Objective To study the clinical effects on patients with brain metastases from lung cancer combined with Elemene Injection and radiotherapy. Method 86 patients with brain metastases from lung cancer were randomly divided into control group and treatment group, 43 cases in each group. Control group was given conventional radiotherapy treatment, while treatment group combined Elemene Injection with radiotherapy. Results Compared with control group, treatment group’s disease control effect was obviously better. Survival rates after treatment for six months, one year, three years were higher than control group, and the number of adverse reactions were lower. Serum MMP-2 and MMP-9 levels were significantly greater. Radiotherapy plan time and total time in hospital for treatment were significantly shorter. Conclusion The combination of Elemene Injection with radiotherapy treatment for patients with brain metastases from lung cancer is very obvious.

AIM:To investigate the effects of atorvastatin reloading in pre-percutaneous coronary intervention ( PCI) period on endothelial progenitor cell ( EPC) count and inflammatory cytokine expression in the stable angina pectoris patients who had previously received long-term statin treatment.METHODS:The patients with stable angina pectoris that had received long-term statin therapy and planned to accept PCI were randomized into 3 groups:80 mg atorvastatin 12 h and 40 mg 2 h before coronary angioplasty (80 mg reloading), pre-operatively with 40 mg/d atorvastatin for 7 d (40 mg re-loading) , and without atorvastatin reloading ( no reloading ) .CD45 -/CD133+/CD34 +, CD45 -/CD34 +/KDR+ and CD45 -/CD144 +/KDR+EPCs in 100 μL peripheral blood were determined by flow cytometry 1 h prior to PCI and 1 h, 6 h and 24 h after PCI.The serum concentrations of soluble intercellular adhesion molecule 1 ( sICAM-1) , C-reactive protein ( CRP) and troponin I ( TnI) were analyzed immediately prior to and 24 h after PCI.RESULTS:(1) In 80 mg reloading group, the numbers of circulating CD45 -/CD133 +/CD34 +and CD45 -/CD34 +/KDR+early differentiation stage EPCs 1 h and 6 h after coronary angioplasty was significantly elevated compared with those before PCI (P<0.05).(2) In control group, the serum concentrations of sICAM-1 and CRP 24 h after PCI were significantly elevated ( P<0.05) compared with preoperative values.(3) The rise in serum TnI concentration from pre-to post-operation in 80 mg reloading group was lowerthan that in control group.CONCLUSION: The method of atorvastatin reload before PCI affects the number of EPCs inperi-operative period.High dose of atorvastatin application before PCI triggers early EPC circulation.The serum levels ofpost-operative inflammatory cytokine sICAM-1 as well as CRP are reduced by atorvastatin reloading before PCI.

China ; epidemiology ; Coronary Disease ; epidemiology ; Humans ; Hypertension ; epidemiology ; Risk Factors ; Stroke ; epidemiology

Objective:To explore the application effect of clinical nursing pathway based on enhanced recovery after surgery (ERAS) concept in perioperative nursing of gastric cancer in the elderly, so as to provide basis for the selection of clinical nursing plan.Methods:A total of 92 patients with gastric cancer who underwent surgical treatment in Hefei Second People′s Hospital from January 2018 to July 2020 were enrolled. They were divided into the observation group and the control group by random number table method, 46 cases in each group. The control group was given routine nursing intervention, while the observation group was given clinical nursing pathway based on ERAS concept for intervention. The postoperative recovery, improvement of nutritional indexes, postoperative complications were compared between the two groups.Results:The first bowel sound time, first exhaust time, first defecation time, leaving bed time, indwelling time of urinary catheter, and postoperative hospitalization time were (18.43 ± 1.80) h, (43.67 ± 8.79) h, (53.06 ± 5.18) h, (22.65 ± 4.95) h, (29.08 ± 2.69) h, (13.93 ± 2.19) d in the observation group, while (22.96 ± 2.24) h, (47.98 ± 8.46) h, (57.97 ± 5.65) h, (31.30 ± 5.73) h, (35.40 ± 3.66) h, (15.48 ± 2.40) d in the control group, there were significant differences between the two groups ( t values were 2.40-10.69, all P<0.05). There was no significant difference in the nutritional indexes before intervention between the two groups( P>0.05). After intervention, the levels of serum total protein, serum albumin and hemoglobin were (64.43 ± 6.22), (35.43 ± 3.07), (125.88 ± 4.75) g/L in the observation group, while (55.97 ± 5.25), (29.96 ± 2.64), (120.05 ± 5.07) g/L in the control group, there were significant differences between the two groups ( t=7.05, 9.16, 5.69, all P<0.05). The incidence of postoperative complications was 4.35%(2/46) in the observation group, 19.57%(9/46) in the control group, there was significant difference between the two groups ( χ2=5.06, P<0.05). Conclusions:The clinical nursing pathway based on ERAS concept can effectively ensure the nutrition needed by patients with gastric cancer during postoperative rehabilitation, accelerate rehabilitation process, and reduce the incidence of postoperative complications.

