医学临床研究
      Home  |  About Journal  |  Editorial Board  |  Instruction  |  Subscribe  |  Advertisement  |  Messages Board  |  Contact Us  |  中文
医学临床研究
   Forthcoming Articles
   Current Issue
   Archive
   Advanced Search
   Read Articles
   Download Articles
   Email Alert
   
Quick Search  
  Adv Search
2016 Vol. 33, No. 8
Published: 2016-08-26
 
 
1457 Observations of Genes Variantions in Primary Adult Ingunial Hernias
NIE Xin,SONG Zhicheng,CHEN Yuanwen,et al
【Objective】To explore the genomic variations in adult primary inguinal hernia. 【Methods】Utilizing gene chips to scan transversalis fascia of patient with ingunial hernia, the results were compared with corresponding genomes of control patients. The genes with the highest different regulation degrees were chosen to be further examined using the RTqPCR method. 【Results】From the array analysis performed on the two groups, 1189 mRNAs were found to be expressed differently between the groups877 mRNAs were upregulated and 312 mRNAs were downregulated. Of the mRNAs, MYL9 showed the highest degree of upregulation and MYH1 showed the higheset degree of downregulation. We chose the MYL9 and MYH1 as target genes for further examination with RTqPCR. The consistency between the RTqPCR results and microarray data was shown. 【Conclusion】The occurrence and development of inguinal hernia may be associated with a multitude of genetic variations, but MYL9 and MYH1 may play the most significant roles.
2016 Vol. 33 (8): 1457-1664 [Abstract] ( 108 ) HTML (1 KB)  PDF  (0 KB)  ( 36 )
1460 Effect of Mandala Drawing on Psychological Assessment and Intervention for Children with Autism
CHEN Canrui，SHAN Herui
【Objective】To study the effect of psychological assessment of Mandala painting on the children with autism. 【Method】The Mandala properties table, childhood autism rating table of 62 children with autism (observation group) and 59 normal children (control group) were studied.Differences of Mandala painting characteristics between the two groups of children were compared, and the correlation characteristics of Mandala paintings and autism symptoms were analyzed. 【Results】Total score of the Mandala properties table of the observation group was significantly lower than that of the control group. The five dimension scores were significantly lower than those of the control group , the difference was statistically significant (Mean P<0.05). Mandala painting characteristics and autism symptoms had a significant negative correlation. Mandala painting had a good prediction effect on autism severity. The case study found that Mandala paintings had better intervention effect on children with autism.【Conclusion】 Mandala drawing can be used in psychological assessment and intervention for autism.
2016 Vol. 33 (8): 1460-1462 [Abstract] ( 75 ) HTML (1 KB)  PDF  (0 KB)  ( 36 )
1463 Differential Expression and Clinical Significance of EGFR gene in Tissue and Plasma in Advanced NonSmall Cell Lung Cancer
CHEN Jianhua，YU Xun
【Objective】To investigate the expression and clinical significance of epidermal growth factor receptor (EGFR) gene (DNA) in tissue and plasma of patients with advanced nonsmall cell lung cancer (NSCLC).【Methods】Sixtyfive cases of NSCLC in our hospital from March to June 2015 were selected, and the plasma and tissue samples were extracted, EGFR DNA gene mutation were detected and compared.【Results】EGFR gene mutations were detected in 23 cases out of 65 patients, and the mutation rate was 35.4%;12 cases were detected in circulating DNA, the mutation rate was 18.5%. The specificity of EGFR gene mutation detection of the plasma DNA was 93.8%; the sensitivity was 43.5%. The mutation rate of EGFR gene was 22.7% in 44 male patients in the tissue samples; the mutation rate of EGFR gene in 21 female patients was 61.9%, the difference was statistically significant (P<0.05). The mutation rate of EGFR gene was 17.1% (7/41) in 41 patients with smoking; EGFR mutation rate was 66.7% (16/24) in 24 patients without smoking, and there was a significant difference between the two groups (P<0.05). The mutation rate of EGFR was 46.3% in 41 cases of adenocarcinoma and the EGFR mutation rate of 24 cases of non adenocarcinoma patients was 16.7%, the difference was statistically significant (P<0.05).The distribution of EGFR gene mutations in plasma was consistent with the results of tumor tissue detection. There were statistically significant differences in different gender, smoking status and different pathological types (P<0.05). There was no significant difference in tumor stage (P>0.05).【Conclusion】 For patients with advanced NSCLC, detection of EGFR DNA gene mutation in plasma circulation has high specificity and low sensitivity, which can be used in the supplementary diagnosis.
