Objective To explore the management practices of projects supported by National Natural Science Foundation in a large general hospital. Methods We carried out an overall analysis on the data of projects supported by National Natural Science Foundation of China from 2011 to 2016 in West China Hospital of Sichuan University. The characteristics of researchers who were granted the foundation were also studied. Results In the recent six years, there were 767 projects granted by the National Natural Science Foundation in the hospital, with an average of 127 projects a year. The Department of Medical Sciences was the top source of approval for the projects (690 items), and its granted projects covered all the categories set by the foundation committee. Most of the researchers who got the fund were between 25 and 40 years of age (501 projects). Researchers in charge of general projects were mainly professors with an age of (43.54±7.28) years old in average. Researchers in charge of Projects for Distinguished Young Scholars were mainly of medium-grade professional titles, and their average age was (32.01±3.05) years old. Moreover, among these young scholars, the age of male researchers [(31.27±2.23) years old] was significantly younger than that of female scholars [(32.90±3.62) years old](P<0.01). Conclusion It is more and more important for National Natural Science Foundation of China to study the accumulation of early research of young scholars and the leading role of the hospital in basic research, personnel training and discipline construction.
ObjectiveTo review the research progress of the surgical treatment for lateral malleolus defect.MethodsThe related literature about surgical treatment and effectiveness of lateral malleolus defect at home and abroad was reviewed, summarized, and analysed.ResultsLateral malleolus defects are often caused by severe trauma or wide resection of fibular neoplasms. Although the incidence is not high, the defects are difficult to handle. These bony defects should be reconstructed to prevent an abnormal gait induced by ankle instability and avoid the occurrence of traumatic arthritis. Various repair methods have been developed, including bone transplantation, fibula lengthening, and ankle arthrodesis.ConclusionThere are various surgical methods to repair the defect of lateral malleolus, but each has its own advantages and disadvantages. In order to achieve the best results, the surgeon should choose the appropriate operation according to his own level, the patient’s specific injury, and age.
Abstract： Objective To evaluate the effect of 100% carbolic acid via bronchofiberscope for the treatment of bron- chopleural fistula. Methods We retrospectively analyzed clinical data of 12 patients with postoperative bronchopleural fistula in Liaoning Tumor Hospital from February 2009 to March 2012. There were 11 male patients and 1 female patient with their average age of 58.0 （45-71） years. All the patients had primary lung cancer, including squamous cell carcinoma in 8 patients and adenocarcinoma in 4 patients， central lung cancer in 8 patients and peripheral lung cancer in 4 patients. Three patients were after right total pneumonectomy， 6 patients were after left total pneumonectomy， 2 patients were after right middle and lower lobectomy， and 1 patient was after left upper lobectomy. All the patients received 100% carbolic acid instillation via bronchofiberscope， and 0.5-1.0 ml carbolic acid solution was instilled on the mucosal surface around the fistula each time. The presence of bubbles in thoracic drainage was observed. If some bubbles remained, such treatment was repeated after 1 week. The effectiveness was analyzed. Results All the 12 patients were cured after carbolic acid treatment, including 8 patients after 5 times of carbolic acid instillation， 2 patients after 7 times of carbolic acid instillation， and 2 patients after 2 times of carbolic acid instillation. The average time for fistula closure was 33 days. All the patients were treated in our outpatient clinic except 2 patients who were too weak but cured after 42 days and 50 days of hospitalization respectively. Conclusion The use of 100% carbolic acid instillation via bronchofiberscope can provide satisfactory clinical outcomes for the treatment of bronchopleural fistula.
