Objective To explore the application status of protease spectrum analysis in breast cancer. Methods The pertinent literatures in recent ten years were screened with key words “breast cancer，diagnosis，and protease spectrum”. Results At present，the candidate markers being identified in enzyme platform were less， such as ITIH4， C3adesArg，C3adesArg△8， haptoglobin-α1，S100-A9， and so on. In addition to S100-A9，the results of markers in the different research institutes were often contradictory. There had been no large-scale applications in clinical research and more further researchs were needed to prove it’s value. Conclusions Breast cancer tissue or cells obviously express chemokines and their receptors which participate the growth， invasion， and metastasis of breast cancer，and many factors influence the activation of their signals. With the development of proteomics research progress of technology and equipment， the improvement of method and more research data， protease spectrum plays an important role in improving the early diagnosis rate of breast cancer.
Objective To systematically review the clinical value of color Doppler ultrasonic for diagnosing female breast cancer. Methods We electronicaaly searched the databases including The Cochrane Library (Issue 2, 2013), EMbase, PubMed, CNKI, WanFang Data, MedaLink ,VIP and CBM for diagnostic tests on breast cancer diagnosed with color Doppler ultrasonic vs. with pathological biopsy (golden criteria) from 1982 to the March, 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies according to QUADAS items. The Meta-DiSc software (version 1.4) was used to conduct pooling on sensitivity, specificity, positive likelihood radio, and negative likelihood radio. Heterogeneity test was performed and the summary receiver operating characteristic curve (SROC) was drawn for area under the curve (AUC). Results A total of 25 studies involving 3 274 patients were included. The results of meta-analysis showed that, SPE, SEN, +LR, −LR and DOR were (0.76, 95%CI 0.74 to 0.78), (0.80, 95%CI 0.78 to 0.82), (3.58, 95%CI 2.63 to 4.87), (0.28, 95%CI 0.22 to 0.35) and (13.76, 95%CI 8.47 to 22.36), respectively. The AUC of SROC curve was 0.865 7. Conclusion Current evidence shows that color Doppler ultrasonic has high sensitivity (80%) and high specificity (76%) in the diagnosis of high-frequency Ultrasound. The positive rate in the breast cancer group is 13.76 times as high as that in non-breast cancer, which indicates color Doppler ultrasonic has good diagnostic value for breast cancer.
Objective To investigate the cl inical effect of minimally invasive internal fixation percutaneous plate osteosynthesis (MIPPO) assisted by arthroscopy on tibial plateau fractures. Methods From September 2005 to December 2007, 29 patients with tibial plateau fracture underwent arthroscopy-assisted MIPPO, including 18 males and 11 females aged18-59 years old (average 34.7 years old). There were 8 cases of type II, 10 of type III, 5 of type IV, 3 of type V, and 3 of type VI according to Schatzker classification system. The fracture was combined with meniscus injury in 13 cases, anterior cruciate l igament injury in 4 cases, and medial collateral l igament injury in 3 cases. The time from injury to operation was 2-10 days. Firstly, the combined injury was treated under arthroscopy. Then, reduction of tibial plateau fractures was performed, bone grafting was conducted in the area of bone defect, and internal fixation using strut plates was performed after establ ishing subcutaneous tunnel via minimally invasion. Early rehabil itation activities were carried out for each patient 1 day after operation. Results No early compl ications such as poor heal ing of incisions, infections, and osteofascial compartment syndrome occurred. Over the follow-up period of 12-39 months (average 24 months), there was no failure of internal fixation, traumatic knee osteoarthritis, and inversion and eversion of the knee. The fractures healed within 3-4.5 months (average 3.5 months). The cl inical effect was excellent in 23 cases, good in 4 cases, and fair in 2 cases according to Lysholm knee rating system, and the excellent and good rate was 93.1%. Conclusion Arthroscopy-assisted MIPPO is a safe and effective way of managing tibial plateau fractures due to its features of minimal invasion, earl ier recovery, fewer compl ications, and simultaneous treatment of associated intra-articular injuries.
