1.Evaluation of esophagogastric variceal bleeding using multi-slice CT portal venography
Yanghong YU ; Shan DING ; Kexue DENG
Acta Universitatis Medicinalis Anhui 2013;(11):1376-1379
Objective To discuss the relationship between the diameter of portal vein and esophagogastric variceal bleeding and the severity of liver cirrhosis by CT portal venography ( CTPV). To analyze the occurence about esophagogastric variceal bleeding under in different liver cirrhosis degree. Methods 60 patients of portal hyperten-sion with liver cirrhosis and 15 healthy volunteers (controls). According to Child-Pugh classification, 60 patients were divided into Child-Pugh A,B and C groups,According to the patients whether the esophagogastric variceal bleeding or not, it was divided into two groups that esophagogastric variceal bleeding (EVB) and no EVB. All of patients underwent with 64-slice spiral CT. Image post-processing techniques such as MIP, VR, MPR and SSD were applied to measuring the diameters of portal venous system vessels and depict the portosystemic collaterals of portal venous system. Results The diameters of the right branch of portal vein and super mesenteric vein were no statisti-cal significance between bleeding group and no bleeding group. The rest parameters of portal system in EVB group are all larger than those of no EVB group(P<0.05). Age and gender in two groups had no statistic significance. All diameters of portal system in cirrhotic group were all larger than those of control group(P<0.05). In different liver function,there are differences in each groups of diameter. The bleeding rate of different groups according to he-patic function showed statistical significance(P <0.05), higher the degree of liver cirrhosis, higher the bleeding rate. Conclusion The diameters of portal system in EVB group are larger than no EVB. All diameters of portal sys-tem in cirrhotic group are all larger than those of control group. There is difference the diameter of vascular in differ-ent hepatic function. Different degree of liver cirrhosis can predict the esophagogastric variceal bleeding.
2.Comparison between the effects of oxaliplatin or irinotecan combined with fluoropyrimidine in the treatment of advanced gastric cancer
Lijia BU ; Yiyin ZHANG ; Fuxing XIONG ; Jiqing HAO
Acta Universitatis Medicinalis Anhui 2013;(11):1372-1375
Objective To retrospectively observe and compare the efficacy and safty of irinotecan or oxaliplatin combined with fluoropyrimidine in the first line treatment of advanced gastric cancer. Methods 71 patients were divided into two groups. The irinotecan group consisted of 37 patients. Irinotecan 180 mg/m2 was injected in 90 minutes on d1. And the oxaliplatin group consisted of 34 patients. Oxaliplatin 85 mg/m2 was injected on d1. All the groups combined fluoropyrimidine. 5-Fluorouracil (5-Fu) 400 mg/m2 and leucovorin 200 mg/m2 were injected on d1,2 and 5-Fu 600 mg/m2 was 22 h continuous injected on d1,2, every 2 weeks was a cycle. It could also take capecitabine 1.0 g/m2 or tegafur-gimeracil-oteracil potassium 25 mg/m2 Bid for d1~14 orally, every 3 weeks was a treatment. Results 65 patients were evaluated. The response rates were 32.35% and 22.58%, the disease con-trol rates were 76.47% and 70.97%, and the median progression free survival (PFS) were 5 (3.962~6.038) months and 4 (2.730~5.270) months in irinotecan group and oxaliplatingroup, respectively, with no significant difference (P>0.05). Toxicity was tolerable, major adverse events were neutropenia, nausea and vomiting in two group. The incidence rate of diarrhea (45.95%) was higher in irinotecan group, and the peripheral nerve toxicity was 29. 41% in oxaliplatin group. Conclusion The effects of irinotecan or oxaliplatin combined with fluoropyrimi-dine in the treatment of advanced gastric cancer are comparable, and their toxicities are tolerable.
3.Treatment experience of 20 cases of artificial total hip revision
Zhonglian ZHU ; Zongsheng YIN ; Jiansheng ZHOU ; Kun ZHU
Acta Universitatis Medicinalis Anhui 2013;(12):1544-1546
20 cases of artificial total hip joint rebuilding were selected, all of which were unilateral total hip joint rebuilding. Harris scores before and after the surgery and hip joint activity evaluation were carried out to the pa-tients. The average follow-up duration was 1 to 2 years. Up to the last follow-up,the activity of hip joint had been obviously improved compared with that before the operation. Through X-ray, the phenomena such as radiolucent zone around the prosthesis,prosthesis shift or osteolysis around the prosthesis haven't been seen. The short-term clinical effect of artificial total hip joint rebuilding was obvious for patients with hailure of first total hip joint re-placement caused by various reasons.
