Objective To explore the effect of tumor necrosis factor-α antagonist (Remicade) on the patients with active moderate to severe ulcerative colitis (UC) who failed to response to mesalazine or sulfasalazine Sah'cyloyl treatment for six months period.Methods The patients were collected in our hospital,who diagnosed by colonoscopy as moderate to severe ulcerative colitis and failed to response to mesalazine or sulfasalazine Salicyloyl treatment for six months period;These patients were randomly divided into control group(22 cases) and treatment group(28 cases) ;glucocorticoid was used alone in control group while it was combined with Remicade in treatment group.After treatment for six months,they were suffered from colonoscopy and clinical evaluation.Results There were significant differences between control and treatment group of the recover rate concerning the clinic symptoms such as abdominal pain,diarrhea,and mucous bloody stool.There were 7 cases complete remission,13 cases effective outcome and 9 cases ineffective,with complete remission rate of 31.67% .efficiency rate 59.09% in control group.There are 17 cases complete remission,25 cases effective outcome and 3 cases ineffective,with complete remission rate of 60.71% ,efficiency rate 89.28% in treatment group.There was significant difference (P<0.05) between two groups of complete remission rate and efficiency rate.There were 3 cases recurring in control group,with the recurrence rate of 13.67% ,while there were 2 cases recurring in treatment group with the recurrence rate of 7.14%.There was significant dif-ferene( P<0.05) between two groups with regards to recurrence rate;Besides,there were no significant adverse effect.Conclusion The combination with Remicade and glucocorticoids in the treatment of refractory severe ulcerative colitis was more effective and can also reduce the relapse rate.

ObjectiveTo observe the efficacy of simethicone, mosapride combined with flupentixol-meiltracen in the treatment for functional dyspepsia(FD). MethodsThe diagnosis of functional dyspepsia patients treated according to Zung Self-rating Anxiety Scale (SAS) ＞ 40, Hamilton Depression Scale(HAMD) ＞ 17 for inclusion criteria,a total of 64 patients were selected and randomly divided into two groups. The treatment group( simethicone,mosapride combined with flupeentixol-meiltracen) in 33 cases and the control group ( single flupenthixol melitracen) in 31cases. 2 groups of the period of treatment was 4 weeks. Evaluation before and after treatment with mood disorder scale score changes and syndrome efficacy and adverse reactions. ResultsThe treatment group after treatment, regardless of scale score change of mood disorders, syndrome treatment efficacy were significantly better than the control group,especially in the syndrome efficacy difference was significant( P ＜0.05 ,P ＜0.01 ) ;after the treatment without obvious adverse reaction. ConclusionThe simethicone, mosapride combined with flupentixol-meiltracen treatment with anxiety and depression in patients with functional dyspepsia could effectively relieve the symptoms of functional dyspepsia,and relieve the patient's psychological disorder;certainly result in fewer adverse reactions.

Objective To research whether double antiplatelet drug combined with pantoprazole can reduce digestive tract damage,or aggravate cardiovascular system side effect.Methods 270 patients diagnosed as ischemic stroke received double antiplatelet drug were randomly divided into two groups.The treatment group received panto-prazole,the control group did not took any gastric drug.The side effect of the digestive and cardiovascular system was observed.Results 268 patients were followed up for 90 days,and digestive system side effect of the treatment group (136 cases)included indigestion in 26 cases(19.11%),stool occult blood(+)in 11 cases(8.08%),melena in 8 cases(5.89%),hematemesis in 0 case,and the control group (132 cases)included indigestion in 42 cases (31.82%),stool occult blood(+)in 23 cases(17.42%),melena in 19 cases(14.39%),hematemesis in 4 cases. There were significant differences between the two groups(χ2 =6.66,4.56,11.2 and 4.18,all P <0.05).Cardiovas-cular system side effect of the treatment group included palpitation or chest distress or chest pain in 4 cases (3.68%),myocardial ischemia diagnosed by electrocardiogram in 4 cases(2.94%),myocardial infarction and died of cardiovascular disease in 0 case,and the control group included palpitation or chest distress or chest pain in 4 cases (3.00%),myocardial ischemia diagnosed by electrocardiogram in 3 cases(2.27%),myocardial infarction and died of cardiovascular disease in 0 case.There were no statistical differences between the two groups(χ2 =6.66 and 4.56, both P >0.05 ).Conclusion Double antiplatelet drug combined with pantoprazole had a positive significance in reducing the digestive tract damage of ischemic stroke patients,and didn't increase the incidence of cardiovascular sys-tem side effect.

