Objective To evaluate the effect of early clinical interference strategies on preventing the conversion of acute pancreatitis to the severe form and aggravation of severe acute pancreatitis (SAP). Methods The patients with acute pancreatitis admitted to this hospital were divided into two therapeutic phases by different therapeutic methods from January 2001 to December 2008. Patients in the first phase (from January 2001 to December 2004) were treated by the routine management, and the second phase (from January 2005 to December 2008) by the routine management combined with early clinical interference strategies. Then, the ratio of conversion from acute pancreatitis to SAP and prognosis of SAP between two phases were compared. Results Compared with the first phase, the rate of aggravation of acute pancreatitis was significantly decreased in the second phase (4.48% vs. 21.18%), the average healing time of SAP, the incidences of systemic and local complications and the mortality of pancreatitis were reduced (P＜0.05). When early clinical interference strategies were performed, some adverse reaction and complications occurred in 35 cases, but without severe consequence. Conclusion Early clinical interference strategies may serve as a beneficial strategy on preventing the progression of mild acute pancreatitis to the severe form or halting the aggravation of acute pancreatitis.
Objective To detect the effects of cytokines on the expression of early growth response gene-1 (Egr-1) in cultured human retinal pigment epithelial (RPE) cells. Methods Immunofluorescence staining, Western blotting and reverse transcription polymerase chain reaction (RT-PCR) were used to detect and quantitatively analyze the expression of Egr-1 protein and mRNA in cultured human RPE cells which were exposed to stimulants, including 20 mu;g/ml lipopolysaccharide (LPS), 40 ng/ml tumor necrosis factor (TNF)-alpha;, 10 U/ml interferon (IFN)gamma;, 30% supernatant of monocyte/macrophage strain (THP1 cells) and the vitreous humor from healthy human eyeballs, for 0, 10, 20, 30, 40 and 60 minutes, respectively. Results The RPE cells stimulated for 0 minute revealed faint green fluorescence of Egr-1 in the cytoplasm. With exposure to the stimulants, the expressionof Egr-1 increased obviously and b green fluorescence was found in cytoplasm in some nuclei of RPE cells. Compared with the untreated RPE cells, after stimulated by 20 mu;g/ml LPS, 40 ng/ml TNFalpha;, 10 U/ml IFNgamma;, 30% supernatant of THP-1 cells and the vitreous humor, the approximate ultimate amplitudes of Egr-1 mRNA enhanced 1.9, 1.3, 14, 1.2, and 1.4 times, respectively; the greatest amplitudes of Egr-1 protein increased 3.4, 1.2, 1.7, 32, and 1.3 times, respectively. Conclusion LPS, TNF-alpha;, IFN-gamma;, supernatant of THP-1 cells and the vitreous humor can upregulate the expression of Egr-1 mRNA and protein in cultured human RPE cells, and induce its nuclear transposition, which suggests the activation of Egr-1.
目的 总结术后早期炎性肠梗阻的临床特点及诊治经验。方法 回顾性分析我院2004年1月至2010年12月期间收治的22例腹部手术后早期炎性肠梗阻患者的临床资料。结果 全组均行保守治疗，均治愈出院。肠梗阻解除时间平均6.5d。2例出院后再次出现慢性肠梗阻，经保守治疗好转。结论 术后早期炎性肠梗阻在腹腔严重感染性疾病术后多见，治疗以保守治疗为主，同时应动态观察腹部症状、体征变化，严防误诊、误治。
Objective To evaluate the diagnostic efficiency of serum soluble CD26 （sCD26） on the diagnosis of colorectal cancer. Methods The serum sCD26 concentration of 59 colorectal cancer patients, 51 colorectal benign disease patients, and 41 healthy volunteers were detected by ELISA. The diagnostic efficiency of sCD26 and carcinoma embryonic antigen （CEA） was assessed by receiver operating characteristics （ROC） analysis. The association between sCD26 and colorectal cancer was assessed by logistic regression which included CEA in the model. Results Increased serum sCD26 was observed in colorectal cancer patients （P＜0.01）, but the differences of sCD26 in different Dukes stages were not statistic significance （P=0.78）. The area under cure （AUC） of sCD26 confirmed by ROC analysis was 0.72 〔95% confidence interval （CI）：0.63-0.82, P＜0.01〕. The diagnostic sensitivity and specificity for sCD26 at 526 μg/L, the optimal diagnostic threshold, were 0.59 （95% CI： 0.48-0.72） and 0.80 （95% CI： 0.67-0.90）, respectively. Positive serum sCD26 was associated with colorectal cancer after adjusted for CEA with odds ration （OR） 5.17 （95% CI：1.72-15.53, P＜0.01）, as confirmed by logistic regression. Increased positive rate of serum sCD26 was observed in patients at Dukes A stage （P=0.03）, but not Dukes B, C, and D stage （P＜0.05）. Conclusions Serum sCD26 has high diagnostic performance for colorectal cancer. The association of sCD26 is independent of serum CEA. Compared to serum CEA, sCD26 has more potential to be an early biomarker for colorectal cancer diagnosis.
