Table of Content

20 March 2021, Volume 36 Issue 3

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Meta-analysis of the relationship between obstructive sleep apnea hypopnea syndrome and serum lipid levels

Zhao Chong, Liu Zhongyang, Xu Feng, Li Huafeng

2021, 36(3):  197-202.  doi:10.3969/j.issn.1004-583X.2021.03.001

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Objective To systematically evaluate the correlation between obstructive sleep apnea hypopnea syndrome (OSAHS) and serum lipid levels, and to explore the clinical significance of changes in serum lipid levels of OSAHS patients. Methods PubMed, Cochrane Library, CNKI, VIP and Wanfang database were searched. The literatures and references enrolled were manually searched to find the published case-control studies on the relationship between OSAHS and serum lipid levels. The retrieval time was from the establishment of the database to December 2018. Meta-analysis was conducted with revman5.3 software after screening, extracting data and evaluating the risk of bias by two researchers independently. Results A total of 9 studies including 1473 patients, were enrolled in the screening. The results of meta-analysis showed that triglycerides (MD=0.60, 95%CI[0.54, 0.67], P<0.01) and low-density lipoprotein levels (MD=0.25, 95%CI[0.02, 0.49], P<0.01) in OSAHS patients were higher than those in control group, while the level of high-density lipoprotein (MD=-0.17, 95%CI[-0.25, -0.08], P<0.01) was lower than that in the control group. Conclusion The results of meta-analysis indicate that patients with OSAHS often have dyslipidemia. However, due to the limited number of studies and the quality of them, the above conclusions and related mechanisms still require experimental research with higher quality and larger samples to further verify.

Observations on clinical treatment of COVID-19 complicated with cardiovascular disease

Lu Haoyang, Lu Jiazhong, Han Mingfeng, Lvh Xincai, Zhang Biao, Rong Chengzhen, Jia Leilei, Pan Qiangqiang, Ma Leilei, Zhao Ren

2021, 36(3):  203-207.  doi:10.3969/j.issn.1004-583X.2021.03.002

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Objective To explore the treatment measures for patients suffering from novel coronavirus pneumonia disease (hereinafter referred to as “COVID-19”) with cardiovascular complications. Methods Clinical data of 155 patients with COVID-19 were collected, therapies and medications of such patients were analyzed, and clinical therapies for 21 patients with cardiovascular complications were analyzed. Results The single-center incidence of patients with COVID-19 complicated with cardiovascular complications hit 13.5%, the number of patients with hypertension was greater (95.2%), elderly patients with COVID-19 had higher incidence of complicating cardiovascular diseases (38.5%), incidence of acute cardiovascular events during hospital stay was 4.76%. No adverse drug reactions were observed in the application of conventional cardiovascular drugs during the treatment. Critically type COVID-19 patients had high incidence of cardiovascular events during the hospital stay, one case was found to suffer from the drop of blood pressure in the course of plasma exchange therapy. The symptom was relieved by elevated blood pressure treatment, 134 patients who had no cardiovascular complications, two patients experienced hvpertension during the process of pneumonia treatment. Conclusion Potentially induced adverse events should be noted while treating COVID-19 patients. While generic medications and therapies are known to be basically safe and effective for common type of COVID-19 patients with cardiovascular complications, the interactions may potentially take place in critically ill patients with inflammatory cytokine storm and underlying cardiovascular conditions.

Correlation between serum free fatty acid and cardiac function in patients with acute heart failure

Bai Lian, Guo Peng, Luan Bo, Bai Hao, Jiang Shan

2021, 36(3):  208-211.  doi:10.3969/j.issn.1004-583X.2021.03.003

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Objective To explore the correlations between serum free fatty acid(FFA) and cardiac function in patients with acute heart failure(AHF). Methods One hundred and sity three patients with AHF were divided into the LVEF<40% group and LVEF≥50% group basics on left ventricular ejection fraction(LVEF). FFA, N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin I(cTnI)and other related indicators were detected when admission. Indicators including the left ventricular ejection fraction(LVEF), LVEF fraction shortening(FS), left ventricular end-diastolic diameter(LVEDD), eft ventricular end-systolic dimension(LVESD) and TEi index were recorded. Results FFA, NT-proBNP and cTnI in LVEF<40% group was significantly higher than such indexes in LVEF≥50% group (P<0.05). FFA, NT-proBNP and cTnI were risk factors for LVEF<40% in AHF patients. The predicted AUC of FFA and NT-proBNP for patients with LVEF<40% were 0.856 and 0.810 respectively. In AHF patients, the cardiac function of high FFA group was significantly lower than that of low FFA group (P<0.05). Conclusion FFA, NT-proBNP and cTnI are the risk factors of LVEF < 40% in patients with AHF. FFA has certain predictive value for predicting the deterioration of patients' heart function among of these.

