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2019 Vol. 42, No. 3
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2019, 42(3): 285-289.
doi: 10.12122/j.issn.1674-4500.2019.03.01
Abstract:
Breast cancer is the most common malignant tumor in women, and the mortality rate is even higher. The survival rate of breast cancer patients is closely related to the tumor stage. Neoadjuvant chemotherapy is suitable for preoperative treatment of tumors. Because it can reduce the stage of breast cancer, reduce the volume of lesions, and achieve the purpose of surgery or breast conserving. Functional imaging techniques that reflect microscopic changes in the lesion can prioritize the morphological changes of the tumor. It can reflect the sensitivity of the breast cancer patient to neoadjuvant chemotherapy response by reflecting changes in the tumor vasculature and metabolism. It provides effective adjustment for clinical treatment options. This paper reviews the advantages and disadvantages of the functional imaging technique in the chemotherapy response of breast cancer after neoadjuvant chemotherapy.
Breast cancer is the most common malignant tumor in women, and the mortality rate is even higher. The survival rate of breast cancer patients is closely related to the tumor stage. Neoadjuvant chemotherapy is suitable for preoperative treatment of tumors. Because it can reduce the stage of breast cancer, reduce the volume of lesions, and achieve the purpose of surgery or breast conserving. Functional imaging techniques that reflect microscopic changes in the lesion can prioritize the morphological changes of the tumor. It can reflect the sensitivity of the breast cancer patient to neoadjuvant chemotherapy response by reflecting changes in the tumor vasculature and metabolism. It provides effective adjustment for clinical treatment options. This paper reviews the advantages and disadvantages of the functional imaging technique in the chemotherapy response of breast cancer after neoadjuvant chemotherapy.
2019, 42(3): 290-293.
doi: 10.12122/j.issn.1674-4500.2019.03.02
Abstract:
Objective To analyze the correlations between the ultrasonographic features and CD34 expression in invasive ductal carcinoma of the breast. Methods The expression of CD34 in invasive ductal carcinoma of the breast and its correlations with genes (VEGFA, VEGFR and PDGFR) that encoding angiogenesis-related factors were analyzed by the cancer genome atlas. We retrospectively analyzed the ultrasonographic features and CD34 immunohistochemical staining of 100 patients with pathologically diagnosed invasive ductal carcinoma of the breast. Their correlation was analyzed. Results There was no significant correlation between CD34 and VEGFA at mRNA levels in breast invasive ductal carcinoma. There was a significant positive correlation between CD34 and VEGFR/PDGFR at mRNA levels. Among all the ultrasonographic features, invasive ductal carcinoma of the breast with blood flow of grade Ⅱ~Ⅲ had a higher expression of CD34 than that of grade 0~Ⅰ. The invasive ductal carcinoma of the breast with axillary lymph node metastasis had a higher expression of CD34 than that without metastasis. Conclusion Among all the ultrasonographic features, the blood flow grading and axillary lymph nodes metastasis are associated with CD34 expression. The clinicians may select anti-angiogenic drugs for patients based on both CD34 and ultrasonographic features.
2019, 42(3): 294-296.
doi: 10.12122/j.issn.1674-4500.2019.03.03
Abstract:
Diffusion tensor imaging (DTI) are applied to the diagnosis of the central nervous system diseases, while the study of DTI in clinical application of peripheral nervous system is in the ascendant. Former studies have shown that DTI can identify the early microscopic lesions of the peripheral nerves, therefore it is possible to diagnose and treat peripheral nerves diseases early. Compared with neurophysiological examination and spinal canal angiography, DTI has the advantages of noninvasive and quantitative evaluation. So it is expected to become a new generation of auxiliary tools for the diagnosis of peripheral nervous system diseases. In this paper, the common parameters of DTI value of peripheral nerve, delineation method of region of interest (ROI), calculation method of DTI value, influencing factors related to DTI value, application situation and limitations of DTI in peripheral nerve are discussed.
Diffusion tensor imaging (DTI) are applied to the diagnosis of the central nervous system diseases, while the study of DTI in clinical application of peripheral nervous system is in the ascendant. Former studies have shown that DTI can identify the early microscopic lesions of the peripheral nerves, therefore it is possible to diagnose and treat peripheral nerves diseases early. Compared with neurophysiological examination and spinal canal angiography, DTI has the advantages of noninvasive and quantitative evaluation. So it is expected to become a new generation of auxiliary tools for the diagnosis of peripheral nervous system diseases. In this paper, the common parameters of DTI value of peripheral nerve, delineation method of region of interest (ROI), calculation method of DTI value, influencing factors related to DTI value, application situation and limitations of DTI in peripheral nerve are discussed.
2019, 42(3): 297-300.
doi: 10.12122/j.issn.1674-4500.2019.03.04
Abstract:
Objective To explore the safety and effectiveness of early microsurgical removal of bleeding arteriovenous malformations. Methods The clinical data of 46 patients with AVM by early microsurgical treatment in our hospital from January 2015 to April 2019 were retrospectively reviewed in the acute stage of bleeding（within the first week after bleed）. All patients showed a cerebral AVM on DSA or CTA at admission. Results In the 46 patients, total resection was achieved in 40 cases（86.9%, 40/46）. A favorable functional outcome was observed in 26 patients, 13 cases were mild disability, 5 cases were severe disability, and 2 patients died. The patients with high Spetzler-Martin（SM）grade, volume hematoma larger than 50 ml, AVM located in cerebellar resulted in poor outcomes. Conclusion Early microsurgery for bleeding AVMs is a safe and definitive treatment. It achieves both immediate cerebral decompression and protection against rebreeding, resects cerebral AVMs totally, avoids neurologic comprimise and allows a more rapid rehabilitative course whenever necessary.
