The esophageal disease is a major clinical disease. The esophageal stent has extensive clinical applications in the treatment of esophageal diseases. However, the clinical application of esophageal stent is limited, because there are lots of complications after implantation of esophageal stent. Biodegradable esophageal stent has two advantages: biodegradability and good histocompatibility. It is expected to solve a variety of complications of esophageal stent and provide a new choice for the treatment of esophageal diseases. Standardized esophageal stents are not fully applicable to all patients. The application of 3D printing technology in the manufacture of biodegradable esophageal stent can realize the individualized treatment of esophageal stent. And meanwhile, the 3D printing technology can reduce the manufacturing cost of the stent. This review aimed to summarize and discuss the application of esophageal stent, the current research status and prospect of biodegradable esophageal stent and the prospect of 3D printing technology in degradable esophageal stent, hoping to provide evidence and perspectives for the research of biodegradable esophageal stent.
目的:总结分析子宫内膜癌临床特点、治疗方法的疗效及与各预后高危因素之间的关系，以提高临床诊疗水平。方法:回顾性分析我院1998年1月～2005年12月收治住院的子宫内膜癌患者499例的临床病理资料，总结患者的一般情况、临床特点并进行随访，分析内膜癌高危因素对预后的影响。采用寿命表法计算患者生存率，Wilcoxon (Gehan) 比分法及Cox比例风险模型分析预后因素。结果:(1) 手术－病理分期I、Ⅱ、Ⅲ期患者5年生存率分别为94%、100％、75.3％，IV期患者1年生存率57.1%、2年生存率11.4％。(2) 单因素分析显示：病理类型、手术－病理分期、组织学分级、肌层浸润深度、淋巴结转移和是否行淋巴结切除术是影响预后的高危因素。（3）多因素分析显示：病理类型、手术－病理分期、组织学分级和肌层浸润深度是影响患者预后的独立危险因素。结论:(1) 对具有高危因素的患者，如特殊病理类型、手术－病理分期期别晚、组织学分级为G3和深肌层浸润，应辅以术后治疗以提高生存率。(2)分期越晚，生存率越低（Plt;0.05）。
Objective To investigate the relationship between Oxfordshire community stroke project (OCSP) classification and MRI classification in acute cerebral infarction. Methods A total of 282 patients with acute cerebral infarction were retrospectively evaluated with OCSP classification and imaging characteristics. Results According to OCSP classification, of all 282 patients with acute cerebral infarction, 32 (11.3%) experienced total anterior circulation infarction (TACI), 86 (30.5%) partial anterior circulation infarction (PACI), 111 (39.4%) lacunar infarction (LACI), and 53 (18.8%) posterior circulation infarction (POCI). The consistency was found in 201 cases (71.3%) between the OCSP classification and imaging classification, with the accuracy of 77% (27/35) for TACI, 79% (42/53) for PACI, 69% (95/137) for LACI and 65% (37/57) for POCI. Conclusion OCSP classification can predict the location and size of cerebral infarction with a high accuracy, and is well consistent with the MRI findings.
Objective To explore the characteristics of cognitive impairment in patients with alcohol dependence, and analyze the related influencing factors. Methods The Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of 65 alcohol dependent patients hospitalized between January 1st and December 31st, 2014. The features of cognitive impairment and related influencing factors were analyzed. Results The differences of MoCA attention and delayed recall between different drinking year groups had statistical significance (P<0.05). The correlations of drinking year with MoCA attention (r=–0.250,P=0.044), and with delayed recall (r=–0.326,P=0.008) were both negative. MoCA scores, naming, attention and delayed recall were different statistically among different age groups (P<0.05). The correlations of ages with MoCA scores (r=–0.429,P<0.001), naming (r=–0.261,P=0.035), attention (r=–0.391,P=0.001) and delayed recall (r=–0.461,P<0.001) were all negative. MoCA scores, the visuoconstructional skills, language, abstraction and delayed recall were significantly different among different education level groups (P<0.05). The correlations of education level with MoCA scores (rs=0.650,P<0.001), the visuoconstructional skills (rs=0.540,P<0.001), language (rs=0.486,P<0.001), abstraction (r=0.602,P<0.001) and delayed recall (rs=0.593,P<0.001) were all positive. Ages had an effect on MoCA scores by multiple linear regression analysis (P<0.01). Conclusions For alcohol dependent patients with cognitive impairment, cognitive function is correlated with drinking year, age and education level. The cognitive function is much serious in patients with older age and longer drinking years. This kind of patients should be focused on and intervened early.