Effects of Guhong injection combined with salvianolate on neurological function and hemorheology in patients with acute cerebral infarction

Zhao Yang, Ma Liang, Zhong Qigang

2021, 36(3):  212-215.  doi:10.3969/j.issn.1004-583X.2021.03.004

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Objective To investigate the effect of Guhong injection combined with salvianolate on neurological function and hemorheology in patients with acute cerebral infarction(ACI). Methods A total of 154 ACI patients in our hospital were selected as the research objects, and were divided into control group (77 cases,treated with salvianolate) and combined group (77 cases,treated with salvianolate combined with Guhong injection) by the random list method. The clinical efficacy, defect score of nervous function and hemorheology indexes were compared in the two groups, and the occurrence of adverse reactions was observed during the treatment. Results After treatment, the total effective rate of the combined group was higher than that of the control group (P<0.05). The neurological deficit scores of the two groups were lower than those before treatment, and the combined group was lower than the control group (P<0.05). The plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, fibrinogen level of the two groups were decreased than that before treatment, and the score of the combined group was lower than that of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The neurologic impairment and hemorheology of ACI patients can effectively improve by Guhong injection combined with salvianolate, being significant curative effect and good safety, and has certain clinical application value.

Effects of task-oriented training based on occupation-based analysis in upper limb function of stroke patients

Sun Xiuli, Xiao Yao, Hu Guojin, Zhang Li, Wang Chenxinzi, Hua Jiaqi

2021, 36(3):  216-219.  doi:10.3969/j.issn.1004-583X.2021.03.005

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Objective To study the effects of task-oriented training based on occupation-based analysis in upper limb functions of stroke patients with hemiplegia. Methods Sixty stroke patients admitted from January 2019 to November 2020 were randomly divided into control group (n=30) and observation group (n=30) by means of random number table. The patients in control group received regular neurology drug therapy and conventional rehabilitation therapy based on acupuncture and moxibustion therapy including traditional occupational therapy. The patients in observation group completed task-oriented occupational therapy after receiving traditional occupational therapy in the occupational therapy department on the basis of therapy in the control group. Canadian Occupational Performance Measure (COPM), Fugl-Meyer Motor Assessment Scale upper limb part (FMA-UE) and nine-hole socket test were used to assess the upper limb performance, motor function, finger flexibility and coordination of patients before and four weeks after treatment. Results COPM satisfaction scores, COPM expressivity scores, FMA-UE and nine-hole insert test results of patients in two groups were better after treatment than before treatment. The differences in the COPM expressivity scores, COPM satisfaction scores, FMA-UE scores and nine-hole insert test results of observation group were better than those of control group (P<0.05). Conclusion The task-oriented training based on occupational analysis can improve upper limb motor function and finger flexibility in convalescent stroke patients and improve the performance and satisfaction of patients' occupational activities.

Clinical value of CEA, CA125, and CYFRA21-1 levels in efficacy evaluation of EGFR-TKIs in the treatment of EGFR mutation-positive non-small cell lung adenocarcinoma

