目的:探討液相芯片檢測胰腺炎患者外周血中細胞因子濃度的可行性,及其在胰腺炎中的臨床應用價值。方法: 收集90例胰腺炎患者(包括重癥和輕癥)和30例正常對照者的外周血,離心提取血清,利用液相芯片檢測血清中細胞因子IL10,IL6,TNFα的濃度,比較不同程度炎癥患者以及與對照之間細胞因子的濃度差異,分析血清中細胞因子濃度差異與臨床表現之間的關系。結果:液相芯片可以方便地在僅25 μl的血清樣本中同時準確檢測這三種細胞因子的含量,檢測的有效范圍為0.10～2000 pg/mL。IL10 的濃度在對照、輕型和重型胰腺炎組中分別為51.97±31.72 pg/mL, 32.88±9.70 pg/mL和3.57±0.99 pg/mL, 輕型組與重型組間以及重型組和對照間差異有顯著性(P lt; 005)。IL10在發病三天內和三天后的濃度分別為 42.47±10.15 pg/mL和12.28±5.04 pg/mL, 兩者間差異有顯著性(P lt; 0.01). Il6 的濃度在三天后從60.90±24.37 pg/mL下降到34.52±13.57 pg/mL,但差異沒有顯著性(Pgt;0.05);TNF-α的濃度在各組間沒有顯著差異(Pgt;0.05)。結論:液相芯片檢測技術可以快速準確的檢測少量血樣標本中IL10,IL-6,TNFα等細胞因子的濃度,在胰腺炎患者中細胞因子IL-10的濃度與胰腺炎輕重程度以及患病時間密切相關,IL-10的濃度可以作為該病臨床處理的依據和藥物療效的監測指標。
Objective To evaluate the risk factors affecting the prognosis in patients with myasthenia gravis after thymeetomy. Methods Therapeutic effects were evaluated with Relative Counting Method in 136 cases with myasthenia gravis who receivingthymectomy. Six clinical factors including sex, age, preoperative course, et al. were converted into quantitative parameters and used for analysis. Cumulative logit model for ordinal response was employed to investigate the therapeutic effects of various factors. Results Sex, age and preoperative course exerted significant effects on postoperative prognosis in patients with myasthenia gravis, while clinical subtype, pathological changes and preoperative administration of cholinesterase inhibitors had no significant impact on therapeutic effects. Conclusion Some factors may lead to the remission and improvement in postoperative patients with myasthenia gravis, therefore, they should be included for the evaluation of prognosis. Early diagnosis and early thymeetomy may improve the therapeutic effects and shorten the duration of amelioration.
Objective To investigate the clinicopathologic features and effect of surgical treatment of pancreatic neuroendocrine carcinoma（PNEC）. Methods Clinical data of 31 patients with PNEC treated from Jan. 2008 to Mar. 2012 in our hospital were analyzed，and the expressions of protein CgA，Syn，CD56，CK，VEGF，and Ki-67 were detected by immunohistochemical method. The differences of survival rate and time between radical excision group and palliative surgery group were analyzed by log-rank test. Results Of the 31 patients，22 patients received radical resection and 9 patients received palliative surgery. The positive expression rate of protein CgA，Syn，CD56，CK，and VEGF was 64.52%（20/31），100%（31/31），77.42%（24/31），90.32%（28/31），90.32%（28/31），respectively. According to the percentage of Ki-67 positive cells， 14（45.16%） patients expressed less than 3%，7（22.58%） patients expressed between 3% and 20%， and 10（32.26%）patients expressed more than 20%. The survival rate and time of radical resection group were significantly higher and longer than palliative surgery group（P＜0.001）. Conclusions PNEC is a high potential malignancy and demonstrates aggressive biological behavior. Radical resection can improve the prognosis of patients with PNEC.
