目的 探讨组织蛋白酶B（CB）在膀胱移行细胞癌（TCC）中的表达以及其与TCC浸润的关系。 方法 取TCC标本40例，TCC分级Ⅰ级23例，Ⅱ～Ⅲ级17例；表浅型TCC（Tis，Ta，T1期） 25例，浸润型TCC（T2～4期）15例。另取10例正常膀胱组织作为对照。用链霉素抗生物素蛋白-过氧化物酶连接法行CB免疫组织化学染色观察并计算CB阳性细胞百分率。 结果 正常膀胱组织中基质无明显着色；在TCC癌组织中，CB可为细胞染色，部分基质亦有染色，部分毛细血管内皮细胞及部分成纤维细胞CB表达阳性，在癌周血管内皮细胞的阳性着色CB表达增强。CB在分级和分期高的癌组织中多为弥散阳性染色。TCC分级Ⅰ级组、TCC分级Ⅱ～Ⅲ级组、TCC分期表浅型组、TCC分期浸润型组及正常对照组的CB阳性细胞百分比分别为10.53% ± 3.76%、21.52% ± 3.58%、11.32% ±2.69%、20.57% ± 3.25%、0.11% ± 0.18%，TCC各组均高于正常对照组（P＜0.01）；TCC分级Ⅱ～Ⅲ级组高于TCC分级Ⅰ级组，TCC分期浸润型组高于TCC分期表浅型组，差异均有统计学意义（P＜0.01）。 结论 CB可能成为判断TCC进展和预后的重要指标。
In recent years, the potential value of clinical big data have been gradually realized, and disease prediction models have begun to become a hot spot in clinical research. Predictive models of different types of diseases play an increasingly important role in individual risk assessment. However, due to the lack of reporting specifications for studies on disease prediction model, the structure and quality of reports are mostly mixed. In 2015, BMJ published a paper entitled "Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement" stated that there should be a uniform study of predictive models for disease diagnosis and prognosis. This article interprets key contents of the statement to promote research and understanding of the report specification.
ObjectiveTo investigate the characteristics and influencing factors of N1 in T2 stage of the 8th TNM stage of The International Association for the Study of Lung Cancer (IASLC) (3 cm <tumor size≤5 cm) non-small cell lung cancer (NSCLC), to provide the basis for dissecting intrapulmonary lymph node more accurately during the operation.MethodsWe collected the clinical information of patients who underwent the pulmonary malignant tumor surgery in Dalian Central Hospital between October 2011 and November 2016. Through the inclusion and exclusion criteria, a total of 68 patients were obtained, including 48 males and 20 females, aged 48–81 (63.1±7.6) years. According to the pathological results, we invesigated the characteristics and influencing factors of N1 in T2 stage non-small cell lung cancer.ResultsThe results showed that the highest positive rate of lymph node was 14.8% in the 12th group, 14.3% in the 13th group, and 13.9% in the 6th group, respectively. In the single factor analysis, it showed that male, T2b stage, poorly differentiated degree were the risk factors for intrapulmonary lymph node metastasis in T2 stage (P<0.05). But the intrapulmonary lymph nodes metastasis was no significant correlation with above factors according to the multivariate analysis.ConclusionIt is necessary to extract the intrapulmonary lymph node of T2 stage NSCLC at utmost, especially for the No.12 and No.13 high-risk areas. T2b stage with odd ratio (OR) at 3.038 and poorly differentiated degree (OR=1.945) may be the risk factors for the intrapulmonary lymph nodes metastasis of NSCLC in T2 stage. But they are not determining factors.
Objective To study the expression of NLRP3 inflammasome and its downstream inflammatory factors in patients with chronic obstructive pulmonary disease (COPD) and healthy controls, and to reveal the effect and significance of NLRP3 inflammasome in the pathogenesis of COPD. Methods Forty patients with acute exacerbation COPD (AECOPD) who were hospitalized from November 2016 to May 2017 were recruited in the AECOPD group, and recruited in the stable COPD group when they entered the stable stage. Forty healthy individuals were recruited in the control group. General information and peripheral blood were collected from each subject. The levels of NLRP3 mRNA and caspase-1 mRNA in peripheral blood mononuclear cells were measured by real-time PCR. The levels of IL-18 and IL-1β were measured by enzyme-linked immunosorbent assay. Results The levels of NLRP3 mRNA, IL-18 and IL-1β in the AECOPD patients were significantly higher than those in the stable COPD group [2.11±0.77, 12.79 (7.10, 43.13) pg/ml, 17.02 (8.36, 52.21) pg/ml vs. 1.60±0.44, 10.66 (6.32, 18.59) pg/ml, 13.34 (7.07, 16.89) pg/ml, all P<0.05] . The levels of NLRP3 mRNA, IL-18 and IL-1β in the AECOPD patients were significantly higher than those in the control group [2.11±0.77, 12.79 (7.10, 43.13) pg/ml, 17.02 (8.36, 52.21) pg/mlvs. 1.00±0.49, 6.29 (4.73, 7.93) pg/ml, 5.93 (4.81, 9.67) pg/ml, all P<0.05]. The levels of NLRP3 mRNA, IL-18 and IL-1β were significantly higher in the stable COPD group than the control group [1.60±0.44, 10.66 (6.32, 18.59) pg/ml, 13.34 (7.07, 16.89) pg/mlvs. (1.00±0.49, 6.29 (4.73, 7.93) pg/ml, 5.93 (4.81, 9.67) pg/ml, all P<0.05]. Correlation analysis showed that the plasma IL-18 level was positive correlated with leukocyte count and neutrophil percentage in the AECOPD group (r=0.372, P<0.05;r=0.386, P<0.05). The expression of NLRP3 mRNA in the AECOPD group and stable COPD group were positively correlated with the CAT score (r=0.387, P<0.05;r=0.399, P<0.05) . Conclusion NLRP3 inflammasome is involved in the inflammatory response in COPD patients.