He Yiwen, Qiao Tiankui

2021, 36(3):  220-224.  doi:10.3969/j.issn.1004-583X.2021.03.006

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Objective To explore the relationship of treatment effects between the correlation of carcinoembryonic antigen(CEA), carbohydrate antigen 125(CA125), cytokeratin 19 fragment antigen 21-1(CYFRA21-1) level and clinical effect of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs) for lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) mutation. Methods One hundred and eighty six patients with EGFR mutations of advanced non-small cell lung cancer(NSCLC) from our hospital were selected. The first generation of EGFR-TKIs was used for therapy, and the correlation between CEA, CA125, CYFRA21-1 level before treatment and progression-free survival(PFS), overall survival(OS) was analyzed. Results The median PFS and OS of 186 lung adenocarcinoma patients receiving EGFR-TKIs treatment after treatment were 8.8 months and 22.9 months respectively, and the median PFS and OS of lung adenocarcinoma patients with high CEA level (13.2 months, 26.7 months) were better than those of patients with normal CEA level (8.1 months, 12.8 months), the median PFS and OS of patients with elevated CA125 level (13.5 months, 26.8 months) were better than those of patients with normal CA125 level (8.2 months, 12.4 months), the median PFS and OS of patients with normal CYFRA21-1 level (12.8 months, 25.8 months) were better than those of patients with elevated CYFRA21-1 level (8.3 months, 13.5 months)(P<0.05). Conclusion It is positive predictors for evaluating the efficacy of EGFR-TKIs, that the elevated levels of CEA and CA125 and normal levels of CYFRA21-1 in patients with EGFR-mutant lung adenocarcinoma.

Value of serum NSE, CEA and CA125 levels in diagnosis and efficacy evaluation of patients with small cell lung cancer

Yang Ke, Chen Jun

2021, 36(3):  225-228.  doi:10.3969/j.issn.1004-583X.2021.03.007

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Objective To explore the value of the serum neuron-specific enolase(NSE), carcinoembryonic antigen(CEA), and carbohydrate antigen 125(CA125) levels in the diagnosis and efficacy evaluation of patients with small cell lung cancer(SCLC). Methods Forty eight patients with SCLC(SCLC group) and 53 patients with non-small cell lung cancer (NSCLC group) admitted in People's Hospital of Zhengzhou were selected, the normal subjects in physical examination in the hospital during the same period were separately selected and divided into the control group. The serum levels of NSE, CEA and CA125 of patients was tested in all groups respectively, and the serum levels of NSE, CEA and CA125 of SCLC patients in all groups in 1 week, 2 weeks and 4 weeks after chemotherapy were tested. Results NSE level in the SCLC group was significantly higher than that in NSCLC group, and CEA and CA125 levels were significantly lower than NSCLC group (P<0.05). ROC results showed that AUC of NSE, CEA, and CA125 of the diagnosis of SCLC was 0.825, 0.613, 0.533, respectively, and the sensitivity and specificity were 77.1%, 81.1%, 58.3%, 66%, 89.6%, 41.9%, respectively. Compared the level of NSE at different stage of TNM, it satisfied stage Ⅳ> stage Ⅲ> stage Ⅱ> stage Ⅰ (P<0.05). The difference in the level of CEA and CA125 was not significant (P>0.05); the level of NSE and CEA after treatment was significantly lower than that before treatment(P<0.05) (4 w <2 w <1 w), and the difference in the level of CA125 was not significant (P>0.05). Conclusion Serum NSE is eligible to be used as one important tumor marker for diagnosis and clinical staging of SCLC, NSE and CEA are of important reference value for efficacy of SCLC, while CA125 has low specificity in the diagnosis of SCLC and is not suitable as a tumor marker of SCLC.

Epidemiological characteristics, underlying diseases and treatments of elderly hospitalized patients with pneumonia

Cai Mujing, Chen Jingjing, Huang Rukun, Cai Xiaoni, Zheng Ruoxian

2021, 36(3):  229-232.  doi:10.3969/j.issn.1004-583X.2021.03.008

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Objective To investigate underlying diseases, etiological characteristics and treatments in elderly hospitalized patients with community-acquired pneumonia (CAP), and analyze the factors related to the length of hospital stay of the patients. Methods A total of 400 CAP patients who were hospitalized in our hospital were enrolled and assigned into the elderly group(n=274, ages ≥65 years old) and the non-elderly group(n=126, ages <65 years old) by age. The underlying diseases, etiological characteristics and treatment measures of the two groups were compared, and the influencing factors of the length of hospital stay in the elderly group were analyzed by Logistic regression. Results The indicators of hypertension (35.04%), diabetes (20.44%), coronary heart disease (12.04%), chronic heart failure (9.85%), chronic obstructive pulmonary disease (COPD)(15.69%), and chronic kidney disease (12.41%) of the elderly group were all higher than those of the non-elderly group(P<0.05). The indicators of bacteria (28.83%) and fungi (18.98%) infection in the elderly group were higher than those in the non-elderly group (P<0.05). The proportion of patients with 2 pathogens detected in the elderly group (16.06%) was higher than that in the non-elderly group (P<0.05); Multivariate Logistic analysis showed that, ages≥80 years old (OR=6.477), complicated malignant tumors (OR=8.642), complicated chronic heart failure (OR=14.625), glucocorticoid treatment (OR=6.729) were the independent influencing factors of the length of hospital stay of the elderly patients with CAP (P<0.05). Conclusion Most elderly patients with CAP were associated with a variety of underlying diseases, and elderly (ages ≥80 years old), complicated malignant tumors, complicated chronic heart failure, use of glucocorticoids are independent factors influencing the length of hospital stay.