2019, 42(3): 301-305.
doi: 10.12122/j.issn.1674-4500.2019.03.05
Abstract:
ObjectiveTo explore the value of transvaginal doppler ultrasound examinations in diagnosis and differential diagnosis of retained products of conception (RPOC) after induced abortion. Methods43 cases of RPOC after induced abortion were reviewed retrospectivly. The patients were suffered from pathologically proved RPOC in between January 2016 and December 2018, with age from 18 to 39 years (average 30.1±4.4). All patients underwent transvaginal doppler ultrasound examinations preoperatively, and the sonographies were collected. Two experienced ultrasonologists reviewed the sonographies together to analyze the sonographic features of RPOC, including the uterinesize, size, morphology, echo, blood perfusion of RPOC lesions, changes of endometrium, and complications. ResultsThe volume increase of uterus was found in 19 cases, among which bulging out of the uterus were found in 3 cases.Masses in uterine cave were found in 41 cases, which present as patchyinhomogeneous echoes. When CDFI was performed to the patients, blood perfusion with varied kinds of degree was detected in the masses. Blur interfaces between the masses and myometrium were found in 31 cases, while blood flow signal connecting masses and myometrium were detected in 5 cases. Abnormal endometrial thickening with inhomogeneous echoes was found in 8 cases, among which the endometrial abnormalities were the only abnormal findings in 2 cases. Uterine cavity fluid (blood) was found in 19 cases. Additionally, uterine fibroids, adenomyomas, ovarian cystic masses, intrauterine device were found in 4, 2, 7, and 1 cases, respectively. ConclusionTransvaginal doppler ultrasound examinations can exhibit morphology, blood perfusion of RPOC, and the adjacent tissue changes. It plays a crucial role in diagnosis and differential diagnosis of RPOC in clinical work.
2019, 42(3): 306-309.
doi: 10.12122/j.issn.1674-4500.2019.03.06
Abstract:
ObjectiveTo explore the diagnostic value and clinical significance of transvaginal color doppler ultrasound in patients with type I and type II cesarean scar pregnancy (CSP). MethodsSeventy-one CSP patients were detected by transvaginal color Doppler ultrasound from January 2016 to December 2018. The ultrasonographic features and clinical manifestations of 71 patients were collected and analyzed. ResultsIn 71 CSP patients diagnosed by transvaginal color Doppler ultrasound, 56 patients were diagnosed as type I CSP and 15 patients were diagnosed as type II CSP. Thirty-for cases (47.89%) developed symptom of irregular vaginal bleeding after menopause and 17 cases (23.95%) developed symptom of lower abdominal pain, indicating that early clinical manifestations of CSP patients were atypical. Fourty-five patients out of 71 CSP patients received further treatments. The coincidental rate of pathological diagnosis was 88.2% for type I CSP patients, whereas 100.0% for type II CSP patients. ConclusionTransvaginal color Doppler ultrasound is valuable for early diagnosis of CSP and prevention of pregnancy risk. Further prospective multicenter research is necessary to further ascertain the diagnostic value and clinical significance of transvaginal color Doppler ultrasound for CSP patients.
2019, 42(3): 310-313.
doi: 10.12122/j.issn.1674-4500.2019.03.07
Abstract:
ObjectiveTo investigate the clinical application value of high frequency ultrasound examination in carpal tunnel syndrome with a small incision. MethodsA total of 66 patients diagnosed with CTS who failed in conservative treatment and required minimal-access carpal tunnel release technique were divided into ultrasound group and control group, with 33 cases in each. The effective rate, operative time, blood loss volume, average hospital day, scar length, incidence of postoperative pain and complications were compared between the two groups. ResultsAll patients were followed up for 12 months, the efficacy of blood loss volume(16.39±4.44 mL vs 18.97±5.05 mL, P<0.05), operative time(12.55±1.75 min vs 13.48±2.02 min, P<0.05), incidence of postoperative complications(9.1% vs 33.3%, P<0.05) were improved significantly in ultrasound group. There was no significant difference between the two groups in average hospital day, scar length and incidence of postoperative pain and complications (P>0.05). ConclusionMinimal-access carpal tunnel release technique assisted with high frequency ultrasound is a safe and reliable method for carpal tunnel syndrome. It is beneficial for patients to recover from operation.
2019, 42(3): 314-316.
doi: 10.12122/j.issn.1674-4500.2019.03.08
Abstract:
Pseudoaneurysm is a common complication of vascular injury due to one or more pulsatile hematoma formed in the surrounding soft tissue by the blood flowing out of the damaged artery wall. Long-term repeated puncture increases the risk of PSA. Early diagnosis and treatment can reduce complications and adverse consequences. The paper reports the diagnosis and treatment of a case of complex pseudoaneurysm of humerus artery caused by dialysis puncture. We discuss the ultrasonic diagnosis and treatment of complex pseudoaneurysm in combination with literature review. Early interventional ultrasound percutaneous balloon occlusion combined with surgical intervention can prevent the further development of pseudoaneurysm, improve the cure rate and provide reference for clinical diagnosis and treatment.
Pseudoaneurysm is a common complication of vascular injury due to one or more pulsatile hematoma formed in the surrounding soft tissue by the blood flowing out of the damaged artery wall. Long-term repeated puncture increases the risk of PSA. Early diagnosis and treatment can reduce complications and adverse consequences. The paper reports the diagnosis and treatment of a case of complex pseudoaneurysm of humerus artery caused by dialysis puncture. We discuss the ultrasonic diagnosis and treatment of complex pseudoaneurysm in combination with literature review. Early interventional ultrasound percutaneous balloon occlusion combined with surgical intervention can prevent the further development of pseudoaneurysm, improve the cure rate and provide reference for clinical diagnosis and treatment.
