Objective To investigate the efficacy and safety of a schedule of 2 cycles' high-dose dexamethasone (HD-DXM) as an initial therapy in adults immune thrombocytopenia (ITP), and compare with conventional dose prednisone therapy. Method A total of 59 newly diagnosed ITP patients were divided into 2 groups randomly. In 30 patients ( Dexamethasone group), oral HD-DXM was administered at 40 mg/d for 4 consecutive days, repeated one week later, and then failed to maintain. In the remaining 29and then gradually tapered. Results For short-term efficacy, after 1 and 2 weeks of treatment, the response rate in Dexamethasone group was significantly higher than that in Prednisone group (50. 0% vs 24. 1%, P ＜0. 01; 73.3% vs 55.2%, P ＜0. 05 ), while 3 weeks later, there was no remarkable difference between the two groups(83.3% vs 68.9%, P ＞ 0. 05 ), though the response rate in Dexamethasone group remained higher. For long-term effect, at the end of the 2nd and 3rd months of follow-up, the relapse rate in Dexamethasone group was significantly lower than that in Prednisone group(24. 0% vs 40. 0%, P ＜ 0. 05;32.0% vs 65. 0%, P ＜ 0. 01 ), while at the end of the 1st month of follow-up, there was no significant difference( 16. 0% vs 20. 0%, P ＞0.05 ). In addition, it's well tolerated and no complications such as severe infection or Cushing syndrome were complained in Dexamethasone group. Conclusion HD-DXM possesses an advantage over conventional dose prednisone therapy in efficacy and safety.

Objective To investigate the difference of vacuum sealing drainage (VSD) on the effect of one-stage skin graft and second-stage sugery after scar release.Methods A total of 42 patients who wanted to undergo scar release and skin graft was randomly divided to control group (n =21) and VSD treatment group (n =21).The control group implemented skin graft immdiately after scar release while VSD treatment group were treated with VSD for 3 days after scar release and then implemented skin graft.The rate of subcutaneous blood stasis and the survival rate of skin graft were observed at 7 days after skin graft.The condition of grafted skin contracture and hyperplasia after half a year was also observed.Results The incidcnce of subcutaneous blood stasis was significantly lower in the VSD group than that in the control group (P ＜ 0.05).The survival rate of skin grafts was significantly higher in the VSD group than that of the control group (P ＜ 0.05).The score of Vancouver scar was significantly lower in the VSD group than that in the control group (P ＜ 0.05).Conclusions VSD treatment of second-stage sugery after scar release can reduce the occurrence of subcutaneous blood stasis,promotc skin graft survival,reduce postoperative skin graft contracture and improve the prognosis of patients compared to one-stage skin graft.

OBJECTIVE To analyze trimethylation of genome-wide histone H3 lysine 4(H3K4met3) induced by silicon dioxide(SiO2)through chromatin immunoprecipitation linked to microarrays(ChIP-chip)in lung fibroblast(LF)of rats. METHODS A primary co-culture model of rat alveolar macrophages (AM)and LF in vitro. AM were exposed to 100 mg · L-1 free SiO2 for 24 h,before LF were collected and the phenotype of LF was determined after transdifferentiation by immunohistochemistry. ChIP-chip was used to profile the variations of trimethylation in H3K4 of lung fibroblasts in CpG island regions. ChIP-qPCR was used to validate the microarray results. The mRNA expression of nfib and kpna3 was analyzed by qRT-PCR. RESULTS Totally 1815 (518 increased and 1297 decreased) genes of H3K4met3 displayed significant differences in SiO2 100 mg·L-1 group compared with control group(Cy3/Cy5 value>2.0 or <0.5,NimbleScan V2.5 software). The results of ChIP-qPCR were quite consistent with those of microarray. CONCLUSION There are significant differences in methylation of genome-wide H3K4 between SiO2 100 mg·L-1 group and control group. These novel candidate genes may become potential biomarkers or new interfered targets.

Alzheimer''s disease (AD) has brought to us huge medical and economic burdens, and so discovery of its therapeutic drugs is of great significance.In this paper, we utilized knowledge graph embedding (KGE) models to explore drug repurposing for AD on the publicly available drug repurposing knowledge graph (DRKG).Specifically, we applied four KGE models, namely TransE, DistMult, ComplEx, and RotatE, to learn the embedding vectors of entities and relations on DRKG.By using three classical knowledge graph evaluation metrics, we then evaluated and compared the performance of these models as well as the quality of the learned embedded vectors.Based on our results, we selected the RotatE model for link prediction and identified 16 drugs that might be repurposed for the treatment of AD.Previous studies have confirmed the potential therapeutic effects of 12 drugs against AD, i.e., glutathione, haloperidol, capsaicin, quercetin, estradiol, glucose, disulfire, adenosine, paroxetine, paclitaxel, glybride and amitriptyline.Our study demonstrates that drug repurposing based on KGE may provide new ideas and methods for AD drug discovery.Moreover, the RotatE model effectively integrates multi-source information of DRKG, enabling promising AD drug repurposing.The source code of this paper is available at https://github.com/LuYF-Lemon-love/AD-KGE.