Objective To evaluate the association between iodine intake and treatment outcomes of radioiodine remnant ablation in patients with papillary thyroid cancer (PTC),and to investigate the determinants related to the ablation efficacy.Methods A total of 95 PTC patients (28 males,67 females;average age 39.8 years) without distant metastases from January 2013 to May 2014 were enrolled in this retrospective study.All patients underwent total thyroidectomy and 2-4 weeks of low iodine diet (LID) before initial 131I therapy.Patients were divided into 3 groups according to urinary iodine excretion (UIE):moderate-severe iodine deficiency group (0＜UIE＜50 μg/L,n =30),mild iodine deficiency group (50 μg/L≤UIE＜100 μg/L,n =26),adequate iodine group (100 μg/L ≤ UIE ＜ 300 μg/L,n =39).Patients were followed up for 3-6 months after radioiodine ablation,successful ablation was defined as no visible uptake in the thyroid bed on diagnostic 131I whole body scan and Tg level ＜2 μg/L (with negative TgAb),or no visible uptake in thyroid bed on posttreatment 131I whole body scan.x2 test,two-sample t test,Mann-Whitney u test and logistic regression analysis were performed.Results In all,84.2％ (80/95)of patients were successfully ablated.The successful rates in the three iodine intake groups were 96.7％ (29/30),84.6％ (22/26) and 74.4％ (29/39),respectively,with significant difference (x2=7.374,P＜0.05).Univariate analysis revealed that UIE,pre-treatment TSH,pre-treatment Tg and the amount of remnant thyroid tissue at ablation affected ablation efficacy (x2 =7.374,t =2.037,z =-2.966,x2 =4.144,all P＜0.05).Logistic regression showed that the level of pre-treatment Tg (P ＜ 0.05) and iodine intake (P ＜ 0.05) were independent factors of ablation efficacy.Conclusion Iodine intake before 131I remnant ablation is one of the important factors affecting treatment outcomes.Thyroid remnant could be more successfully ablated if reasonable LID protocols be adopted according to the iodine nutritional status before treatment.

Objective To investigate the clinicopathological characteristics and postoperative prognosis analysis of intra-thoracic localized Castleman disease (LCD).Methods The clinical data of 9 patients with intra-thoracic LCD who accepted surgical treatment were retrospectively analyzed.There were 5 males and 4 females,with age of (32.8 ± 10.9) years.Two patients complained of chest pain,1 patient suffered from paraneoplastic pemphigus,and the rest were diagnosed by physical examination.Four cases were diagnosed with LCD by preoperative CT examination.Results All patients underwent surgical resection.Four patients were performed open surgery and 5 patients had video assisted thoracic surgery.All patients accepted radical surgery.But 2 of these patients had postoperative complications.One patient was the injury of phrenic nerve and another was pericardial effusion.Patho-histological showed hyaline vascular type of Catleman disease in all patients.All patients survived without recurrence during the follow-up for 2-53 months.Conclusions Intra-thoracic is rare and liable to misdiagnosed.For increasing the preoperative diagnosis rate of LCD,the combined application of imaging tests is important,and clinicians and radiologists should also enhance the awareness of this disease.Complete surgical resection of the tumor is the best therapeutic alternative for intra-thoracic LCD.

