目的:探討米非司酮治療異位妊娠的療效,安全性及對患者生育的影響。方法:選取符合保守治療條件患者31例,觀察米非司酮治療異位妊娠過程中的臨床癥狀,各項試驗室指標的變化;出現不良反應的幾率及嚴重程度;治療后輸卵管的通暢情況,以判斷是否對患者生育造成影響。結果:治療成功率為87.09%;不良反應出現率為19.35%,均為輕度不適;成功病例中未育患者輸卵管通暢率為100%。結論:米非司酮是一種治療異位妊娠的高效藥物,具有安全性高,不良反應少,對生育無影響的優點。
Objective To study the clinical significance of gasdermin-D（GSDMD) and caspase-1 expressions in the invasive ductal breast carcinoma. Methods Seventy-seven female patients with invasive ductal carcinoma of breast performed radical resection in the 904th Hospital of Joint Logistic Support Force of PLA from January 2015 to June 2016 were selected as the research object. The expressions of GSDMD and caspase-1 protein in cancer tissues and 20 adjacent tissues were detected by immunohistochemistry, and their correlation with clinicopathological features was analyzed. Kaplan-Meier analysis was used to draw the survival curve, and log-rank test was used for univariate survival analysis, and Cox proportional hazards regression analysis of prognostic factors in patients with breast invasive ductal carcinoma. Results The proportion of high expression of GSDMD and caspase-1 protein in adjacent tissues were significantly higher than those in breast cancer tissues (P<0.05). Univariate analysis results showed that the survival time of patients with invasive ductal carcinoma of breast were correlated with lymphatic metastasis, TNM staging, and the expression status of progesterone receptor, GSDMD, caspase-1 and Ki-67 (P<0.05). Multivariate analysis results showed that the low expression of GSDMD protein [HR=4.096, 95%CI (1.102, 15.216), P<0.05] and low expression of caspase-1 protein [HR=3.945, 95%CI (1.062, 14.652), P<0.05] were the independent risk factor that affect the survival rate of patients with invasive ductal carcinoma of breast. Conclusion The low expression of GSDMD and caspase-1 protein in invasive ductal carcinoma of breast are independent risk factors for postoperative survival.
Objectives To systemically review and investigate the efficacy of intensive glucose control in Type 2 diabetes mellitus. Methods Database searches of MEDLINE, EMBASE, Cochrane Controlled Trials Register, VIP Database, CNKI, and CBM disc (from the date of establishment of the databases to June 2009) were conducted. Additional studies were retrieved via references of articles and direct contact with the authors to retrieve relevant data. Prospective, randomized controlled trials of intensive glucose control compared with standard therapy in diabetic patients were selected. We accessed the quality of included trials and extracted the relevant data. Statistical analysis was performed using The Cochrane Collaboration’s software RevMan 5.0. Results Eight trials with a total of 37 004 participants were included. The Meta-analysis showed: intensive glucose therapy was associated with a significant 9% reduction in the odds of cardiovascular events [OR=0.91, 95%CI (0.85, 0.98), P=0.007], and a 26% reduction in the microvascular events [OR=0.74, 95%CI (0.60, 0.91), P=0.005]. For the peripheral vascular events, no statistical difference was found between intensive therapy and standard therapy [OR=0.94, 95%CI (0.83, 1.07), P=0.35]. No statistical difference could be found in total mortality [OR=1.00, 95%CI (0.92, 1.08), P=0.98] and cardiovascular mortality [OR=1.03, 95%CI (0.83, 1.28), P=0.77]. Intensive therapy could increase more than 1.1-fold odds of hypoglycemia compared with standard-therapy [OR=2.12, 95%CI (1.24, 3.60), P=0.006]. Conclusions Findings from this meta-analysis suggest that intensive glucose control significantly reduces the risk of cardiovascular events and microvascular events, and increases the risk of hypoglycemia, while no prominent difference is found in mortality.
Sarcoidosis is a multi-organ inflammatory disorder characterized by the presence of non-caseating granulomas primarily affecting the lungs. The pathogenesis of sarcoidosis has not been fully clarified. In recent years, studies have suggested that a variety of pathogen infections, including Mycobacterium tuberculosis, Propionibacterium acnes, fungi, viruses, may be related to the occurrence and progression of sarcoidosis. This article reviews the researches on sarcoidosis and pathogen infection, aiming to explore the potential role of pathogen infection in the pathogenesis of sarcoidosis and provide another direction for the treatment of sarcoidosis.