Objective To integrate the result of whole genome expression data and whole genome promoter CpG island methylation data, to screen the epigenetic modulated differentially expressed genes from transformed porcine bone marrow mesenchymal stem cells (BMSCs) after long-term cultivation. Methods Bone marrow from 6 landrace pigs, 3-month-old about 50 kg weight, was aspirated from the medullary cavity of the proximal tibia. The BMSCs were isolated, and purified by Ficoll density gradient centrifugation combined with adherent culture method. The transfor mation of BMSCs was tested by several methods including cell morphology observation, karyotype analysis, clone forming in soft agarose, serum requirement assay, and tumor forming in mice. The Agilent Pig 4x44k Gene Expression Microarray was used to investigate the differentially expressed mRNA. The methylated genes expression profile was performed using customized pig methylation chip. The gene expression and DNA methylation profiles were integrated to find out the epigenetic modulated differentially expressed genes, and to complete the bioinformatic analysis. Results BMSCs showed a change in appearance, from the initial spindle shape to a more flatted morphology then to small contact shape. After additional passages, BMSCs gradually acquired recovery of proliferating capacity and transformation properties such as anchorage-independent growth, chromosomal abnormality, and tumor formation in nude mice. The gene chip analysis demonstrated that 257 genes were upregulated and 315 genes were downregulated during long-term cultures as well as multiple signal pathways transduction involved, such as cell cycle, ECM-receptor interaction, focal adhesion, regulation of actin cytoskeleton, pathways in cancer, and P53. The analysis from methylation chip of coding genes suggested epigenetic regulation was involved in BMSCs spontaneous transformation and play a important role on it; 962 genes were hypermethylated and 1219 genes were hypomethylated, which were involved in the biological process of cellular metabolic, structure, and tumor generation. The combined analysis of genes regulated by methylation in the transformation process of BMSCs found that the methylation changes of the 35 genes were contrary to the direction of expression change (correlation coefficient r=–0.686, P=0.000); in which the methylation level of 21 genes promoter regions were increased while the gene expression decreased, and the methylation level of the 14 genes promoter regions decreased and the gene expression increased. At the same time, KEGG enrichment analysis revealed multiple genes regulated by methylation, involved in stem cell differentiation and multiple cell signaling pathways. Among the 14 down-regulated genes, many of them have the role of regulating the interaction of tumor and immunization, and the change of the methylation status of the CDKN3 promoter region may be closely related to the cell oncology. Conclusion The results deepen our understanding of the crucial role of coding genes methylation modification in BMSCs transformation, and may provide new approach to establish safe criteria for BMSCs clinical applications and transformation prevention.
目的 调查汶川地震灾区中学生肠易激综合征（IBS）的患病情况，分析罗马Ⅱ和罗马Ⅲ诊断标准对该人群IBS患病率的影响。 方法 在汶川地震后2年半和3年，分别用罗马Ⅱ和罗马Ⅲ标准制定IBS中学生问卷调查表对地震灾区和非地震灾区5所中学的中学生进行2次调查，分析比较IBS患病率的变化。 结果 用罗马Ⅱ标准调查发现地震灾区中学生IBS患病率为23.6%；非地震灾区患病率为21.6%，二者比较无统计学意义（P=0.267）；用罗马Ⅲ标准调查发现地震灾区中学生IBS患病率为6.2%，非地震灾区患病率为4.6%，二者比较无统计学意义（P=0.139）。符合两种诊断标准的地震灾区IBS学生有10.3%，非地震灾区IBS学生有9.2%，两者差异无统计学意义（P＞0.05）。②支持两种诊断标准的症状方面，地震灾区IBS学生每天排便＞3次或每周排便＜3次等症状相比较有统计学意义（P＜0.001）。③按罗马Ⅲ标准，各亚型构成比IBS-C为30.4%，IBS-D为28.4%，IBS-M为8.8%，IBS-U为32.4%；按罗马Ⅱ标准，各亚型构成比为IBS-C为28.5%，IBS-D为47.7%，腹泻和便秘交替型为18.6%，罗马Ⅲ标准中的IBS-M和IBS-U合为一组与罗马Ⅱ标准中的腹泻和便秘交替型的构成比进行比较，二者有统计学意义（P＜0.001）。 结论 罗马Ⅱ和罗马Ⅲ两种标准调查地震灾区中学生IBS患病率和分型存在着差异，但两种标准对地震灾区IBS患病率的影响是对等的，患病率和分型的不同是由两种标准的本身的差异造成，可能更接近罗马Ⅲ诊断标准。