OBJECTIVE: To compare the outcome of mini-tract vs standard-tract percutaneous nephrolithotomy (PCNL) in staghorn calculi. METHODS: Between May 2009 and May 2011, 122 patients with renal staghorn calculi were treated by PCNL. Fifty-six patients underwent mini-PCNL and the others underwent standard-PCNL. The therapeutic effect and complication of the 2 groups were compared. RESULTS: The two groups had comparable demographic conditions. Although the operation time was significantly longer in mini-PCNL group [(126±24.5) min vs (98±18.9) min], there was no striking difference in hospital stay [(5.7±1.3) d vs (5.3±1.1) d], hemoglobin drop [(9.5±3.2) g/L vs (10.5±3.3) g/L], stone-free state before charge (91.1% vs 89.4%) and complications. CONCLUSION The efficacy and safety of mini-PCNL and standard-PCNL are not significantly different.
Adult ; Humans ; Kidney Calculi ; surgery ; Male ; Middle Aged ; Miniaturization ; Nephrostomy, Percutaneous ; methods ; Postoperative Complications ; etiology ; Retrospective Studies

OBJECTIVE: To study the effect and outcome of Boari bladder flap plasty surgery for the treatment of kidney-sparing strategy for patients with middle and lower ureteral carcinoma. METHODS: Database at the department of urology in the Second Xiangya Hospital from 2002-2007 was screened and all cases of primary solitary lower ureteral carcinoma treated with Boari bladder flap plasty surgery or radical nephroureterectomy were collected. We performed a retrospective review of the clinical data including sex, age, smoking history, tumor site, size, stage, grade, bladder recurrence, renal function et al and evaluated survival rate. The Cox proportional hazards regression model was build to analyze the correlation between each variable and survival time. RESULTS: Thirty nine patients in total were enrolled, including 16 cases underwent Boari bladder flap plasty surgery and 23 cases underwent radical nephroureterectomy. The median follow-up time was 53 months (range 10-84 months). During the follow-up time, 18 patients died, including 6 patients treated with Boari bladder flap plasty surgery and 12 patients treated with radical nephroureterectomy. The estimated bladder recurrence-free survival rate and cancer-specific survival rate at 5 years were 63% vs 59% and 73.8% vs 73.5%, respectively (P>0.05). The survival rate at 5 years and the overall survival rate were 61% vs 57 % and 64.8% vs 58.1% respectively in the 2 groups (P>0.05). There was no significant difference in renal function before surgery between the two groups [creatinine clearance 57 (32-104 ) mL/ min vs 55 (30-102) mL/ min, P>0.05]. Patients underwent Boari bladder flap plasty showed better renal function than patients underwent radical nephroureterectomy [creatinine clearance 55 (35-102) mL/ min vs 43 (30-89) mL/min, P<0.05]. In multivariate Cox regression analysis, the tumor size, pT stage, tumor cell grade and the estimated glomerular filtration rate level were independent factors that affected the overall survival rate of the patients (P<0.05). The tumor size, pT stage and tumor cell grade were positively correlated to the survival time, and the estimated glomerular filtration rate was negatively correlated to the survival time. CONCLUSION Boari bladder flap plasty surgery could be used to treat lower ureteral carcinoma. Compared with radical nephroureterectomy, Boari bladder flap plasty surgery has equal survival rate and shows superior postoperative renal function.
Carcinoma ; surgery ; Humans ; Kidney ; Neoplasm Recurrence, Local ; Nephrectomy ; Postoperative Period ; Proportional Hazards Models ; Retrospective Studies ; Surgical Flaps ; Survival Rate ; Ureter ; pathology ; Ureteral Neoplasms ; surgery ; Urinary Bladder ; surgery ; Urologic Surgical Procedures ; methods

Objective: This study aims to analyze factors associated with lymphovascular space invasion (LVSI) and evaluate the prognostic significance of LVSI in Chinese endometrioid endometrial cancer (EEC) patients. Methods: Five-hundred eighty-four EEC patients undergoing surgery in our center from 2006 to 2016 were selected for analysis. Univariate analysis and multivariate logistic regression were used to examine relevant factors of LVSI. To evaluate the prognostic role of LVSI, survival analyses were conducted. In survival analyses, both multivariate Cox regression and propensity score matching were used to control the confounders. Results: The incidence of LVSI was 12.16% (71/584). Diabetes history (p=0.021), lymph node metastasis (p=0.005), deep myometrial invasion (p<0.001) and negative PR expression (p=0.007) were independently associated with LVSI. Both Kaplan-Meier method and univariate Cox regressions showed LVSI negative and positive cases had similar tumor-specific survival (TSS) and disease-free survival (DFS). After adjusting for the influence of adjuvant therapy and other clinicopathological factors with multivariate Cox regressions, LVSI still could not bring additional survival risk to the patients (p=0.280 and p=0.650 for TSS and DFS, respectively). This result was verified by Kaplan-Meier survival analyses after propensity score matching (p=0.234 and p=0.765 for TSS and DFS, respectively). Conclusion LVSI does not significantly compromise the survival outcome of Chinese EEC patients.

