multivariate Cox regression analysis was applied on the risk factors that might affect the prognosis of patients, and the degree of influence of various factors on the prognosis of patients was further evaluated. \u0000 \u0000 \u0000Results \u0000Repeated measures analysis showed that the biochemical indicators of the spanning group and the non-crossing group showed a significant downward trend and the difference was statistically significant (TBil: Fintra-group=9.392, Pintra-group =0.000; DBil: Fintra-group=7.581, Pintra-group=0.001). Among them, the total bilirubin (TBil) (Preoperative: (318.69±101.13) μmol/L, 1 week after surgery: (135.98±63.61) μmol/L, 2 weeks after surgery: (60.21±24.81) μmol/L) was lower than the non-crossing group preoperative: (309.07±109.97) μmol/L, 1 week after surgery: (158.87±66.92) μmol/L, 2 weeks after surgery: (75.91±20.46) μmol/L), and the difference was statistically significant (Finter-group=3.362, Pinter-group=0.041). The direct bilirubin (DBil) (Preoperative: (171.93±73.01) μmol/L, 1 week after surgery: (90.38±57.33) μmol/L, 2 weeks after surgery: (36.64±18.95) μmol/L) was lower than the non-crossing group (Preoperative: (174.53±82.74) μmol/L, 1 week after surgery: (107.85±49.07) μmol/L, 2 weeks after surgery: (37.87±14.55) μmol/L.The difference was statistically significant (Finter-group=6.284, Pinter-group=0.003). There was an interaction between the treatment regimen and treatment time (1 week after surgery and 2 weeks after surgery) (TBil: Finteraction=12.262, Pinteraction=0.000; DBil: Finteraction=10.254, Pinteraction=0.000). The results of the multi factor Cox proportional hazard model of the spanning group and the non-crossing group showed that the ALP, DBil, TBil and lymphatic metastasis of malignant tumor were the two independent risk factors that affect the prognosis.However, the pancreatic cancer, ALT and age in the spanning group across the ampulla also have a certain effect on the prognosis of the patients. \u0000 \u0000 \u0000Conclusion \u0000The effect of the placement of biliary stents across the Vater ampullary was more obvious in the short term on the decline of bilirubin.But in the long term, there was no significant difference in the prognosis of patients with biliary stenting position.ALP, TBil, DBil, a","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"35 1","pages":"385-390"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42294376","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}
引用次数: 0
Effect of Garlicin Capsule on Cellular Immune Function in Patients with Breast Cancer undergoing Chemotherapy 大蒜素胶囊对癌症化疗患者细胞免疫功能的影响
Pub Date : 2019-07-01 DOI: 10.3760/CMA.J.ISSN.1008-6315.2019.04.010
Qi Zhou, Haiping Zhang
Objective To investigate the effects of garlicin capsule on immune function in patients with breast cancer undergoing chemotherapy. Methods Form April 2018 to October 2018, 62 patients with breast cancer were treated by operation in Tangshan People′s Hospital and pathologically diagnosed as breast cancer.Random number table method was used to divide the patients into treatment group and control group, with 31 cases in each group.The treatment group was given garlicin capsule combined with EC regimen( the first day(epirubicin hydrochloride injection 90 mg/m2 + cyclophosphamide 90 mg/m2) , 21 days for one cycle, four consecutive cycles), while the control group was given EC regimen alone for 4 courses.The occurrence of adverse reactions was recorded.T lymphocyte subsets were detected before and after treatment to evaluate the immune function of the body. Results There was no significant difference in the number of adverse reactions between the two groups after treatment (Seventy in the treatment group and 69 in the control group) (P>0.05). The levels of CD3+ , CD4+ , CD8+ and CD4+ /CD8+ were (53.76±4.29)%, (40.19±3.71)%, (28.61±2.75)% and (1.41±0.16) in the treatment group before chemotherapy, respectively.While after chemotherapy were (52.41±4.44)%, (39.49±4.06)%, (28.70±2.76)% and (1.35±0.94), respectively.The levels of CD3+ , CD4+ , CD8+ and CD4+ /CD8+ were (54.35±4.09)%, (40.70±4.09)%, (27.62±3.60)% and (1.49±0.24) in the control group before chemotherapy, respectively.While after chemotherapy were (44.27±6.67)%, (35.39±4.96)%, (30.48±3.43)% and (1.17±0.20). After treatment, the levels of CD3+ , CD4+ , CD4+ / CD8+ decreased and CD8+ increased, but there had no significant difference(P>0.05). After treatment, CD3+ (decreased from(54.35±4.09)% to (44.27±6.67)%), CD4+ (decreased from (40.70±4.09)% to (35.39±4.96)%), CD4+ /CD8+ ((decreased from (1.49±0.24) to (1.17±0.20)), the difference was statistically significant(t value was 7.17, 4.60, 5.71, -3.02, P value was 0.000, 0.000, 0.002, 0.000). Compared with control group, the levels of CD3+ 、CD4+ 、CD4+ / CD8+ in treatment group increased and CD8+ decreased significantly (all P<0.01). Conclusion Garlicin capsule can improve the depression of immune function caused by chemotherapy. Key words: Breast cancer; Garlicin capsule; Chemotherapy; Immune function
目的探讨大蒜素胶囊对乳腺癌化疗患者免疫功能的影响。方法2018年4月至2018年10月,唐山市人民医院62例乳腺癌患者行手术治疗,病理诊断为乳腺癌。采用随机数字表法将患者分为治疗组和对照组,每组31例。治疗组给予大蒜素胶囊联合EC方案(第1天(盐酸表柔比星注射液90 mg/m2 +环磷酰胺90 mg/m2), 21 d, 1个周期,连续4个周期),对照组单独给予EC方案,疗程4个疗程。记录不良反应发生情况。治疗前后检测T淋巴细胞亚群,评价机体免疫功能。结果两组患者治疗后不良反应发生次数(治疗组70例,对照组69例)比较,差异无统计学意义(P < 0.05)。化疗前治疗组CD3+、CD4+、CD8+及CD4+ /CD8+水平分别为(53.76±4.29)%、(40.19±3.71)%、(28.61±2.75)%和(1.41±0.16)。化疗后分别为(52.41±4.44)%、(39.49±4.06)%、(28.70±2.76)%、(1.35±0.94)%。对照组化疗前CD3+、CD4+、CD8+及CD4+ /CD8+水平分别为(54.35±4.09)%、(40.70±4.09)%、(27.62±3.60)%和(1.49±0.24)。化疗后分别为(44.27±6.67)%、(35.39±4.96)%、(30.48±3.43)%、(1.17±0.20)%。治疗后CD3+、CD4+、CD4+ / CD8+水平降低,CD8+升高,但两组比较差异无统计学意义(P < 0.05)。治疗后CD3+(由(54.35±4.09)%降至(44.27±6.67)%)、CD4+(由(40.70±4.09)%降至(35.39±4.96)%)、CD4+ /CD8+(由(1.49±0.24)%降至(1.17±0.20)),差异均有统计学意义(t值分别为7.17、4.60、5.71、-3.02,P值分别为0.000、0.000、0.002、0.000)。与对照组相比,治疗组CD3+、CD4+、CD4+ / CD8+水平显著升高,CD8+水平显著降低(均P<0.01)。结论大蒜素胶囊可改善化疗引起的免疫功能低下。关键词:乳腺癌;外胶囊;化疗;免疫功能
{"title":"Effect of Garlicin Capsule on Cellular Immune Function in Patients with Breast Cancer undergoing Chemotherapy","authors":"Qi Zhou, Haiping Zhang","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.010","url":null,"abstract":"Objective \u0000To investigate the effects of garlicin capsule on immune function in patients with breast cancer undergoing chemotherapy. \u0000 \u0000 \u0000Methods \u0000Form April 2018 to October 2018, 62 patients with breast cancer were treated by operation in Tangshan People′s Hospital and pathologically diagnosed as breast cancer.Random number table