Objective To study the expressions of phosphatese and tensin homolog deletedin chromosom ten （PTEN）, Fas/FasL system and matrix metalloproteinnases-2 （MMP-2） in human gastric cancer. Methods Seventy-five cases of gastric carcinoma were selected from paraffin wax embodied specimens with full clinicopathological data, and another 15 cases of normal gastric mucosa specimens were selected as the control group. SP immunohistochemistry was used to measure the expressions of PTEN， Fas/FasL and MMP-2 in them. The data was statistically analyzed by χ2 test and relative analysis. Results The expressions of PTEN, Fas/FasL and MMP-2 were correlated with the lymphatic metastasis, degree of infiltration, clinical TMN stage and pathological histological differentiated degree of gastric cancer (Plt;0.05). PTEN was positive correlated with Fas/FasL (r=0.401, Plt;0.001). MMP-2 was negative correlated with Fas/FasL (r=－0.720， Plt;0.001). MMP-2 was negative correlated with PTEN (r=－0.336， Plt;0.001). Conclusion There is guidance meaning in testing the expressions of PTEN, Fas/FasL and MMP-2 in gastric cancer to estimate the prevention, diagnoses, therapy and prognosis of gastric cancer.
Objective To compare efficacy of laparoscopic and open duodenal circular drainage operation for superior mesenteric artery compressing syndrome (SMACS). Methods From December 2012 to December 2015, the clinical data of 23 cases of laparoscopic duodenal circular drainage operation (laparoscope group) and 28 cases of open duodenal circular drainage operation (open group) were analyzed. The operation time, intraoperative bleeding, postoperative ambulation time, postoperative analgesics usage, postoperative the first exhaust time, postoperative the first feeding time, postoperative hospitalization time and postoperative incidence of complications were compared. The patients were followed up to confirm the effect after the operation. Results There were no differences of the age, sex, and body weight index between the laparoscope group and the open group (P>0.05). The operation time had no significant difference between these two groups (P>0.05). Compared with the open group, the intraoperative bleeding was less (P<0.05), the postoperative ambulation time, postoperative the first exhaust time, postoperative the first feeding time, postoperative hospitalization time were shorter (P<0.05), the rates of postoperative analgesics usage, incision infection, pulmonary infection, and intestinal obstruction were lower (P<0.05) in the laparoscope group. The rates of anastomotic leakage and anastomotic bleeding, and total postoperative complications rate had no significant differences between these two groups (P>0.05). All the patients were followed up for 8–36 months. The clinical symptoms disappeared and the body weight increased to normal level in the two groups. Conclusions Preliminary results of in this study show that laparoscopic duodenal circular drainage operation in treatment of SMACS has some advantages such as less trauma, faster recovery, fewer complications and shorter hospitalization time. Laparoscopy will be an ideal choice for treatment of SMACS.
Objective To explore the mechanism, surgical method, and effectiveness of proximal phalangeal bone avulsion fracture caused by A2 circular trochlea injury of the flexor digitorum tendon. Methods A retrospective analysis was conducted on the clinical data of 4 patients with proximal phalangeal bone avulsion fracture caused by A2 circular trochlea injury of flexor digitorum tendon admitted between May 2018 and September 2022. The patients were all male, the age ranged from 26 to 52 years, with an average of 33 years. The injured fingers included 1 case of middle finger and 3 cases of ring finger. The causes of injury were rock climbing of 2 cases and carrying heavy objects of 2 cases. Preoperative anteroposterior and lateral X-ray films and CT examination of the fingers showed a lateral avulsion fracture of the proximal phalanx, with a fracture block length of 15-22 mm and a width of 3-5 mm. The total active range of motion (TAM) of the injured finger before operation was (148.75±10.11)°. The grip strength of the middle and ring fingers was (15.50±2.88) kg, which was significantly lower than that of the healthy side (50.50±7.93) kg (t=−8.280, P<0.001). The time from injury to operation was 2-7 days, with an average of 3.5 days. One Kirschner wire with a diameter of 1.0 mm was used for direct fixation through the fracture block, while two Kirschner wires with a diameter of 1.0 mm were used for compression fixation against the fracture block. The fracture healing was observed, and the TAM of the injured finger and the grip strength of the middle and ring fingers were measured. The finger function was evaluated according to the upper limb functional assessment trial standards of the Chinese Medical Association Hand Surgery Society. ResultsThe incisions all healed by first intention after operation. All patients were followed up 6-28 months, with an average of 19 months. X-ray films showed that all avulsion fractures of proximal phalanx reached bony union, and the healing time ranged from 4 to 8 weeks, with an average of 4.6 weeks. At last follow-up, the grip strength of the middle and ring fingers was (50.50±7.76) kg, which significantly improved when compared with preoperative one (t=−8.440, P<0.001). The TAM of the injured finger reached (265.50±2.08)°, and there was a significant difference when compared with preoperative one (t=−21.235, P<0.001). According to the upper limb functional assessment trial standards of the Chinese Medical Association Hand Surgery Society, the finger function was all evaluated as excellent in 4 cases. ConclusionUsing Kirschner wire fixation through bone blocks and external compression fixation of bone blocks for treating proximal phalangeal bone avulsion fracture caused by A2 circular trochlear injury of the flexor digitorum tendon can achieve good effectiveness.
