Objective To investigate the clinical value of transthyretin (TTR) from patients with early rheumatoid arthritis (ERA). Methods 58 patients with ERA , 34 patients with later RA (LRA) and 34 healthy control (HC) were included in the research. TTR was analyzed by ELISA, whose variance was analyzed. TTR density, disease activity score28 (DAS28) score and rheumatoid factor (RF) were tested, and their correlation with TTR was analyzed. Results Serum level of TTR with ERA significantly increased compared with that with LRA and HC (P < 0.05), no statistical significance with LRA group and HC. TTR level was no correlation with the number of swelling and tender joints, disease activity score 28, RF, ESR, CRP, anti-cyclic citrylinated peptide antibody and anti-keratin antibodies, hemoglobin, thrombocyte and albumin. Conclusion Serum level of TTR significantly increased with ERA patients, contributing to early diagnosis for RA.

Objective To study the academic level of randomized control trials(RCTs)published from 2004 to 2009 in Chinese Journal of Hepatobiliary Surgery.Methods Published work about RCTs in 72 issues of Chinese Journal of Hepatobiliary Surgery was searched by finding relevant articles published during 2004-2009.Correlated indexes including literature received time, literature publishing time, the total number of citations, number of citations in Chinese, number of citations in English, research funding situations, the number of authors, article affiliations in all RCTs, together with single(or multiple)center study situation, positive conclusions, the starting time, the end time,and number of patients recruited in clinical RCTs were extracted for aggregate analysis.Results During the past six years, a total of 135 articles of RCT were published in Chinese Journal of Hepatobiliary Surgery, accounting for 8.7% in all clinical studies.The average number of RCTs in each issue was 1.88.The average time for publishing time delay was 450 days.The total number of citations in RCTs was 1252 and the average number of RCTs for citations was 9.3.53 RCT studies were financed, accounting for 39% of the total number of research papers.Beijing Friendship Hospital attached to the Capital University of Medical Sciences had published 8 papers of RCT and it is the institution of publishing the largest number of such papers in the journal.The number of multi-center study for RCTs was one and all RCT studies had significant conclusions.The average research duraton in RCTs was 45 months.The total number of patients in 33 clinical RCTs was 2705 and the average number of patients recruited in each RCT was 82.Conclusion Chinese Journal of Hepatobiliary Surgery put emphasis on the strongest evidence and the most valuable RCT researches that have great significance in the field of domestic hepatobiliary surgery for clinical treatment and experimental research.

ObjectiveTo investigate the diagnosis and treatment of purple urine bag syndrome following transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods Clinical data of 13 patients who developed purple urine bag syndrome out of 117 patients undergoing TACE for HCC in the Sixth Afifliated Hospital of Sun Yat-sen University between January 2012 and May 2014 were retrospectively studied. Among the 13 patients, 4 were males and 9 were females with the age ranging from 35 to 68 years old and the median of 53 years old. The tumor diameter was≤5 cm in 8 cases and was > 5 cm in 5 cases. The operative duration of TACE was≤30 min in 6 cases and was >30 min in 7 cases. The informed consents of all patients were obtained and the local ethical committee approval had been received. The diagnostic criteria was pink to purple urine in the urine bag after TACE and no blood urine detected by urine routine test.ResultsThe incidence of purple urine bag syndrome following TACE was 11.1% (13/117). After purple urine bag syndrome was confirmed, the patients were given the comprehensive therapy of urine acidification, rehydration, regular change of urinary catheter and urine bag, and gastrointestinal function improvement. No anti-infective therapy was given. The average indwelling time of urinary catheter was (12±3) d.ConclusionsIt is not a rare case for purple urine bag syndrome following TACE for HCC, thus it should be taken seriously. The treatment mainly includes urine acidiifcation, rehydration and gastrointestinal function improvement.

OBJECTIVETo evaluate the efficacy and feasibility of the Chinese drugs for supplementing Qi and activating blood circulation in preventing DVT after big operations in orthopaedics and traumatology and observe the change of D-dimer before and after treatment.

METHODSeventy patients ranging in age from 39 to 94 years who were treated by big operations in orthopaedics and traumatology were divided into two groups randomly. Traditional Chinese medinine (TCM) group (group A) and western medicine group (group B). On the 2rd day after operation d-dimer was tested from both groups and the patients in group A were given one dose of TCM every day and the patients in group B were subcutaneously injected low-molecular-weight heparins calcium (LMWH). On the 8th after operation d-dimer was tested again from both groups. The parameters, such as the incidence of DVT and pulmonary thromboembolism, bleeding condition, were evaluated respectively.

RESULTThe D-dimer decreased in group A and had significant difference (P < 0.05), group B had no significant difference, there was also no significant difference between two groups. DVT was found in 1 patient in group B (1/35). Petechiae were found in 10 patients in group A (10/35) and in 26 patients in group A (26/35), which had significant difference (P < 0.05).

CONCLUSIONBoth the Chinese drugs and anti-coagulation drug can prevent the incidence of DVT effectively, and Chinese herbs are feasible in the prevention of DVT.