【摘要】 目的 〖JP2〗探討護理干預對前臂游離皮瓣移植修復口腔癌圍手術期軟組織缺損患者的經驗。 方法 2005年6月—2009年6月，對收治的63例口腔癌術后軟組織缺損應用前臂橈側游離皮瓣修復患者的圍手術期護理方法進行回顧性分析，并做好術前心理護理及相關準備，術后嚴密觀察皮瓣移植情況，以便及時發現血管危象，同時做好口腔、呼吸道、體位及皮瓣供受區護理。 結果 通過精心護理，密切觀察移植皮瓣，及早發現、及時處理血管危象，從而確保63例患者皮瓣移植一次性成活率達95.24%，療效滿意。 結論 科學合理的圍手術期護理是前臂游離皮瓣移植修復口腔癌術后軟組織缺損成功的重要保證。【Abstract】 Objective To investigate the perioperative nursing experiences of the transplanted forearm free flaps for reconstruction of soft tissue defects after oral cancer operation. Methods We retrospectively analyzed the clinical data of perioperative nursing care for 63 patients with soft tissue defects after oral cancer reconstructed with radial forearm free flaps. Psychological care and related preparation work was well carried out before operation. After operation, we closely monitored the outcome of transplantation of skin flaps to detect vascular crisis as early as possible, and at the same time, intensive care for oral cavity, respiratory tract, flap position and the affected areas was done. Results By intensive care, closely monitoring the transplanted flaps, and early discovery and management of the vascular crisis, we achieved a satisfying one-time transplantation survival rate of 95.24% for the 63 patients. Conclusion Scientific and proper perioperative care is an important factor in the successful reconstruction of soft tissue defects with free forearm flaps after oral cancer operation.
Objective To explore the effects of DNA cross-linking repair 1B (DCLRE1B) gene on the migration and invasion ability of hepatocellular carcinoma cell. Methods Bioinformatics analysis was used to analyze the expression of DCLRE1B mRNA in hepatocellular carcinoma, and its relationship with the prognosis and related influencing factors of patients. Immunohistochemical staining was used to detect the expression of DCLRE1B protein in resected hepatocellular carcinoma tissues and their corresponding normal liver tissues. The DCLRE1B gene silenced Huh7 and HepG2 hepatocellular carcinoma cell lines were constructed by lentivirus, and the transfected effect was detected by Western blot. The migration and invasion of DCLRE1B silenced hepatocellular carcinoma cells were detected by scratch test and Transwell method. The changes of genes related to epithelial mesenchymal transformation (EMT) after DCLRE1B silencing were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Results ① The biological information analysis results showed that: The mRNA expression of DCLRE1B was highly expressed in a variety of tumors including hepatocellular carcinoma (P<0.05). The mRNA expression of DCLRE1B was associated with the TNM staging of tumor (P<0.05). The relative expression level of DCLRE1B mRNA in hepatocellular carcinoma patients was related to their prognosis. The overall survival situation (P=0.038) and progression free survival situation (P=0.005) of hepatocellular carcinoma patients in the high expression group were worse than those in the low expression group. Univariate and multivariate Cox analysis showed that the expression of DCLRE1B gene was an independent factor affecting the prognosis of hepatocellular carcinoma (P<0.05). ② The positive rate of DCLRE1B protein expression in resected hepatocellular carcinoma tissues was higher than that in normal liver tissues (P<0.05). ③ Cell experiment results showed that: After stable silencing DCLRE1B gene of hepatocellular carcinoma cell (Huh7 and HepG2) constructed by lentivirus, the expression of DCLRE1B protein was significantly down regulated (P<0.05). After silencing DCLRE1B gene, the migration and invasion ability of hepatocellular carcinoma cells were significantly decreased (P<0.05). After silencing DCLRE1B, the mRNA expressions of E-cadherin, matrix metalloproteinase 9, and β-catenin were up regulated (P<0.05), and the mRNA expressions of N-cadherin and Vimentin were down regulated (P<0.05), but the mRNA expression of zinc finger transcription factor had no significant change, and the difference was not statistically significant (P＞0.05). Conclusion Silencing DCLRE1B gene can inhibit the migration and invasion ability of hepatocellular carcinoma cells, and its mechanism may be related to the process of EMT.