2019, 42(3): 317-320.
doi: 10.12122/j.issn.1674-4500.2019.03.09
Abstract:
ObjectiveTo evaluate the value of spiral CT three-dimensional reconstruction combined with fiberoptic bronchoscopy in etiological diagnosis of atelectasis. MethodsEighty-four patients with atelectasis who were diagnosed and treated in our hospital from February 2017 to February 2019 were selected as the study subjects. According to the random number table method, the subjects were divided into two groups, 42 cases each. The experimental group was diagnosed by spiral CT three-dimensional reconstruction combined with fiberoptic bronchoscopy, while the control group was diagnosed by fiberoptic bronchoscopy. The differences of positive rate of etiological diagnosis, diagnostic examination time and incidence of adverse reactions between the two groups were analyzed. ResultsWith pathological examination as the gold standard, the positive rate of etiological diagnosis in the experimental group was 100.0%, and the control group was 92.9%. The diagnostic time of the experimental group was 12.07±2.39 min, which was significantly shorter than that of the control group (16.14±1.86 min, P<0.05). The incidence of adverse reactions (bleeding, vomiting, hypoxia, iatrogenic pneumothorax, tracheospasm, arrhythmia) in the experimental group was 4.8%, which was significantly lower than that of the control group (19.0%, P<0.05). ConclusionThe spiral CT three-dimensional reconstruction combined with fiberoptic bronchoscopy could improve the diagnostic level of etiology of atelectasis. At the same time, it can reduce the time consumed and the incidence of adverse reactions in the process of examination by fiberoptic bronchoscopy.
2019, 42(3): 321-324.
doi: 10.12122/j.issn.1674-4500.2019.03.10
Abstract:
ObjectiveTo analyze CT and MRI findings of ovarian thecoma and to compare with the pathological trait. MethodsCT and MRI findings of ovarian thecomas in 32 cases proved by surgery and pathology were analyzed retrospectively. ResultsOne case was bilateral,and 31 cases was singe. All nearly round or elliptic.The size of the tumors ranged from 0.3 cm to 28.4 cm, with mainly solid. The solid part or cystic wall were equivalent and low hybrid density on unenhanced CT. The rumors exhibited isointensity and hypointensity on T1WI,heterogeneous signal on T2WI. Eleven cases showed low signal nodules in the tumor on T2WI-SPAIR. After contrast injection,the solid part of tumors demonstrated mild to moderate enhancement and delayed slight progressive enhancement. Nine cases showed more obvious enhancement of fine vascular shadows. Three cases showed "pocket egg" sign. ConclusionThe imaging features of thecoma are helpful in preoperative diagnosis and differential diagnosis.
2019, 42(3): 325-328.
doi: 10.12122/j.issn.1674-4500.2019.03.11
Abstract:
Objective To investigate the diagnosis and treatment of diffuse large B-cell lymphoma of esophagus and cardia complicated with primary bronchogenic carcinoma, and analyze the causes of misdiagnosis, provide reference for clinical practice. Methods The clinical data, diagnosis and treatment of a patient with diffuse large B-cell lymphoma of esophagus and cardia complicated with primary bronchogenic carcinoma were analyzed retrospectively. The related literatures were analyzed. Results After admission, enhanced CT and gastroscopy were performed in the chest and abdomen. The bronchoscopy was performed for the secondary malignant tumor of esophagus and lung involved by cardiac malignant tumor. The biopsy results suggested that diffuse large B-cell lymphoma of the cardia and esophagus was associated with primary bronchogenic carcinoma. Conclusion Diffuse large B-cell lymphoma complicated with bronchogenic carcinoma is easy to form esophagotracheal fistula, which seriously endangers the life of the patients. Therefore, pathological biopsy of esophagus and lung should be performed when esophageal ulcerative lesions complicated with pulmonary space-occupying lesions found. It can help make a definite diagnosis and make the next treatment plan.
2019, 42(3): 329-332.
doi: 10.12122/j.issn.1674-4500.2019.03.12
Abstract:
ObjectiveTo explore the influence factors of fetal MRI imaging quality based on fast MRI sequences. MethodsFifty cases of fetus were collected during January 2017 to January 2018 in our hospital, who were undergone prenatal ultrasound screening or fetal abnormal suspected and needed further inspection in middle-late pregnancy pregnant women. The patients were scanned by SIEMENS 1.5 T magnetic resonance (NMR) with rapid multi-level multi-angle scanning technique. The MRI image quality was evaluated. The image quality was therefore analyzed to explore the connection with gestational age, position and amniotic fluid volume. The reason to the decline of the image quality were analyzed. ResultsAll the 50 pregnant women selected were able to undergo the examination successfully. Forty cases were able to obtain high contrast and high signal-to-noise ratio images, which met the clinical diagnostic requirements. There was no significant difference between the quality of MRI imaging and gestational age, fetal position or amniotic fluid volume (P>0.05). Motion artifacts, fetal bladder hyperplasia and pleated artifacts reduced the image quality. ConclusionIn the premise of high quality MRI images which meet the demand of diagnosis, rapid scanning technique can be applied. It has tiny image artifact, high signal to noise ratio and resolution. There is no relevance between the MRI quality and the gestational age, the fetal position or amniotic fluid volume. The high quality MRI imaging in prenatal examination is important.
2019, 42(3): 333-335.
doi: 10.12122/j.issn.1674-4500.2019.03.13
Abstract:
Esophageal fistula refers to the abnormal communication between esophagus and adjacent organs caused by various reasons. It can be divided into gastroesophageal anastomotic fistula, esophago-tracheal fistula, esophageal mediastinum fistula. It can be diagnosed by esophageal barium contrast examination. The surgical treatment, endoscopic treatment and conservative treatment are current treatments. Once esophageal fistula occurs, patients often have uncontrollable infection. The mortality rate is high if not diagnosed and treated in time. This paper reports a case of misdiagnosis of esophageal-mediastinal fistula with negative upper gastrointestinal radiography. It summarizes the diagnosis and treatment of esophageal fistula to improve the understanding of esophageal fistula and the efficiency of early diagnosis.
