Hepatitis B e Antigens ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans

Objective To investigate the effects of mindfulness training on cancer related fatigue (CRF) in patients with breast cancer .Methods Two hundreds young and middle‐aged patients with breast cancer receiving chemotherapy in our hospital from January to June 2015 were divided into the observation group and control group ,100 cases in each group .The control group was given the routine nursing ,while on this basis the observation group was given the mindfulness training .The cancer related fa‐tigue status was evaluated according to the CFS scale .The CFS various dimensions and total fatigue scores before and after inter‐vention were compared between the two groups .Results The fatigue status existed in most of patients with breast cancer after chemotherapy ,the occurrence rate of CRF was 97 .0% ,which was dominated by moderate fatigue ,followed by mild fatigue ,severe fatigue was minimal ;the body fatigue ,cognitive fatigue ,emotional fatigue and total fatigue scores in the second time of chemothera‐py had no statistically significant differences between the two groups (P>0 .05);in the fourth and sixth time of chemotherapy ,the body fatigue ,cognitive fatigue ,emotional fatigue and total fatigue scores in the observation group were significantly lower than those in the control group ,the differences were statistically significant (P<0 .05) .Conclusion The mindfulness training interven‐tion can relieve the fatigue status and improve the living quality of the patient .

Age-related white matter changes are considered as a manifestation of arteriolosclerotic small vessel disease and are associated with advanced age and vascular risk factors.White matter changes have been recognized as one of the manifestations of cerebral small vessel disease.They are the pathological basis of cognitive impairment and functional loss in the elderly.Studies have shown that when white matter changes develop to a certain extent,there will be many clinical symptoms,including cognitive impairment,dementia,depression,gait disturbances,and urinary incontinence,and they are associated with the increased risks of stroke and death.

OBJECTIVETo observe the intervention effects of electroacupuncture at "Yishu" (EX-B 3) on rats with type-2 diabetes mellitus (T2DM), so as to provide experiment references for acupuncture to treat T2DM.

METHODSAmong seventy male Wistar clean-grade rats, 8 rats were randomly selected into a control group; the rest rats were made T2DM model. Fifty-two rats which were successfully made T2DM model, according to randomized block method, were divided into a model group (10 rats), a medication group (10 rats), an electroacupuncture at "Shenshu" (BL 23) group (11 rats), an electroacupuncture at "Pishu" (BL 20) group (10 rats) and an electroacupuncture at "Yishu" (EX-B 3) group (11 rats). Seven days after successful establishment of model, the rats in the model group were fixed in the self-made rat bag without receiving any treatment; the rats in the medication group, according to body mass (10 mL/kg), were treated with intragastric administration of glimepiride; the rats in all the electroacupuncture groups were treated with electroacupuncture at "Shenshu" (BL 23), "Pishu" (BL 20) and "Yishu" (EX-B 3), respectively. The continuous wave was selected with a frequency of 15 Hz and a current intensity of 4 to 6 mA. The treatment was given 20 min per treatment, once a day, 5 treatments per week for continuous 4 weeks. Before the establishment of model and continuous 4 weeks after the intervention, blood samples were collected from rats' caudal vein, and fasting blood glucose (FBG) was measured with FBG device each week. After the last intervention, the rats were killed and hypothalamus, pituitary and adrenal gland were collected. The colorimetric method was applied to measure the contents of triglyceride (TG), cholesterol (TC), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C); radioimmunoassay was used to test the contents of glycated serum protein (GSP), fasting insulin (FINS), corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH) and cortin (CORT).