Objective Inappropriate drug dosage is a serious problem in pediatrics, mainly due to the lack of clinical evidence in children, suitable preparation formulation, and standardized methods for dose adjustment. A method for evaluating and monitoring appropriate dosage in pediatrics is urgently needed. The drug utilization index (DUI) based on the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) has been widely used in the assessment of appropriate dosage in adults. We explored possible methods for assessing appropriate dosage in children. Methods Based on our previous studies, we discuss cDUI in the assessment of appropriate dosage in children as follows: the meaning of cDDD, the establishment of a standardized system, and the classified evaluation of dosage in pediatrics. Results Although the definition of cDDD draws on the concept of defined daily dose (DDD), the meaning of cDDD is different from that of the latter. Specifically, the purpose of cDDD is to evaluate appropriate pediatric dose, while DDD is a unit of measurement. cDDD could be used to assess dose rationality for common and serious pediatric diseases, and would be refined over time. A single cDDD should be assigned per drug and indication and given per drug and route of administration. The influence of age, weight, diagnosis, and administration route on the dosage should be considered. Classified evaluation should be used and weight should be given to the above mentioned factors in order to evaluate the appropriate dose objectively and comprehensively. Conclusion Dosage regulation in pediatrics has an important role in improving medical quality and protecting the safety, effectiveness, and economy of medical therapy in children. The establishment of a cDUI system is a good try in pediatric dosage evaluation. Although there are still defects within this proposed system and methodology, the principle seems feasible.
Objective To investigate the expressions of CXCR4 and β-catenin in pancreatic cancer, explore the relationship between them, and explore the possible biomarkers about invasion and metastasis of pancreatic cancer. Methods Forty-eight samples of pancreatic cancer and 20 samples of normal pancreas tissues were selected. The expressions of CXCR4 and β-catenin were examined by the immunohistological technique. Spearman, Chi-square， and rank test were used to analyze the relation between the protein expressions and clinical characteristics. Survival analysis was evaluated by Kaplan-Meier product limit method and Log-rank test. Variables were evaluated by Cox proportional hazards analysis. The size of test was 0.05. Results The positive expression rates of CXCR4 and β-catenin in pancreatic cancer tissues were 85.4% (41/48) and 75.0% (36/48), respectively. Co-expression rate of CXCR4 and β-catenin was 70.8% (34/48). There were significant differences between various CXCR4 staining and lymph node metastasis and TNM stage (P=0.012, 0.005, respectively). β-catenin positive expression was associated with lymph node metastasis (P=0.047). However, abnormal β-catenin positive expression could not determine the clinical survival. Kaplan-Meier estimated curves suggested that clinical prognosis was poor for patients with CXCR4 expression. Multivariate analysis showed that CXCR4, late TNM stage, and lymph node metastasis were independent prognostic factors for pancreatic cancer. Conclusions Both CXCR4 and β-catenin abnormally express in pancreatic cancer. CXCR4 may be an important marker for pancreatic cancer progression.
Objective To explore the effects of enteral tube feeding on moderate AECOPD patients who underwent noninvasive positive pressure ventilation ( NPPV) . Methods Sixty moderate AECOPD patients with NPPV admitted from January 2009 to April 2011 were recruited for the study. They were randomly divided into an enteral tube feeding group (n=30) received enteral tube feeding therapy, and an oral feeding group (n=30) received oral feeding therapy. Everyday nutrition intake and accumulative total nutrition intake in 7 days, plasma level of prealbumin and transferrin, success rate of weaning, duration of mechanical ventilation, length of ICU stay, rate of trachea cannula, and mortality rate in 28 days were compared between the two groups. Results Compared with the oral feeding group, the everyday nutrition intake and accumulative total nutrition intake in 7 days obviously increased (Plt;0.05) , while the plasma prealbumin [ ( 258.4 ±16.5) mg/L vs. (146.7±21.6) mg/L] and transferrin [ ( 2.8 ±0.6) g/L vs. ( 1.7 ±0.3) g/L] also increased significantly after 7 days in the enteral tube feeding group( Plt;0.05) . The success rate of weaning ( 83.3% vs. 70.0%) , the duration of mechanical ventilation [ 5. 6( 3. 2-8. 6) days vs. 8. 4( 4. 1-12. 3) days] , the length of ICU stay [ 9. 2( 7. 4-11. 8) days vs. 13. 6( 8.3-17. 2) days] , the rate of trachea cannula ( 16. 6% vs. 30. 0% ) , the mortality rate in 28 days ( 3. 3% vs. 10. 0% ) all had significant differences between the enteral tube feeding group and the oral feeding group. Conclusions For moderate AECOPD patients with NPPV, enteral tube feeding can obviously improve the condition of nutrition and increase the success rate of weaning, shorten the mechanical ventilation time and the mean stay in ICU, decrease the rate of trachea cannula and mortality rate in 28 days. Thus enteral tube feeding should be preferred for moderate AECOPD patients with NPPV.