Esophageal fistula refers to the abnormal communication between esophagus and adjacent organs caused by various reasons. It can be divided into gastroesophageal anastomotic fistula, esophago-tracheal fistula, esophageal mediastinum fistula. It can be diagnosed by esophageal barium contrast examination. The surgical treatment, endoscopic treatment and conservative treatment are current treatments. Once esophageal fistula occurs, patients often have uncontrollable infection. The mortality rate is high if not diagnosed and treated in time. This paper reports a case of misdiagnosis of esophageal-mediastinal fistula with negative upper gastrointestinal radiography. It summarizes the diagnosis and treatment of esophageal fistula to improve the understanding of esophageal fistula and the efficiency of early diagnosis.
2019, 42(3): 336-339.
doi: 10.12122/j.issn.1674-4500.2019.03.14
Abstract:
ObjectiveTo explore the clinical value of fiberoptic bronchoscope and DNA ploidy analysis system in the diagnosis and treatment of bacterial pneumonia. MethodsWe collected the clinical data of 96 cases of bacterial pneumonia in the Xiaolan Hospital affiliated to the Southern Medical University from October 2017 to March 2018. The systematic retrospective analysis were perfromed to gender, age, clinical manifestation, laboratory examination results, radiographic examination results, treatment methods and curative effect. ResultsA total of 96 cases of bacterial pneumonia were examined by fiberoptic bronchoscopy and alveolar lavage in local anesthesia. The alveolar lavage fluid was analyzed by DNA ploidy. Among them, 39 male and 57 female were included with age of 17-92 years old. Chest ct manifestations: double lung lesions in 58 cases, left lung in 23 cases, right lung in 15 cases, exudation in 63 cases, real change in 54 cases, bronchial dilatation in 13 cases, pleural effusion in 7 cases. Laboratory Examination: 64 cases of erythrocyte sedimentation rate abnormality, infective markers, elevation of interleukin 42 cases, calcitonin increased in 78 cases,55 cases had immunoglobulin increased. The peripheral leukocytes number: 16 cases were less than 4×109, 68 cases were (4-10)×109, 12 cases were (10-20)×109. Results of fiberoptic bronchoscopy: 96 cases of bronchial membrane inflammation. The bacterial culture of lavage fluid and the positive sputum culture were 0 case of normal flora. In 96 cases of pneumonia, 87 cases were rapidly improved by fiberoptic bronchoscope and the cure rate reached 90.6%. Twenty-three cases received DNA ploidy analysis of bronchial lavage fluid, and no abnormal DNA cells were found. ConclusionThe treatment of adult bacterial pneumonia with fiberoptic bronchoscopy under local anesthesia is simple, safe and effective. Fiberoptic bronchoscopy and DNA ploidy analysis are valuable in the diagnosis and treatment of bacterial pneumonia in adults.
2019, 42(3): 340-342.
doi: 10.12122/j.issn.1674-4500.2019.03.15
Abstract:
Objective To analyze the effect of refined nursing on patients with ectopic pregnancy undergoing laparoscopic surgery. Methods A total of 92 patients with ectopic pregnancy who underwent laparoscopic surgery were randomly divided into the control group and the research group. The control group received routine nursing care. The research group was strengthened the refined nursing intervention and compared the postoperative pain and rehabilitation between the two groups. Situation and satisfaction of nursing services were compared. Results The postoperative pain degree of research group was generally lighter than that of the control group（P<0.05）. The incidence of pain in research group was significantly lower than that of the control group（P<0.05）. The first time of bed-out and hospitalization in research group were shorter in the research group than in the control group（P< 0.05）. The satisfaction of nursing service in research group was significantly higher than that of the control group（P<0.05）. Conclusion Fine nursing can effectively alleviate the pain degree after ectopic pregnancy, reduce the incidence of pain, shorten the postoperative recovery time, and improve the satisfaction of nursing service.
2019, 42(3): 343-348.
doi: 10.12122/j.issn.1674-4500.2019.03.16
Abstract:
Cut like hemeobox 1 protein (CUX1), also known as CDP、CUT or CUTL1, is a member of homeodomain DNA-binding protein family. In the process of transcription and translation, CUX1 gene can produce different protein isoforms with different lengths, including p200, P110 and p75. The loss of CUX1 plays a positive role in Myeloid Leukemia as reported. On the contrary, CUX1 overexpresses is found in a lot kinds of cancers, such as mammary cancer, lung cancer, pancreatic cancer, glioma and pancreatic neuroendocrine tumor, and its expression level is connected with patients prognosis. So, CUX1 can act as a potential biologic marker and therapeutic target for diagnosis and prognosis of tumors. The paradox role of CUX1 in cancers can be explained with researches after a long time. In the fundamental studies, P200 as an unabridged protein isoform can stimulate DNA base repairing, which is associated with the pharmaceutic resistance of cancer; and the short isoforms of CUX1 can regulate the proliferation, migration and invasion through regulating some signal pathways, such as PI3k/AKT、Wnt/β-catenin and TGF-β pathways. This review aims to introduce the research progress about correlation analysis and regulatory mechanism of CUX1 in different tumors.
Cut like hemeobox 1 protein (CUX1), also known as CDP、CUT or CUTL1, is a member of homeodomain DNA-binding protein family. In the process of transcription and translation, CUX1 gene can produce different protein isoforms with different lengths, including p200, P110 and p75. The loss of CUX1 plays a positive role in Myeloid Leukemia as reported. On the contrary, CUX1 overexpresses is found in a lot kinds of cancers, such as mammary cancer, lung cancer, pancreatic cancer, glioma and pancreatic neuroendocrine tumor, and its expression level is connected with patients prognosis. So, CUX1 can act as a potential biologic marker and therapeutic target for diagnosis and prognosis of tumors. The paradox role of CUX1 in cancers can be explained with researches after a long time. In the fundamental studies, P200 as an unabridged protein isoform can stimulate DNA base repairing, which is associated with the pharmaceutic resistance of cancer; and the short isoforms of CUX1 can regulate the proliferation, migration and invasion through regulating some signal pathways, such as PI3k/AKT、Wnt/β-catenin and TGF-β pathways. This review aims to introduce the research progress about correlation analysis and regulatory mechanism of CUX1 in different tumors.