method was used to divide the patients into treatment group and control group, with 31 cases in each group.The treatment group was given garlicin capsule combined with EC regimen( the first day(epirubicin hydrochloride injection 90 mg/m2 + cyclophosphamide 90 mg/m2) , 21 days for one cycle, four consecutive cycles), while the control group was given EC regimen alone for 4 courses.The occurrence of adverse reactions was recorded.T lymphocyte subsets were detected before and after treatment to evaluate the immune function of the body. \u0000 \u0000 \u0000Results \u0000There was no significant difference in the number of adverse reactions between the two groups after treatment (Seventy in the treatment group and 69 in the control group) (P>0.05). The levels of CD3+ , CD4+ , CD8+ and CD4+ /CD8+ were (53.76±4.29)%, (40.19±3.71)%, (28.61±2.75)% and (1.41±0.16) in the treatment group before chemotherapy, respectively.While after chemotherapy were (52.41±4.44)%, (39.49±4.06)%, (28.70±2.76)% and (1.35±0.94), respectively.The levels of CD3+ , CD4+ , CD8+ and CD4+ /CD8+ were (54.35±4.09)%, (40.70±4.09)%, (27.62±3.60)% and (1.49±0.24) in the control group before chemotherapy, respectively.While after chemotherapy were (44.27±6.67)%, (35.39±4.96)%, (30.48±3.43)% and (1.17±0.20). After treatment, the levels of CD3+ , CD4+ , CD4+ / CD8+ decreased and CD8+ increased, but there had no significant difference(P>0.05). After treatment, CD3+ (decreased from(54.35±4.09)% to (44.27±6.67)%), CD4+ (decreased from (40.70±4.09)% to (35.39±4.96)%), CD4+ /CD8+ ((decreased from (1.49±0.24) to (1.17±0.20)), the difference was statistically significant(t value was 7.17, 4.60, 5.71, -3.02, P value was 0.000, 0.000, 0.002, 0.000). Compared with control group, the levels of CD3+ 、CD4+ 、CD4+ / CD8+ in treatment group increased and CD8+ decreased significantly (all P<0.01). \u0000 \u0000 \u0000Conclusion \u0000Garlicin capsule can improve the depression of immune function caused by chemotherapy. \u0000 \u0000 \u0000Key words: \u0000Breast cancer; Garlicin capsule; Chemotherapy; Immune function","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"35 1","pages":"337-341"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42238037","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}
引用次数: 0
Evaluation of modified Overlap method in digestive tract reconstruction after totally laparoscopic total gastrectomy for gastric cancer 改良重叠法在癌症全腹腔镜全胃切除术后消化道重建中的应用评价
Pub Date : 2019-07-01 DOI: 10.3760/CMA.J.ISSN.1008-6315.2019.04.016
B. Ma, N. Cao
Objective To evaluate the clinical effect of modified Overlap method in digestive tract reconstruction of totally laparoscopic total gastrectomy(TLTG) for gastric cancer. Methods The data of 86 patients with gastric cancer who underwent TLTG from January 2014 and January 2017 were collected from the First Hospital of Lanzhou University.All the patients underwent D2 lymphadenectomy.Forty-four patients′ digestive tracts were reconstructed with traditional Overlap method (control group), and 42 patients′ digestive tracts were reconstructed with modified Overlap method (modified group). The intraoperative and postoperative conditions, postoperative tumor-free survival, tumor recurrence and metastasis were compared between the two groups.Follow up lasted as of February 2018. Results TLTG was successfully performed in both groups, and no case was converted to laparotomy.The time of esophagojejunostomy ((20.4±2.3) min vs.