Objective To explore the clinical significance of systemic rehabilitation training on knee functional recovery after anterior cruciate ligament (ACL) reconstruction. Methods Patients who underwent arthroscopic knee ACL reconstruction and met the inclusion criteria were included from January 2015 to October 2016. A 4-phase, 16-week systemic rehabilitation training was given individually according to surgical conditions, sports and other factors. Visual Analogue Scale (VAS), knee range of motion (ROM), knee circumference, and 10-meter walking time were measured before surgery, and 3, 6, and 12 months after surgery. At the same time, the function and stability of the knee joint were graded by Lysholm score, Holden walking score, International Knee Documentation Committee (IKDC) score, and KT-1000 test. The postoperative one-year scores were compared with the other side, and the patient satisfaction was evaluated one year after surgery. Results All patients were followed up for at least one year. The VAS pain score, ROM, knee circumference, 10-meter walking time, Lysholm score, Holden score, IKDC score, and KT-1000 of all patients were significantly better than their preoperative levels (P<0.05), and there was no significant difference in joint function from the contralateral side (P>0.05). No serious complications such as infection occurred. Conclusion Systemic rehabilitation exercises can help patients with well-restored knee joint function after ACL reconstruction.
Abstract： Objective To investigate the cerebral protective effects of hyperoxia management during deep hypothermia circulatory arrest（DHCA） rabbit by the blood gas indexes, superoxide dismutase（ SOD） activity and malondialdehyde （MDA） levels of brain, and ratio of water to brain. Methods A DHCA and antegrade selective cerebral perfusion （ASCP） rabbit model was established. Twenty-four 11-13 week-old male New Zealand rabbits（ weighing 2.7 to 3.4 kg） were assigned to three groups with a random number table: a sham operation group （Sham group）, an ASCP group （S group）, and an ASCP ＋ hyperoxia management group （SH group）. There were eight rabbits in each group. We recorded the intraoperative values for arterial oxygen pressure （PaO2）, arterial oxygen saturation （SaO2）, jugular venous oxygen pressure（PjvO2）, jugular venous oxygen saturation（ SjvO2） and blood lactate level. The brain SOD activity, MDA levels, and ratio of water to brain were measured after the operation. Results Before initiating circulatory arrest, before initiating reperfusion and five minutes of reperfusion, levels of PaO2 , PjvO2 , and SjvO2 in the SH group were significantly higher than those of the S group and Sham group. SOD activity in the SH group was not significantly different from that of the S group[（213.53±33.52） U/mg. prot vs. （193.02±27.67） U/mg. prot] and Sham group[（213.53±33.52） U/mg. prot vs.（244.38±35.02）U/mg. prot], but the SOD activity in the S group was lower than that in the Sham group（ P ＜ 0.05）. MDA levels in the SH group were lower than that in the S group[（1.42±0.30） nmol/mg. prot vs. （2.37±0.55） nmol/mg. prot, P ＜ 0.05]. Conclusion Our data show that hyperoxia management during DHCA＋ASCP improves rabbits’PjvO2 and SjvO2, maintains brain SOD activity, and decreases brain MDA levels, demonstrating the neuroprotective effects of hyperoxia mangagement.
OBJECTIVE: To investigate the selection and manufacture of ideal extracellular matrix materials in bone tissue engineering. METHODS: The recent literatures about biodegradable polymers served as culture scaffolds of osteoblasts were widely reviewed, the advantages and disadvantages of biodegradable synthetic polymers and natural polymers were analysed. RESULTS: The ideal extracellular matrix material in bone tissue engineering should be made up of inorganic materials, synthetic polymers and natural polymers, which possesses morphological structure of three-dimensional foam with self-mediated drug slow delivery system of bone growth factors. CONCLUSION: The design and manufacture of combined extracellular matrix materials in bone tissue engineering is a very important and urgent challenge.
Mussel foot proteins (MFp) could cure rapidly under water and adhere to different substrates. It has broad application prospects as an biocompatible bioglue. The soluble recombinant SUMO-MFp fusion protein (SFp3) was efficiently expressed inE.coli, and about 5% of tyrosine of SFp3 were converted into DOPA by using mushroom tyrosinase. The adhesion strength of the mixture of DOPA-containing SFp3 (DSFp3) and hyaluronic acid (MW = 1 500 kD) was more than twice that of the cyanoacrylate-based tissue adhesives, Dermabond®, and it reached 52% of its maximal strength within 5 minutes on cowhide. A layer-by-layer assembly of hyaluronic acid with DSFp3 was observed to form compact sheet structures through biofilm interferometry assay and scanning electron microscopy. This work provides a solution and theoretical basis for the low adhesion strength and slow curing of protein-based bioglue.