2019, 42(3): 349-352.
doi: 10.12122/j.issn.1674-4500.2019.03.17
Abstract:
Bariatric surgery is the best way to treat metabolic syndrome now. Patients can lose weight, better type 2 diabetes and other complications of obesity by rebuilding digestive tract and influencing endocrine system. Female sex function is an important element to the quality of female life. The main risk factors for female sex function are age, obesity, complications of obesity, etc. This article reviews the effect of bariatric surgery on female sex function, and discusses the mechanism. Bariatric surgery is becoming popular in China since 2005. But there were few domestic researches on this topic. We need further discussion on the effect of bariatric surgery on female sex function.
Bariatric surgery is the best way to treat metabolic syndrome now. Patients can lose weight, better type 2 diabetes and other complications of obesity by rebuilding digestive tract and influencing endocrine system. Female sex function is an important element to the quality of female life. The main risk factors for female sex function are age, obesity, complications of obesity, etc. This article reviews the effect of bariatric surgery on female sex function, and discusses the mechanism. Bariatric surgery is becoming popular in China since 2005. But there were few domestic researches on this topic. We need further discussion on the effect of bariatric surgery on female sex function.
2019, 42(3): 353-357.
doi: 10.12122/j.issn.1674-4500.2019.03.18
Abstract:
Inflammatory bowel disease（IBD）is a group of chronic non-specific intestinal inflammatory diseases, including ulcerative colitis（UC）and Crohn’s disease（CD）.The causes are not clear. The intestinal flora disorder plays an important role in the pathogenesis of IBD. Fecal microbiota transplantation can reconstruct intestinal flora.It has great value in the clinical application of IBD. Fecal microbiota transplantation treat the feces of healthy individuals into suspension.It infuses them into the digestive tract of ibd patients, and reconstruct intestinal microecology, so as to effectively alleviate the condition of IBD patients. However, the problems exist in the clinical application of fecal microbiota transplantation in IBD, such as the selection of donors, the preparation of fecal bacteria solution, the way and frequency of transplantation. This review summarizes the therapeutic application of fecal microbiota transplantation in IBD.
Inflammatory bowel disease（IBD）is a group of chronic non-specific intestinal inflammatory diseases, including ulcerative colitis（UC）and Crohn’s disease（CD）.The causes are not clear. The intestinal flora disorder plays an important role in the pathogenesis of IBD. Fecal microbiota transplantation can reconstruct intestinal flora.It has great value in the clinical application of IBD. Fecal microbiota transplantation treat the feces of healthy individuals into suspension.It infuses them into the digestive tract of ibd patients, and reconstruct intestinal microecology, so as to effectively alleviate the condition of IBD patients. However, the problems exist in the clinical application of fecal microbiota transplantation in IBD, such as the selection of donors, the preparation of fecal bacteria solution, the way and frequency of transplantation. This review summarizes the therapeutic application of fecal microbiota transplantation in IBD.
2019, 42(3): 358-363.
doi: 10.12122/j.issn.1674-4500.2019.03.19
Abstract:
The marginal zone lymphoma (MZL) is an invasive tumor originating from the memory cells in the marginal zone and belongs to small B-cell lymphoma. MZL is divided into spleen marginal zone lymphoma (SMZL), mucosa-associated lymphoid tissue (MALT) lymphoma,and lymph node marginal zone lymphoma (NMZL). They have different clinical characteristics, morphological and pathological features, immunophenotypic characteristics and molecular genetic characteristics. Comprehensive analysis is helpful for the diagnosis of marginal lymphoma subtypes and differential diagnosis with other small B cell lymphomas.In recent years, with further study of the pathogenesis of MZL, clinical treatment has been progressing, and many new drugs have been used in clinical trails, promising new hope for MZL patients.
The marginal zone lymphoma (MZL) is an invasive tumor originating from the memory cells in the marginal zone and belongs to small B-cell lymphoma. MZL is divided into spleen marginal zone lymphoma (SMZL), mucosa-associated lymphoid tissue (MALT) lymphoma,and lymph node marginal zone lymphoma (NMZL). They have different clinical characteristics, morphological and pathological features, immunophenotypic characteristics and molecular genetic characteristics. Comprehensive analysis is helpful for the diagnosis of marginal lymphoma subtypes and differential diagnosis with other small B cell lymphomas.In recent years, with further study of the pathogenesis of MZL, clinical treatment has been progressing, and many new drugs have been used in clinical trails, promising new hope for MZL patients.
2019, 42(3): 364-368.
doi: 10.12122/j.issn.1674-4500.2019.03.20
Abstract:
Objective To investigate the therapeutic effect of aescin gel on cervicitis in rats. Methods Sodium aescinate was extracted from Chinese buckeye seeds by alcohol extraction method and prepared into a gel. The cervicitis model was induced in SD rats by 25% phenolic glue injection and aescinate gel was local administrated to treat the rats. After treatment, the changes of vaginal redness and secretion of the model rats were observed. The paraffin-embedded sections of the cervical tissues were taken and HE staining was used to observe histopathological changes. Results Aescin gel significantly accelerated the damage repair of model animals. It significantly reduced the vaginal swelling and secretion in rats. HE staining showed that the infiltration of inflammatory cells in the injured sites in rats was significantly reduced after treatment with aescin. Conclusion Sodium aescinate gel has a good effect on cervicitis rats. It is expected to be used for the treatment of cervicitis.
2019, 42(3): 369-372.
doi: 10.12122/j.issn.1674-4500.2019.03.21
Abstract:
Implantation has become an important method to repair dentition defect and missing teeth, and peri-implant inflammation is an important cause of implant failure. In order to improve the success rate of implants, it is very important to find effective methods to prevent inflammation around implants. This article reviews the research status and progress of implant surface modification and drug carrier. The results show that surface modification has little side effect on the host, but its antibacterial activity is relatively weak. The composite antibacterial coating with titanium dioxide nanotubes, calcium phosphate and other carriers has good antibacterial properties.But there are still some problems such as drug release rate and release amount difficult to control, difficult to maintain long-term antibacterial activity and so on, which need further research and solution.