OBJECTIVE: To explore and analyze the clinical characteristics and treatment strategy of severe complications caused by esophageal foreign bodies. METHOD: A retrospective study was carried out on 49 cases with foreign bodies in esophagus through careful analysis of their clinical data to explore the associated problems with etiology and therapy. Among this complications, there were cases of 13 periesophageal abscess, 20 cases of abscess in the neck, 11 cases of mediastinal abscess, 3 tracheoesophageal fistula, 1 case of aorta injury and 1 septicemia. RESULT: Forty-eight (97.96%) of the patients recovered while one died. CONCLUSION Hard esophagoscopy under general anesthesia is the main therapeutic strategy to take out the esophageal foreign bodies. When it failed or severe complications such as perforation or others emerged, open surgery like lateral neck incision or thoracotomy supplemented with positive and timely supporting therapy are vital and essential.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Esophagus ; Female ; Foreign Bodies ; complications ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

OBJECTIVE:To provide reference for clinical rational drug use and the prevention and treatment of drug-resistance bacteria.METHODS:A total of 148 patients with oral infection after orthodontic treatment were selected from a hospital during Jul.2011-Jul.2016.The distribution of pathogenic bacteria and drug resistance were analyzed retrospectively.RESULTS:Among 148 patients with oral infection,275 clinical specimens were detected,including 209 positive specimens with positive rate of 76.00％.A total of 332 pathogenic bacteria were detected,including 85 Gram-positive bacteria (25.60％) and 247 Gram-negative bacteria (74.40％).Top 7 isolated bacteria in the list of quantity were Actinobacillus pleuropneumoniae (54 strains,16.27％),Porphyromonas gingivalis (41 strains,12.35 ％),Tannerella forsythia (37 strains,11.14 ％),Streptococcus oralis (33 strains,9.94％),Klebsiella pneumoniae (30 strains,9.04％),Staphylococcus aureus (26 strains,7.83％) and Pseudomonas aeruginosa (25 strains,7.53％).Resistance rates of S.aureus to penicillin G,gentamicin,ciprofloxacin,oxacillin and tetracycline were all in high level (resistance rate＞50％),but it was sensitive to vancomycin and teicoplanin (resistance rate of 0).Enterococcus faecalis showed high resistance to penicillin G,erythromycin and oxacillin (resistant rate＞50％),but was sensitive to vancomycin and rifampicin (resistant rate of 0).K.Pneumoniae showed high resistance to gentamicin,ciprofloxacin,levofloxacin and cefazolin (resistant rate＞ 50％),but was sensitive to imipenem,ceftazidime,cefepime,ampicillin sodium and sulbactarn sodium,amoxicillin and clavulanate potassium (resistant rate＜ 10 ％).Resistant rates of P aeruginosa to gentamicin and levofloxacin were ≥ 80 ％,but it was sensitive to aztreonam (resistant rate of 8.00 ％).Resistant rate of Escherichia coli to piperacillin was 84.21％,but it was sensitive to imipenem and ampicillin sodium and sulbactam sodium (resistance rate of 5.26％).CONCLUSIONS:After orthodontic treatment,the pathogens of oral infection are various,mainly Gram-negative bacteria,and their drug resistance is not optimistic.The drugs with high sensitivity to the main pathogens include vancomycin,imipenem and enzyme inhibitor complex preparations,etc.Clinical attention should be paid to the cultivation of pathogenic bacteria and drag sensitivity test;according to the results of drug sensitivity test,targeted antibiotics should be selected to improve the antibacterial effect and delay the emergence of drug-resistant bacteria.

OBJECTIVETo assess the value of G-banded karyotyping in combination with multiplex ligation-dependent probe amplification (MLPA) as a tool for the detection of chromosomal abnormalities in fetuses with congenital heart defects.

METHODSThe combined method was used to analyze 104 fetuses with heart malformations identified by ultrasonography. Abnormal findings were confirmed with chromosomal microarray analysis (CMA).

RESULTSNineteen (18%) fetuses were found to harbor chromosomal aberrations by G-banded karyotyping and MLPA. For 93 cases, CMA has detected abnormalities in 14 cases including 10 pathogenic copy number variations (CNVs) and 4 CNVs of uncertain significance (VOUS). MLPA was able to detect all of the pathogenic CNVs and 1 VOUS CNV.

CONCLUSIONCombined use of G-banded karyotyping and MLPA is a rapid, low-cost and effective method to detect chromosomal abnormalities in fetuses with various heart malformations.

Chromosome Aberrations ; Chromosome Banding ; Chromosome Disorders ; diagnosis ; genetics ; DNA Copy Number Variations ; Female ; Fetal Diseases ; diagnosis ; genetics ; Genetic Testing ; methods ; Heart Defects, Congenital ; diagnosis ; genetics ; Humans ; Karyotyping ; methods ; Multiplex Polymerase Chain Reaction ; methods ; Pregnancy ; Prenatal Diagnosis ; methods ; Reproducibility of Results ; Sensitivity and Specificity

OBJECTIVETo explore the molecular etiology of two pedigrees affected with type II Waardenburg syndrome (WS2) and to provide genetic diagnosis and counseling.