In order to solve the problem of early classification of Alzheimer’s disease (AD), the conventional linear feature extraction algorithm is difficult to extract the most discriminative information from the high-dimensional features to effectively classify unlabeled samples. Therefore, in order to reduce the redundant features and improve the recognition accuracy, this paper used the supervised locally linear embedding (SLLE) algorithm to transform multivariate data of regional brain volume and cortical thickness to a locally linear space with fewer dimensions. The 412 individuals were collected from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) including stable mild cognitive impairment (sMCI, n = 93), amnestic mild cognitive impairment (aMCI, n = 96), AD (n = 86) and cognitive normal controls (CN, n = 137). The SLLE algorithm used in this paper is to calculate the nearest neighbors of each sample point by adding the distance correction term, and the locally linear reconstruction weight matrix was obtained from its nearest neighbors, then the low dimensional mapping of the high dimensional data can be calculated. In order to verify the validity of SLLE in the task of classification, the feature extraction algorithms such as principal component analysis (PCA), Neighborhood MinMax Projection (NMMP), locally linear mapping (LLE) and SLLE were respectively combined with support vector machines (SVM) classifier to obtain the accuracy of classification of CN and sMCI, CN and aMCI, CN and AD, sMCI and aMCI, sMCI and AD, and aMCI and AD, respectively. Experimental results showed that our method had improvements (accuracy/sensitivity/specificity: 65.16%/63.33%/67.62%) on the classification of sMCI and aMCI by comparing with the combination algorithm of LLE and SVM (accuracy/sensitivity/specificity: 64.08%/66.14%/62.77%) and SVM (accuracy/sensitivity/specificity: 57.25%/56.28%/58.08%). In detail the accuracy of the combination algorithm of SLLE and SVM is 1.08% higher than the combination algorithm of LLE and SVM, and 7.91% higher than SVM. Thus, the combination of SLLE and SVM is more effective in the early diagnosis of Alzheimer’s disease.
Objective To investigate the expressions of aldehyde dehydrogenase 1 (ALDH1) and sex determining region Y-box protein 2 (SOX2) in breast cancer tissues and their clinical significance. Methods Immunohistochemistry was used to detect the expressions of ALDH1 and SOX2 protein in cancerous and its paracancer tissues of 80 patients with breast cancer treated in our hospital from 2017 to 2019, and to analyze the correlation between the expressions of ALDH1 and SOX2 protein, as well as the relationship between their expression and clinicopathological characteristics and prognosis of breast cancer patients. Results The positive expression rates of ALDH1 and SOX2 protein in breast cancer tissues were 75.0% and 62.5%, respectively. The positive expression rates of ALDH1 and SOX2 protein in paracancer tissues were 30.0% and 21.3%, respectively. The positive rates of ALDH1 and SOX2 protein expressions in breast cancer tissues were higher than those in paracancer tissues, and the difference was statistically significant (P<0.05). The expressions of ALDH1 and SOX2 proteins in breast cancer tissues were correlated with histological grade, TNM stage and axillary lymph node status of breast cancer (P<0.05). By Spearman correlation analysis, ALDH1 was positively correlated with SOX2 expression (rs=0.507, P<0.001). The univariate analysis of statistically significant indicators and the combination of clinical characteristics of the logistic regression multivariate analysis found that, breast cancer tumor size, histological grade, TNM stage, axillary lymph node status and ALDH1 protein and SOX2 protein expressions were not significantly correlated with those reaching disease-free survival (DFS) after follow-up (P>0.05, which may be affected by small sample size and small number of endpoint events). The Kaplan-Meier method was used to plot survival curves, and log-rank test results showed that the cumulative DFS rates of patients with positive ALDH1 and SOX2 protein expression were lower than those of with negative expression (P<0.05). Conclusions ALDH1 and SOX2 proteins are highly expressed in breast cancer tissues, and they are positively correlated. Survival curves show that positive ALDH1 and SOX2 proteins in breast cancer tissues tend to have a poorer prognosis.