目的 探讨姑息性右室-肺动脉连接术在重症紫绀型先天性心脏病治疗中的临床应用。 方法 回顾性分析郑州市第七人民医院心脏外科 2011 年 1 月至 2015 年 1 月期间所有行姑息性右室-肺动脉连接术治疗的重症紫绀型先天性心脏病患者 25 例的临床资料，其中男 17 例、女 8 例，年龄 31（5～108）个月，体重 3.5～37.2（12.82±6.73）kg。 结果 25 例姑息性右室-肺动脉连接术后早期死亡 2 例（术后 30 d 内），早期死亡率 8.0%（2/25）。患者术后动脉血氧饱和度与术前差异有统计学意义（62.43%±7.83%vs. 81.62%±6.25%，P<0.05）。术后随访 6 个月至 3 年（每 3 个月复查一次超声心动图），23 例患者 McGoon 比值（1.05±0.14vs. 1.61±0.18，P<0.05）和 Nakata 指数[（112.37±14.38）mm2/m2 vs. （165.74±22.62） mm2/m2，P<0.05]均明显上升，且差异有统计学意义。17 例患者行二期根治手术治疗。 结论 姑息性右室-肺动脉连接术能够有效促进重症紫绀型先天性心脏病患者的自身肺血管床发育，为行二期根治术创造条件。
Objective To summarize the effectiveness of Kirschner wire buckling combined with bone fixation in the treatment of metacarpal avulsion fracture. Methods The clinical data of 35 patients of metacarpal avulsion fracture admitted between March 2017 and June 2022 were retrospectively analyzed. There were 22 males and 13 females; the age ranged from 20 to 55 years, with an average of 31.6 years. There were 17 cases of the second metacarpal avulsion fracture, 6 cases of the fourth metacarpal avulsion fracture, and 12 cases of the fifth metacarpal avulsion fracture. The causes of injury included 21 cases of strangulation, 8 cases of sprain, and 6 cases of sports injury. X-ray film examination showed that the size of the avulsion fracture of metacarpal bone ranged from 0.30 cm×0.20 cm to 0.55 cm×0.45 cm. The total active motion (TAM) of the injured finger before operation was (154.00±17.38)°. The time from injury to operation was 3-10 days, with an average of 5.8 days. Follow-up regularly after operation, X-ray film and CT examination were performed to evaluate fracture healing and TAM of injured finger was measured. The finger function was evaluated by the trial standard of upper limb function evaluation of Hand Surgery Society of Chinese Medical Association. Results All the incisions healed by first intention. All 35 patients were followed up 9-36 months, with an average of 28 months. All metacarpal avulsion fractures achieved bony healing, and the healing time was 4-6 weeks, with an average of 4.8 weeks. The metacarpophalangeal joint of the patient was stable, without stiffness, and the flexion and extension activities were good. At last follow-up, the TAM of the injured finger reached (261.88±6.23)°, which was significantly different from that before operation (t=−35.351, P<0.001). The finger function was evaluated according to the trial standard of upper limb function evaluation of the Society of Hand Surgery of Chinese Medical Association, and 33 cases were excellent and 2 cases were good, with an excellent and good rate of 100%. Conclusion The treatment of metacarpal avulsion fracture with Kirschner wire buckling combined with bone fixation has the advantages of less trauma, firm fixation, and less interference to the soft tissue around metacarpophalangeal joints, which is a good alternative method for the metacarpal avulsion fracture.
