1.The diagnosis and treatment strategy of thymomas associated with myasthenia gravis
Journal of International Oncology 2010;37(6):448-451
The mechanism of development of thymomas associated with myasthenia gravis(MG) is not completely clear. It is not hard to make diagnosis of thymomas associated with MG via clinical manifestation,radiological investigation and laboratory examination, however, the treatment of thymomas associated with MG remains controversial and there is no straightforward guidelines in the literatures. Most scholars think surgery is the first choice to treat thymomas associated with MG, but for those who are not suitable for surgery, radiotherapy and chemotherapy would be considered to be their choice combined with anti-cholinesterase and steroidsdrugs therapy.
2.Application of flexible laryngeal mask airway in oral & maxillofacial day surgery
Na GE ; Ming GUAN ; Xi LI ; Shuai LI ; Enbo WANG
Journal of Peking University(Health Sciences) 2015;47(6):1010-1014
Objective:To access the feasibility and safety of application of flexible laryngeal mask air-way ( FLMA) in oral&maxillofacial day surgery. Methods:Retrospective study was conducted of 40 oral& maxillofacial day surgery patients (3 to 61 years of age) using FLMA under general anaesthesia in De-partment of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology. All the patients were with American Society of Anesthesiologists ( ASA ) physical status Ⅰ -Ⅱ, including 19 males and 21 females. The patients' vital signs were recorded at five different time points:baseline before anesthesia ( T0 ) , time right after the FLMA insertion ( T1 ) , time at incision ( T2 ) , 15 min after incision ( T3 ) and time at the end of the operation ( T4 ) . The first attempted FLMA insertion successful rate and the number of timed of changing to endotracheal intubation were recorded. During operation, frequencies of movement, hypoxia and obstruction of airway were noted and the operation time, anesthesia time, time from the end of the operation to extubation, movement and coughing following extubation and sore throat within 24 h were taken down. Operation-related complications of bleeding, hematoma and injury of local nerves were recorded within 24 h as well. Results:The operations of all the 40 patients were successfully done under general anaesthesia. The 36 ( 90%, 36/40 ) patients using FLMA successfully were under steady process, including 16 males and 20 females. The first attempted successful rate of FLMA insertion was 80% (32/40), and the second 50% (4/8). Three out of the 4 failed FLMA patients were changed to endotracheal intubation after the second attempt failed. The other patient was changed to endotracheal intubation before operation because of leak. The average operation time was (46. 58 ± 22. 57) min, the anesthesia time was ( 77 . 97 ± 26 . 82 ) min and the time from the end of operation to extubation was (8. 31 ± 3. 33) min. All the patients were recorded without obvious body movement during the operation procedure. There were 4 patients (11. 11%, 4/36) with slight body movement during extubation. The incidence of sore throat was 13. 89% (5/36) within 24 h postoperatively. There were no complications of bleeding, hematoma and injury of local nerves. The vital signs of baseline T0 were significantly different from those at other time points T1, T2, T3, and T4 (P<0. 01). As to the hearts rate after anesthesia, the values at T1, T2, T3 and T4 for two-two comparison, there was no statistical difference (P>0. 05). As to the values of systolic blood pressure and diastolic blood pressure after anesthesia at T1 and T4 , T2 and T3, for two-two comparison, there was no statistical difference (P>0. 05). As to the respiratory rate from the start of the surgery, the values at T2, T3 and T4 showed no statistical difference (P>0. 05). Conclusion:Flexible laryngeal mask airway is a supraglottic airway management method. It is suitable and safe for securing the airway in oral & maxillofacial day surgery. The advantages of fewer haemody-namic changes and postoperative complications are confirmed.
3.Review on primary intraventricular hemorrhage
Xiuying GUAN ; Sunquan HONG ; Shuai ZHOU ; Xiangyang KONG ; Jianhua ZHAO
International Journal of Biomedical Engineering 2015;38(5):314-318
Primary intraventricular hemorrhage is a rare type of non-traumatic cerebral hemorrhage neurological disorder.Not only has it higher mortality and morbidity,but also complicated etiologies.However,there is still lack of standard diagnostic techniques and treatment methods for decreasing mortality rate and improving prognosis of primary,intraventricular hemorrhage.Rational use of ultra-early hemostatic therapy and acute surgery therapy are considered as clinical treatment strategies to increase survival rate and improve the quality of life for primary intraventricular hemorrhage patients.This paper aims to give review on some etiology,diagnosis and therapy methods of primary intraventricular hemorrhage,and to provide new ideas for the treatment.