Implantation has become an important method to repair dentition defect and missing teeth, and peri-implant inflammation is an important cause of implant failure. In order to improve the success rate of implants, it is very important to find effective methods to prevent inflammation around implants. This article reviews the research status and progress of implant surface modification and drug carrier. The results show that surface modification has little side effect on the host, but its antibacterial activity is relatively weak. The composite antibacterial coating with titanium dioxide nanotubes, calcium phosphate and other carriers has good antibacterial properties.But there are still some problems such as drug release rate and release amount difficult to control, difficult to maintain long-term antibacterial activity and so on, which need further research and solution.
Perioperative application of epicardial temporary pacemaker in patients with heart valve replacement
2019, 42(3): 373-377.
doi: 10.12122/j.issn.1674-4500.2019.03.22
Abstract:
ObjectiveTo determine the clinical application of temporary epicardial pacing wires placed in patients undergoing surgery for cardiac valve replacement. MethodsA retrospective observational study was performed on 723 consecutive heart valve replacement surgery patients between January 2013 and December 2017. Logistic regression analysis was performed to identify independent predictors of temporary cardiac pacing. ResultsTemporary epicardial pacing wires were placed in 20 of 723 (2.77%) patients undergoing surgery for cardiac valve replacement. Only 1 patient (5%) required temporary pacing died who were compared with the 19 (2.70%) died in patients did not have insertion of temporary pacing wires. Two (0.28%) required temporary pacing who did not have insertion of temporary pacing wires, 17 (85.00%) required temporary pacing who had insertion of temporary pacing wires. The determinants of temporary cardiac pacing (adjusted odds ratios; 95% confidence interval) were : age over 60 (1.009;1.003,1.015;P=0.002), NYHA III- IV (4.5;1.4,16.7;P=0.014), I° AVB (5;1.01,34.8;P=0.042), aorta cross clamp time greater than 60 min (6.1;1.4,29.2;P=0.027), PAP greater than 50 mmHg (14.0;5.2,109.7;P=0.032). ConclusionThe routine use of temporary epicardial pacing wires after valve replacement surgery is necessary for high risk patients including II-III° atrioventricular block, supraventricular bradycardia, heart rate still less than 100 beats、min after using atropine or isoproterenol is poor, fast and slow syndrome. Furthermore, the determinants of temporary cardiac pacing: age greater than 60 years, I°AVB, and NYHA class III-IV, or PAP greater than 50 mmHg, or aortic block time greater than 60 min.
2019, 42(3): 378-382.
doi: 10.12122/j.issn.1674-4500.2019.03.23
Abstract:
ObjectiveTo evaluate the reported quality of randomized controlled trials (RCTs) literature abstract of endometrial cancer published in Chinese using the abstract CONSORT statement. MethodsEndometrial-cancer-related RCTs were searched in CNKI, CBM, VIP and WF databases from inception to March 2017. the literature abstracts were conducted quality assessment in accordance with the abstract CONSORT standard. Meta-Analyst and RevMan5.1 software were used for statistical analysis. ResultsA total of 171 Chinese RCTs were included which the published areas were mainly Sichuan, Heilongjiang, Guangdong, Henan and Shandong. The number of reference writers ranged from 1 to 3, with a total of 131 articles (76.6%). Statistical data showed that the number of published articles has increased significantly and reached to 164 (95.9%) since the publication of the abstract CONSORT in 2008. The quality of the 11 entries in the RCTs has been significantly improved. In addition, the complete reporting rate of 5 articles (2.9%) collected by CSCD was significantly higher than that of the 164 non-CSCD articles (95.9%).The serious reporting flaws were appeared for RCT abstract of endometrial cancer regarding following items: title randomized, subject, investigated outcome indes, randomization, blinding, statistical methods, numbers analysised, trial registration, funding. The pooled RR with 95%CI were 0.3(0, 4.5), 7.0(4.0, 11.9), 0.3(0, 4.5), 12.3(8.1, 18.1), 1.2(0.3, 4.6), 5.8(3.2, 10.5), 4.1(2.0, 8.3), 0.3(0, 4.5), 10.5(6.7, 16.1), respectivly． ConclusionAt present, Chinese published endometrial cancer RCT abstract quality is poor. In this study, the quality of these RCT reports are evaluated by CONSORT in order to understand the current status and to improve the quality of Chinese abstracts published for endometrial cancer RCTs.
2019, 42(3): 383-387.
doi: 10.12122/j.issn.1674-4500.2019.03.24
Abstract:
Objective To analyze the correlation between anxiety, depression status of patients before or after cardiac surgery and NSE. Methods We use Spearman correlation to explore the correlation between anxiety, depression status of patients before or after cardiac surgery and NSE. Results Patients with cardiac surgery had mild anxiety and depression during the perioperative period. The anxiety and depression score of patients had no correlation with NYHA grades, preoperative oxygenation index, and liver and kidney function. The anxiety and depression status of patients were mainly caused by concerns about the desease condition and surgery. Conclusion The preoperative anxiety and depression are not related to postoperative liver and kidney function and brain damage.