How to realize the control of limb movement and apply it to intelligent robot systems at the level of cerebellar cortical neurons is a hot topic in the fields of artificial intelligence and rehabilitation medicine. At present, the cerebellar model usually used is only for the purpose of controlling the effect, borrowing from the functional mode of the cerebellum, but it ignores the structural characteristics of the cerebellum. In fact, in addition to being used for controlling purposes, the cerebellar model should also have the interpretability of the control process and be able to analyze the consequences of cerebellar lesions. Therefore, it is necessary to establish a bionic cerebellar model which could better express the characteristics of the cerebellum. In this paper, the process that the cerebellum processes external input information and then generates control instructions at the neuron level was explored. By functionally segmenting the cerebellum into homogeneous structures, a novel bionic cerebellar motion control model incorporating all major cell types and connections was established. Simulation experiments and force feedback device control experiments show that the bionic cerebellar motion control model can achieve better control effect than the currently widely used cerebellar model articulation controller, which verifies the effectiveness of the bionic cerebellar motion control model. It has laid the foundation for real brain-like artificial intelligence control.
Objective To investigate the changes of autophagy after spinal cord injury (SCI) in rats and its relationship with multisite phosphorylation of B-cell lymphoma-2 (Bcl-2) protein. Methods Forty male Sprague-Dawley rats aged 8 weeks were used to prepare SCI models by modified Allen method, and the SCI model were prepared successfully in 36 rats. The 36 SCI models were randomly divided into SCI group, autophagy inhibitor group, and autophagy promoter group, with 12 rats in each group. Another 12 rats were selected as sham operation group with only laminectomy and no spinal cord injury. At the end of modeling, the autophagy inhibitor group and the autophagy promoter group were intrathecally injected with 20 μL of 600 nmol/L 3-methyladenine and 25 nmol/L rapamycin, respectively, once a day for 4 weeks. The sham operation group and the SCI group were injected with only 20 μL of normal saline at the same time point. The motor function of rat in each group was evaluated by the Basso-Beattie-Bresnahan (BBB) score at 1 day and 1, 2, 4 weeks after modeling. The rats in each group were sacrificed at 24 hours after the last injection and the spinal cord tissues were taken. ELISA assay was used to detect the levels of inflammatory factors in spinal cord tissues, including myeloperoxidase (MPO), tumor necrosis factor α (TNF-α), and interleukin 1β (IL-1β); the morphological changes of spinal cord were observed by HE staining; the autophagy of mitochondria in spinal cord tissues was observed by transmission electron microscopy; the expressions of Beclin1 and microtubule-associated protein light chain 3 (LC3) were detected by immunofluorescence staining; neuronal apoptosis in spinal cord tissues were observed by TUNEL staining; LC3/TUNEL positive cells were calculated by immunofluorescence double staining; the expressions of Bcl-2 associated X protein (Bax), Bcl-2, p-Bcl-2 (Ser87), and p-Bcl-2 (Ser70) were detected by Western blot. Results Compared with sham operation group, BBB score of SCI group decreased at each time point, while the levels of MPO, TNF-α, and IL-1β increased; peripheral space of nerve cells enlarged, cells swelled, vacuoles appeared, and autophagic bodies appeared in mitochondria; the positive rates of Beclin1 and LC3 proteins, and apoptotic rate of neurons significantly increased; the LC3/TUNEL positive cells significantly increased; the expressions of Bax, p-Bcl-2 (Ser87), and p-Bcl-2 (Ser70) proteins increased, while the expression of Bcl-2 protein decreased; all showing significant differences (P<0.05). Compared with SCI group, BBB score in autophagy inhibitor group decreased at each time point, while the levels of MPO, TNF-α, and IL-1β increased; a few autophagic vesicles appeared in mitochondria; the positive rates of Beclin1 and LC3 proteins decreased and the apoptotic rate of neurons increased significantly; the LC3 positive cells decreased and the TUNEL positive cells increased; the expressions of Bax, p-Bcl-2 (Ser87), and p-Bcl-2 (Ser70) proteins increased, while the expression of Bcl-2 protein decreased. The results of autophagy promoter group were opposite to those of autophagy inhibitor group; all showing significant differences between groups (P<0.05). Conclusion Induction of autophagy after SCI in rats can reduce neuronal apoptosis and protect spinal cord function, which may be related to the inhibition of Bcl-2 protein multisite phosphorylation.