In order to overcome the shortcomings of high false positive rate and poor generalization in the detection of microcalcification clusters regions, this paper proposes a method combining discriminative deep belief networks (DDBNs) to automatically and quickly locate the regions of microcalcification clusters in mammograms. Firstly, the breast region was extracted and enhanced, and the enhanced breast region was segmented to overlapped sub-blocks. Then the sub-block was subjected to wavelet filtering. After that, DDBNs model for breast sub-block feature extraction and classification was constructed, and the pre-trained DDBNs was converted to deep neural networks (DNN) using a softmax classifier, and the network is fine-tuned by back propagation. Finally, the undetected mammogram was inputted to complete the location of suspicious lesions. By experimentally verifying 105 mammograms with microcalcifications from the Digital Database for Screening Mammography (DDSM), the method obtained a true positive rate of 99.45% and a false positive rate of 1.89%, and it only took about 16 s to detect a 2 888 × 4 680 image. The experimental results showed that the algorithm of this paper effectively reduced the false positive rate while ensuring a high positive rate. The detection of calcification clusters was highly consistent with expert marks, which provides a new research idea for the automatic detection of microcalcification clusters area in mammograms.
Objective To investigate the efficacy and prognostic risk factors of high flow nasal cannula (HFNC) in elderly patients with respiratory failure. Methods Clinical data of 172 elderly patients with respiratory failure admitted to 363 Hospital from April 2020 to August 2022 were retrospectively collected. The patients were divided into an observation group (n=86) and a control group (n=86) according to treatment method. The observation group (54 males, 32 females), mean 68.67±2.36 years old, received HFNC oxygen therapy. The control group (52 males, 34 females), mean 68.12±2.14 years old, received conventional oxygen therapy. According to the prognosis after HFNC treatment, the observation group was subdivided into a poor prognosis group (n=21) and a good prognosis group (n=65). The clinical effects of different treatment methods in the two groups were analyzed, and the risk factors affecting prognosis of elderly patients with respiratory failure treated by HFNC were analyzed by multivariate logistic regression. A line graph model was constructed, and the model was verified by receiver operator characteristic curve and cumulative gain graph. Results Repeated measures ANOVA was conducted on the oxygen therapy indicators of the two groups of patients. The results showed that pH, PaO2, PaCO2, and respiratory rate all have statistical significance in terms of time effect (F=423.25, P<0.001; F=326.25, P<0.001; F=128.79, P<0.001; F=323.16, P<0.001), inter-group effect (F=128.79, P<0.001; F=205.46, P<0.001; F=310.52, P<0.001; F=123.15, P<0.001), and interactive effect (F=111.06, P<0.001; F=198.76, P<0.001; F=134.28, P<0.001; F=112.47, P<0.001). This indicated that the impact of time on pH, PaO2, PaCO2, and respiratory rate differs depending on the treatment method. The scores of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), the level of brain natriuretic peptide (BNP), the heart rate before treatment, the posterior root of tongue fall, the initial HFNC flow and the duration of HFNC in the poor prognosis group were significantly higher than those in the good prognosis group. Initial PaO2/FiO2 was significantly lower than that in the good prognosis group (P<0.05). Multiple factor analysis showed that APACHEⅡ score>17 points, BNP level>150 ng/L before treatment, heart rate >105 times/min before treatment, posterior root of tongue drop, initial HFNC flow>55 L/min, initial PaO2/FiO2<150 mmHg were independent influencing factors for poor prognosis of elderly patients with respiratory failure treated by HFNC. The histogram model showed that the total score of the above 6 indicators is 284, corresponding to a probability of poor prognosis of 71.6%, which proved that the prediction ability of this model is good. Conclusions The application of HFNC in elderly patients with respiratory failure has a significant effect. APACHEⅡ score, BNP level before treatment, heart rate before treatment, posterior root of tongue fall, initial HFNC flow, initial PaO2/FiO2 are all risk factors affecting the prognosis, which should be paid attention to in clinic to improve the therapeutic effect.