Objective To discuss feasibility and effectivity of intraoperative ultrasound (US) during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm. Methods A radiographic contrast nephropathy patient of abdominal aortic aneurysm and left internal iliac artery aneurysm was treated by EVAR without iodine contrast media assisted by US. Then summarized the data of this patient. Results The precise placement of the stent-graft was performed for abdominal aortic aneurysm. The left internal iliac artery aneurysm was successfully treatment with the stent-graft and coils. Intraoperative Ⅱ type endoleak from inferior mesenteric artery and Ⅰ b type endoleak from right iliac stent were identified by using US. The operative duration was 120 min and the blood loss was only 20 mL. Ⅱ type endoleak was still detected and the Ⅰ b type of endoleak was loss on postoperative a week. Conclusion Intraoperative US-assisted EVAR in patients with infrarenal abdominal aortic aneurysm represents a new option for intraoperative visualization of aortoiliac segments required as proximal or distal fixation zones and identification of endoleaks, especially in those patients with contraindications for usage of iodine-containing contrast agents.
ObjectiveTo systematically review the efficacy of kinesio taping on upper limb function recovery in stroke patients.MethodsPubMed, The Cochrane Library, Web of Science, WanFang Data, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of the efficacy of kinesio taping on upper limb function recovery in stroke patients from inception to December 20th, 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 13 RCTs involving 589 patients were included. The results of meta-analysis showed that: compared with the control group, kinesio taping significantly improved FMA-UE score (MD=6.21, 95%CI 3.68 to 8.74, P<0.000 01), VAS score (MD=1.76, 95%CI 1.30 to 2.23, P<0.000 01) and MBI score (MD=10.28, 95%CI 8.43 to 12.13, P<0.000 01) of patients.ConclusionCurrent evidence shows that the kinesio taping can significantly improve the upper limb motor function, pain and daily living ability of stroke patients. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
ObjectiveTo verify the existing domestic and foreign formulas of normal predictive value indicator for adult pulmonary diffusion capacity’s applicability at current stage in Kunming.MethodsBased on the pulmonary diffusion capacity parameters determination of diffusion capacity for carbon monoxide of the lung (DLCO) collected from one-breath breathing test completed by 680 adults with healthy lung function and without any disease which may cause pulmonary diffusion dysfunctions in Kunming, the regression equation of adult DLCO normal predicted value in Kunming was initially established; the fitting degree of DLCO predicted value and measured value was verified; and the correlation between European adults (instrument-inherent ECCS93) and the normal predicted values of adult DLCO in Shanghai, Chongqing and Lhasa were calculated and contrasted.ResultsThe regression equation of adult DLCO normal predicted value in Kunming was initially established: for male, 0.483+0.063×height (cm)+0.041×weight (kg)–0.071×age (years); for female, 1.679+0.055×height (cm)+0.018×weight (kg)–0.060×age (years). The data collected from the one-breath breathing test were similar to the predicted values obtained from the normal adult male and female DLCO prediction formulas in Kunming, the difference was not statistically significant (tM=–0.167, tF=–0.436, both P>0.05), suggesting that the formula for predicting the value established in this study was valid and well fitted. The predicted value of adult DLCO in Kunming area was statistically significant compared with the adult DLCO estimates of European adults and Lhasa, Chongqing and Shanghai in China (FM=713.4, FF=1 442.2, both P<0.001). Lhasa had the highest value; Kunming was the second highest; instrument-inherent European area and Chongqing came to third and fourth; and Shanghai had the lowest predicated adult DLCO value (all P<0.001).ConclusionThe current predictive formulas for adult pulmonary diffusion capacity indicators in China and worldwide are not suitable for the populations in Kunming.