Application value of Helicobacter pylori, PG and G17 in diagnosing precancerous lesions of gastric cancer

Jin Ying, Wang Pai, Feng Shibing

2021, 36(3):  233-237.  doi:10.3969/j.issn.1004-583X.2021.03.009

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Objective To explore the correlation among Helicobacter pylori(H.pylori), pepsinogen(PG), and gastrin 17(G17) in precancerous lesions of gastric cancer(PLGC). Methods 856 patients who underwent gastroscopy in our hospital were selectively divided into the case group (n=471, patients with PLGC detected by the pathology) and the control group (n=385, patients with no PLGC detected by the pathology). In the case group, patients were assigned into the chronic atrophic gastritis (CAG) group (n=157), the intestinal metaplasia (IM) group (n=153), the low-grade intraepithelial neoplasia(LGIN) group (n=82), and the high-grade intraepithelial neoplasia(HGIN) group (n=79). The H.pylori infection type and the PG and G17 levels were detected in each group. Results The rate of H.pylori infection type I in the CAG group was higher than that of the control group (P<0.05). PGⅠ in the CAG group was lower than that of the control group (P<0.05). PGⅡ in the IM group, LGIN group and the HGIN group were higher than those of the control group (P<0.05). PGⅠ/PGⅡ(PGR) in the CAG group, the IM group, the LGIN group and the HGIN group were lower than those of the control group (P<0.05). G17 in the LGIN group and the HGIN group were higher than that of the control group (P<0.05). PGⅠ, PGⅡ, and G17 were positively correlated with the positive H.pylori infection. PGR level was negatively correlated with the positive H.pylori infection (P<0.05). Conclusion The H.pylori infection type and the levels of PG and G17 are closely related to PLGC. Detecting of the H.pylori infection type, PG and G17 is of great value for early screening of PLGC.

Effects of dense ligation on liver function and hemodynamics in patients with esophageal variceal bleeding

Huo Xiaoxia, Niu Weiwei, Han Xu, Zhang Xiaolan

2021, 36(3):  238-241.  doi:10.3969/j.issn.1004-583X.2021.03.010

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Objective To investigate the effects of dense ligation on liver function and hemodynamics in patients with esophageal variceal bleeding(EVB). Methods A total of 120 patients of liver cirrhosis with EVB were randomly divided into two groups, the observation group was treated with dense ligation, the control group received sclerotherapy. The liver function and hemodynamic level of patients in two groups were compared. Results ALT, γ-GT and ALP levels of patients of liver cirrhosis with EVB in two groups decreased after treatment, and the observation group was significantly higher than the control group (P<0.05); the blood flow velocity and blood flow in two groups increased after treatment, and the observation group was significantly higher than the control group (P<0.05); The success rate of hemostasis in observation group was higher than that in control group, as well as the incidence of complications was lower than that in the control group (P<0.05). Conclusion Dense ligation is safe and effective in treating patients of liver cirrhosis with EVB, and it can effectively improve the liver function and hemodynamic level of patients.

Relation of radiation-induced lung injury to peripheral blood IL-6, VEGF,TNF-α and TGF-β in patients with esophageal cancer