2016 Vol. 33 (8): 1463-1469 [Abstract] ( 91 ) HTML (1 KB)  PDF  (0 KB)  ( 34 )
1466 Clinical Analysis of FertilityPreserving Operations in 25 Cases of EarlyStage Cervical Cancer
ZOU Wen
【Objective】To evaluate the therapeutic security of fertilitypreserving operations in patients with earlystage cervical cancer. 【Methods】Data from 25 cases of earlystage cervical cancer who had undergone fertilitypreserving operations from January 2005 to December 2014 in the Second Xiangya Hospital of Central South University was analyzed. 【Results】1. Until April 2015, 24 cases (96%) had completed followup posttrachelectomy; 1 case failed to follow up. 2. 24 cases who had completed followup had no tumor recurrence in five years. 1 case of patient with cervical cancerⅠB1 after ART（Abdominal Radical Trachelectomy） had tumor recurrence after 6 years. The recurrence rate was 4.2% (1/24). 3 cases (12.5%) had recurred CINⅠin five years after surgery, including 2 cases of patients with cervical cancerⅠA1 after CKC(Cold Knife Conization) and 1 case with cervical cancerⅠA1 after VRT（Vaginal Radical Trachelectomy） . 3. 15 cases of patients had pregnancy plans after surgery and 10 cases became pregnant. The pregnancy rate was 66.7%. In the 10 patients who successfully became pregnant, 6 cases had term delivery (60%), 3 cases had preterm delivery (30%), and 1 case had a miscarriage (10%).【Conclusion】1. Fertilitypreserving surgeries in patients with early cervical cancer is safe. 2.To cervical cancerⅠA1 with good tumor differentiation, CKC has a shorter operation time, less bleeding, fewer tumor recurrences, and can obtain a higher pregnancy rate.
2016 Vol. 33 (8): 1466-1469 [Abstract] ( 77 ) HTML (1 KB)  PDF  (0 KB)  ( 28 )
1470 Effects of Extracorporeal Photopheresis Treated Donor Lymphocyte Infusion on Graft Outcome After Murine Heart Transplantation
YE Junsheng,LI Juan,ZHOU Minjie,et al
【Objective】 To investigate the effects of extracorporeal photopheresis（ECP） treated donor lymphocyte infusion on graft survival after murine heart transplantation. 【Methods】Abdominal ectopic heart transplantations were performed using BALB/C mice as donors and C57BL/6 mice as recipients. Mice in the control group did not receive any treatment other than transplantation. For mice in ECP treated group, donor splenocytes suspension was treated by ECP and then injected into recipients via penis vein 7 days before transplantation. The graft survival was assessed by abdominal palpation after transplantation. The spleen were harvested on day 7 for further flow cytometry test; and the H&E staining and immunohistochemistry staining of T lymphocyte of graft tissue was evaluated. 【Results】The graft survival time in the ECP treated group was significantly prolonged compared to the control group（20±4.67 d vs 7.5±0.70 d，P＜0.001）. The frequency of effective T cells in the spleens of recipients in ECP treated group was significantly decreased compared to in the spleens of recipients in the control group. The frequency of CD4+CD25+ Foxp3+ regulatory T cells in the spleen of ECP treated mice was higher than that of control group mice. 【Conclusion】Infusion of ECP treated donor lymphocytes prolongs graft survival after murine heart transplantation, possibly via suppressing effector T cell reaction and induction of regulatory T cell generation.