OBJECTIVETo evaluate the clinical results of tube gastrostomy in radical cystectomy and ileal conduit.

METHODSWe retrospectively analyzed the data of 98 patients undergoing radical cystectomy and ileal conduit between March 2007 and February 2010. According to postoperative gastrointestinal decompression methods, the patients were divided into nasogastric decompression group (n=50) and tube gastrostomy group (n=48), and the gastrointestinal recovery time, surgical complications and hospital stay were compared between them.

RESULTSNo statistical difference was found in gastrointestinal recovery time, hospital stay, or surgical complications between the two groups, but the incidence of pulmonary infection was significantly lower in tube gastrostomy group than in nasogastric decompression group (P<0.05).

CONCLUSIONTube gastrostomy is an easy, safe and effective means for gastric decompression after radical cystectomy with ileal conduit, especially suitable for elderly patients and those with potential pulmonary disorder.

Aged ; Aged, 80 and over ; Cystectomy ; Decompression, Surgical ; methods ; Female ; Gastrostomy ; Humans ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Urinary Diversion

Objective To study the surgery effect on early application of toe flap to repair thumb severe electric bum.Methods From July 2007 to October 2017,a total of 25 cases of thumb severe electric burn were repaired by thumb toe flap grafting.The function of the finger after operation was evaluated comprehensively,and the effect of 72 hours before and after the injury was compared.Results All the flaps survived and the finger function was excellent.The excellent and good rate of 25 cases was 72％.The excellent and good rate of 72 hours before and after injury were 85.7％ and 54.5％ respectively.5 cases had bad wound complications after operation.1 cases were operated within 72 hours after injury,and 4 cases were operated after 72 hours.Conclusions The early application of toe flap to repair severe electric bum thumb can maximize the recovery of function of the thumb.The earlier the operation,the fewer complications,the better the repair effect.

Objective:To analyze the clinical characteristics of patients with acute glyphosate herbicide poisoning and the differences in the severity of poisoning.Methods:A retrospective analysis was performed on patients with acute glyphosate herbicide poisoning admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to December 2020. The general information, exposure time, poisoning dose, poisoning cause, poisoning route, clinical manifestations, laboratory examination results during hospitalization, treatment measures, hospital stays and prognosis of the patients were collected. The patients were graded according to the poisoning severity scoring standard of Chinese Expert Consensus on Diagnosis and Treatment of Acute Poisoning in 2016. The highest severity score during hospitalization was used as the final grade. According to the final grade, asymptomatic and mild patients were included in the mild group, and moderate, severe and death patients were included in the severe group. The independent sample T test or Mann-Whitney U test was used for measurement data, and χ2 test or Fisher's exact test was used for counting data. The differences of general data and clinical data between the two groups were compared. Results:According to the inclusion and exclusion criteria, 83 patients with acute glyphosate herbicide poisoning were selected as the study subjects. All patients survived, mainly mild poisoning (56.6%), with a male to female ratio of 33∶50, and an average age of 39 years. The number of poisoning cases increased yearly (the highest in 2019), and most cases occurred in spring and summer. The main cause of poisoning was suicide (71.1%), direct oral administration (83.1%) was the primary route of poisoning, and the dominating clinical manifestations were digestive symptoms (71.1%). Laboratory tests showed increased white blood cell count (WBC), neutrophil percentage (NEUT %) and D-dimer, and decreased hemoglobin and potassium. Compared with the mild group, patients in the severe group were older [(51±17) years vs. (35±19) years], had a higher proportion of suicide and direct oral administration, a longer hospital stay [8.0 (4.8, 12.0) d vs. 3.0 (2.0, 5.5) d], a higher dose of poisoning [200.0 (50.0, 200.0) mL vs. 30.0 (11.3, 57.5) mL], and higher NEUT % within 24 h of admission [(83.4±10.4) vs. (73.2±12.8)]. The increase of WBC, NEUT %, aspartate aminotransferase, prothrombin time, D-dimer and the decrease of serum potassium were more common in the severe group than the mild group, with statistical significance (all P<0.05). Conclusions:The number of patients with acute glyphosate herbicide poisoning is increasing yearly. Generally, the condition is mild and the prognosis is satisfying. The severity is more serious in the middle-aged and elderly patients andthose with direct oral administration, high toxic dose, and high NEUT % within 24 h of admission. Severe poisoning is more likely to cause changes in laboratory indicators.