RESULTSFour weeks after the intervention, except that the rat's body mass in the normal group continued to increase, body mass in the model group, medication group and each electroacupuncture group were significantly reduced (P<0.01, P<0.05). Compared with the model group, the FBG in the electroacupuncture at "Pishu" (BL 20) group and electroacupuncture at "Yishu" (EX-B 3) group were obviously reduced (P<0.05, P<0.01); FBG in the electroacupuncture at "Yishu" (EX-B 3) group was lower than that in the medication group and electroacupuncture at "Shenshu" (BL 23) group (both P<0.05). The contents of TG, HDL-C and LDL-C in the electroacupuncture at "Yishu" (EX-B 3) group were reduced (P<0.05, P<0.01), the content of TG was significantly lower than that in the medication group and electroacupuncture at "Shenshu" (BL 23) group (both P<0.05), the content of LDL-C was significantly lower than that in electroacupuncture at "Shenshu" (BL 23) group (P<0.05). Insulin sensitivity index (ISI) in the medication group, electroacupuncture at "Pishu" (BL 20) group and electroacupuncture at "Yishu (EX-B 3)" group were evidently increased (P<0.05, P<0.01); ISI in the medication group was lower than that in the electroacupuncture at "Yishu" (EX-B 3) group (P<0.05). The content of CRH in the electroacupuncture at "Yishu" (EX-B 3) group was lower than that in the medication group and electroacupuncture at "Shenshu" (BL 23) group (P<0.05, P<0.01); the content of CORT in the electroacupuncture at "Yishu" (EX-B 3) group was lower than that in the medication group and electroacupuncture at "Pishu" (BL 20) group (both P<0.05).

CONCLUSIONElectroacupuncture at "Yishu" (EX-B 3) could reduce the level of CORT to improve the insulin resistance in rats with T2DM, improve insulin sensitivity index, regulate blood lipid metabolism and relieve the hyperactivity of the HPA axis.

Acupuncture Points ; Acupuncture Therapy ; Animals ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; metabolism ; therapy ; Electroacupuncture ; Hormones ; metabolism ; Humans ; Hypothalamus ; metabolism ; Male ; Pituitary-Adrenal System ; metabolism ; Rats ; Rats, Wistar

Cellular fibronectin (cFn) is a type of bioactive non-collagen glycoprotein regarded as the main substance used to maintain periodontal attachment. The content of cFn in some specific sites can reflect the progress of periodontitis or peri-implantitis. This study aims to evaluate the expression of cFn messenger RNA (mRNA) in tissues of adult periodontitis and peri-implantitis by real-time fluorescent quantitative polymerase chain reaction (PCR) and to determine its clinical significance. A total of 30 patients were divided into three groups of 10: healthy, adult periodontitis and peri-implantitis. Periodontal tissue biopsies (1 mm×1 mm×1 mm) from each patient were frozen in liquid nitrogen. Total RNA was extracted from these tissues, and the content, purity and integrity were detected. Specific primers were designed according to the sequence, and the mRNA expression levels of cellular fibronectin were detected by real-time PCR. The purity and integrity of the extracted total RNA were both high, and the specificity of amplified genes was very high with no other pollution. The mRNA expression of cFn in the adult periodontitis group (1.526±0.441) was lower than that in the healthy group (3.253±0.736). However, the mRNA expression of cFn in the peri-implantitis group (3.965±0.537) was significantly higher than that in the healthy group. The difference revealed that although both processes were destructive inflammatory reactions in the periodontium, the pathomechanisms were different and the variation started from the transcription level of the cFn gene.
Adult ; Alveolar Bone Loss ; metabolism ; Female ; Fibronectins ; analysis ; genetics ; Gingiva ; metabolism ; Humans ; Male ; Middle Aged ; Peri-Implantitis ; metabolism ; Periodontal Attachment Loss ; metabolism ; Periodontal Index ; Periodontal Pocket ; metabolism ; Periodontitis ; metabolism ; Periodontium ; metabolism ; RNA, Messenger ; analysis ; Real-Time Polymerase Chain Reaction ; Transcription, Genetic ; genetics ; Young Adult

