Objective:To explore the standardization of totally implantable venous power port of nursing process in CT enhancement and application effect of contrast medium injection, so as to provide a safer and more efficient way for contrast medium injection in CT enhanced examination for patients with malignant tumors.Methods:A non-randomized prospective study was conducted, 358 patients with malignant tumors were selected in Sun Yat-sen Memorial Hospital, Sun Yat-sen University who underwent CT enhanced examination from August 1, 2022 to July 31, 2023, 179 patients who had been implanted totally implantable venous power port were selected as the experimental group, and the standardized nursing procedure was given. The other 179 patients were the control group, using radiology routine high-pressure intravenous indwelling needle as the contrast medium access, with routine peripheral venous nursing process. The incidence of contrast medium extravasation during CT enhanced examination was observed and compared between the two groups.Results:All the patients were included. There were 85 males and 94 females, aged (55.50±11.72) years old in the control group. There were 83 males and 96 females, aged (54.50±12.24) years old in the experimental group. The incidence of contrast medium extravasation was 0 in the experimental group and 3.35%(6/179) in the control group. The difference between the two groups was statistically significant (Fisher exact probability, P<0.05). Conclusions:The application of standardized nursing procedure of totally implantable venous power port to the injection of contrast medium in CT enhanced examination of malignant tumor patients, can significantly reduce the incidence of contrast medium extravasation.

Objective:To investigate the effect of endometriosis (EMT) on oocytes, embryo quality and pregnancy and delivery outcomes in infertility patients treated with in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:A retrospective cohort study was conducted to select the EMT patients (383 cases, EMT group) and the infertility patients with tubal factor (1 613 cases, control group) who underwent IVF/ICSI-ET treatment in the Department of Reproductive Medicine, the First Affiliated Hospital of Harbin Medical University from January 2016 to December 2023. The cases were matched with the number of age, body mass index, anti-Müllerian hormone, proportion of infertility type, duration of infertility, ovulation stimulating therapy, insemination mode, number of previous IVF/ICSI cycles of the two groups by 1∶1 propensity score matching. Totally 285 patients with EMT and 285 patients in control group were finally included to analyze the effects of EMT on embryo quality and pregnancy outcome.Results:1) There were no statistically significant differences in the duration of gonadotropin (Gn) used, the total dosage and the initiating dosage of Gn used, and the levels of estradiol, luteinizing hormone, and progesterone on the human chorionic gonadotropin (hCG) injection day between the two groups (all P>0.05). 2) The total number of oocytes (7.48±5.15), the number of MⅡ oocytes (6.38±4.61), the number of transferable embryos (4.16±3.16), the number of high-quality embryos [2.00 (0.00, 3.00)] and the rate of two pronuclei (2PN) high-quality embryos [42.33% (602/1 422)] in EMT group were all lower than those in control group [8.45±4.86, P=0.021; 7.32±4.43, P=0.013; 4.95±3.19, P=0.003; 2.00 (1.00, 4.00), P=0.002; 48.76% (747/1 532), P=0.032], the differences were statistically significant. 3) There were no statistically significant differences in clinical pregnancy rate, embryo implantation rate, premature birth rate, early abortion rate, ectopic pregnancy rate, male/female ratio, number of weeks of delivery and cesarean section rate between the two groups with fresh cycle transplantation and with embryo freezing in fresh cycle and embryo transferred in the first resuscitation cycle (all P>0.05), the live birth rate of EMT patients with fresh cycle transplantation [29.71% (41/138)] was lower than that of control group [48.90% (89/182), P=0.023], and the difference was statistically significant. 4) EMT was not an independent factor of clinical pregnancy rate and live birth rate after IVF/ICSI treatment, but age and number of embryos transferred were independent factors of clinical pregnancy rate and live birth rate of IVF/ICSI treatment ( OR=0.923, 95% CI: 0.868-0.982, P=0.011; OR=0.890, 95% CI: 0.832-0.952, P=0.001; OR=2.408, 95% CI: 1.331-4.356, P=0.004; OR=3.838, 95% CI: 1.869-7.879, P<0.001). Conclusion:EMT may reduce the number of oocytes and MⅡ oocytes in infertility patients treated with IVF/ICSI-ET, and the quality of embryos in patients with EMT treated with IVF is worse, but it does not affect the clinical pregnancy outcome and delivery outcome in patients with EMT.