4.Effect of growth hormone in preventing re-adhesion after transcervical resection of intrauterine adhesions
Yinfeng HU ; Bing WEI ; Enxue SONG
Acta Universitatis Medicinalis Anhui 2013;(11):1405-1407
Eighty cases of intrauterine adhesions who received adhesion separation technique were divided into two groups equally. The control group was placed intrauterine device and ballon catheter in intrauterine,and received o-ral female estrogen cycle treatment. The test group with the same treatment was added growth hormone treatment. Three months later,all of the patients were checked the hysteroscopy and intrauterine device was took out, also the uterine cavity form,and follow-up recovery of endometrial and menses were evaluated. Then it showed:①Endome-trial thickness increased by an average of (1.73±0.83) mm in the test group,while the control group average in-creased by (1.10±0.66) mm. The difference was statistically significant (t=3.73,P<0.01).② The re-adhe-sion rate was 45.0% in the control group,while it was 32.5% in the test group,respectively. The difference was not statistically significant. ③ The difference of mensual recovery between both groups was not statistical significant. Therefore growth hormone can promote the growth of endometrium of intrauterine adhesions after resection of adhe-sions.
5.Application of lectin microarray technology for the diagnosis of common gynecological tumors
Lili PEI ; Chaoqiang XIAO ; Wei HE
Acta Universitatis Medicinalis Anhui 2013;(11):1348-1351
Objective To probe the clinical values of the human serum glycoprotein profiles for the diagnosis of common gynecological tumors. Methods A total of 123 clinical serum samples which included 31 breast cancer, 24 cervical cancer, 19 ovarian cancer and 49 healthy individuals were collected. A lectin microarray consisting of 15 lectins with different glycan binding specificities was used to determine the glycoprotein profiles of serum sam-ples. Stepwise discrimination analysis method was adopted to establish function model of clinical serum samples classification with SPSS 15. 0 software. Results Two grades of diagnostic discrimination function models were es-tablished. The first grade discrimination function could differentiate gynecological tumors from healthy individuals, the diagnostic accuracy rates of retrospective inspection were 85. 7% and 83. 8% respectively, and the total diag-nostic accuracy rate was 84.6%. The second grade discrimination function was used to differentiate breast tumor, cervical tumor and ovarian tumor, the diagnostic accuracy rates of retrospective inspection were 96.8%,75.0%and 78.9% respectively, and the total diagnostic accuracy rate was 85.1%. Conclusion The human serum gly-coprotein profiles are associated with gynecological tumors, and the established discrimination function models based on lectin microarray data have a helpful reference value for the clinical diagnosis of gynecological tumors.
6.Effect of prenatal and postnatal exposure to bisphenol A on body weight of immature mice
Yun LI ; Wei FANG ; Meiling LI ; Tong SHEN
Acta Universitatis Medicinalis Anhui 2013;(11):1333-1335
Objective To investigate the effect of maternal exposure to bisphenol A(BPA) via drinking water on body weight of immature offspring during pregnancy and lactation. Methods The pregnant female ICR mice were exposed to BPA groups(2. 282 9,22. 829 0,228. 290 0 μg/L) by drinking water from gestational day(GD)0 till postnatal day (PND)21,water and dimethyl sulfoxide(0. 01%) were served as blank and vehicle control. Maternal body weight was recorded every three days during pregnancy. Weight of pups per litter was measured every three days during lactation. Body weight of offspring was taken notes every week till PND 42 after delactation. ResultsThere was no significant difference in pregnant maternal body weight, average numbers and body weight of pups per litter preweaning among all groups. The offspring weight of the high-dose group at PND 42 was increased compared with control groups(P<0.05). The weight of female offspring was not significantly different among all groups at PND 28~42. The male offspring weight of the middle/high group at PND 35 and all groups at PND 42 significantly was elevated(P<0.05,P<0.01),and the high group was most significant. Conclusion Body weight of immature offspring is affected,especially male offspring after delectation by pregnant and lactational BPA exposure.
7.Reteplase fusion protein:expression, purification and the effect of chaperones on its renaturation
Wei WANG ; Wenyi ZOU ; Qinglin FAN ; Lihua SONG
Acta Universitatis Medicinalis Anhui 2013;(11):1287-1291
Objective To construct the prokaryotic expression system of reteplase fusion protein and research the effect of chaperones on its renaturation. Methods Inserted the reteplase gene into the prokaryotie expression vector PET32a and then expressed it by the induction of IPTG in E. coli BL21. Researched the effect of chaperones on the renaturation of fusion protein by adding different chaperones. Results The analysis of SDS-PAGE and Western blot indicated that reteplase fusion protein was expressed correctly. Chaperones DsbA,pKJE7,pTf16 had the conspicu-ous effect on the renaturation of fusion protein. The result of activity assay indicated that the refolded reteplase fu-sion protein had fibrinolytic activity. Conclusion Chaperones can promote renaturation of reteplase fusion protein.