4.Imaging diagnosis of ameloblastomas of the jaw
Shuai GUAN ; Dapeng HAO ; Jihua LIU ; Weihua FENG ; Wenjian XU
Journal of Practical Radiology 2014;(5):747-750
Objective The purpose of the study was to characterize the X-ray and CT findings of ameloblastomas of the jaw.Meth-ods X-ray (n=9)and CT (n=20)findings of 20 patients with pathologically proven ameloblastomas of the jaw were obtained.Image features included location,size,shape,density of the lesion,and changes of adjacent bone were assessed.Results 1 9 cases were located in the mandible,including 10 cases in the molar-ramus region,four cases in the whole half of the mandible body,two cases in the whole half of the mandible body and the opposide mantum,one case in the whole mandible body,two cases in the anterior teeth region and mantum.One case was located in the molar region of the maxilla.Three cases were uniocular and 17 cases were multiocular in shape.All lesions caused expansile changes in the adjacent bone,including expanding towards the lip and bucca(n=15),the lingua(n=3),and expanding uniformly(n=2).The interruptions of the surrounding bone cortex were demonstrated in 1 9 cases.Conclusion There are some characteristic imaging find-ings for ameloblastomas of the jaw.Correct preoperation dignosis can be made on the basis of imaging findings.
5.Amplification,cloning,expression and protein analysis of enterovirus 71 VP1 gene
Yunfeng LIU ; Zhenwen ZHOU ; Ruili GUAN ; Qihong GUAN ; Mingyong LUO ; Shuai ZHOU
International Journal of Laboratory Medicine 2014;(16):2126-2128,2131
Objective To conduct the amplification,cloning,bioinformatics analysis,prokaryotic expression and purification of enterovirus 71 VP1 gene segment and to initially confirm the biological activity of the recombinant expression product.Methods A pair of specific primers was designed according to GenBank EV71 sequence,viral RNA as a template was extracted from the throat swab specimens in the EV71 patients.EV71 VP1 gene was amplified by RT-PCR.After enzyme digestion,the expression vector pET28a was inserted.The prokaryotic expression vector of pET28a-EV71 VP1 was constructed.Then the E.coli DH5a transforma-tion was performed.IPTG was adopted for induction expression.The expression results were analyzed by using SDS-PAGE and Western blot.The bioinformatics analysis of the sequenced results was performed by the software.Expressed protein was purified and the plates were coated,ELISA was used to test the VP1 specific IgG antibody in serum samples of EV71 positive and COX A16-positive patients.Results The BLAST alignment showed that the homology of the objective gene EV71 VP1 was 99% com-pared with other strains(JQ766207.1)in GenBank.EV71 VP1 protein was about 32×103 ,which mainly existed in the form of in-clusion body.The bioinformatics analysis showed that EV71 VP1 protein was a hydrophilic protein,without transmembrane region and N-terminal signal peptide sequence,the tertiary structure existed.The ELISA results showed that the specific IgG OD value in EV71-positive patients was(2.425±0.521),OD value in COX A16 positive patients was(1.205 ±0.314),the normal control OD value was(0.353±0.128).The sensitivity and specificity of EV71 VP1 protein detection were 84% and 88% respectively.Conclu-sion The pET28a-EV71 VP1 expression vector is successfully constructed;the preliminary analysis on the serum of the infected patients by ELISA shows that the obtained objective protein has higher sensitivity and specificity,which is initially confirmed to have biological activity and can be further used for the related study on EV71 diagnosis and vaccine.
6.Comparative analysis of trace elements in five marine-derived shell TCM using multivariate statistical analysis.
Shuai ZHANG ; Zhen CHEN ; Yu-qiang FU ; Hui-li GONG ; Hua-shi GUAN ; Hong-bing LIU
China Journal of Chinese Materia Medica 2015;40(21):4223-4228
A comparable study were carried out by determination of trace elements on five marine-derived shell traditional Chinese medicine (TCM) (Ostreae Concha, Haliotidis Concha, Margaritifera Concha, Meretricis Concha, and Arcae Concha), which were recorded in the Chinese Pharmacopoeia (2010 version). Seven trace elements in 51 batches of this type of shell TCM were analyzed by Inductively Coupled Plasma Mass Spectrometry (ICP-MS), combined with principal component analysis (PCA) methods. The content of element Se, which exhibited significant differences among different drugs, could be used as a key element to distinguish this type of drugs. Meanwhile, the contents of elements Co, Cu, Mo, and Ba in Haliotidis Concha, Co and As in Margaritifera Concha, Mo and As in Meretricis Concha, Mo, As, and Ba in Arcae Concha, and Zn in Meretricis Concha were relatively stable. In the PCA plot, Arcae Concha and Meretricis Concha could be efficiently distinguished from Ostreae Concha together with Haliotidis Concha, and Margaritifera Concha. The results also showed a correlation with their medicinal function. In conclusion, trace elements in marine-derived shell TCM could not be neglected for their quality control.