Zhao Ruofei, Wang Lei, Li Yingcan, Li Dan, Zhu Guolian

2021, 36(3):  242-245.  doi:10.3969/j.issn.1004-583X.2021.03.011

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Objective To explore the levels of peripheral blood cytokine interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), and transforming growth factor-β (TGF-β) in patients with esophageal cancer with relation to radiation-induced lung injury (RILI). Methods Retrospective analysis was performed in 97 patients with esophageal cancer who had been admitted to our hospital from March 2018 to March 2020. According to whether RILI developed after the treatment, the patients were divided into RILI group(n=25) and non-RILI group(n=72). The peripheral blood IL-6, VEGF, TNF-α, and the level of TGF-β for patients in two groups were determined before and after the radiotherapy. The correlation between various indexes and RILI development was analyzed, and diagnostic efficiency was evaluated. Results IL-6, VEGF, TNF-α, and TGF-β in RILI group were increased, and all the indexes except VEGF in non-RILI group were decreased after the radiotherapy(P<0.05). Whether the patients developed RILI had significant correlation with the levels of peripheral blood IL-6, VEGF, TNF-α, and TGF-β (r=-0.564, r=-0.266, r=-0.758, and r=-0.583)(P<0.05). ROC results showed that the AUC of IL-6, VEGF, TNF-α, and TGF-β were successively 0.837, 0.645, 0.989, and 0.884. In addition, their sensitivity and the specificity were 68.0% and 91.7%, 88.0% and 47.2%, 100.0% and 90.3%, and 92.0% and 77.8%, respectively. Conclusion The levels of peripheral blood IL-6, VEGF, TNF-α, and TGF-β in patients with esophageal cancer are significantly correlated with RILI development after the radiotherapy, and they can be used as factors to predict RILI development.

Analysis of clinical characteristics and related factors of rheumatoid arthritis complicated with malignant tumors in patients

Liu Ziyi, Wang Jibo

2021, 36(3):  246-250.  doi:10.3969/j.issn.1004-583X.2021.03.012

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Objective To investigate the clinical characteristics and related factors of rheumatoid arthritis(RA) complicated with malignant tumor inpatients. Methods Clinical data of patients with RA complicated with malignant tumor admitted to the Affiliated Hospital of Qingdao University from February 2013 to August 2019 were retrospectively analyzed. Complete clinical data of a total of 217 patients with RA complicated with malignant tumors were collected(tumor group), and 308 patients with RA but without tumors during the same period were randomly selected as controls(control group). Results The number of women/men, RA duration, and smokers in tumor group were higher than those in control group(P<0.05), while the utilization rate of steroid hormone and traditional anti-rheumatic drugs in tumor group was lower than that in control group(P<0.05). The course of RA, smoking history and gender difference were the independent risk factors of RA complicated with malignant tumor(P<0.05), while the treatment history of methotrexate or leflunomide was the independent protective factor(P<0.05). Conclusion RA patients have an increased risk of malignancy. RA patients with long course of disease, females and smoking history should be alert to the possibility of cancer. Methotrexate or leflunomide can reduce the risk of cancer.

Expression of PD-1 on T-lymphocytes in acute leukemia after allogeneic hematopoietic stem cell transplantation

Liu Jianning, Sun Li, Niu Zhiyun, Wen Shupeng, Wang Ying, Zhang Xuejun, Wang Fuxu

2021, 36(3):  251-255.  doi:10.3969/j.issn.1004-583X.2021.03.013

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Objective To explore the dynamic change and clinical significance of PD-1 (programmed cell death protein 1) expression on T-lymphocytes in acute leukemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods Twenty-three healthy volunteers (the control group) and 40 patients with acute leukemia (the transplantation group) were selected, peripheral blood samples were collected 1, 2, 3, 4, 5, 6 months after allo-HSCT, and PD-1 expression levels on CD3⁺CD4⁺ and CD3⁺CD8⁺ T-lymphocytes were tested by the flow cytometry. The differences of PD-1 expression levels between the allo-HSCT group and the control group were analyzed. Results The expression levels of PD-1 on CD3⁺CD4⁺ and CD3⁺CD8⁺ T-lymphocytes in acute leukemia patients in the transplantation group at 1 and 2 months after allo-HSCT were higher than those of the control group. The PD-1 expression levels on CD3⁺CD4⁺ T-lymphocyte in the transplantation group were higher than those of the control group at 3, 4, 5 and 6 month after allo-HSCT, but they showed a downtrend with the transplantation time, while the PD-1 expression levels in CD3⁺CD8⁺ T-lymphocyte had no obvious statistical significance (P>0.05 for all). Conclusion The PD-1expression levels on CD3⁺CD4⁺ T-lymphocyte in patients with acute leukemia after allo-HSCT were higher than those normal levels at the early stage and showed a downtrend with the transplantation time; while the PD-1 expression levels on CD3⁺CD8⁺ T-lymphocyte were increased transiently at the early stage after allo-HSCT.