Objective To investigate the value of laparoscopy in comprehensive early ovarian cancer staging by comparing the feasibility and safety of laparoscopy and laparotomy in surgical staging of early-stage epithelial ovarian cancer (EOC). Methods A total of 102 patients with EOC who underwent comprehensive laparoscopic (LPS group, n=71) or laparotomic (LPT group, n=31) staging at Southwest Hospital from November 2007 to November 2014 were retrospectively analyzed. The perioperative parameters, postoperative complication rate and the long-term curative effect were compared between the two groups. Results (1)LPS group had less intra-operative blood loss [(288±239) vs (631±463) ml], lower rate of blood transfusion(14%vs 58%), larger number of pelvic dissected lymph nodes (18.1±5.6 vs 15.5± 4.6), lower vasual analogue scalescore(VAS) pain score (2.1 ± 1.6 vs 3.0 ± 1.1), shorter gastrointestinal recovery time [(2.6 ± 0.8) vs (3.5 ± 0.9) days] and shorter hospital stay [(9.9 ± 2.9) vs (11.3 ± 5.0) days] when compared with LPT group (all P<0.01). No significant difference were found in operation time, number of para-aortic lymph nodes, rate of postoperative upstaging and adjuvant chemotherapy between the two groups (all P>0.05). (2) No significant difference was found in postoperative rate of complications [11%(8/71) vs 19%(6/31),χ2=1.192, P=0.275]. (3) No significant difference was found in recurrence rate [17%(11/66) vs 14%(4/29), χ2=0.125, P=0.724] and 5-year overall survival (86.7% vs 86.8%, P=0.874). Conclusion Compared with LPT group, there are no significance differences in recurrence rate and mortality between two groups, laparoscopic staging, which could be recommended as a choice of surgical treatment of early ovarian cancer, shows more favorable operative outcomes including minimally invasive, less intra-operative blood loss, less postoperative pain and quicker recovery.

Objective To measure the outcomes of the cochlear implantation for patients with Warrensburg syndrome in comparison with non-syndromic patients with sensorineural hearing loss. Methods 16 of 1 300 Waardenburg syndrome patients who received cochlear implants at PUMC hospital were reviewed in this papers. The authors will discuss the effects between Warrensburg syndrome and non- syndromic patients with sensorineural hearing loss by means of the Parents Evaluation of Aural-Oral Performance of Children (PEACH). Results There were no statistical difference in quiet, in noise, in overall results and in conversation on the phone between Warrensburg syndrome and non-syndromic patients. There was statistical difference between in quiet and in noise in every group. Conclusion The auditory perception and speech recognition between Warrensburg syndrome and non-syndromic patients with sensorineural hearing loss is same, and the results in quiet is better than that in noise.