8.Different anesthesia in elderly patients with gastric cancer surgery influence blood concentrations of melatonin and its correlation with postoperative agitation
Xuefeng WANG ; Cai FANG ; Xin WEI ; Xiaoqing CHAI
Acta Universitatis Medicinalis Anhui 2013;(12):1539-1541
To evaluate the different anesthesia in elderly patients with gastric cancer surgery influence blood con-centrations of melatonin and its correlation with postoperative agitation. The agitation scroes were evaluated and re-corded,and the blood samples were taken twice:before induction as well as just at the end of surgery,then making correlation analysis. The agitation scroes were significantly lower in group ET than in group T(P<0.01);the level of postoperative blood concentrations of melatonin was higher in group ET than that in group T(P<0.01);the agi-tation scroes and the level of postoperative blood concentrations of melatonin were negatively correlated ( r =-0.429,P<0.05).
9.The changes of bone resorption in prednisone treatment of nephrotic syndrome and the intervention of α-D3 on it
Xueping WU ; Li HAO ; Guiling LIU
Acta Universitatis Medicinalis Anhui 2013;(12):1530-1532
Objective To discuss the change of bone resorption of primary nephrotic syndrome (PNS) patients with prednisone treatment, andα-D3 effects on it. Methods ①30 PNS patients diagnosed and 28 healthy people in our hospital were selected;blood and urine samples before and after enough prednisone (pred) treatment were collect-ed to detect the iPTH, calcium and urinary DPD. ②30 PNS patients after 6 weeks enough prednisone treatment were randomly divided into Pred +α-D3 group and Pred group. Results ① PNS group compared with healthy group, urine DPD excretion rate was significantly increased(P<0.05),and blood iPTH was significantly increased (P<0.01);blood calcium was similar to healthy group. ② PNS patient after treatment with pred compared with that before treatment, urine DPD excretion rate was significantly increased(P<0.01),and blood iPTH was signifi-cantly increased(P<0.01). There was no obvious change in blood calcium.③Pred+α-D3 group compared with Pred group, urine DPD excretion rate was significantly decreased(P<0.01),and blood iPTH was significantly de-creased(P<0.05). There was no obvious change in blood calcium. Conclusion α-D3 can effectively reduce bone resorption in PNS patients.
10.Comparison between flexible laryngeal mask airway and tracheal intubation in children undergoing adenoidectomy and tonsillectomy
Yuanyuan HOU ; Ye ZHANG ; Lijun WENG ; Bin WANG
Acta Universitatis Medicinalis Anhui 2013;(12):1515-1518
Objective To compare the eficacy and safety of flexible laryngeal mask (FLMA) and endotracheal tube (ETT) in children undergoing adenoidectomy and tonsillectomy. Methods Forty children with snoring disease scheduled for selective adenoidectomy and tonsillectomy surgery under intravenous compound inhalation general an-esthesia were divided randomly into either FLMA group or ETT group. MAP,HR and SpO2 were recorded before an-esthesia induction(T0 ), 1 (T1 ),3 (T2 ),5 (T3 ) min after intubation,1(T4 ),3 (T5 ) min after extubation. Param-eters for respiratory mechanics included peak airway pressure (Ppeak ), mean airway pressure (Pmean ), end tidal CO2 (PetCO2 ),and airway sealing pressure. All of the above indicators were recorded 5 min (T6 ) after intubation, 10 (T7 ),20 (T8 ) min after put in mouth gag,5 (T9 ) min after removing mouth gag. Meanwhile,chievement ratio of first time insertion,incidence of regurgitation aspiration,bucking,laryngospasm,wheezing when extubation and af-ter extubation,anesthesia time,surgery time,extubation time were recorded. Complications such as nausea and vomi-ting,pharyngeal pain,hoarseness were followed up 24 hours after surgery. Results MAP, HR during T1 , T2 , T3 , T4 ,T5 were significantly higher in group T than T0 , and those in group FLMA (P<0.05). MAP, HR were not sig-nificantly changed in group FLMA during each time. Ppeak , Pmean was significantly lower in group FLMA than that in group ETT. The extubation time was shorter and the incidence of coughing and pharyngalgia after operation was low-er in group FLMA than that in group ETT. Conclusion Compared with endotracheal intubation, on the basis of not affecting surgical operation, FLMA is an effective, safe anesthesia for adenoidectomy and tonsillectomy surgery in children, with the advantages of hemodynamic stability, mild airway trauma,and is a easy handling method, with minor laryngeal stimulation during intubation and extubation, more stable hemodynamics, reliable respiratory me-chanics and low incidence of postoperative upper airway complications.