Objective To evaluate the correlation between mycoplasma genitalium and HIV infection. Methods Databases including MEDLINE, ScienceDirect, EMbase, WanFang Data, and CNKI were searched from inception to March 2012, so as to identify the independent cohort studies, case-control studies and cross-sectional studies. Moreover, the references of relevant studies were also retrieved. According to the inclusion and exclusion criteria, the studies were screened, the data were extracted, and the methodological quality of the included studies was assessed. Then meta-analysis was performed using RevMan 4.2 and SAS 9.1.3 softwares. Results A total of 19 studies were included, including 3 430 HIV infected patients and 7 656 controlled participants. The results of meta-analyses showed that the HIV infection group was more likely to infect mycoplasma genitalium than the control group (OR=2.34, 95%CI 1.68 to 3.28, Plt;0.000 01). The same results were found in both subgroup and sensitivity analyses. Conclusion Mycoplasma genitaliuman infection is closely related to HIV infection. However, detailed pathogenesis is still unknown. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to prove the above.
目的:评价免疫印迹法检测胰岛自身抗体（GAD-A、ICA、IAA）与酶联免疫法测ICA、GAD-A放射免疫法测IAA结果的一致性。方法:采用免疫印迹法测定81例糖尿病患者胰岛自身抗体,将结果与酶联免疫法测定的GAD-A、ICA,放射免疫法测定IAA结果进行比较。结果:免疫印迹法阳性检出率为:GAD-A 51.8%,ICA 18.5%,IAA 27.1%；酶联免疫法（GAD-A、ICA）、放射免疫法（IAA）阳性检出率:GAD-A 32.1%,ICA 34.5%,IAA 30.8%；上述两组结果进行比较,两组相比ICA和GAD-A有统计学差异（Plt;0.05）,IAA无统计学差异。两组结果一致率比较:GAD-A 50.6%,ICA 64.2%,IAA 69.1%。结论:与临床常用酶联免疫法检测GAD-A、ICA,放射免疫法检测IAA比较,免疫印迹法和酶联免疫法在ICA及GAD-A阳性检出率上的差异有显著性,和放射免疫法在IAA阳性检出率上差异无显著性。
Lung four dimensional computed tomography (4D-CT) can lead to accurate radiotherapy. However, for the safety of patients, the scan spacing of 4D-CT cannot be too small so that the inter-slice resolution of lung 4D-CT is low, and thus the coronal and sagittal images need to be interpolated to obtain high-resolution images. This paper presents a super-resolution reconstruction technique based on multi-model Gaussian process regression. We use the high-resolution transversal images and the corresponding low-resolution images as the training sets. The high-resolution pixels of the coronal and sagittal images can be predicted by constructing multiple Gaussian process regression models. The experimental results show that our method is superior to bicubic algorithm, projections onto convex sets, sparse coding, multi-phase similarity based method and Gaussian process regression method based on self-learning block in terms of the edge and detail recovery. The results demonstrate that the proposed method can effectively improve the quality of lung 4D-CT images, and potentially be applied to better image-guided radiation therapy of lung cancer.
Objective To approach the prognosis after liver transplantation （LT） of liver function for Child grade A in patients with portal hypertension， and to compare with periesophagogastric devascularization with splenectomy （PDS）. Methods The data of 195 portal hypertension cases with Child A caused by hepatitis B cirrhosis who received surgical treatment of PDS （152 cases） or LT （43 cases） in division of liver transplantation center of West China Hospital of Sichuan University from 1999 to 2011 were retrospectively analyzed. The pre-， intra-， and postoperative variables in two groups that including patients’ age， score of Child， score of model for end-stage liver disease （MELD）， total bilirubin （TB），creatinine （Cr）， international normalized ratio （INR）， albumin （Alb）， complications of portal hypertension， amount of intraoperative bleeding and blood transfusion， operative time， and in the ICU and hospital stay time were compared. The postoperative outcomes were statistically analyzed including severe postoperative complications， short-term and long-term survival rates. Results Compared with PDS group， the amount of intraoperative bleeding and blood transfusion of LT group were morer （P＜0.05）， the operative time， in the ICU and hospital stay time of LT group were longer （P＜0.05）. The rate of severe postoperative complications in LT group was higher than that in PDS group 〔18.60% （8/43） vs. 1.97% （3/152），P＜0.05〕. The levels of TB and Cr during the postoperative period in LT group were higher than that in PDS group （P＜0.05）. Although the INR on day 1 after operation in LT group was higher than that in PDS group （P＜0.01）， but the difference disappeared soon on day 7 after operation in two groups （P＞0.05）.The 1-， 3-， and 5-year survival rates of the LT and PDS groups were 90.3%， 86.5%， 86.5%， and 100%， 100%， 100%， respectively， significant difference were observed in both short-term and long-term survival rates between the two groups （P＜0.05）. Conclusion LT offered no significant survival benefit to patients with portal hypertension and Child A due to hepatitis B cirrhosis， whereas PDS could be an effective treatment.