(46.5±4.4) min, t=9.493), total operation time ((253.3±12.8) min vs.(278.6±14.9) min, t=5.462) in the modified group were significantly shorter than those in the control group, and there were significant differences between the two groups (all P 0.05). The two groups were followed up for 12~25 months.No recurrence or metastasis occurred. Conclusion Compared with traditional Overlap method, the modified Overlap method can simplify the anastomotic procedures, shorten operation time and achieve an effective and reliable anastomosis effect after TLTG. Key words: Gastric neoplasms; Laparoscopy; Radical surgery; Esophagojejunostomy
目的评价改良重叠法在全腹腔镜胃癌全胃切除术消化道重建中的临床效果。方法收集2014年1月至2017年1月兰州大学附属第一医院行TLTG的86例胃癌患者资料。所有患者均行D2淋巴结切除术。采用传统重叠法重建44例患者的消化道(对照组),采用改良重叠法重建42例患者的消化道(改良组)。比较两组患者术中、术后情况、术后无肿瘤生存、肿瘤复发及转移情况。随访持续到2018年2月。结果两组均成功行TLTG,无一例转剖腹手术。改良组食管空肠造口时间((20.4±2.3)min vs(46.5±4.4)min, t=9.493)、总手术时间((253.3±12.8)min vs(278.6±14.9)min, t=5.462)均显著短于对照组,两组比较差异均有统计学意义(P均0.05)。两组患者随访12~25个月。无复发或转移发生。结论与传统重叠法相比,改进的重叠法可简化吻合程序,缩短手术时间,获得有效可靠的吻合效果。关键词:胃肿瘤;腹腔镜检查;根治手术;Esophagojejunostomy
{"title":"Evaluation of modified Overlap method in digestive tract reconstruction after totally laparoscopic total gastrectomy for gastric cancer","authors":"B. Ma, N. Cao","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.016","url":null,"abstract":"Objective \u0000To evaluate the clinical effect of modified Overlap method in digestive tract reconstruction of totally laparoscopic total gastrectomy(TLTG) for gastric cancer. \u0000 \u0000 \u0000Methods \u0000The data of 86 patients with gastric cancer who underwent TLTG from January 2014 and January 2017 were collected from the First Hospital of Lanzhou University.All the patients underwent D2 lymphadenectomy.Forty-four patients′ digestive tracts were reconstructed with traditional Overlap method (control group), and 42 patients′ digestive tracts were reconstructed with modified Overlap method (modified group). The intraoperative and postoperative conditions, postoperative tumor-free survival, tumor recurrence and metastasis were compared between the two groups.Follow up lasted as of February 2018. \u0000 \u0000 \u0000Results \u0000TLTG was successfully performed in both groups, and no case was converted to laparotomy.The time of esophagojejunostomy ((20.4±2.3) min vs.(46.5±4.4) min, t=9.493), total operation time ((253.3±12.8) min vs.(278.6±14.9) min, t=5.462) in the modified group were significantly shorter than those in the control group, and there were significant differences between the two groups (all P 0.05). The two groups were followed up for 12~25 months.No recurrence or metastasis occurred. \u0000 \u0000 \u0000Conclusion \u0000Compared with traditional Overlap method, the modified Overlap method can simplify the anastomotic procedures, shorten operation time and achieve an effective and reliable anastomosis effect after TLTG. \u0000 \u0000 \u0000Key words: \u0000Gastric neoplasms; Laparoscopy; Radical surgery; Esophagojejunostomy","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"35 1","pages":"364-367"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47695266","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}