Objective To evaluate the effect of video- assisted thoracoscopic pulmonary segmentectomy in patients with isolated pulmonary arteriovenous fistula (PAVF). Methods A retrospective analysis was performed on 10 patients with PAVF in the department of thoracic surgery of the first affiliated hospital of Nanjing Medical University between January 2010 and December 2016. Computed tomography angiography (CTA) and three-dimensional reconstruction were performed before operation, and all patients accepted video-assisted thoracoscopic pulmonary segmentectomy. Results The diagnosis of PAVF was identified by CTA, with maximum diameter of tumor of 3.0- 5.0 cm. No perioperative mortality or postoperative complications were observed including bleeding, hemoptysis, serious air leakage, and bronchopleural fistula. The lesions were completely removed in all 10 patients, and no patients converted to open surgery intraoperatively. Blood gas analysis showed that oxygen partial pressure before operation, in the first day after operation and the third month after operation was (62.5 ± 6.7), (70.2 ± 4.8) and (75.4 ± 4.8) mmHg (1 mmHg = 0.133kPa) respectively; which was significantly increased successively (P<0.05). After a follow-up time of 3-30 months, no recurrences were observed. Conclusions Video- assisted thoracoscopic pulmonary segmentectomy guided by preoperative CTA and three-dimensional reconstruction is a very effective method for the treatment of isolated PAVF.

OBJECTIVETo test the efficiency of transfecting (99)Tc(m)-labeled anti-miR208b oligonucleotide into early hypertrophic cardiac myocytes in vitro.

METHODSThe anti-oligonucleotide targeting miR208b (AMO) was synthesized and modified with LNA followed by conjugation with N-hydroxysuccinimidyl S-acetyl-meraptoacetyl triglycine (NHS-MAG3) and radiolabeling with (99)Tc(m). NHS-MAG3-LNA-AMO and labeled AMO were purified with Sep-Pak C18 column chromatography, and the former was examined for UV absorption at the 260 nm using Gene Quant DNA/RNA calculator. The labeling efficiency, radiochemical purity, stability and molecular hybridization activity were analyzed. An angiotensin II-induced cell model of hypertrophic cardiac myocytes was transfected with (99)Tc(m)-NHS-MAG3-LNA-AMO via liposome, and the relative expression of miRNA208b and retention ratio of the labeled AMO in early hypertrophic cells were determined.

RESULTSThe labeling efficiency and radiochemical purity of the labeled AMO after purification exceeded 84% and 86%, respectively. The radio- chemical purities of the labeled AMO incubated in serum and normal saline for 12 h were both higher than 80%, and the labeled AMO showed a capacity to hybridize with the target gene. In the hypertrophic model of cardiac myocytes, the retention ratio of labeled AMO at 6 h was higher than 20%.

CONCLUSIONThe (99)Tc(m)-labeled antisense probe can be efficiently transfected into hypertrophic cardiac myocytes in vitro, which provides an experimental basis for subsequent radionuclide imaging studies.

Humans ; Isotope Labeling ; Liposomes ; MicroRNAs ; genetics ; Myocytes, Cardiac ; Oligonucleotides ; Oligonucleotides, Antisense ; Oligopeptides ; Radiopharmaceuticals ; Silicon Dioxide ; Succinimides ; Transfection

OBJECTIVE: To investigate the expression of breast cancer metastasis suppressor 1 (BRMS1) gene protein and the expression of BRMS1 gene promotor area methylation in supraglottic cancer and to evaluate its clinical significance. METHOD: The expression of BRMS1 protein and BRMS1 gene promotor area methylation were examined by using Western blotting method and methylation-specific polymerase chain reaction(MSP) method in 70 cases of supraglottic cancer tissues and 60 cases of their surrounding laryngeal normal mucosa tissues (LNT) and 44 cases of cervical lymph node metastasis of supraglottic cancer. RESULT: Western blot results indicate that BRMS1 protein expression is declined expression level in supraglottic cancer tissue than the expression of BRMS1 protein in LNT of supraglottic cancer. Compared with para carcinoma normal laryngeal mucous tissue, BRMS1 gene protein in supraglottic cancer tissue primary lesion decreased obviously, and it is decreased more obviously in cervical lymph node metastasis lesion, the discrepancy is notable (P < 0.05). MSP results indicate BRMS1 gene promotor methylation is coordinated with its down-expression in supraglottic cancer tissue. BRMS1 promotor area methylation analysis reveal that there were 34 patients with methylation in 70 patients' supraglottic cancer tumor primary lesion, hold 48.6% (34/70); 32 patients have methylation in 44 patients' cervical metastasis lymph node tissue, hold 72.7% (32/44); however, there is no methylation in 60 para carcinoma tissue (r(s) = 0.66, P < 0.05). CONCLUSION The expression of BRMS1 protein in supraglottic cancer is significantly decreased. It had correlation with clinical stage and pathologic differentiation and cervical lymph node metastasis of supraglottic cancer. BRMS1 gene promotor methylation is related with down-expression of BRMS1 gene protein of supraglottic cancer. Maybe BRMS1 gene promotor methylation is one of the reasons of its down-expression.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; metabolism ; pathology ; DNA Methylation ; Female ; Glottis ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Neoplasm Staging ; Promoter Regions, Genetic ; RNA, Messenger ; genetics ; Repressor Proteins ; Squamous Cell Carcinoma of Head and Neck