Animal Shells
;
chemistry
;
Animals
;
Aquatic Organisms
;
chemistry
;
Bivalvia
;
chemistry
;
Mass Spectrometry
;
Medicine, Chinese Traditional
;
Trace Elements
;
analysis
7.Bladder anatomical changes and dose variation during the course of intensity-modulated radiation therapy of cervical cancer
Haowen PANG ; Jie QIU ; Hong QUAN ; Shuai SUN ; Bo YANG ; Qiu GUAN ; Fuquan ZHANG
Chinese Journal of Radiation Oncology 2011;20(3):218-221
Objective To investigate bladder anatomical changes and dose variation in patients with cervical cancer.Methods We analyzed 20 patients,undergoing external beam radiotherapy scanning cone beam CT(CBCT)before each fraction.Bladder was contoured on each CBCT,was projected onto the planning CT and assesses anatomical changes and dose variation.Results A total 451 CBCT images,for 20 patients were collected for analysis,show more change in bladder volume and position.In 15 cases bladder volume and V45 had no significant correlation(r=0.225 -0.473,all P>0.05),4 cases shows negative correlation(r=-0.564,P<0.05;r=-0.597,P<0.01;r=-0.942,P<0.01;r=-0.816,P<0.01),1 case shows positive correlation(r=0.662,P<0.01).Have more than the criteria(V45≤50%)number is 64/451(14.2%)in whole treatment.Conclusions For most patients by filling adequacy bladder,bladder dose variation is acceptable:CTV lager for individual patients should be closely observed its regression,implementation of the offline or online calibration.
8.Changes of rectal volume and location and their influence on rectal dose during the course of intensity-modulated radiotherapy of cervical cancer
Haowen PANG ; Jie QIU ; Shuai SUN ; Bo YANG ; Qiu GUAN ; Fuquan ZHANG
Chinese Journal of Radiation Oncology 2012;21(3):258-261
ObjectiveTo investigate the anatomical changes and dose variation of rectum during radiotherapy in patients with cervical cancer.Methods Ten patients with cervical cancer underwent intensity-modulated radiotherapy using online cone beam computed tomography (CBCT) before each fraction.Rectum was contoured on each CBCT and projected onto the planning CT to analyze the changes of the rectal volume and position.The rectal volume receiving ≥ 45 Gy ( V45 ) was evaluated accordingly.Results227 CBCT images in 10 patients were collected.The rectal volume changed from ( 35.0 ± 7.3)cm3 to (97.7±14.7) cm3.The shift of rectal center was (0.14 ±0.06) cm in left and right direction,(0.24±0.10) cm in anterior and posterior direction,and (0.55±0.28) cm in superior and inferior direction.The V45 of rectum varied from (9.19±2.46)% to (60.54 ±11.67)%.In7 of the 10 patients,rectal volume and V45 of the rectum had significant positive correlation (r =0.582 - 0.743,all P < 0.01 ).Among the 227 images,the V45 of rectum was ≤50% in 68 images (30.0% ).ConclusionsSignificant changes in rectal volume and position occurred during fractionated radiotherapy in patients with cervical cancer,which resuhs in variations in the dose rectum received.For most patients,rectal volume and the V45of rectum had significant positive correlation.