引用次数: 0
Effect of vitamin D on antiplatelet drug responsiveness in elderly patients with ischemic stroke 维生素D对老年缺血性脑卒中患者抗血小板药物反应性的影响
Pub Date : 2019-07-01 DOI: 10.3760/CMA.J.ISSN.1008-6315.2019.04.003
Liang Chen, Jing Zhang, Xiao-Jie Shi, Zhizhong Liu, Yanyan Sun
Objective To investigate the effect of vitamin D on platelet reactivity after combined treatment with aspirin and clopidogrel in elderly patients with ischemic stroke. Methods A total of 190 elderly patients with ischemic stroke treated with aspirin and clopidogrel in Beijing Bo′ai Hospital from June 2017 to August 2018 were enrolled in this study.Venous blood was collected for platelet aggregation rate, 25-hydroxyvitamin D[25(OH)D] and clinical biochemical indexes during 1~2 weeks.According to 25 (OH) D quartile, the patients were further divided into Q1(≤7.18 μg/L) group (n=50), Q2: (>7.18-≤9.39 μg/L) group (n=50), Q3: (>9.39-≤13.74 μg/L) group (50), Q4: (>13.74 μg/L) (n=40). In order to evaluate the effect of calcitriol on platelet aggregation, platelet rich plasma (PRP) in healthy group (15 cases) and clopidogrel resistance group (15 cases) were treated with calcitriol (10 nmol/L) and saline (37 ℃ pretreatment for 5 minutes), respectively, and to compare the difference of maximum platelet aggregation rate induced by ADP between the two treatments. Results There were significant differences in ADP-induced maximum platelet aggregation rate (MPAR) ((49.36±23.34)%, (48.80±20.90)%, (37.02±18.24)%, (36.02±14.46)%, F=3.426, P=0.018) and clopidogrel resistance (CR)/ clopidogrel sensitive (CS) ratio (30/20, 24/26, 15/35, 10/30, χ2=15.119, P=0.002) among the vitamin D quartiles (increasing). Moreover, the MPAR and CR showed a decreasing trend with the increase of vitamin D concentration.Logistic regression analysis showed that serum 25(OH)D level was an independent inhibited factor for clopidogrel resistance in elderly patients with ischemic stroke (Q4 vs Q1, OR=0.699, 95%CI 0.582~0.838, P<0.001; Q3 vs Q1, OR=0.848, 95%CI 0.755-0.953, P=0.006). In vitro, compared with physiological saline, the aggregation rates of platelet in healthy group and CR group decreased after calcitriol pretreatment, and the difference was statistically significant(healthy group: (69.8±12.7)% vs (58.6±11.5)%, t=12.13, P<0.001; CR group: (65.5±8.3)% vs (56.3±7.6)%, t=11.48, P<0.001). Conclusion Vitamin D reduces the high residual platelet reactivity after antiplatelet therapy.Further study is needed to determine whether vitamin D supplementation may improve the efficacy of clopidogrel. Key words: Ischemic stroke; Antiplatelet therapy; Vitamin D; Drug resistance
目的探讨维生素D对老年缺血性脑卒中患者阿司匹林与氯吡格雷联合治疗后血小板反应性的影响。方法选取2017年6月至2018年8月在北京博爱医院接受阿司匹林和氯吡格雷联合治疗的老年缺血性脑卒中患者190例。1~2周采集静脉血检测血小板聚集率、25-羟基维生素D[25(OH)D]及临床生化指标。根据25 (OH) D四分位数进一步分为Q1(≤7.18 μg/L)组(n=50)、Q2(>7.18-≤9.39 μg/L)组(n=50)、Q3(>9.39-≤13.74 μg/L)组(50)、Q4 (>13.74 μg/L)组(n=40)。为评价骨化三醇对血小板聚集的影响,将健康组(15例)和氯吡格雷耐药组(15例)的富血小板血浆(PRP)分别给予骨化三醇(10 nmol/L)和生理盐水(37℃预处理5分钟)处理,比较两种处理对ADP诱导血小板最大聚集率的差异。结果adp诱导的血小板最大聚集率(MPAR)分别为(49.36±23.34)%、(48.80±20.90)%、(37.02±18.24)%、(36.02±14.46)%,F=3.426, P=0.018)和氯吡格雷耐药/氯吡格雷敏感比(30/ 20,24 / 26,15 / 35,10 /30,χ2=15.119, P=0.002)在维生素D四分位数间差异有统计学意义(增高)。随着维生素D浓度的增加,MPAR和CR呈下降趋势。Logistic回归分析显示,血清25(OH)D水平是老年缺血性卒中患者氯吡格雷耐药的独立抑制因素(Q4 vs Q1, OR=0.699, 95%CI 0.582~0.838, P<0.001;Q3 vs Q1, OR=0.848, 95%CI 0.755-0.953, P=0.006)。在体外,与生理盐水相比,骨化三醇预处理后健康组和CR组血小板聚集率降低,差异有统计学意义(健康组:(69.8±12.7)% vs(58.6±11.5)%,t=12.13, P<0.001;CR组:(65.5±8.3)% vs(56.3±7.6)%,t = 11.48, P < 0.001)。结论维生素D可降低抗血小板治疗后残余血小板高反应性。补充维生素D是否可以提高氯吡格雷的疗效还需要进一步的研究。关键词:缺血性脑卒中;抗血小板治疗;维生素D;耐药性