Objective:To investigate the efficacy and feasibility of radiofrequency resection of supraglottic laryngeal carcinoma under a multifunctional opener.Methods:The clinical data of four cases of supraglottic laryngeal carcinoma (type T1N1M0 in two cases, T2N1M0 in one case, and T1N0M0 in one case) who received treatment in the Affiliated Hospital of Jining Medical University during January-June 2019 were retrospectively analyzed. Radiofrequency resection of supraglottic laryngeal carcinoma under a multi-functional opener combined with bilateral neck II-IV region lymph node dissection was performed. Swallowing, breathing and phonation were observed and analyzed based on references.Results:Among the four cases, two cases had a normal diet at 3 days after surgery, one case had a normal diet at 7 days after surgery, and one case had a normal diet at 16 days after surgery. Tracheotomy was not performed in any case. After surgery, breathing and speech communication were not affected.Conclusion:Radiofrequency surgery under a multifunctional opener can be used for treatment of early supraglottic laryngeal cancer. It is an effective treatment with minimal trauma, mild postoperative pain and promotes the early recovery of normal swallowing function.

BACKGROUND: Segmentectomy has gradually become one of the standard surgical methods for small pulmonary nodules with early lung cancer on imaging. This study aimed to investigate the perioperative outcomes of patients who underwent uniport video-assisted thoracoscopic surgery (VATS) segmentectomy for identifying the intersegmental boundary line (IBL) by the near-infrared fluorescence imaging with intravenous indocyanine green (ICG) method or the modified inflation-deflation (MID) method and assess the feasibility and effectiveness of the ICG fluorescence (ICGF)-based method. METHODS: We retrospectively analyzed the perioperative data in total 198 consecutive patients who underwent uniport VATS segmentectomy between February 2018 and August 2020. With the guidance of preoperative intelligent/interactive qualitative and quantitative analysis-three dimensional (IQQA-3D), the targeted segment structures could be precisely identified and dissected, and then the IBL was confirmed by ICGF-based method or MID method. Clinical effectiveness and postoperative complications of the two methods were evaluated. RESULTS: An IBL was visible in 98% of patients by the ICGF-based group, even with the low-doses of ICG. The ICGF-based group was significantly associated with the shorter IBL clear presentation time [(23.59±4.47) s vs (1,026.80±318.34) s] (P<0.01) and operative time [(89.3±31.6) min vs (112.9±33.3) min] (P<0.01), compared to the MID group. The incidence of postoperative prolonged air leaks was higher in the MID group than in the ICGF-based group (8.0% vs 26.5%, P=0.025). There were no significant differences in bleeding volume, chest tube duration, postoperative hospital stays, surgical margin width and other postoperative complications (P>0.05). CONCLUSIONS The ICGF-based method could highly accurately identify the IBL and make anatomical segmentectomy easier and faster, and therefore has the potential to be a feasible and effective technique to facilitate the quality of uniport VATS segmentectomy.
Feasibility Studies ; Humans ; Indocyanine Green ; Ion Transport ; Lung Neoplasms/surgery* ; Pneumonectomy ; Postoperative Complications ; Retrospective Studies ; Thoracic Surgery, Video-Assisted