ObjectiveTo investigate the effect of extranodal extension of axillary lymph nodes metastasis on the prognosis of patients with triple-negative breast cancer (TNBC). MethodsThe TNBC patients with axillary lymph node metastasis admitted to the Nanyang Central Hospital from January 2017 to January 2019 were collected. The clinicopathologic characteristics and prognosis of TNBC patients with or without extranodal extension were analyzed and compared, and the factors affecting prognosis were analyzed. ResultsA total of 216 patients were included, including 123 patients without extranodal extension and 93 patients with extranodal extension. Compared with the patients without extranodal extension, the proportions of the patients with histological grade Ⅲ, 10 or more metastatic lymph nodes, and 5 cm or greater tumor diameter were higher in the patients with extranodal extension (P<0.05). The results of multivariate analysis showed that the 10 or more metastatic lymph nodes was the risk factor affecting the overall survival (OS) and disease-free survival (DFS) of the TNBC patients (P<0.05), and the histological grade Ⅲ and lower human epidermal growth factor receptor-2 (HER-2) expression were the risk factors affecting the OS of the TNBC patients (P<0.05), as well as the extranodal extension was the risk factor affecting the DFS of the TNBC patients (P<0.05). The 5-year cumulative disease-free survival rate of the patients with extranodal extension was worse than that of the patients without extranodal extension (70.2% vs. 83.3%, χ2=6.934, P=0.008). The 5-year cumulative overall survival rate had no statistically significant difference between the them (75.3% vs. 82.1%, χ2=1.969, P=0.161). ConclusionsFrom the results of this study, the prognosis of TNBC patients with extranodal extension is worse. Especially the patients with histological grade Ⅲ, 10 or more metastatic lymph nodes, and with lower HER-2 expression should be paid attention.
Objective To evaluate the outcomes of sleeve resection following neoadjuvant chemoimmunotherapy for lung cancer. Methods The clinical data of patients diagnosed with lung cancer and underwent sleeve lobectomy surgery at Tianjin Chest Hospital were retrospectively analyzed. Patients were divided into two groups: a neoadjuvant treatment group and a surgery alone group. The clinical data of two groups were compared. Results Finally 22 patients were collected, including 19 males and 3 females with a median age of 63 years. There were 7 patients in the neoadjuvant treatment group, and 15 patients in the surgery alone group. There was no statistical difference in surgical time, intraoperative bleeding, lymph node dissection, postoperative catheterization time, or postoperative drainage volume between the two groups (P>0.05). In the neoadjuvant treatment group, 1 patient had a second thoracotomy exploration for hemostasis due to bronchial artery bleeding, 2 patients had wound infection, 1 patient had immune-associated pneumonia before surgery, and 1 patient had immune-associated pneumonia before postoperative adjuvant therapy. Postoperative pathological results of patients in the neoadjuvant treatment group showed that 1 (1/7, 14.3%) patient had pathological complete response, and 3 (3/7, 42.9%) patients achieved major pathological response. Conclusion Neoadjuvant chemoimmunotherapy can lead to complications, including operation-related complications and immunotherapy-related complications. However, the degree of postoperative pathological remission is also significantly improved. Overall, sleeve resection following neoadjuvant chemoimmunotherapy can be considered as a treatment option for patients with lung cancer.