{"title":"Effect of vitamin D on antiplatelet drug responsiveness in elderly patients with ischemic stroke","authors":"Liang Chen, Jing Zhang, Xiao-Jie Shi, Zhizhong Liu, Yanyan Sun","doi":"10.3760/CMA.J.ISSN.1008-6315.2019.04.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1008-6315.2019.04.003","url":null,"abstract":"Objective \u0000To investigate the effect of vitamin D on platelet reactivity after combined treatment with aspirin and clopidogrel in elderly patients with ischemic stroke. \u0000 \u0000 \u0000Methods \u0000A total of 190 elderly patients with ischemic stroke treated with aspirin and clopidogrel in Beijing Bo′ai Hospital from June 2017 to August 2018 were enrolled in this study.Venous blood was collected for platelet aggregation rate, 25-hydroxyvitamin D[25(OH)D] and clinical biochemical indexes during 1~2 weeks.According to 25 (OH) D quartile, the patients were further divided into Q1(≤7.18 μg/L) group (n=50), Q2: (>7.18-≤9.39 μg/L) group (n=50), Q3: (>9.39-≤13.74 μg/L) group (50), Q4: (>13.74 μg/L) (n=40). In order to evaluate the effect of calcitriol on platelet aggregation, platelet rich plasma (PRP) in healthy group (15 cases) and clopidogrel resistance group (15 cases) were treated with calcitriol (10 nmol/L) and saline (37 ℃ pretreatment for 5 minutes), respectively, and to compare the difference of maximum platelet aggregation rate induced by ADP between the two treatments. \u0000 \u0000 \u0000Results \u0000There were significant differences in ADP-induced maximum platelet aggregation rate (MPAR) ((49.36±23.34)%, (48.80±20.90)%, (37.02±18.24)%, (36.02±14.46)%, F=3.426, P=0.018) and clopidogrel resistance (CR)/ clopidogrel sensitive (CS) ratio (30/20, 24/26, 15/35, 10/30, χ2=15.119, P=0.002) among the vitamin D quartiles (increasing). Moreover, the MPAR and CR showed a decreasing trend with the increase of vitamin D concentration.Logistic regression analysis showed that serum 25(OH)D level was an independent inhibited factor for clopidogrel resistance in elderly patients with ischemic stroke (Q4 vs Q1, OR=0.699, 95%CI 0.582~0.838, P<0.001; Q3 vs Q1, OR=0.848, 95%CI 0.755-0.953, P=0.006). In vitro, compared with physiological saline, the aggregation rates of platelet in healthy group and CR group decreased after calcitriol pretreatment, and the difference was statistically significant(healthy group: (69.8±12.7)% vs (58.6±11.5)%, t=12.13, P<0.001; CR group: (65.5±8.3)% vs (56.3±7.6)%, t=11.48, P<0.001). \u0000 \u0000 \u0000Conclusion \u0000Vitamin D reduces the high residual platelet reactivity after antiplatelet therapy.Further study is needed to determine whether vitamin D supplementation may improve the efficacy of clopidogrel. \u0000 \u0000 \u0000Key words: \u0000Ischemic stroke; Antiplatelet therapy; Vitamin D; Drug resistance","PeriodicalId":10365,"journal":{"name":"Clinical Medicine of China","volume":"35 1","pages":"300-305"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45398593","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}
