Objective To test the reliability and validity of the short version of depression-anxiety-stress scale (DASS-21) for students in the disaster region.Methods DASS-21 and the Chinese version of UCLA PTSD Reaction Index for DSM-IV,Revision I were used to evaluate psychological health among 876 students from grades 5 to 9 after Ya' an earthquake.Results (1) Each of the items had a good distinction degree,with CR value ranging from 9.268 to 22.438 (P＜ 0.01),and the correlation coefficients ranged from 0.306 to 0.742.(2)The Cronbach' s alpha coefficients ranged from 0.781 to 0.911.(3) The correlation coefficients between total score and each dimension ranged from 0.714 to 0.914,and the correlation coefficient between PTSD and total DASS score,depression anxiety and stress score was 0.626-0.774.(4)Through the item analysis and explore factor analysis,the revised scale contained 21 items and 3 subscales which could explain 47.813％ of the total variance(KMO =0.937,x2 =3126.85,df=210,P＜0.01),and the results of confirmatory factor analysis supported the three-factor model (x2/df=4.180,P＜0.01,PCFI =0.728,CFI =0.904,IFI =0.905,TLI =0.881,and RMSEA =0.060),and the load of each item was between 0.339 to 0.715.Conclusion The short version of DASS-21 is reliable and valid,and can be used as a tool for post-disaster stress assessment on local students.

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

OBJECTIVETo study the imaging characteristics and variations of individual digitized hepatic vein and portal vein which were reconstructed by medical image three-dimensional visualization system (MI-3DVS), assess the value of MI-3DVS assisted hepatectomy.

METHODSFrom June 2008 to September 2012, the clinical data of 81 patients who underwent hepatectomy with the assist of MI-3DVS were retrospectively reviewed. There were 61 male and 20 female patients, and their age were 12-81 years (median 46 years). The patients with malignant tumors were in 69 cases and with benign tumors in 12 cases. The characteristics and variations of individual digitized hepatic vein and portal vein were observed.Omnidirectional rotation of the three-dimensional (3D) model to observe the distribution of intrahepatic venous system as well as the relationship between the tumor and the veins. 3D models were then simulated resection by the Freeform modeling system.

RESULTSOf all the 81 3D models of the patients, greater posterior hepatic veins appeared in 10 (12.3%) cases, segment VI hepatic vein appeared in 34 (41.9%) cases. The portal vein was separted with the left branch and the right branch in the hilar in 64 cases, the portal trunk was divided into the left branch of portal vein, the right anterior portal branches, the right posterior portal branches trifurcated in 10 cases, the branch of right anterior portal vein start from the left trunk and the branch of right posterior portal vein start from the main trunk independently in 6 cases, there was 1 case, lack of left branch of portal vein. 81 patients underwent hepatectomy with the assist of MI-3DVS, minor hepatectomy in 57 cases, major hepatectomy in 24 cases (comparatively-reduced major hepatectomy in 12 cases). R0-resection was achieved in all of the patients. Both the inflow and the outflow were maintained in the residual liver after the completion of hepatectomy. Postoperative liver failure was observed in none of the patients.

CONCLUSIONSMI-3DVS in liver resection was the best choice of surgical approach provides an intuitive basis, and it could reduce the risk of surgery to prevent postoperative hepatic failure.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Hepatectomy ; methods ; Hepatic Veins ; anatomy & histology ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Portal Vein ; anatomy & histology ; Retrospective Studies ; Young Adult

OBJECTIVE: To compare the accuracy of three-dimensional reconstruction of cervical CT and ultrasound for estimating residual thyroid volume. METHODS: We performed a retrospective analysis of 17 patients with 21 residual thyroid glands undergoing thyroidectomy surgery between February, 2017 and March, 2018 in our department. We compared the residual thyroid volume in preoperative ultrasound with the intraoperative measurement and the volume measured using threedimensional CT reconstruction before surgery. RESULTS: The maximum vertical and anterioposterior diameters of the residual thyroid measured by preoperative ultrasound differed significantly from the volume data measured intraoperatively ( < 0.05), but the difference in the maximum left-right diameters was not statistically significant (>0.05). The maximum vertical, leftright, and anteroposterior diameters estimated by three-dimensional reconstruction of cervical CT was all similar with those measured intraoperatively (>0.05). CONCLUSIONS Compared with ultrasound examination, three-dimensional reconstruction of neck CT is more accurate for estimating the residual thyroid volume and provides more reliable evidence for clinical calculation of postoperative I dose for thyroid cancer.
Humans ; Imaging, Three-Dimensional ; Retrospective Studies ; Thyroid Neoplasms ; Tomography, X-Ray Computed ; Ultrasonography

Lorlatinib (PF-06463922) is a highly selective and potent third generation anaplastic lymphoma kinase (ALK) inhibitor with dual activity against c-ros oncogene 1, a receptor tyrosine kinase (ROS1). In November 2018, the US Food and Drug Administration approved lorlatinib for treatment of disease progression in ALK-positive and late-stage NSCLC patients who receive the treatment with crizotinib and at least one of other ALK inhibitors; and those with disease progression after treatment of alectinib or ceritinib as the first ALK inhibitor. The results of phase I/II clinical trials showed that it has effective initial anti-tumor activity, strong intracranial therapeutic activity, with less tolerance and safety issues. This paper systematically reviewed the chemical structure, mechanism of action, pharmacodynamics, pharmacokinetics, usage and dosage, clinical research, safety and upcoming research fields of lolatinib, to provide an update on clinical or laboratory research and clinical practice.