2019, 42(3): 388-392.
doi: 10.12122/j.issn.1674-4500.2019.03.25
Abstract:
ObjectiveTo evaluate the changes in the functional and structural parameters of small airway in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). MethodsFify-nine patients with AECOPD were required to complete the COPD assessment test (CAT), modified Medical Research Council Questionnaire for assessing the severity of breathlessness (mMRC), St George's respiratory questionnaire(SGRQ), impulse oscillation (IOS),pulmonary function test and high-resolution computerized tomography(HRCT, Visit 1 and Visit 4)at four time points: within 24 h of admission (Visit 1), the day before discharge (Visit 2), 8th day after discharge (Visit 3), 21st day after discharge (Visit 4). ResultsResistance at 5 Hz (R5), resistance at 20 Hz(R20) and R5-R20 decreased significantly during follow-up, whilereactance at 5 Hz (X5) and resonant frequency(Fres) not continue to decline significantly after Visit 2. The thickness of the third generation of apical bronchus of the right upper lobe (WT) and the adjacentpulmonary artery diameter (BWT) decreased significantly compared with before (P<0.05). During the change between Visit 4 and Visit 1,ΔR5,ΔR20,ΔR5-R20,ΔZ5,ΔFres were positively associated withΔCAT,ΔmMRC,ΔSGRQ respectively (P<0.05).ΔBWT were positively correlated toΔCAT,ΔmMRC,ΔSGRQ (r=0.45, 0.37, 0.92, P<0.05), andΔWT were positively related toΔCAT,ΔSGRQ (r=0.42, 0.40, P<0.05). ConclusionThe functional and structural indexes of small airway represented by IOS and HRCT are obviously improved with the recovery of AECOPD. They can be used to evaluate the treatment strategy of acute exacerbation.
2019, 42(3): 393-396.
doi: 10.12122/j.issn.1674-4500.2019.03.26
Abstract:
Objective To investigate the interaction between CD74 and RUNX3 in human pancreatic cancer capan-2 cells. Methods The lentiviral CD74-siRNA vector and blank vector were constructed. Restriction enzyme digestion was constructed correctly. Then Capan-2 cells were transfected by the lentivirus vector. The cell line stably low expression of CD74 was confirmed by Western blot and RT-PCR. The effect of low CD74 expression on RUNX3 protein and mRNA expression were detected by Western blot and RT-PCR. Co-immunoprecipitation assay was performed to verify the interaction between CD74 and RUNX3 in capan-2 cells. Results Protein and mRNA of CD74 were stably and lowly expressed in Capan-2 cells of the experimental group (P<0.05). Decreased CD74 level significantly inhibited RUNX3 protein and mRNA expression (P<0.05). RUNX3 was detected in the protein complex from the immunoprecipitation by using anti-CD74 antibody. CD74 in the protein complex from the immunoprecipitation was detected by using anti-RUNX3 antibody. Conclusion There is an interaction between CD74 and RUNX3 in human pancreatic cancer Capan-2 cells.
2019, 42(3): 397-400.
doi: 10.12122/j.issn.1674-4500.2019.03.27
Abstract:
Objective To explore the effect of estrogen and progesterone combined with curettage on missed abortion and prevention of intrauterine adhesion. Methods A total of 84 cases of missed abortion in obstetrics department of our hospital from March 2017 to March 2018 were selected as the research object. All patients were divided into control group（n=42）and observation group（n=42）according to random number table method. Patients in the control group were given hysteroscopic hysterectomy, and patients in the observation group were treated with estradiol valerate tablets before operation and levonorgestrel ethinylestradiol tablets after operation. After 3 months follow-up, the time of vaginal bleeding, menstruation, endometrial thickness, incidence and severity of intrauterine adhesion were compared between the two groups. Results The differences of vaginal bleeding time after operation and the number of uterine aspiration between observation group and control group were not significant（P>0.05）. The menstruation time in the observation group was significantly shorter than that in the control group（24.46±4.15 d vs 39.89±4.85 d）. The postoperative 14 d endometrial thickness was significantly greater than that in the control group（7.79±2.06 mm vs 4.89±1.69 mm, P<0.05）. The intrauterine tissue adhesion rates within 3 months after the operation of the observation group and the control group were 4.76%（2/42）and 21.43%（9/42）, respectively（P<0.05）. The difference of the severity of intrauterine tissue adhesion between the two groups was not significant（P>0.05）. The incidences of complications in the observation group was not different from the control group（P>0.05）. Conclusion Estrogen and progesterone combined with curettage for missed abortion can significantly shorten the postoperative vaginal bleeding time, promote endometrial repair and reduce intrauterine tissue adhesion.
2019, 42(3): 401-405.
doi: 10.12122/j.issn.1674-4500.2019.03.28
Abstract:
ObjectiveTo investigate the effect evaluation of N-acetylcysteine combined with tamoxifen for the treatment of clomiphene resistant polycystic ovary syndrome evaluation and its effect on ovulation and sex hormone. MethodsA total of 110 patients with PCOS were selected from September 2015 to October 2017 in our hospital. All patients were randomly divided into the observation group and the control group, with 55 cases in each group. The control group was treated with tamoxifen, and the observation group was treated with N-acetylcysteine combined with tamoxifen. The clinical efficacy, clinical symptoms, estrogen levels, ovulation and pregnancy, insulin resistance index and adverse reactions were compared between the two groups. ResultsThe total effective rate of the observation group was significantly higher than that of the control group(90.9% vs 72.7%, P<0.05). The scores of hirsutism and ovary in the observation group were significantly lower than those in the control group. The endometrial thickness and cervical mucus score were significantly higher in the observation group than the control group(P<0.05). The levels of LH, T and E2 in the observation group were significantly lower than those in the control group(P<0.05), while there was no significant difference of FSH(P>0.05). The ovulation rate, the number of mature follicles and the pregnancy rate of the observation group were significantly higher than those of the control group. The rate of early abortion was significantly lower than that of the control group (P<0.05). The levels of FBG, FINs, HOMA-IR and HOMA-β in the observation group were significantly lower than those in the control group(P<0.05). There was no significant difference of the incidence of adverse reactions between the two groups (P>0.05). ConclusionN-acetylcysteine combined with tamoxifen therapy can effectively improve the clomiphene resistant polycystic ovary syndrome patients with insulin resistance and Kaohsiung hormones symptoms, promote ovulation and pregnancy.