Objective To explore the impact of SARS-CoV-2-positive donors on the prognosis of heart transplant recipients. MethodsThe Medline, EMbase, CENTRAL, CNKI, Wanfang Data, VIP and China Biology Medicine from inception to May 2023 were searched by computer for studies about impact of SARS-CoV-2-positive donors on the prognosis of heart transplant recipients. The data were extracted from all the relevant literatures, and the quality of the data was assessed using the Newcastle-Ottawa Scale (NOS). All statistical analyses were conducted by the Stata 11.0 software. Results A total of 10 studies (NOS score ranging from 5 to 9 points) involving 643 patients were enrolled. The pooled results demonstrated that the pooled mortality of heart transplant recipients from SARS-CoV-2-positive donors was 4% (95%CI 2% to 5%). And the incidence of composite outcome, regarding graft failure, rejection and death as poor prognosis, was 7% (95%CI 5% to 9%). Besides, compared with recipients from SARS-CoV-2-negative donors, the pooled odds ratio (OR) value of death of SARS-CoV-2-positive donors was 0.68 (95%CI 0.38 to 1.22, Z=1.28, P=0.200). The pooled OR value of rejection rate was 0.41 (95%CI 0.27 to 0.64, Z=3.97, P<0.005). For the composite outcome, the pooled OR value was 0.50 (95%CI 0.37 to 0.69, Z=4.30, P<0.005). In addition, there was no statistical difference in the length of hospital stay between heart transplant recipients from SARS-CoV-2-positive donors and negative donors (SMD=–0.03, 95%CI –0.22 to 0.15, Z=0.36, P=0.720). Conclusion The application of heart from SARS-CoV-2-positive donor for transplantation is safe and feasible. However, further prospective studies with longer follow-up are still needed to verify its impact on long-term outcomes.
【摘要】 目的 研究2型糖尿病（type 2 diabetes mellitus，T2DM）合并非酒精性脂肪性肝病（non-alcoholic fatty liver disease， NAFLD）患者血浆脂肪细胞特异性脂肪酸结合蛋白（adipocyte-specific fatty acid-binding protein，A-FABP）的水平及其相关因素。 方法 2009年10月—2010年10月选取T2DM合并NAFLD组（A组）60例，未合并NAFLD组56例（B组）为研究对象。测定体质量指数（body mass index，BMI），检测血脂、糖化血红蛋白（hemoglobin A1c，HbA1c）等生化指标。放射免疫法测定空腹胰岛素（fasting insulin，FINS），空腹C肽水平（fasting C-peptide，FCP），计算胰岛素抵抗指数（homeostasis model of assessment-insulin resistance，HOMA-IR）、胰岛素敏感指数（insulin sensitivity index，ISI），测定A-FABP、C反应蛋白（C-reaction protein，CRP）及肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）。 结果 与B组患者相比，A组患者其血浆A-FABP水平、BMI、腰围、腰臀比、丙氨酸氨基转移酶、门冬氨酸氨基转移酶、CRP、TNF-α、FCP、FINS、总胆固醇、甘油三酯、Ln（HOMA-IR）升高，Ln（ISI）降低，差异有统计学意义（Plt;0.05）；两组HbA1c差异无统计学意义（Pgt;0.05）。A-FABP水平变化与TNF-α、HOMA-IR、CRP呈正相关，与ISI呈负相关。 结论 T2DM伴NAFLD中，A-FABP升高与胰岛素抵抗是并存的，且存在明显相关关系，二者在疾病的发生发展中均可能具有重要的作用。【Abstract】 Objective To analyze the serum level of adipocyte-specific fatty acid-binding protein (A-FABP) in patients with type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD), and its related factors. Methods From October 2009 to October 2010, 112 patients with T2DM were categorized into two groups: the group with NAFLD (group A) with 60 patients, and the group without NAFLD (group B) with 56 patients. Body mass index (BMI), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and hemoglobin A1c (HbA1c) were detected. Radioimmunoassay was carried out to measure fasting insulin (FINS) and fasting C-peptide (FCP), and homeostasis model of assessment-insulin resistance (HOMA-IR) and insulin sensitivity index (ISI) were calculated. At the same time, A-FABP, C-reaction protein (CRP) and tumor necrosis factor-α (TNF-α) were also detected. Results Compared with patients in group B, plasma levels of A-FABP, BMI, waistline, waist to hip ratio, ALT, AST, TG, TC, HDL-C, LDL-C, CRP, FCP, FINS, and HOMA-IR for patients in group A were all higher, while ISI was lower; and the differences in the above-mentioned parameters were statistically significant (Plt;0.05). The levels of HbA1c in the two groups were not significantly different (Pgt;0.05). The change of A-FABP level was positively correlated with TNF-α, HOMA-IR and CRP, while it wasnegatively correlated with ISI. Conclusions In patients with T2DM with NAFLD, there is an obvious correlation between the coexisting A-FABP rise and insulin resistance. Both of them played critical roles in the onset and developing of the disease.