Objective:To investigate the effect of endometriosis (EMT) on oocytes, embryo quality and pregnancy and delivery outcomes in infertility patients treated with in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:A retrospective cohort study was conducted to select the EMT patients (383 cases, EMT group) and the infertility patients with tubal factor (1 613 cases, control group) who underwent IVF/ICSI-ET treatment in the Department of Reproductive Medicine, the First Affiliated Hospital of Harbin Medical University from January 2016 to December 2023. The cases were matched with the number of age, body mass index, anti-Müllerian hormone, proportion of infertility type, duration of infertility, ovulation stimulating therapy, insemination mode, number of previous IVF/ICSI cycles of the two groups by 1∶1 propensity score matching. Totally 285 patients with EMT and 285 patients in control group were finally included to analyze the effects of EMT on embryo quality and pregnancy outcome.Results:1) There were no statistically significant differences in the duration of gonadotropin (Gn) used, the total dosage and the initiating dosage of Gn used, and the levels of estradiol, luteinizing hormone, and progesterone on the human chorionic gonadotropin (hCG) injection day between the two groups (all P>0.05). 2) The total number of oocytes (7.48±5.15), the number of MⅡ oocytes (6.38±4.61), the number of transferable embryos (4.16±3.16), the number of high-quality embryos [2.00 (0.00, 3.00)] and the rate of two pronuclei (2PN) high-quality embryos [42.33% (602/1 422)] in EMT group were all lower than those in control group [8.45±4.86, P=0.021; 7.32±4.43, P=0.013; 4.95±3.19, P=0.003; 2.00 (1.00, 4.00), P=0.002; 48.76% (747/1 532), P=0.032], the differences were statistically significant. 3) There were no statistically significant differences in clinical pregnancy rate, embryo implantation rate, premature birth rate, early abortion rate, ectopic pregnancy rate, male/female ratio, number of weeks of delivery and cesarean section rate between the two groups with fresh cycle transplantation and with embryo freezing in fresh cycle and embryo transferred in the first resuscitation cycle (all P>0.05), the live birth rate of EMT patients with fresh cycle transplantation [29.71% (41/138)] was lower than that of control group [48.90% (89/182), P=0.023], and the difference was statistically significant. 4) EMT was not an independent factor of clinical pregnancy rate and live birth rate after IVF/ICSI treatment, but age and number of embryos transferred were independent factors of clinical pregnancy rate and live birth rate of IVF/ICSI treatment ( OR=0.923, 95% CI: 0.868-0.982, P=0.011; OR=0.890, 95% CI: 0.832-0.952, P=0.001; OR=2.408, 95% CI: 1.331-4.356, P=0.004; OR=3.838, 95% CI: 1.869-7.879, P<0.001). Conclusion:EMT may reduce the number of oocytes and MⅡ oocytes in infertility patients treated with IVF/ICSI-ET, and the quality of embryos in patients with EMT treated with IVF is worse, but it does not affect the clinical pregnancy outcome and delivery outcome in patients with EMT.

Objective:To observe the efficacy of apatinib combined with first-line chemotherapy and maintenance therapy of only apatinib in patients with extensive small-cell lung cancer.Methods:The clinical data of 56 newly diagnosed patients with extensive small-cell lung cancer in the Fifth People′s Hospital of Dalian City from January 2018 to June 2019 were retrospectively analyzed. Among them, 27 patients (experimental group) were treated with first-line chemotherapy combined with apatinib, and 29 patients (control group) were treated with first-line chemotherapy alone. In experimental group, the expression levels of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor (VEGFR)-2 1 day before chemotherapy and 1 day after chemotherapy were detected by enzyme linked immunosorbent assay method. Response evaluation criteria in solid tumor (RECIST) was used to evaluate the efficacy. The occurrence of adverse reaction was recorded. The patients were followed up for 12 to 24 months, and progression-free survival and 1-year survival were recorded.Results:The objective response rate, median progression-free survival time and 1-year survival rate in experimental group were significantly higher than those in control group: 81.5% (22/27) vs. 55.2% (16/29), 10.5 months vs. 8.5 months and 81.5% (22/27) vs. 55.2% (16/29), and there were statistical differences ( P<0.05); there was no statistical difference in disease control rate between 2 groups ( P>0.05). In experimental group, the patients with complete response and partial response after chemotherapy were classified as effective subgroup (22 cases), and the patients with stationary disease and progressive disease were classified as ineffective subgroup (5 cases). There were no statistical difference in VEGF and VEGFR-2 before chemotherapy between 2 subgroups ( P>0.05). The VEGF and VEGFR-2 in effective subgroup were significantly lower than those in ineffective subgroup: (275.34 ± 16.15) ng/L vs. (330.24 ± 23.21) ng/L and (89.35 ± 4.34) ng/L vs. (112.34 ± 5.45) ng/L, and there were statistical differences ( P<0.01). There were no uncontrollable adverse reactions in 2 groups, and there was no statistical difference in the incidence of adverse reactions between 2 groups ( P>0.05). Conclusions:Application of apatinib in first-line therapy and maintenance therapy for patients with extensive small-cell lung cancer can improve clinical efficacy and survival benefit with controllable adverse reactions.