2019, 42(3): 406-409.
doi: 10.12122/j.issn.1674-4500.2019.03.29
Abstract:
ObjectiveTo investigate the effect of fufang Xiaochengqi tang combined with somatostatin on the treatment of paralytic ileus and gastrointestinal hormones. MethodsFrom July 2015 to August 2018, 82 patients with paralytic ileus in the department of intensive medicine were included. The patients were randomly divided into the observation group and the control group (n=41). The control group was treated with somatostatin, and the observation group was treated with fufang Xiaochengqi tang combined with somatostatin. The clinical effect, clinical symptom improvement time, clinical symptoms and signs, serum gastrointestinal hormones and the incidence of adverse reactions were compared between the two groups. ResultsThe total effective rate in the observation group was significantly higher than that in the control group (P<0.05). Compared with the control group, the time of first defecation, the recovery of bowel sounds and the disappearance of main symptoms in the observation group were significantly shorter(P<0.05). The cases of abdominal distention and abdominal pain, nausea and vomiting, anus stop defecation and exhaust, gastrointestinal decompression in the observation group were lower than that in the control group (P<0.05). The serum gastrin, motilin, substance P in the observation group were significantly higher than that in the control group(P<0.05). No significant adverse reactions occurred during treatment in both groups. ConclusionFufang Xiaochengqi tang combined with somatostatin in the treatment of paralytic ileus can effectively improve the clinical symptoms of patients and reduce the level of serum gastrointestinal hormones.
2019, 42(3): 410-413.
doi: 10.12122/j.issn.1674-4500.2019.03.30
Abstract:
ObjectiveTo exlpore the diagnostic value of serum miR-31 in non-small cell lung cancer. MethodsA total of 42 patients with non-small cell lung cancer were enrolled. The serum of 40 patients with lung cancer, paracancerous tissues, serum, and normal subjects were collected to detect the expression level of miR-31. ResultsmiR-31 in non-small cell lung cancer tissues was significantly higher than that of paracancerous tissues(P< 0.05). Clinical stage and lymph node metastasis were independent risk factors affecting the expression level of miR-31. The serum miRNA levels of patients were significantly higher than that of normal human serum(P< 0.05). The ROC curve indicates that the miRNA had a sensitivity of 0.829 and a specificity of 0.763 for the diagnosis of non-small cell lung cancer. ConclusionmiRNA can be used as a new molecular marker for non-small cell lung cancer.
2019, 42(3): 414-417.
doi: 10.12122/j.issn.1674-4500.2019.03.31
Abstract:
ObjectiveTo explore the clinical prognosis after R-PA combined with Butylphthalide soft capsules treating patient with acute progressive MCA cerebral ischemic stroke. MethodA total of 87 cases with acute progressive MCA cerebral ischemic stroke from January 1st 2015 to May 31st 2015 were selected via orientation matching. The patients were divided into two groups based on different therapy method. 44 cases in observation group (R-PA group) were performed with R-PA combined with Butylphthalide soft capsules. The other 43 cases in control group (rt-PA group) received rt-PA combined with Butylphthalide soft capsules. The recent clinical prognosis were compared and evaluated by NIHSS scale and forward clinical prognosis by GOS and ADL scale. ResultsThe gender composition, age, the time from onset to receiving treatment, infarct area, and GCS at admission between two groups had no significant difference (P>0.05). There is no difference of NIHSS score between R-PA group and rt-PA group at 2th hour, 24th hour, and 7th day (P>0.05). The difference of NIHSS score between R-PA group and rt-PA group at 1th month was significant(P<0.05). It was lower in R-PA group. The GOS and ADL score were higher in R-PA group than that in rt-PA group at 3th, 6th, 9th month. There was no difference at 3th month (P>0.05), but had a significant difference at 6th, 9th month (P<0.05). GOS score above 4 and ADL score above 75 were considered as favorable prognosis. Although there was no significant difference between in R-PA group and rt-PA group, the favorable prognosis rate was higher in R-PA group than rt-PA group (GOS: 70.45%、53.49%; ADL: 70.45%、60.47%, respectively). ConclusionR-PA combined with Butylphthalide soft capsules treating patient with acute progressive MCA cerebral ischemic stroke has a better forward clinical prognosis than rt-PA combined with Butylphthalide soft capsules. As the rt-PA’s derivate, R-PA is valuable in treating acute progressive MCA cerebral ischemic stroke.
2019, 42(3): 418-421.
doi: 10.12122/j.issn.1674-4500.2019.03.32
Abstract:
ObjectiveTo establish the trimester-specific reference intervals of thyroid tests during pregnancy in Foshan, Guangdong, then to evaluate the prevalence of gestational thyroid diseases. MethodsThe medical records of pregnant women with took prenatal care in Foshan from Jun 2017 to Jun 2018 were retrospectively analyzed. The thyriod tests included TSH, FT4, TPOAb, TgAb. All pregnant women were screened according to the National Academy of Clinical Biochemistry (NACB) recommendations. A total of 1386 samples at different stages of gestation were selected for setting reference intervals, which were 2.5th-97.5th. ResultsThe TSH and FT4 trimester-specific reference intervals were 0.03-3.86 mU/L, 11.81-21.86 pmol/L(1st trimester); 0.13-4.50 mU/L, 11.75-20.99 pmol/L(2nd trimester); and 0.38-4.73 mU/L, 10.84-18.48 pmol/L(3rd trimester), respectively. The prevalence of clinical hypothyroidism, subclinical hypothyroidism, hyperthyroidism, subclinical hyperthyroidism were 0%, 0.93%, 0.93%, and 1.55%(1st trimester); 0%, 1.29%, 1.29%, 3.23%(2nd trimester); 0%, 2.11%, 0.55%, 2.39%(3rd trimester), respectively. There were significant differences between trimester-specific thyroid function reference intervals and the reference range of the kit on the prevalence of hyperthyroidism during 1st trimester and subclinical hyperthyroidism during 1st-3rd trimester. ConclusionThe establishment of trimester-specific thyroid function reference intervals of Foshan city provides a clinical basis for the diagnosis of gestational thyroid diseases. The thyroid tests reference range of the kit can be used for the diagnosis of clinical hypothyroidism and subclinical hypothyroidism, while it is not suitable for the diagnosis of hyperthyroidism and subclinical hyperthyroidism in foshan city.