Objective To explore the inducing factors, the serum total immunoglobulin E (IgE) and specific IgE of bronchial asthma in Mianyang children, for better control of childhood asthma. Methods A total of 1 288 cases of asthma who were hospitalized in pediatric respiratory ward or asthma clinic from March 2013 to February 2016 were enrolled in the study. All cases complied with the diagnostic criteria for acute episode of childhood bronchial asthma revised in 2008 by the National Children’s Asthma Cooperative Group. The causes of asthma attack were asked by doctors, and the patient’s serum total IgE and specific IgE was tested. Results Respiratory tract infections were the most common cause (1 057 cases, 82.1%), which was followed by weather changes and exposure to cold air (694 cases, 53.9%), and then food (304, 23.6%). The risk of asthma induced by respiratory infections was highest in <2-year old group (358 cases, 97.5%), and lowest in 10-14-year old group (42 cases, 33.3%), with a decreasing trend with age (χ2trend=239.865, P<0.001). Food was also an important inducing factor, and seafood was the most frequent (121 cases, 39.8%). Total serum IgE was positive in 868 cases (67.4%). The positive rate in <2-year old group (52.6%) was the lowest, and the positive rate in 10-14-year old group (89.7%) was the highest, with an increasing trend with age (χ2trend=88.055, P<0.001). Serum specific IgE was positive in 733 cases (56.9%). The positive rate in <2-year old group (37.1%) was the lowest, and the positive rate in 10-14-year old group (92.6%) was the highest, with an increasing trend with age (χ2trend=150.361, P<0.001). The progressive rate of dust mites in inhalation and dietary allergens was highest (668 cases, 51.8%), which was followed by house dust (431 cases, 33.4%). Conclusions The most common inducing factor for bronchial asthma in Mianyang children is respiratory tract infection, followed by the weather changes and cold air exposure, and then food. Detection of serum total IgE and specific IgE is more valuable in elderly children with bronchial asthma.
ObjectiveTo systematically review the efficacy and safety of robotic-assisted hepatectomy (RAH) versus traditional laparoscopic hepatectomy (TLH) for hepatic neoplasms.MethodsDatabases including PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, WanFang Data and CBM databases were electronically searched to collect cohort studies about the RAH vs. the TLH for liver neoplasms from inception to December 10th, 2016. Two reviewers independently screened the literatures, extracted data and assessed the risk of bias of the included studies. And finally, a meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 17 studies involving 1 389 patients were included. The meta-analysis results showed that: compared to TLH group, RAH group was associated with more estimated blood loss (WMD=39.56, 95%CI 4.65 to 74.47, P=0.013), longer operative time SMD=0.55, 95%CI 0.29 to 0.80, P<0.001), and later in the first nutritional intake time (SMD=1.06, 95%CI 0.66 to 1.45,P<0.001). However, there were no significant differences in the length of hospital stay, conversion to laparotomy, intraoperative blood transfusion, resection rate of tumor margin, complications and 90-day mortality between the two groups.ConclusionCurrent evidence indicates that TLH is superior to RAH in terms of operative time, intraoperative blood loss and the first nutritional intake time, but there are no statistically significant differences in the primary outcomes, suggesting that RAH and TLH have similar efficacy and safety for hepatic neoplasms. Due to the limitation of quality and quantity of the included studies, the above conclusions need to be verified by more high-quality research.