Objective To investigate the therapeutic effect of the chitosan/polyethylene glycols-succinate/ mitomycin C (CH/PEG-SA/MMC) film on epidural scarring tissues. Methods According to a specific proportion of respective materials, the film of CH/PEG-SA/MMC was developed under some condition. Thirty SD rats were selected and randomized into 6 groups with 5 rats in each group. A rat model of lumbar laminectomy was used. The amount of 20 mg of the CH film was implanted into the animals in group I, 20 mg of CH/PEG film in group II, 20 mg of CH/PEGSA film in group III, 0.05 mg/mL of the MMC soaking for 5 minutes in group IV, 20 mg of CH/PEG-SA/MMC film in group V, and nothing was done in group VI. Specimens were harvested 4 weeks after the above procedures and were then subjected to immunohistochemical and histological examinations to compare their therapeutic effects on epidural cicatricial tissues. Results All rats were in good conditions after operation, without gait abnormal ity, restlessness, infection and death. There was no significant difference among the 6 groups in the postoperative Rydell score (P lt; 0.05). The content of hydroxyprol ine in groups I, II, III, IV, V and VI was (0.570 8 ± 0.345 0), (0.728 6 ± 0.150 6), (0.553 4 ± 0.122 3), (0.313 3 ± 0.106 4), (0.261 9 ± 0.102 1)and (1.020 1 ± 0.120 6) μg/ mg, respectively. There was a significant difference between groups IV, V and groups I, II, III (P lt; 0.05), and there was significant difference between group VI and the rest 5 groups (P lt; 0.05). According to the histological observation, group V had less collagenous fiber parallel ing the dura mater, with few inflammatory cells infiltration, with few capillary vessels and no reaction of macrophages. Conclusion CH/PEG-SA/MMC films can effectively reduce the amount of Hyp in epidural scarring tissues after lumbar laminectomy and therefore is a good treating method in preventing scarring tissue adhesion.
ObjectiveTo evaluate the efficacy of tubless therapy for pulmonary bulla resection under the concept of fast track surgery.MethodsWe retrospectively analyzed the clinical data of 45 patients (29 males and 16 females at an average age of 26.1 years) with pulmonary bullae in our hospital between January 2015 and December 2017. These patients were divided into two groups. Among them, 25 patients were treated with preoperative gastric tubes and catheters, tracheal intubation anesthesia and postoperative drainage tubes (a tube group). And 20 patients were treated with no preoperative gastric tube or catheter, sublaryngeal anesthesia and no postoperative drainage tube (a tubless group). ResultsThere was a statistical difference in postoperative pain index (2.60±1.14 vs. 5.16±1.24, P<0.001) and larynx complication (P=0.00) between the two groups. Shorter period of epidural analgesic tubes (1.40±0.50 d vs. 2.84±0.75 d, P<0.001), shorter operation and anesthesia time (15.00±2.59 min vs. 18.56±2.10 min, P<0.001; 95.30±4.38 min vs. 105.50±4.59 min, P<0.001), shorter hospital stay (9.45±1.66 d vs. 12.80±1.87 d, P<0.001), and less expense (20 245.96±1 113.02 yuan vs. 22 147.06±1 735.01 yuan, P<0.001) in the tubless group were found compared with the tube group. But there was no statistical difference in incidence of complication of lung (P=0.43) between the two groups.ConclusionTubless therapy in the treatment of pulmonary bulla resection can accelerate the postoperative recovery with shorter hospital stay and less expense, and is an advantageous treatment.
ObjectiveTo investigate the clinical value of multidisclplinary team (MDT) in the application of non-small cell lung cancer (NSCLC). MethodsWe retrospectively analyzed the postoperative clinical data of 80 patients with NSCLC in the First Hospital of Lanzhou University between January 2014 and May 2018. There were 56 males, 24 females at age of 59±10 years. Forty five patients were performed lobectomy with conventional model, 35 patients were also performed lobectomy after MDT discussion. The clinical effect of the two groups was compared. ResultsCompared to conventional model, MDT can shorten operation time, intraoperative blood loss, postoperative chest drainage, catheterization time, complications, length of stay and hospital costs. But there was no significant difference in intraoperative transthoracotomy proportion, delayed wound healing and postoperative pulmonary leakage between the two groups. ConclusionThe efficacy of MDT in the surgical treatment of NSCLC is satisfactory. The MDT is valuable during operation, which reduces surgical trauma and accelerate patients’ recovery, and deserves the clinical promotion.