2016 Vol. 33 (8): 1470-1474 [Abstract] ( 60 ) HTML (1 KB)  PDF  (0 KB)  ( 21 )
1474 Analysis of the Prognostic Factors of Patients with Diffuse Large B Cell Lymphoma
LI Fen,CHEN Qiong,TU Yuan,et al
【Objective】To analyze the prognostic factors of patients with diffuse large B cell lymphoma (DLBCL). 【Methods】The clinical data of 58 patients with DLBCL who were treated January 2009  June 2011 at our hospital was analyzed retrospectively. Univariate analysis and Cox multivariate analysis were performed to analyze relevant factors of DLBCL.【Results】Univariate analysis showed that relevant factors that affect the prognosis of patients with DLBCL are age, clinical stage, serum LDH, PS classification, efficacy of recent treatment, and extranodal lesions. Cox regression analysis showed that independent risk factors that affect the prognosis of patients with DLBCL are age, and the clinical efficacy and staging of recent treatment. The fiveyear survival rates of the low risk group, middlelow risk group, middlehigh risk group, and high risk group were 68.75% (11 / 16), 57.14% (12 / 21), 36.36% (4 / 11), 10.00% (1 / 10), respectively; survival rates decreased as the severity of risk increased. The differences were statistically significant (P<0.05). 【Conclusion】Independent risk factors associated with the prognosis of DLBCL patients, including the patient's age and the efficacy and clinical stage of recent treatment, should be based on relevant factors to develop appropriate treatment programs to improve the prognosis.
2016 Vol. 33 (8): 1474-1476 [Abstract] ( 62 ) HTML (1 KB)  PDF  (0 KB)  ( 36 )
1477 Prognosis Evaluation on Piribedil and Madopar Monotherapy in the Treatment of Patients with Early Parkinson's Disease
ZHAO Lei

【Objective】To evaluate the comprehensive prognosis effect of piribedil and Madopar for the treatment of early Parkinson's syndrome when administered. 【Methods】Sixtyfour patients with early Parkinson's syndrome in our hospital were selected as the research object. According to the random number table method, the patients were divided into two groups (n=32). Group A were treated with piribedil and Group B were treated with Madopar. Before and after treatment, 99mTcTRPDAT1 specific uptake value, UPDRS (Parkinson's disease) and clinical efficacy of patients in the two groups were tested and compared through dopamine transportersingle photon emission computed tomography (TRODATSPECT). 【Results】 At 6 months and 10 months after treatment, the UPDRS in the two groups were significantly reduced compared to before treatment . After 6 months and 10 months of treatment， the UPDRS scores in Group A were significantly lower than those in Group B (P<0.05). The specific uptake values of  99mTcTRODAT1 on the ipsilateral and contralateral side of the patients in Group A were significantly lower than those in Group B (P<0.05). The therapeutic effect rate and total effective rates in Group A were 40.63% and 90.63% respectively, which were significantly higher than  25.00% and 65.62% in Group B (P<0.05). The incidence of adverse reactions in Group A was 18.75%, which was significantly lower than 31.25% in Group B (P<0.05). 【Conclusion】In the clinical treatment of early Parkinson's syndrome, taking Madopar alone can accelerate the apoptosis of dopaminergic neurons and promote disease progression, while taking piribedil does not impact the prognosis of patients or cause adverse effects.