Treatment and prognosis of malignant hypertension complicated with thrombotic microangiopathy for young IgAN patients

Di Dingxin, Zhang Zheng, Li Yetong, Zou Guming, Gao Hongmei, Li Wenge

2021, 36(3):  256-261.  doi:10.3969/j.issn.1004-583X.2021.03.014

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Objective To observe the treatment and prognosis of malignant hypertension(MHT) complicated with thrombotic microangiopathy(TMA) for young patients with IgA nephropathy(IgAN), and its relationship with the expression level of angiotensin receptors in the kidney (AT1R, AT2R, MASR ), aldosterone receptors and renin. Methods The clinicopathological data of 13 cases of MHT complicated with TMA for young IgAN patients were analyzed, related factors affecting the prognosis were discussed, and the expression of AT1R, AT2R, MASR, AldR and renin in renal tissues were observed by immunohistochemistry(IHC). Results Ten patients entered the primary endpoint with a median follow-up of 11 months. Independent risk factors affecting prognosis for patients involved anemia, 24-hour proteinuria ≥ 1.0 g/d, decreased eGFR during renal biopsy and pathological capillary proliferative lesions. The expression of AT1R and AT2R in glomerulus, tubulointerstitium and renal vessels of the experimental group were significantly higher than those of the control group (P<0.01), and the expression of MASR in the glomerulus and renal vessels and the expression of AldR in the renal tubulointerstitium and renal vessels were significantly higher than those in the control group (P<0.01). There was significant positive correlation between the degree of proliferation in capillaries and the expression of AldR in renal tubules, and the expression of renin was positively correlated with the level of serum creatinine. Conclusion Young IgAN patients with MHT and TMA have poor prognosis, and those are all the main factors of disease progression, such as anemia, 24-hour proteinuria ≥ 1.0 g/d, and renal pathological severe damage. The activation of renin angiotensin aldosterone system plays an important role in the pathogenesis and progression of the disease.

Relations between the expression of cyclinD1, p27 and the ultrasonographic features of central lymph node metastasis in the PTMC

Ye Dan, Zhang Jiabo, Yao Lingli, Guo Yu

2021, 36(3):  262-265.  doi:10.3969/j.issn.1004-583X.2021.03.015

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Objective To investigate the relations between the expression of cyclinD1, p27 and ultrasonographic features of central lymph node metastasis in the papillary thyroid microcarcinoma(PTMC). Methods Sixty patients with PTMC receiving central lymph node dissection in the hospital were selected, ultrasonographic features of all cases were recorded, and the expressions of cyclinD1 and p27 in thyroid tumor tissues were detected by immunohistochemical method. The patients were divided into two groups including the central lymph node metastasis group and central lymph node non-metastasis group based on results of postoperative pathological examinations, the relations between ultrasound features and central lymph node metastasis were analyzed, and relations between the expressions of CyclinD1 and P27 in central lymph node metastasis and ultrasound features were analyzed. Results In ultrasound features,the nodular boundary, calcification, aspect ratio ≥1 and multifocus in ultrasound features were related with central lymph node metastasis (P<0.05). High expression of CyclinD1 combined with low expression of p27 had a correlation with central lymph node metastasis (P<0.05).The patients with high expression of cyclinD1 were more likely to have unclear boundary of nodules, calcification or aspect ratio ≥1(P<0.05), and the patients with low expression of p27 are also prone to have the aspect ratio ≥1(P<0.05). Conclusion When nodules with unclear boundaries, calcification and high expression of cyclinD1 or when the aspect ratio ≥1 complicated with high expression of cyclinD1 or lower expression of p27, the possibility of central lymph node metastasis is high, hence, it is necessary to take prophylactic central lymph node dissection.

A case of AL type amyloidosis nephropathy treated with sequential chemotherapy

Gao Xinglian, Tong Zongwu, Yang Chongmeng, Zhao Yanhong, Lu Yongxin, Ding Rong

2021, 36(3):  266-269.  doi:10.3969/j.issn.1004-583X.2021.03.016

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A male patient with AL type amyloidosis nephropathy was presented. The main clinical manifestations were edema, oliguria, abdominal distension, hypoproteinemia, hyperlipidemia and massive proteinuria. The diagnosis was confirmed by renal biopsy. After the sequential use of “CBD” and “TCD” chemotherapy, the patient's condition improved and good partial remission was achieved. The diagnosis, treatment and prognosis of AL type amyloidosis nephropathy were discussed in the article.