Adult ; Aged ; Aged, 80 and over ; Anticoagulants ; administration & dosage ; Blood Circulation ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Heparin, Low-Molecular-Weight ; administration & dosage ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; Orthopedics ; Postoperative Complications ; drug therapy ; prevention & control ; Qi ; Traumatology ; Venous Thrombosis ; drug therapy ; prevention & control

OBJECTIVE: To carry out genetic analysis for a fetus with confined placental mosaicism (CPM) for trisomy 2 (T2) in conjunct with fetal uniparental disomy (UPD). METHODS: Amniocentesis and chromosomal karyotyping was carried out for a pregnant woman with a high risk for chromosome 2 anomalies indicated by non-invasive prenatal testing (NIPT). Single nucleotide polymorphism array (SNP-array) and trio-whole exome sequencing (Trio-WES) were carried out. Ultrasonography was used to closely monitor the fetal growth. Multifocal sampling of the placenta was performed after delivery for copy number variation sequencing (CNV-seq). RESULTS: The fetus was found to have a normal chromosomal karyotype. SNP-array has revealed multiple regions with loss of heterozygosity (LOH) on chromosome 2. Trio-WES confirmed the presence of maternal UPD for chromosome 2. Ultrasonography has revealed intrauterine growth restriction and oligohydramnios. Intrauterine fetal demise had occurred at 23⁺⁴ weeks of gestation. Pathological examination had failed to find salient visceral abnormality. The placenta was proved to contain complete T2 by CNV-seq. CONCLUSION T2 CPM can cause false positive result for NIPT and may be complicated with fetal UPD, leading to adverse obstetric outcomes such as intrauterine growth restriction, oligohydramnios and intrauterine fetal demise.
Female ; Humans ; Pregnancy ; Amniocentesis ; Chromosomes, Human, Pair 2/genetics* ; DNA Copy Number Variations ; Fetal Death ; Fetal Growth Retardation/genetics* ; Fetus ; Mosaicism ; Oligohydramnios ; Placenta ; Trisomy/genetics* ; Uniparental Disomy/genetics*

Objective To investigate the clinical efifcacy of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treatment of liver metastasis of colon cancer. Methods A total of 68 patients with liver metastasis of colon cancer in the Sixth Affiliated Hospital of Sun Yat-sen University from June 2007 to May 2011 were enrolled in this prospective study. The informed consents of all patients were obtained and local ethical committee approval had been received. There were 43 males and 25 females with a mean age of (59±4) years old. The patients were divided into RFA group and Control group with 34 cases in each group according to random number table method. Patients in both groups underwent TACE ifrstly and patients in RFA group underwent RFA 3 weeks after TACE treatment. Cluster of differentiation (CD) 3+, CD4+, CD8+positive cell percentage and CD4+/CD8+ratio were deifned by flow cytometry before and after treatments in two groups. The tumor diameter after treatments and general efifcacy were observed. The patients were followed up and the tumor recurrence and survival of the patients were observed. The comparisons of tumor diameter and immune function between two groups were conducted using t test. The comparison of efifcacy between two groups was conducted using rank sum test. The survival analysis was conducted using Log-rank test and Z test. Results The CD4+, CD8+percentage and CD4+/CD8+ratio were (42±4)%, (13±3)%, 2.9±0.9 in RFA group after treatment and were (33±4)%, (17±3)%, 2.3±0.9 in Control group, where signiifcant differences were observed (t=5.483,-6.488, 9.321;P<0.05). The tumor diameter in RFA group after treatment [(0.9±0.1) cm] was significantly smaller than that in Control group [(1.9±0.2) cm] (t=-4.573, P<0.05). The total effective rate in RFA group was 62%(21/34) and was 35%(12/34) in Control group. The treatment efifcacy of RFA group was better than that of Control group (Z=4.769, P<0.05). The 2-, 3-year survival rates in RFA group (38.2%, 23.5%) were significantly higher than those in Control group (14.7%, 5.9%) (Z=4.836, 4.221; P<0.05). Conclusions TACE combined with RFA is a safe and effective regimen in treating liver metastasis of colon cancer. The efifcacy may be associated with the improvement of the body’s immune function.

Objective:To explore the application value of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in preoperative screening of different residual types of atrial septal defect (ASD) occlusion.Methods:A retrospective analysis was conducted on the clinical data of 120 ASD patients who received interventional treatment for atrial septal defect at the Second People′s Hospital of Liaocheng from January 2020 to December 2021. Patients underwent TTE and TEE examinations before surgery, and were divided into two groups based on the results of the preoperative TTE examination: those with strong echogenicity of the defect margin and swing amplitude<5 mm were classified as group A ( n=60); Patients with fine echoes and a swing amplitude of ≥5 mm at the defect margin were classified as group B ( n=60). The study compared the differences in measuring the maximum diameter of atrial septal defect between two groups of patients using TTE and TEE, and evaluated the correlation between the maximum diameter of the defect measured by these two methods and the waist diameter of the occluder. Results:There was no statistically significant difference in the maximum diameter of atrial septal defect measured by TTE and TEE in group A ( P>0.05), while there was a statistically significant difference in group B ( P<0.01). In group A patients, the correlation between the maximum diameter of ASD measured by TTE and TEE and the diameter of the occluder waist was good ( r=0.993, 0.991); In group B patients, the correlation between the maximum diameter of ASD measured by TEE and the diameter of the occluder waist was higher ( r=0.995), significantly greater than the correlation with TTE measurements ( r=0.897). The difference between the waist diameter of the occluder and the values measured by TTE and TEE in group A patients was small and not statistically significant ( P>0.05); The difference between the waist diameter of the occluder and the TEE measurement value in group B patients was significantly smaller than the difference with the TTE measurement value ( P<0.01). Conclusions:For patients with atrial septal defect with strong residual echo and small amplitude of oscillation, TTE and TEE have considerable application value and can be used instead of TEE in case screening; For patients with atrial septal defect with thin residual echoes and large oscillation amplitude, further TEE examination is needed to help surgeons more accurately select suitable occluders.