9.Analysis of Myocilin gene regulatory network using a genetic genomics approach
Hong, LU ; Lu, LU ; Huai-jin, GUAN ; Hui, CHEN ; Jun-fang, ZHANG ; Nan, HU ; Jie, SHUAI
Chinese Journal of Experimental Ophthalmology 2013;31(9):851-854
Background The pathogenesis of primary open angle glaucoma(POAG) and high myopia are very complex.To construct the regulatory network of virulence genes and relevant genes that involved in pathogenicity are helpful for reveal of the pathogenesis.Objective The aim of this study was to investigate myocilin(Myoc),a gene that contributes to POAG and high myopia in eyes of BXD Recombinant Inbred(BXD RI)mice and construct the regulatory network of Myoc.Methods The affymetrix microarray system was used to detect the differential expression of Myoc in the eyes of C57BL/6J(B6),DBA/2J(D2) and BXD RI mice.Expression quantitative trait loci (eQTL) mapping was performed to construct the regulatory network of Myoc gene.Results The average expression level of the Myoc gene in the BXD strains was 10.83,and the gene exhibited expression levels ranging from 8.39 in BXD55 mice tol 1.43 in B6 mice.The eQTL mapping for the Myoc gene showed a significant likelihood ratio statistic (LRS) of 21.78.The QTL was mapped in chromosome 2,and Myoc was located on chromosome 1,indicating that the Myoc gene was a trans-acting QTL.Olfml2a was identified to be a candidate upstream gene of Myoc by analysis of bioinformatics.Genetic regulatory network analysis demonstrated that a series of genes associated with Myoc probably played roles in the pathogenesis and development of POAG and high myopia.Conclusions The genetical genomics approach provides a powerful tool for constructing pathways that contribute to complex traits,such as POAG and high myopia.
10.A study of the efficacy of L-3,5-diiodotyrosine and inorganic iodine in iodine-deficiency Wistar rats
Fengfeng ZHANG ; Qingzhen JIA ; Qiuling PEI ; Xiaotian CHENG ; Hongyun CHEN ; Shuai GUAN ; Yahui ZHANG
Chinese Journal of Endemiology 2016;35(3):170-173
Objective To study the efficacy of L-3,5-diiodotyrosine (DIT) and inorganic iodine (KIO3) in iodine-deficiency Wistar rats.Methods Sixty Wistar rats,weighting about 160-180 g,were divided into two groups according to body weight by the random number table method:iodine-deficiency model (40 rats) was fed with low-iodine food (the iodine content was 35.9 μg/kg);optimal-iodine model (20 rats) was fed with low-iodine food and given with KIO3 water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day.Model was established for 3 months.Iodine-deficiency model was subdivided into low iodine (LI) group,KIO3 group and DIT group,eight,nine,ten rats in each group;from optimal-iodine model,nine rats were randomly selected as optimal iodine (NI) group.LI group was fed with low-iodine food;KIO3 group was fed with low-iodine food and given with KIO3 water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day;DIT group was fed with low-iodine food and given with DIT water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day;NI group was fed with low-iodine food and given with KIO3 water (the iodine content was 18 mg/L) 0.5 ml by intragastric once a day.After 3 months,24-hour urine of the rats was collected.According to the method for determination of iodine in urine by As3 +-Ce4+ catalytic spectrophotometry (WS/T 107-2006),iodine content in urine was detected.Rats were anesthetized intraperitoneally with 25% urethane,blood from abdominal aortic was collected to determinate the serum thyroid hormone [total triiodothyronine (TT3),total thyroxine (TT4),free triiodothyronine (FT3),free thyroxine (FT4)] level in rats by automatic electrochemical luminescence immunoassay.All the rats were sacrificed to analyze the thyroid weight.Results ① The urine iodine showed significant differences in the four groups (x2 =25.24,P < 0.05).The median of urine iodine concentration in the LI,NI,KIO3 and DIT groups were 3.00,286.14,223.37,214.33 μg/L,respectively.The urine iodine concentration in LI group was significantly lower than those of other three groups (all P < 0.05).② The serum TT3,TT4,FT3,FT4 levels showed significant differences in the four groups (F =63.48,140.73,130.20,365.27,all P < 0.05).And the hormone levels in KIO3 group were lower than those of the DIT group [TT3:(1.57 ± 0.20) vs.(1.97 ± 0.18) mmol/L,TT4:(51.23 ± 4.90) vs.(71.94 ± 5.27) mmol/L,FT3:(5.34 ± 0.45) vs.(6.98 ± 0.33) pmol/L,FT4:(26.18 ± 2.30) vs.(35.47 ± 2.28) pmol/L,all P < 0.05].③The color of thyroid in KIO3 and DIT groups became pale pink.The absolute and relative thyroid weight showed significant differences in the four groups (F =225.05,345.40,all P < 0.05).The absolute thyroid weight [(31.76 ± 1.75) mg] and relative thyroid weight [(11.69 ± 3.47) mg/100 g] in DIT group was lower than that of the KIO3 group [(36.31 ± 5.23) mg,(12.83 ± 4.38) mg/100 g,all P < 0.05].Conclusion Animal experimental results show that DIT has a better iodine-supplementing efficacy than that of KIO3.