2016 Vol. 33 (8): 1477-1479 [Abstract] ( 68 ) HTML (1 KB)  PDF  (0 KB)  ( 29 )
1480 Predictive Value of G3I on Postoperative STR in Patients with Acute STEMI after pPCI
PENG Bin,NI Aihua,FANG Yongxiang
【Objective】To evaluate the predictive effect of grade 3 ischemia（G3I）on postoperative ST segment resolution (STR) in patients with acute STsegment elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (pPCI). 【Methods】Two hundred and eightytwo patients with STEMI were selected, According to the degree of STR, they were divided into STR group (n=234) and nonSTR group (n=48), the patients were followed up for 12 months, and the major adverse cardiovascular events within hospital and discharged were recorded. 【Results】82.9% of pPCI postoperative ST segment fell good, those fell bad accounted for 48 (17.1%). The level of serum Nterminal pro brain natriuretic peptide (NTproBNP) B, Troponin I (cTnI),the peak of creatine kinase isoenzyme (CKMB) and the incidence of G3I in the nonSTR group were significantly higher than those in the STR group, and LVEF was lower than that of the STR group. Killip grading difference between the two groups was statistically significant (mean P<0.05). Logistic regression analysis showed that G3I was an independent predictor of nonSTR after pPCI (P=0.018). The average length of hospital stay in patients of the nonSTR group after pPCI was longer (P=0.011), and the incidence of major adverse cardiac events was high (P=0.026).【Conclusion】G3I on initial ECG can predict nonSTR of STEMI patients after pPCI. Patients with nonSTR often have poorer clinical outcomes. 
2016 Vol. 33 (8): 1480-1483 [Abstract] ( 78 ) HTML (1 KB)  PDF  (0 KB)  ( 35 )
1484 An Investigation on the Mechanism of Hydrogen SulfideInduced Delayed Preconditioning on Myocardial Ischemia Reperfusion Injury in Rats
JIANG Haitao,RAN Ke,LI Zhijian, et al
【Objective】To investigate the mechanism of hydrogen sulfide delayed preconditioning on myocardial ischemia reperfusion injury in rats. 【Methods】Three groups (n=10 animals/group) of SpragueDawley male rats were studied: group S consisted of control rats that received no treatment, Group IR consisted of rats treated with NS (1.0 ml/kg iv) 24 h before ischemia, and Group H consisted of rats treated with NaHS (0.05 mg/kg) 24 h before ischemia. Group IR and H were subjected to ischemia by 30 min of coronary artery occlusion followed by 2 h of reperfusion. At the end of reperfusion, the plasma concentration of IL6 and IL10 were measured. The peroxisome proliferatoractivated receptor γ (PPARγ) was measured by Western blotting. 【Results】Compared with Group S, Group H and Group IR had higher levels of IL6 and IL10 (P<0.05). Compared with Group IR, Group H had lower levels of IL6 and higher levels of IL10 (P<0.05). Compared with Group S, Group H and Group IR had lower PPARγ protein expression in myocardium (P<0.05).Compared with Group IR, Group H had higher levels of PPARγ protein expression (P<0.05).【Conclusion】The hydrogen sulfide delayed preconditioning attenuates myocardial IR injury possibly through upregulating PPARγ expression in rats.
2016 Vol. 33 (8): 1484-1488 [Abstract] ( 54 ) HTML (1 KB)  PDF  (0 KB)  ( 24 )
1486 Correlation between the Level of Serum Pre albumin (PAB) and the Degree of Coronary Artery Disease in Patients with Acute Myocardial Infarction (AMI)
HE Penghui,ZHANG Xuedan
【Objective】To investigate the correlation between the level of serum pre albumin (PAB) and the degree of coronary artery disease in patients with acute myocardial infarction (AMI).【Methods】One hundred and ninetyfour cases of acute myocardial infarction patients treated in our hospital from June 2012 to June 2015 as were selected as observation group, and 58 cases of health persons with routine checkup in hospital without cardiovascular disease in same period as control group. The levels of serum PAB were observed in two groups of patients with different degree of vascular disease, and the correlation between serum PAB level and AMI coronary artery disease was analyzed.【Results】Compared with control group, the PAB level of patients in observation group on admission was significantly decreased, and GRACE score was increased significantly, the comparison between groups were statistically significant (P<0.05). Depending on the different degree of pathological changes, the PAB level in the observation groups presented that the single coronary artery lesion group > the double coronary artery lesions group ＞ the triple coronary artery lesions group, the comparison between the groups was statistically significant (P<0.05) . 136 cases of cardiovascular events occured in the observation group, and compared patients without cardiovascular events the PAB level was higher, and GRACE score was lower, the difference was statistically significant (P<0.05). The spearman correlation analysis showed that PAB level had a negative correlation with the degree of the AMI lesions (r=0.202,P<0.05) , the GRACE risk score (r=0.236,P<0.05) and the incidence of cardiovascular events (r=-0.211,P<0.05). 【Conclusion】 The serum prealbumin level of patients with acute myocardial infarction was related with pathological degree and prognosis , so it can be used as a reference index of early diagnosis and treatment, and prognosis judgment.