Objective:To investigate the effect of pidotimod in reducing pulmonary infection in patients with lung cancer undergoing chemotherapy.Methods:One hundred and twenty patients with lung cancer in the Fifth People′s Hospital of Dalian City from July 2017 to July 2018 were selected. The patients were divided into control group and pidotimod group by random digits table method with 60 cases each. The patients were treated with standard two drugs chemotherapy containing platinum drug according to the pathological type, and the patients in pidotimod group were combined with pidotimod. The number of pulmonary infections during chemotherapy, number of completed scheduled chemotherapy and adverse reaction were observed. The correlation between pulmonary infection and pidotimod was analyzed by multivariate orderly Logistic regression.Results:The incidence of pulmonary infection in pidotimod group was significantly lower than that in control group: 18.33% (11/60) vs. 40.00% (24/60), and there was statistical difference ( χ2 = 6.845, P<0.01). The rate of completed scheduled chemotherapy in pidotimod group was significantly higher than that in control group: 55.00% (33/60) vs. 36.67% (22/60), and there was statistical difference ( χ2 = 4.062, P<0.05). Multivariate orderly Logistic regression analysis result showed that pidotimod could reduce the risk of pulmonary infection ( OR = 0.210, 95% CI 0.072 to 0.606, P = 0.004), and help to complete the scheduled chemotherapy ( OR = 2.323, 95% CI 1.080 to 5.003, P = 0.031). In pidotimod group, no obvious adverse reaction related to pidotimod application was detected, and chemotherapy was not affected. Conclusions:Application of pidotimod can reduce the chance of pulmonary infection in patients with lung cancer undergoing chemotherapy and help patients complete scheduled chemotherapy.

Objective: To analyze the expression of c-MET and its prognostic correlation in patients with lung adenocarcinoma. Methods: The clinical data and pathological specimen of patients with lung adenocarcinoma in Dalian 5th People′s Hospital from January 2006 to December 2011 were retrospectively analyzed. The expression difference of c-MET between lung adenocarcinoma tissue and normal adjacent tissues was compared. The correlation of c-MET with the pathology and clinical factors was also analyzed. Results: A total of 82 patients were retrospective analyzed, including 82 pathological specimens of lung adenocarcinoma and 45 specimens of normal adjacent tissues. Among 53 patients with stage Ⅰ-Ⅱ lung adenocarcinoma, 31 cases had low expression of c-MET and 22 cases had high expression of c-MET. Among 29 patients with stage Ⅲ lung adenocarcinoma, 10 cases had low expression of c-MET and 19 cases had high expression of c-MET. There was a correlation between TNM stage and c-MET positive expression in lung adenocarcinoma (P=0.037). The positive expression rate of c-MET was not significantly correlated with age, sex and differentiation degree (P > 0.05). Among 82 cases of lung adenocarcinoma, 39 cases had low expression of c-MET and 43 cases had high expression of c-MET; 45 cases of para-carcinoma tissuehad low expression of c-MET. The positive expression rate of c-MET in lung adenocarcinoma tissues was significantly higher than that in para-carcinoma tissue (P < 0.01). Kaplan-Meier survival curve analysis showed that the median disease-free survival was 41.5 months in c-MET high-expression group and 55.3 months in low-expression group. The expression level of c-MET was closely related to disease-free survival in lung adenocarcinoma patients (P < 0.05). Conclusions The expression of c-MET is significantly increased in patients with lung adenocarcinoma. The expression level has relevance with TNM staging and prognosis.