引用次数: 0
Effect of laparoscopic hepatectomy on immune function, inflammatory factors and prognosis of patients with hepatocellular carcinoma 腹腔镜肝切除术对肝癌患者免疫功能、炎症因子及预后的影响
Pub Date : 2019-07-01 DOI: 10.3760/CMA.J.ISSN.1008-6315.2019.04.013
Jie Chen, Bin Zhao, Jun Li, Gaofeng Zhang
Objective To study the effect of laparoscopic hepatectomy resection on immune function, inflammatory factors and prognosis of patients. Methods One hundred and four patients with hepatocellular carcinoma admitted Zigong Fourth People′s Hospital from July 2015 to December 2016 were selected as the study subjects.According to the different surgical methods, they were randomly divided into observation group and control group with 52 cases in each group.The control group received open hepatectomy, while the observation group received laparoscopic hepatectomy.The immune function, inflammatory factors, and surgery related indicators were compared between the two groups. Results The observation time of the observation group was significantly longer than that in the control group.The blood loss was significantly less than the control group.Gastrointestinal function recovery time and postoperative hospital stay were significantly shorter than control group (t=7.553, 13.855, 15.100, 16.873, all P<0.01), three days after surgery, the serum IgA, IgG, and IgM levels were significantly higher than control group (t=16.009, 10.076, 14.138, all P<0.01). The levels of IL-6, IL-10 and TNF-α were significantly lower than the control group (t=8.538, 6.851, 11.103, P<0.05, all P<0.01). Conclusion Laparoscopic hepatectomy can promote the recovery of patients after surgery, which may be related to the reduction of immune function inhibition, inflammatory response and other factors. Key words: Liver cancer; Surgical resection; Laparoscopy; Immune function; Inflammatory factors
目的探讨腹腔镜肝切除术对患者免疫功能、炎症因素及预后的影响。方法选取自贡市第四人民医院2015年7月至2016年12月收治的104例肝细胞癌患者作为研究对象。根据手术方法的不同,随机分为观察组和对照组,每组52例。对照组采用开放式肝切除术,观察组采用腹腔镜肝切除术。比较两组患者的免疫功能、炎症因子和手术相关指标。结果观察组的观察时间明显长于对照组。失血量明显少于对照组。胃肠功能恢复时间和术后住院时间均显著短于对照组(t=7.553、13.855、15.100、16.873,均P<0.01),术后3天血清IgA、IgG和IgM水平均显著高于对照组(t=16.009、10.076、14.138,均<0.01),IL-10和TNF-α显著低于对照组(t=8.538,6.851,11.103,P<0.05,均P<0.01)。关键词:癌症;手术切除;腹腔镜;免疫功能;炎症因子
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引用次数: 0
Study on correlation between serum uric acid level and brachial ankle pulse wave velocity in patients with systemic lupus erythematosus 系统性红斑狼疮患者血尿酸水平与肱踝脉波速度的相关性研究
Pub Date : 2019-07-01 DOI: 10.3760/CMA.J.ISSN.1008-6315.2019.04.005
Jie-rui Wang, Hui-jing Shi, Wen-hao Yang, Na Li, Wenfang Yang, Jian Wang, W. Yuan, Bai-lu Liu, Yuqin Hu, Lina Li, R. Shu, Haichen Song, Yixuan Han, P. Yu