目的探讨术后早期肠梗阻的临床特点、诊断及治疗。方法对10例术后早期肠梗阻患者进行回顾性分析。结果10例均为机械性肠梗阻。保守治疗6例，其中治愈5例，死亡1例； 手术治疗4例，其中3例术中有绞窄性肠梗阻征象，均治愈。1例术中发现为广泛癌性粘连，行部分粘连松解术，术后第8天再发肠梗阻，保守治疗1天无效，患者自动出院。结论术后早期肠梗阻诊断并不困难； 保守治疗多数有效，故宜先行保守治疗； 可疑肠绞窄时应及时中转手术。
Clinically, non-contrastive computed tomography (NCCT) is used to quickly diagnose the type and area of stroke, and the Alberta stroke program early computer tomography score (ASPECTS) is used to guide the next treatment. However, in the early stage of acute ischemic stroke (AIS), it’s difficult to distinguish the mild cerebral infarction on NCCT with the naked eye, and there is no obvious boundary between brain regions, which makes clinical ASPECTS difficult to conduct. The method based on machine learning and deep learning can help physicians quickly and accurately identify cerebral infarction areas, segment brain areas, and operate ASPECTS quantitative scoring, which is of great significance for improving the inconsistency in clinical ASPECTS. This article describes current challenges in the field of AIS ASPECTS, and then summarizes the application of computer-aided technology in ASPECTS from two aspects including machine learning and deep learning. Finally, this article summarizes and prospects the research direction of AIS-assisted assessment, and proposes that the computer-aided system based on multi-modal images is of great value to improve the comprehensiveness and accuracy of AIS assessment, which has the potential to open up a new research field for AIS-assisted assessment.
ObjectiveTo investigate the improvement of femoral rotation alignment in total knee arthroplasty (TKA) by robotic-arm assisted positioning and osteotomy and its short-term effectiveness.MethodsBetween June 2020 and November 2020, 60 patients (60 knees) with advanced osteoarthritis of the knee, who met the selection criteria, were selected as the study subjects. Patients were randomly divided into two groups according to the random number table method, with 30 patients in each group. Patients were treated with robotic-arm assisted TKA (RATKA) in trial group, and with conventional TKA in control group. There was no significant difference in gender, age, side and course of osteoarthritis, body mass index, and the preoperative hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), posterior condylar angle (PCA), knee society score-knee (KSS-K) and KSS-function (KSS-F) scores between the two groups (P>0.05). The clinical (KSS-K, KSS-F scores) and imaging (HKA, LDFA, MPTA, PCA) evaluation indexes of the knee joints were compared between the two groups at 3 months after operation.ResultsAll patients were successfully operated. The incisions in the two groups healed by first intention, with no complications related to the operation. Patients in the two groups were followed up 3-6 months, with an average of 3.9 months. KSS-K and KSS-F scores of the two groups at 3 months after operation were significantly higher than those before operation (P<0.05), but there was no significant difference between the two groups (P>0.05). X-ray re-examination showed that the prosthesis was in good position, and no prosthesis loosening or sinking occurred. HKA, MPTA, and PCA significantly improved in both groups at 3 months after operation (P<0.05) except LDFA. There was no significant difference in HKA, LDFA, and MPTA between the two groups (P>0.05). PCA in trial group was significantly smaller than that in control group (t=2.635, P=0.010).ConclusionRATKA can not only correct knee deformity, relieve pain, improve the quality of life, but also achieve the goal of restoring accurate femoral rotation alignment. There was no adverse event after short-term follow-up and the effectiveness was satisfactory.