ObjectiveTo summarize the effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture.MethodsBetween January 2011 and October 2016, 25 cases with comminuted Jones fracture were treated with mini locking plate combined with Kirschner wire. There were 9 males and 16 females with an average age of 31.4 years (range, 16-66 years). The fractures located on the left side in 11 cases and on the right side in 14 cases. The causes of injury included spraining in 21 cases, falling down in 3 cases, and bruise in 1 case. The bone fragment of all cases was more than 3 pieces. The fracture line was mostly Y-shape or T-shape. Twelve of them were combined with other fractures. The time from injury to operation was 1-9 days (mean, 5 days). The mini locking plate and Kirschner wire were removed at 9-12 months postoperatively. At 12 months postoperatively, the pain was evaluated by the visual analogue scale (VAS) score, and the function by the American Orthopaedic Foot & Ankle Society (AOFAS) score.ResultsAll incisions healed by first intention. All cases were followed up 12-36 months with an average of 21.7 months. Fracture union was observed in all patients without complications such as nonunion, delayed union, and malunion. The fracture union time was 8-12 weeks (mean, 9.4 weeks). At 12 months postoperatively, the VAS score was 1.15±0.87; the AOFAS score was 89.45±6.24, and the results were excellent in 14 cases, good in 9 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 92%.ConclusionThe procedure of mini locking plate combined with Kirschner wire for comminuted Jones fracture has such advantages as convenient operation, more rigid fixation, high rate of fracture healing, and good functional recovery in foot.
Study of the mechanical properties of in vivo corneal materials is an important basis for further study of corneal physiological and pathological phenomena by means of finite element method. In this paper, the elastic coefficient (E) and viscous coefficient (η) of normal cornea and keratoconus under pulse pressure are calculated by using standard linear solid model with the data provided by corneal visualization scheimpflug technology. The results showed that there was a significant difference of E and η between normal cornea and keratoconus cornea (P < 0.05). Receiver operating characteristic curve analysis showed that the area under curve (AUC) for E, η and their combined indicators were 0.776, 0.895 and 0.948, respectively, which indicated that keratoconus could be predicted by E and η. The results of this study may provide a reference for the early diagnosis of keratoconus and avoid the occurrence of keratoconus after operation, so it has a certain clinical value.
ObjectiveTo investigate the medical quality of rehabilitation departments in medical institutions at all levels in Shenzhen and analyze the problems, so as to promote the continuous improvement of rehabilitation care quality in this city.MethodsFrom September to November 2019, a field investigation was carried out in 53 rehabilitation departments in Shenzhen. Five dimensions were scored by experts, including professional capacity, rules and regulations, knowledge and skills, supervision and feedback, and hospital infection control. Descriptive statistical analysis was used to characterize the data, and one-way analysis of variance was used to analyze the difference among different level hospitals.ResultsThe average score of rehabilitation medical care quality in Shenzhen was 83.98±8.28. The average score of tertiary, secondary, and primary hospitals were 85.61±7.02, 84.54±7.83, and 77.55±10.60, respectively, and the difference among different level hospitals was statistically significant (P<0.05). According to the standard score, the highest score was in the dimension of supervision feedback (95.75±6.50), and the lowest score was in the dimension of knowledge and skills (77.27±14.64).ConclusionThe overall quality of rehabilitation care in Shenzhen needs to be improved, and the management and professional training systems need to be established.