Objective To measure the diameter of optic nerve sheath by ultrasonography to evaluate the change of intracranial pressure(ICP)in prone position ventilation,and to provide basis for prone position ventilation in patients with increased intracranial pressure (ICH). Methods A total of 58 patients with mechanical ventilation were treated with prospective clinical study from 2016.05.01 to 2017.05.01. The patients were treated with different PEEP and different positions(supine position and prone position),and detected optic nerve sheath diameter(ONSD)behind 3 mm of eye 3 mm by bedside ultrasound. The cause inducing increase of ICP was studied through the changes of ONSD and the data was analyzed by the paired t test. Results Prone position had a significant effect on patients with increased intracranial pressure. PEEP had a significant effect on MAP,Ppeak, Pplat,but had no effect on increased intracranial pressure. Conclusions Prone position ventilation significantly affect the ONSD. Therefore ,it weighs the pros and cons when patients with intracranial hypertension were received prone position ventilation.

Objective The aim of this study was to investigate the expression of miR-320a and cephalospermoma syndrome protein(CYLD)in patients with gastric cancer and its relationship with clinicopathological characteristics and prognosis. Methods A total of 460 patients with gastric cancer underwent tumor resection in our hospital from March 2013 to November 2014 were enrolled. Tumor tissues,non-tumor gastric mucosa tissues and normal tissues were collected. The expression of miR-320a and CYLD at levels of mRNA and protein were detected by Real-Time PCR,immunohistochemistry and Western blotting. The relationship between the expression of miR-320a and CYLD,and the clinicopathological features&prognosis of gastric cancer patients was analyzed. Results The relative expression of miR-320a and CYLD at the mRNA level in tumor tissues was(0. 37 ± 0. 09),(0. 91 ± 0. 23),and the relative expression in non-tumor tissues was(0. 86 ± 0. 15),(1. 56 ± 0. 42),respectively. The relative expression of miR-320a and CYLD mRNA in tumor tissues was significantly different from non-tumor tissues(t=60. 078,29. 113,P=0. 000),the positive ex-pression rate of CYLD protein in tumor tissues was 43. 48% when compared to 73. 91% in non-tumor tissues. The difference was statistically significant(χ2=86. 624,P=0. 003). The expression level of miR-320a was significantly associated with the diameter of the tumor and lymph node metastasis(χ2=25. 859 and 13. 742,P<0. 05). The expression of CYLD was also significantly associated with the TNM stage and degree of tumor differentiation(χ2=37. 725 and 59. 323,P<0. 05). The median survival of patients with low miR-320a expression(20. 36 months,95% CI:19. 252 ~21. 462 months) and those with high miR -320a expression(28. 29 months,95% CI:27.158~29.412 months)were statistically significant(χ2=87.967,P<0.001).The median survival of patients with CYLD negative expression(17. 70 months,95% CI:16. 599~18. 796 months)and those with CYLD positive expression(26. 74 months,95% CI:25. 474~27. 997 months)were statistically significant(χ2=109. 887,P<0. 001);The median survival of patients with the co-expressed miR-320a and CYLD was(29. 01 months,95% CI:26. 831~28. 946 months)and those with the non-co-expressed miR-320a and CYLD(17. 13 months,95% CI:17. 214~19. 568 months)were statistically significant(χ2=117. 680,P<0. 001). There showed a positive correlation between the expression of miR-320a and CYLD at mRNA level(r=0. 607,P<0. 001);miR-320a at the low expression,CYLD at the negative expression,TNM staging,lymph node metastasis and degree of tumor differen-tiation were independent risk factors for the prognosis of gastric cancer(HR=1. 939,2. 180,1. 561,1. 719,1. 608,95% CI:1. 141~3.295,1.252~3.796,1.014~2.403,1.115~2.650,1.097~2.357,respectively)(P<0.05).Conclusion The expressions of miR-320a and CYLD in tumor tissues of patients with gastric cancer is significantly decreased,which is related to the occurrence and development of diseases,and poor prognosis. It is a potential target for diagnosis and treatment of gastric cancer.