2016 Vol. 33 (8): 1486-1488 [Abstract] ( 78 ) HTML (1 KB)  PDF  (0 KB)  ( 29 )
1489 A Study of Cellular Immune Status of Patients with Different Levels of Cerebral Gliomas after Tumor Resection
WANG Dan,CHEN Xiaolai
【Objective】To explore the cellular immune status of patients with different levels of cerebral gliomas after tumor resection.【Methods】Eightysix cases of glioma patients admitted to the Neurosurgery of the hospital from January 2012 to January 2013 were selected as the study objects. In accordance with the degree of malignancy of gliomas (WHO grading standards) they were divided into two groups, lowlevel group (ⅠⅡ grade) with 42 cases, and the highlevel group (ⅢⅣ grade) with 44 cases. 40 healthy people were picked up from people taking physical examination at the same period as normal /control group. One day before surgery and one week after treatment, patients with glioma and people of the control group were extracted from peripheral blood of 3 mL to determine the levels of T lymphocytes and natural killer cells (NK cells), and to compare the differences of the above indexes in patients with different levels of glioma. 86 patients with glioma were divided into CD4+/CD8+>1 group（n=48）and CD4+/CD8+<1group（n=38）, and the survival analysis was conducted to compare the difference between the two groups.【Results】Peripheral blood CD3+,CD4+, CD4+/CD8+, NK cells (CD56 +) of glioma patients were significantly lower than those of the control group, CD8+ was significantly higher than that of the control group, the difference was statistically significant (P<0.05); Before and after surgery, the low grade glioma group CD4+/CD8+ was significantly higher than that in the highgrade gliomas group, CD8+ was lower than the high grade glioma group (P<0.05), and CD3+, CD4+, NK cell (CD56+) no statistical difference (P>0.05); in the low grade glioma group, the median survival time was 32 months, and the median survival time in the high grade glioma group was 15 months, the difference between the two groups was statistically significant (P<0.05); in CD4+/CD8+>1 group, the median survival time was 30 months, and the median survival time in CD4+/CD8+<1 group was 14 months, the difference between the two groups was statistically significant (P<0.05).【Conclusion】The higher the degree of malignancy of glioma patients is, the lower the immune function, the shorter the survival time and the poorer the prognosis will be. Preoperative detection of T lymphocyte subsets in peripheral blood can provide a reference for evaluating the malignancy degree and prognosis of patients with gliomas.
2016 Vol. 33 (8): 1489-1491 [Abstract] ( 89 ) HTML (1 KB)  PDF  (0 KB)  ( 26 )
1492 Correlation Analysis of PTSD Occurrence in Operation Room
ZHANG Jing,TIAN Wei
【Objective】To investigate the related factors of posttraumatic stress disorder (PTSD) in operation room.【Methods】Eightyfive nursing staff in the hospital operation room was selected. The data of the negative life events and trauma events were collected by questionnaire, and their correlation with PTSD occurrence was analyzed.【Results】The occurrence rate of injury events of operating room was 97.65%, the positive rate of PTSD was 36.47%. Traumatic events in the operation room of orthopedics department were related with PTSD occurrence (P<0.05), the influence degree of trauma events was positively correlated with PTSD (P<0.01).【Conclusion】 Nursing staff of operation room bear the pressure of many aspects. The greater the degree of impact, the more likely to occur PTSD. The living and working conditions should be widely concerned, so as to avoid the impact of trauma related factors on nursing staff.
2016 Vol. 33 (8): 1492-1494 [Abstract] ( 80 ) HTML (1 KB)  PDF  (0 KB)  ( 31 )
Copyright © Editorial Board of JOURNAL OF CLINICAL RESEARCH
Supported by:Beijing Magtech