METHODSBlood samples were collected from the proband and his family members. Following extraction of genomic DNA, the coding sequences of PAX3, MITF, SOX10 and SNAI2 genes were amplified with PCR and subjected to DNA sequencing to detect potential mutations.

RESULTSA heterozygous deletional mutation c.649_651delAGA in exon 7 of the MITF gene has been identified in all patients from the first family, while no mutation was found in the other WS2 related genes including PAX3, MITF, SOX10 and SNAI2.

CONCLUSIONThe heterozygous deletion mutation c.649_651delAGA in exon 7 of the MITF gene probably underlies the disease in the first family. It is expected that other genes may also underlie WS2.

Base Sequence ; DNA Mutational Analysis ; Exons ; genetics ; Family Health ; Female ; Genetic Predisposition to Disease ; genetics ; Heterozygote ; Humans ; Male ; Microphthalmia-Associated Transcription Factor ; genetics ; Molecular Sequence Data ; Mutation ; PAX3 Transcription Factor ; Paired Box Transcription Factors ; genetics ; Pedigree ; Polymerase Chain Reaction ; SOXE Transcription Factors ; genetics ; Sequence Deletion ; Snail Family Transcription Factors ; Transcription Factors ; genetics ; Waardenburg Syndrome ; classification ; diagnosis ; genetics

OBJECTIVETo identify potential mutation of SLC22A5 gene in a 5-month-old boy affected with primary carnitine deficiency and provide genetic counseling and prenatal diagnosis for the members of his family.

METHODSDNA was extracted from peripheral blood samples derived from the proband, his parents and elder sister, as well as amniotic fluid from his pregnant mother. All of the 10 exons of the SLC22A5 gene were amplified by PCR and subjected to Sanger sequencing. The amniotic fluid sample was also subjected to G-banded karyotyping and multiplex ligation-dependent probe amplification (MLPA).

RESULTSA homozygous mutation c.760C>T (p.R254X) of the SLC22A5 gene was detected in the proband. Heterozygous mutation c.760C>T (p.R254X) was also found in other family members including the fetus. The karyotyping and chromosomal microdeletion testing for the amniotic fluid sample were both normal.

CONCLUSIONThe newly identified homozygous nonsense c.760C>T (p.R254X) mutation of the SLC22A5 gene probably underlies the primary carnitine deficiency of the proband. Genetic counseling and prenatal diagnosis have been provided for this family.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Cardiomyopathies ; embryology ; genetics ; Carnitine ; deficiency ; genetics ; China ; Exons ; Female ; Genotype ; Humans ; Hyperammonemia ; embryology ; genetics ; Infant ; Male ; Molecular Sequence Data ; Muscular Diseases ; embryology ; genetics ; Organic Cation Transport Proteins ; genetics ; Pedigree ; Pregnancy ; Prenatal Diagnosis ; Solute Carrier Family 22 Member 5

OBJECTIVE: To evaluate the safety and efficacy of reverse partial lung resection for treatment of pediatric pulmonary cysts combined with lung abscesses or thoracic abscess. METHODS: We retrospectively analyzed the clinical data of children undergoing reverse partial lung resection for complex pulmonary cysts in our hospital between June, 2020 and June, 2021.During the surgery, the patients lay in a lateral position, and a 3-5 cm intercostal incision was made at the center of the lesion, through which the pleura was incised and the fluid or necrotic tissues were removed.The anesthesiologist was instructed to aspirate the sputum in the trachea to prevent entry of the necrotic tissues in the trachea.The cystic lung tissue was separated till reaching normal lung tissue on the hilar side.The proximal end of the striated tissue in the lesion was first double ligated with No.4 silk thread, the distal end was disconnected, and the proximal end was reinforced with continuous sutures with 4-0 Prolene thread.The compromised lung tissues were separated, and the thoracic cavity was thoroughly flushed followed by pulmonary inflation, air leakage management and incision suture. RESULTS: Sixteen children aged from 3 day to 2 years underwent the surgery, including 3 with simple pulmonary cysts, 11 with pulmonary cysts combined with pulmonary or thoracic abscess, 1 with pulmonary cysts combined with tension pneumothorax and left upper lung bronchial defect, and 1 with pulmonary herpes combined with brain tissue heterotaxy.All the operations were completed smoothly, with a mean operation time of 129 min, an mean hospital stay of 11 days, and a mean drainage removal time of 7 days.All the children recovered well after the operation, and 11 of them had mild air leakage.None of the children had serious complications or residual lesions or experienced recurrence of infection after the operation. CONCLUSION Reverse partial lung resection is safe and less invasive for treatment of complex pediatric pulmonary cysts complicated by infections.
Humans ; Child ; Abscess ; Retrospective Studies ; Lung/surgery* ; Cysts/surgery* ; Bronchi