Objective To study the clinical significance of the microorganism culture result of amniotic fluid in cesarean section in the treatment of anti-infection after operation. Methods From August 2016 to May 2017 in Women’s and Children’s Hospital of Sichuan Province, 502 amniotic fluid samples were collected in cesarean section to carry out bacteria culture. The correlations between the amniotic fluid culture result and the preoperative and intraoperative risk factors and the correlations between postoperative infection and the preoperative and intraoperative risk factors were analyzed. Results In the 502 amniotic fluid samples, there were 131 samples culture-positive. The microbiological culture results of amniotic fluid were statistically different between the puerperae with gestational age<37 weeks and the ones with gestational age≥37 weeks (P=0.001). Postoperative infection occurred in 6 puerperae, in whom the amniotic fluid culture results were positive in 3 puerperae. There was no statistical difference in the occurrence of postoperative infection between the puerperae with amniotic fluid culture-positive results and the ones with negative results (P=0.382). The occurrence of postoperative infection was associated with preoperative infections, gestational age, using time of antimicrobial, and preoperative rupture of membranes (P<0.05). Conclusions The contamination rate of amniotic fluid specimen was high, which was of low reference value to anti-infection treatment after operation. When an extension of anti-infection treatment be carried out after cesarean section, suitable specimens should be selected according to the infection site.
ObjectiveTo analyze the pathological manifestations and imaging characteristics of bronchiolar adenoma (BA).MethodsThe clinical data of 11 patients with BA who received surgeries in our hospital from January 2019 to September 2020 were retrospectively analyzed, including 5 males and 6 females aged 40-73 (62.40±10.50) years. The intraoperative rapid freezing pathological diagnosis, postoperative pathological classification, cell growth pattern, nuclear proliferation index Ki-67 and other immunohistochemical staining combined with preoperative chest CT imaging characteristics were analyzed.ResultsThe average preoperative observation time was 381.10±278.28 d. The maximum diameter of imaging lesions was 5-27 (10.27±6.34) mm. Eight (72.7%) patients presented with irregular morphology of heterogeneous ground-glass lesions, and 3 (27.3%) patients presented with pure ground-glass lesions. There were 10 (90.9%) patients with vascular signs, 8 (72.7%) patients with vacuolar signs, 1 (9.1%) patient with bronchus sign, 3 (27.3%) patients with pleural traction and 9 (81.8%) patients with burr/lobular sign. The surgical methods included sub-lobectomy in 10 patients and lobectomy in 1 patient. Five (45.5%) patients were reported BA by intraoperative frozen pathology. The postoperative pathological classification included 8 patients with distal-type and 3 patients with proximal-type, and the maximum diameter of the lesions was 4-20 (8.18±5.06) mm. Eight (72.7%) patients showed characteristic bilayer cell structure under microscope, and 10 (90.9%) patients showed thyroid transcription factor 1 expression in pathological tissues. The expression of NapsinA in intracavity cells was found in 9 (81.8%) patients. The Ki-67 index of the lesion tissue was 1%-5% (3.22%±1.72%).ConclusionThe pathological features and imaging findings of BA confirm the premise that BA is a neoplastic lesion. However, to identify BA as a benign or inert tumor needs more clinical data and evidence of molecular pathological studies.
Objective To explore the diagnosis and treatment strategies for elderly patients with ground-glass opacity (GGO) by reviewing the clinical data such as imaging features, surgical methods, postoperative pathological results and average hospital stay. MethodsThe imaging features and postoperative pathological findings of the elderly patients with pulmonary GGO in our hospital from January 2017 to December 2019 were retrospectively analyzed. The patients were divided into an elderly patient group and a non-elderly patient group based on their age. Results Finally 575 patients were included in the study. There were 281 elderly patients, including 83 males and 198 females, with an average age of 67.0±5.3 years. There were 294 non-elderly patients, including 88 males and 206 females, with an average age of 49.1±7.3 years. Compared with the non-elderly patients, elderly GGO patients showed the following distinct clinical features: the lesions were observed for a long time (P<0.001), the GGO margin was not smooth (P<0.001), the pleural signs (P<0.05) and bronchial signs (P<0.05) were obvious, there were more patients of type Ⅱ to Ⅳ GGO (P<0.001), more patients of lobectomy (P<0.05), and more patients of postoperative pathological reports of infiltrating lesions (P<0.05). There was no statistical difference in the average length of stay between the two groups (P>0.05). Multivariate logistic regression analysis showed that GGO diameter and GGO type were the main factors affecting the operation. Observation time, GGO diameter and GGO type were the main influencing factors for postoperative pathological infiltrative lesions. The cut-off value of GGO diameter in predicting infiltrating lesions was 10.5 mm in the elderly group. Conclusion The size and type of GGO are important factors in predicting invasive lesions and selecting surgical methods. Elderly patients with radiographic manifestations of type Ⅱ to Ⅳ GGO lesions with a diameter greater than 10.5 mm should be closely followed.