Objective: To investigate the application value of cardiovascular magnetic resonance tissue-tracking (CMR-TT) in the quantitative assessment of global and segmental myocardial strain after myocardial infarction. Methods: From June 2013 to June 2017, 45 patients with chronic myocardial infarction from the Second Affiliated Hospital of Nanchang University and eighteen normal volunteers as a control group were included in our research. All participants received CMR examination on a 3.0 T MRI scanner. Imaging protocol including FIESTA cine sequence (left ventricle short-axis planes, four chamber and two chamber long-axis planes) and late gadolinium enhancement (LGE). CMR-TT was undertaken using cvi 42 dedicated commercial software, global peak systolic circumferential, longitudinal, radial strains (GPCS, GPLS, GPRS) and segmental peak systolic circumferential, longitudinal, radial strains (PCS, PLS, PRS) in accordance with the American Heart Association's sixteen segment model were all derived. All segments were divided into five groups according to transmural extent expressed as enhanced area per segment: 0% as non-LGE segments group, 1 %-25 % as mild LGE segments group, 26%-50 % as moderate LGE segments group, 51%-75% as severe LGE segments group and >75% as complete LGE segments group. Two-independent samples t-test and Kruskal-Wallis H test were used, respectively, to compare means of 2 and 3 or more groups of continuous variables. Variables with normal distribution were presented as ±s, non-normal variables were reported as median (interquartile range). Results: Patients showed significant lower GPRS, GPCS and GPLS than the control group (15.13%±8.18%, -8.25%±3.23%, -7.11%±2.41% versus 32.41%±12.99%, -14.92%±3.32%, -11.50%±2.51%). PRS, PCS and PLS statistically significantly decreased with increasing extent of myocardial enhancement (t=-6.35,7.33,6.44, P<0.001).Segmental peak systolic strains of five groups were:PRS:24.87% (10.95%,39.02%), 13.26%(5.94%,24.24)%, 9.47%(4.01%,18.40%), 5.98%(-3.74%,11.86%), -2.65%(-6.62%,8.59%), respectively; PCS: -11.84%±5.34%, -8.60%±5.48%, -7.32%±5.59%, -5.30%±5.52%, -2.74%±5.24%, respectively; PLS: -9.47%±6.82%, -7.72%±6.22%, -7.07%±6.49%, -5.55%±5.95%, -3.54%±5.44%, respectively. The differences in the groups were statistically significant (H=164.47,166.61, 59.06, P<0.001). GPRS was positively correlated with LVEF(r=0.543, P<0.001), while GPCS and GPLS were both negatively associated with LVEF (r=-0.654, P<0.001; r=-0.682, P<0.001, respectively). Conclusions CMR-TT can quantitatively assess the severity of myocardial infarction accurately and reliably.Strain parameters have a good correlation with cardiac function indexes, this may be helpful in the recognition of left ventricular remodel after MI.

OBJECTIVETo analyze the clinical and molecular features of a child with carnitine palmitoyltransferase 1A (CPT1A) deficiency.

METHODSClinical data of the child was collected. Blood acylcarnitine was determined with tandem mass spectrometry. DNA was extracted from the child and his parents. All exons and flanking regions of the CPT1A gene were analyzed by PCR and Sanger sequencing.

RESULTSAnalysis showed that the patient carried compound heterozygous mutations c.1787T>C and c.2201T>C of the CPT1A gene, which derived his father and mother, respectively. Both mutations were verified as novel through the retrieval of dbSNP, HGMD and 1000 genome databases. Bioinformatic analysis suggested that the mutations can affect protein function.

CONCLUSIONAcyl carnitine analysis has been the main method for the diagnosis of CPT1A deficiency. The c.1787T>C and c.2201T>C mutations of the CPT1A gene probably underlie the disease in this patient. Gene testing can provide important clues for genetic counseling and prenatal diagnosis.

Base Sequence ; Carnitine O-Palmitoyltransferase ; deficiency ; genetics ; Exons ; Female ; Humans ; Hypoglycemia ; enzymology ; genetics ; Infant ; Lipid Metabolism, Inborn Errors ; enzymology ; genetics ; Male ; Molecular Sequence Data ; Point Mutation ; Pregnancy