Objective To explore the standardized procedures of laparoscopic sleeve gastrectomy (LSG).Methods The clinical data of 153 patients with obesity who underwent LSG at the First Affiliated Hospital of Nanjing Medical University from December 2010 to December 2014 were retrospectively analyzed.All the 153 patients were divided into 3 groups:22 patients in the first stage group were admitted to the hospital from December 2010 to September 2011,57 patients in the second stage group were admitted to the hospital from October 2011 to December 2013 and 74 patients in the third stage group were admitted to the hospital from January 2014 to December 2014.In the first stage group,1.1 cm gastroscope in diameter was introduced into the pylorus as a support,great curve of stomach with 5 cm distances from the pylorus was cut using a green cartridge,and then blue cartridges were used at the body and fundus of stomach.The 3-0 vicryl continuous and whole-layer suture was performed.The routine abdominal drainage was ended at postoperative hour 24 without the gastric tube placement.In the second stage group,36 Fr bougie tube was placed at the gastric antrum,cutting at the proximal 5 cm from pylorus was performed using a green cartridge,and then blue cartridges were used.The 3-0 Vicryl interrupted and wholelayer suture was performed at the reinforcement of staple lines,and no drainage tube was placed.In the third stage group,36 Fr bougie tube was placed at the gastric antrum,cutting at the proximal 3 cm from pylorus was performed using two green cartridges,and then blue cartridges were used.The 3-0 vicryl continuous and whole-layer suture was performed at the reinforcement of staple lines,and no drainage tube was placed.Other common perioperative management included as follows:free greater omentum was done by the supersonic knife.Patients had outof-bed activity after waking up and intake of water and fluid diet at postoperative hour 6-8,including oral liquid diet of 300-500 mL at postoperative hour 24 and 500-1 000 mL at postoperative hour 48.Patients were followed up till May 2015,and return visit at postoperative month 1,3,6,9 and 12 within 1 year and once every 6 months after postoperative year 2.The operation time,volume of intraoperative blood loss,duration of hospital stay and excess weight loss (EWL) percentage were analyzed.Comparison of count data was analyzed by the chi-square test.Measurement data with normal distribution were presented as-x± s.Comparisons among groups were evaluated with the one-way ANOVA and chi-square test.Results All the patients received successfully LSG without conversion to open surgery,perioperative reoperation and death.Four patients were complicated with intraoperative injury,including 3 patients with liver injury and 1 patient with hepatic round ligament injury.No intraoperative and postoperative hemorrhea,postoperative gastric leakage and obstruction were detected.The operation time,volume of intraoperative blood loss,duration of hospital stay and 1-year EWL were (91 ± 31) minutes,(51 ± 33) mL,(4.1 ± 3.4) days,67％ ± 12％ in the first stage group,(56 ± 27) minutes,(24 ± 20) mL,(3.1 ± 2.7) days,65 ％ ± 14％ in the second stage group and (54 ± 18) minutes,(21 ± 20) mL,(3.0 ± 2.1) days,68％ ± 24％ in the third stage group,respectively.There were significant differences in the operation time and intraoperative volume of blood loss among the 3 groups (F =7.471,6.037,P ＜0.05).There was no significant difference in the duration of hospital stay and 1-year EWL among the 3 groups (F =1.439,2.296,P ＞ 0.05).All the patients were followed up.Nineteen patients with sleep apnea had complete remission of symptoms at postoperative month 3.Twenty-one patients with polycystic ovary syndrome had remission of symptoms after operations.Of 27 patients with type 2 diabetes mellitus,25 patients had remission of symptoms at postoperative year 1 and 2 patients had improvement of symptoms.Fifty-seven of 79 patients with lipid metabolism disorders returned to normal at postopera tive year 1.One hundred and twelve patients with fatty liver were improved after operation.Conclusions LSG is safe and feasible with a standardized operative procedure.Whole-layer suture may be prevent the leakage and no placement of gastric tube and drainage tube after operation can reduce the incidence of complications.

Objective To explore the clinical effects of metabolic surgery on obese adolescents.Methods The clinical data of 28 obese adolescents who were admitted to the First Affiliated Hospital of Nanjing Medical University from June 2010 to January 2014 were retrospectively analyzed.Patients underwent gastric bypass and sleeve gastrectomy according to their own intention and were followed up regularly at 1,3,6,9 months after surgery till October 2014.The perioperative conditions and postoperative effecacies of patients were observed.The measurement data with normal distribution were presented as-x ± s,the comparisons of weight-loss trends among different surgeries were analyzed by the repeated measures ANOVA.Results All surgeries were performed under laparoscope without severe complications or deaths,including 16 cases of gastric bypass and 12 cases of sleeve gastrectomy.The median operation time and duration of postoperative stay were 136.5 minutes (range,60.0-320.0 minutes) and 4 days (range,2-8 days),respectively.Three patients had perioperative complications.All patients received postoperative follow-ups.The median body mass index(BMI) at postoperative month 1,3,6,9 were 36.1 kg/m2,33.2 kg/m2,30.2 kg/m2 and 28.4 kg/m2,and mean excess weight loss (EWL) rate were 24.6％,40.4％,55.1％ and 63.9％.The BMIs before operation and at postoperative month 1,3,6,9 were (43 ± 6) kg/m2,(37 ± 5) kg/m2,(34 ± 4) kg/m2,(30 ± 4) kg/m2 and (29 ± 4) kg/m2 in patients undergoing gastric bypass,and (39±4)kg/m2,(35±4)kg/m2,(32 ±5)kg/m2,(31 ±4)kg/m2 and (28 ±4)kg/m2 in patients undergoing sleeve gastrectomy,respectively.The EWL at postoperative month 1,3,6,9 were 24％ ± 9％,40％±9％,59％ ± 12％ and 65％ ± 12％ in patients undergoing gastric bypass,and 25％ ±9％,41％ ± 15％,49％ ± 16％ and 63％ ± 17％ in patients undergoing sleeve gastrectomy,respectively.There was no difference in the change of BMI and EWL between gastric bypass and sleeve gastrectomy (F =0.777,0.332,P ＞ 0.05).Four patients undergoing gastric bypass were found to have nutritional complications in follow-up and recovered after symptomatic treatment.Concltsion Bariatric surgery is safe and feasible for obese adolescents with a significant weight loss.However relevant nutrition complications may occur,it is significant to sustain a long-term followup and nutrition intervention,and the choice of surgical procedures should follow the principle of individuation.

Objective To investigate the influencing factors of successfully switching to sequential ventilation in patients with prolonged weaning due to acute respiratory failure (ARF) after thoracolaparotomy based on the initial rapid shallow breathing index (RSBI) at 60 min after spontaneous breathing trial (SBT), namely, the f/VT optimal value range of 80-120 times/ (min · L), thus providing the basis for determining the ideal timing of weaning in clinical practice.Methods A prospective observational study of sequential ventilation [RSBI during the initial SBT (60 min), 80-120 breaths/ (min · L)] was carried out in 42 patients on mechanical ventilation (≥ 48 h) due to post-thoracolaparotomy ARF in the ICUs.According to the duration of the mechanical ventilation, the patients were divided into 2 groups : successfully prolonged weaning group (≥ 7 days, n =24) and refractory weaning group (＜ 7 days, n =18).The patients with cardiac failure, aged less 18 or over 80, with hepatic dysfunction, or those needing gastrointestinal decompression after esophageal surgery or upper abdomen surgery were excluded.The demographics, APACHE Ⅱ scores and duration of mechanical ventilation of both groups were recorded, and the respiratory work and oxygen metabolism variables before the switch to sequential ventilation (within 24 hours after admission to ICU) and at the time of switching (24 hours in the ICU after admission) were recorded, respectively: clinical puhnonary infection score (CPIS), assessment of cough severity, pH, PaO2, PaCO2 and PaO2/FiO2;hemodynamic and microcirculation-related variables: HR, MAP, fluid balance, BNP and Lac;endocrine and metabolism variables : Hb, ALB and random serum cortisol (COR).The clinical features and the changes of the above-mentioned variables before and at the time of switching were compared between both groups.The independent sample t test was used for the single factor comparison and Mann-Whitney U test was applied to the non-normal distributions.The Fisher exact probability test was used for the single factor comparison of ranked data such as categorical variables.Results There were no significant differences in age, gender and severity of disease between two groups (P ＞ 0.05);the successfully prolonged weaning group had longer duration of invasive mechanical ventilation and ICU stay compared with the refractory weaning group (P ＜ 0.05).There were significant differences in cough severity, PaCO2, pH, HR and fluid balance between two groups before switching (P ＜ 0.05).Compared with those before switching, in the refractory weaning group there were marked decrease in Lac (P ＜ 0.05), obvious increase in cough severity, pH, Hb and ALB (P ＜ 0.05), but there was no significant difference in COR (P ＞ 0.05);while in the successfully delayed weaning group, there were significant decrease in CPIS, PaCO2, HR, MAP, BNP, fluid balance and Lac (P ＜ 0.05), and cough severity, pH, ALB and COR showed an upward trend (P ＜ 0.05).Conclusions The key of successful sequential ventilation is within the values of RSBI ranging from 80 to 120 times/ (min · L) during the initial SBT (60 min) selected as the switching point in patients with prolonged weaning after thoracolaparotomy.The major influencing factors for determining the ideal timing of switching include the matching status between respiratory endurance and respiratory work, the balance between myocardial strength and both cardiac preload and afterload, the severe disease associated with adrenal insufficiency, and malnutrition.