Objective To investigate the relationship between serum uric acid (UA) level and brachial-ankle pulse wave velocity (baPWV) in patients with systemic lupus erythematosus (SLE) and lupus nephritis (LN). Methods A total of 110 hospitalized, out-patient and healthy examinees from January 2017 to September 2017 were selected from Kailuan General Hospital.They were divided into three groups: (1)Fifty-five healthy controls were examined at the same time, and those who had no history of hypertension, myocardial infarction and stroke were excluded by physical examination.(2)Thirty-four SLE patients without LN were diagnosed according to the SLE classification standard revised by the American Society of Rheumatology (ACR) in 1997, excluding those with lupus nephritis.(3)21 SLE patients with LN were diagnosed according to the SLE classification standard revised by the American Society of Rheumatology (ACR) in 1997.Pearson correlation coefficient and multivariate linear regression model were used to analyze the related factors affecting baPWV. Results The level of baPWV and the proportion of baPWV (≥1400 cm/s) in SLE without LN group and SLE with LN group were higher than those in healthy control group (all P<0.05). In SLE without LN group, baPWV was positively correlated with age, systolic blood pressure(SBP)and total cholesterol(CHOL)(r=0.623, 0.528, 0.402, P<0.01 or P<0.05), and negatively correlated with blood uric acid(UA) (r=-0.371, P<0.05), but the correlation was not significant.The correlation between UA and baPWV disappeared after after correction of age, SBP, diastolic blood pressure (DBP) by partial correlation analysis.In SLE with LN group, baPWV was positively correlated with SBP, DBP and serum creatinine(Cr) (r=0.815, 0.725, 0.464, P<0.01 or P<0.05). Multivariate stepwise regression analysis showed that SBP was independently correlated with baPWV in SLE group (t=2.54, P=0.026); UA in SLE group without LN was independently negatively correlated with baPWV(t=-2.96, P=0.042); UA(t=4.24, P=0.013) and SBP(t=7.70, P=0.002) were independently positively correlated with baPWV in SLE group with LN.Logistic regression analysis showed that SLE was a risk factor for baPWV (≥1 400 cm/s), and the OR (95% CI) was 4.31 (1.56-11.88), P=0.005, and there was statistical significance after adjusting for age, SBP, DBP, body mass index (BMI). However, UA was not a risk factor for baPWV (≥ 1 400 cm/s) (P values were 0.163 and 0.519, respectively). Conclusion The degree of arteriosclerosis in SLE patients is higher than that in normal subjects, and the level of UA in SLE patients may be related to baPWV. Key words: Systemic lupus erythematosus; Lupus nephritis; Blood uric acid; Brachial-ankle pulse wave velocity
目的探讨系统性红斑狼疮(SLE)和狼疮肾炎(LN)患者血清尿酸(UA)水平与肱-踝脉波速度(baPWV)的关系。方法选取2017年1月至2017年9月开滦总医院住院、门诊及健康体检者110人。他们被分为三组:(1)同期健康对照55例,体检排除无高血压、心肌梗死、脑卒中病史者。(2)34例无LN的SLE患者按照1997年美国风湿病学会(ACR)修订的SLE分类标准进行诊断。(3)根据1997年美国风湿病学会(American Society of Rheumatology, ACR)修订的SLE分类标准诊断SLE合并LN患者21例。采用Pearson相关系数和多元线性回归模型分析影响baPWV的相关因素。结果SLE无LN组和SLE合并LN组患者血清baPWV水平及baPWV≥1400 cm/s的比例均高于健康对照组(P<0.05)。在无LN的SLE组中,baPWV与年龄、收缩压(SBP)、总胆固醇(CHOL)呈正相关(r=0.623、0.528、0.402,P<0.01或P<0.05),与血尿酸(UA)负相关(r=-0.371, P<0.05),但相关性不显著。偏相关分析校正年龄、收缩压、舒张压后,UA与baPWV的相关性消失。SLE合并LN组baPWV与收缩压、舒张压、血清肌酐(Cr)呈正相关(r=0.815、0.725、0.464,P<0.01或P<0.05)。多因素逐步回归分析显示SLE组收缩压与baPWV独立相关(t=2.54, P=0.026);无LN的SLE组UA与baPWV呈独立负相关(t=-2.96, P=0.042);SLE合并LN组UA(t=4.24, P=0.013)、SBP(t=7.70, P=0.002)与baPWV独立正相关。Logistic回归分析显示SLE是baPWV(≥1 400 cm/s)的危险因素,OR (95% CI)为4.31 (1.56 ~ 11.88),P=0.005,校正年龄、收缩压、舒张压、体重指数(BMI)后差异有统计学意义。然而,UA不是baPWV(≥1 400 cm/s)的危险因素(P值分别为0.163和0.519)。结论SLE患者动脉硬化程度高于正常人,SLE患者UA水平可能与baPWV有关。关键词:系统性红斑狼疮;狼疮肾炎;血尿酸;肱-踝脉波速度
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