Carcinoma, Hepatocellular ; surgery ; Catheter Ablation ; methods ; Combined Modality Therapy ; Embolization, Therapeutic ; Hepatectomy ; Humans ; Laser Coagulation ; Liver Neoplasms ; surgery ; Microwaves ; therapeutic use

OBJECTIVETo observe the effect of electro-needling at acupoints of the yangming meridian on the expression of platelet associated complement-1 (PAC-1) and lower limb functions in acute cerebral infarction (ACI) patients.

METHODS58 ACI patients were randomly assigned to the treatment group and the control group. Conventional therapies were given to all patients. Additionally, the electro-needling at acupoints of the yangming meridian was given to patients in the treatment group. Changes of PAC-1 were detected using flow cytometry. Effect of lower limbs functions of ACI patients before and after electro-needling was assessed using Fugl-Meyer Index. Meanwhile, 20 healthy subjects were selected for reference value.

RESULTSIn the acute stage, the PAC-1 level in ACI patients were significantly higher than that in healthy subjects (P<0.05). The PAC-1 level in the electro-needling group was obviously lowered after treatment (P<0.01). There was no significant difference in the control group between before and after treatment. Significant difference was found in Fugl-Meyer index in the same group between before and after two-week treatment (P<0.05). It was higher in the electro-needling group than in the control group, showing significant difference (P<0.01).

CONCLUSIONSPlatelet activation exists in the acute stage of ACI. Electro-needling at acupoints of the yangming meridian showed obvious inhibition on PAC-1 levels, could improve lower limbs functions of ACI patients. It was inferred that electro-needling at acupoints of the yangming meridian promoted the recovery of paralyzed lower limbs at the early stage mainly by regulating PAC-1 levels, thus postponing the progress of ACI.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Cerebral Infarction ; metabolism ; rehabilitation ; therapy ; Electroacupuncture ; Female ; Humans ; Lower Extremity ; Male ; Middle Aged ; Platelet Membrane Glycoproteins ; metabolism ; Recovery of Function ; Stroke Rehabilitation ; Treatment Outcome

Objective To investigate if Rac1 GTPase activation plays an important role in hyperpermeability and tyresine phosphorylation of tight junction induced by vascular endothelial growth factor (VEGF) in glomertdar endothelial cells (GEnCs). Methods Primary cultured rat endothelial cells were used as experimental model. The effect of VEGF at different concentrations (5 or 50 μg/L) on endothelial permeability was investigated by transendothelial electrical resistance (TEER). The permeability of GEnCs transfected with wild type Rac1 (wtRacl) or dominant negative Racl (N17Rac1) was also detected. Immune precipitation and immune blotting were used to detect the tyrosine phosphor-occludin in GEnCs. Results VEGF at high concentration (50 μg/L) induced hyperpermeability in GEnCs (P<0.05). At the same time, GTP-binding and membrane-bound Racl GTPase significantly increased(P<0.01)in GEnCs. Tyrosine phosphor-occludin was also increased (P<0.05) under VEGF stimulation. However, transfection of GEnCs with N17Rac1 dramatically attenuated the effect of VEGF on tyrosine phospho-occludin and endothelial cell permeability. Conclusions Increased VEGF can induce hyperpermeability in glomerular endothelial cells, which is related to occludin tyrosine phosphorylation through Racl activation. It provides a framework for understanding the role of VEGF-induced Racl-phospho-occludin pathway in the integrity of barrier function in the diabetic milieu.

Aged ; Catheter Ablation ; methods ; Female ; Hematoma ; surgery ; Humans ; Thrombosis ; surgery

OBJECTIVE: To investigate the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of malignant hematopathy and its influencing factors. METHODS: The clinical data of 300 cases received hematopoietic stem cell transplantation due to malignant hematological diseases in Zhu Jiang Hospital of Southern Medical University from January 2010 to June 2018 were analyzed retrospectively, and the factors affecting hematopoietic reconstruction, disease-free survival (DFS) and overall survival (OS) were compared between haploidentical HSCT and HLA matched HSCT. RESULTS: The hematopoietic reconstitution rate, incidence of GVHD, posttransplant recurrence rate and disease-free survival (DFS) were not statistically different between HLA-metched and haploidentical colorts. However, compared with HLA-matched HSCT group the time of platelet implantation was prolonged, the recurrence-related mortality was higher, and the overall survival (OS) rate was lower in the haploidentical HSCT group. Univariate analyses showed that non-remission before transplantation, and grade Ⅲ, Ⅳ aGVHD were the risk factors for OS in both groups (P＜0.05). The age than 40 years old at the time of transplantation and unrelated donors were risk factors for OS in haploidentical HSCT group (P＜0.05). Multivariate analysis showed that non-remission before transplantation and grade Ⅲ, Ⅳ aGVHD were independent prognostic indictor for OS with relative risk (RR) of 4.4 (95% CI,1.5-13.4), 9.3 (95% CI,2.3-37.0), 11.0 (95% CI,3.2-37.3) (P＜0.05) in HLA-matched HSCT group. Unrelated donor, high-risk group, and gradeⅣaGVHD were independent prognostic indictors for OS with relative risk (RR) of 7.4 (95% CI,2.3-23.1), 2.4 (95% CI,1.3-4.5), 4.1(95% CI,1.6-10.5) (P＜0.05) in haploidentical HSCT group. CONCLUSION The comprehensive curative effect of HLA-matched HSCT is better than the haploidentical HSCT in hematological malignancies. In haploidentical HSCT the selecting related donor is better than unrelated donors, which required more platelet transfusion support.
Adult ; Graft vs Host Disease ; Hematologic Neoplasms ; therapy ; Hematopoietic Stem Cell Transplantation ; Humans ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies