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find Author "王群" 27 results
  • 父母及家庭压力因素预测小儿新发癫痫患者的健康相关生活质量

    研究对人口学特征、疾病因素及抗癫痫药物(AEDs)依从性进行校正后,父母及家庭总体和健康相关压力对新发癫痫儿童的纵向通用和癫痫特异性健康相关生活质量(Health-related quality of life, HRQOL)的影响。此项前瞻性纵向研究纳入了124例新发癫痫儿童患者(平均年龄7.2岁, 标准差2.9岁)。患儿父母分别在诊断后1、13、25个月时完成关于父母压力、羞耻感、恐惧和担心以及HRQOL的调查问卷。AEDs的依从性应用电子监测装置进行评估。每次就诊均进行医疗过程回顾以获得发作和药物副作用的数据。高水平的总体及癫痫特异性父母及家庭压力、恐惧和担心以及羞耻感对儿童通用及癫痫特异性HRQOL存在负面影响,大于疾病及人口学因素。总体父母及家庭压力在疾病管理第1年对儿童通用及癫痫特异性HRQOL的影响大于疾病诊断2年后的影响。更大的恐惧和担心对于诊断后13个月更高的癫痫特异性HRQOL有预测作用,而在诊断后2年,更大的恐惧和担心则预示更低的癫痫特异性HRQOL。多个人口学(如年龄)及疾病相关变量(如副作用和AED依从性)影响儿童通用及癫痫特异性HRQOL。尽管一些发现在各项通用及癫痫特异性HRQOL指标中一致,但其它的都是独有的。可改进的父母因素(如总体及疾病特异性父母及家庭压力、羞耻感)对小儿新发癫痫患者诊断后前2年中的HRQOL的影响是不同的。在诊断后第1年内用以改善HRQOL的心理社会干预应当解决父母和家庭压力、总体应对和癫痫管理的预期指导。针对依从性、羞耻感、恐惧和担心的干预措施可改善HRQOL。推动压力、恐惧/担心和羞耻感的父母管理可改善儿童HRQOL结局。

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  • Effect of RNAi Silencing of The DLL4 Gene for Inducing Apoptosis and Chemosensitivity to Docetaxel of Human Breast Cancer Cells

    Objective To explore effect of DLL4 gene in MCF-7 cells of human breast cancer which was inhibitted by short hair in RNA (shRNA) on inducing apoptosis and chemosensitivity to docetaxel. Methods Specific shRNA was designed in accordance with DLL4 gene and transfected into MCF-7 cells of human breast cancer with liposomal (Lip-shRNA group), MCF-7 cells transfected with only liposomal as Lip group, and control group without any treatment. Expressions of DLL4 protein in 3 groups were detected by immunohistochemical method, apoptosis and cell cycle distribution were examined by flow cytometry (FCM). Proliferations and sensitivity of MCF-7 cells to docetaxel in 3 groups were determined by methylthiazoyl-tetrazolium bromide (MTT). Results The averages optical density value and rate of positive area of Lip-shRNA group were significantly lower than that of other 2 groups (P<0.01). The levels of A value at 24h, 48h, and 72h in Lip-shRNA group were significantly lower than that of other 2 groups (P<0.01). Rates of cell apoptosis at 24h, 48h, 72h and 96 h in Lip-shRNA group were significantly higher than that of other 2 goups (P<0.05),and ratio of G2/M was higher too (P<0.05). IC50 of Lip-shRNA group to docetaxel was significantly lower than that of other 2 groups (P<0.05). Conclusions The RNA interference technology can effectively block the expression of DLL4 gene. Inhibition of DLL4/Notch signaling pathway can lead to proliferation inhibition of cancer cell and a concomitant increase in cells undergoing apoptosis, and can enhance the cell sensitivity to docetaxel. DLL4 may be an important target for therapeutic approach of breast cancer.

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  • Application of Gastric Tube in Minimally Invasive Esophagectomy

    Objective To summarize the experiences of applying gastric tube in minimally invasive esophagectomy (MIE), in order to assess its feasibility and safety. [WTHZ]Methods From June 2004 to August 2009, MIE was performed on 102 patients with esophageal carcinoma, including 71 males and 31 females whose age ranged from 37 to 79 years old with an average age of 61.1. Among them, 62 patients underwent thoracoscopic laparotomy 3-incision esophagectomy, 35 patients underwent thoracoscopic and laparoscopic 3-incision esophagectomy and 5 patients underwent thoracotomy and laparoscopic esophagectomy. Prevertebral reconstruction was performed on 58 patients and retrosternal reconstruction was performed on 44 patients. [WTHZ]Results All operations were performed successfully with a perioperative mortality rate of 2.0%(2/102) and a postoperative complication rate of 41.2%(42/102). The complications included anastomotic leakage, anastomotic stricture and lung infection. The complication rate was higher in the retrosternal group than in the prevertebral group (56.8% vs. 29.3%, Plt;0.05). Anastomotic leakage rate in the retrosternal group was also higher than that in the prevertebral group (34.1% vs. 6.9%, Plt;0.05). There was no significant difference in anastomotic stenosis, gastric fistula, dysfunction of gastric emptying, heart and lung complications, chylothorax and injury of recurrent laryngeal nerve between the two groups. [WTHZ]Conclusion Gastric tube is an effective way for reconstruction of the digestive tract after minimally invasive esophagectomy. The choice of prevertebral reconstruction or retrosternal reconstruction should be based on each individual patient.

    Release date:2016-08-30 06:01 Export PDF Favorites Scan
  • Expression and Clinical Significance of DLL4 and S100A4 in Different Molecular Subtypes of Breast Carcinoma

    Objective To study the expressions of Delta-like ligand 4 (DLL4) and S100A4 in breast carcinoma of differect molecular subtypes and explore its clinical significance. Methods The expressions of DLL4 and S100A4 in all molecular subtypes were tested by SP immunohistochemistry in 108 cases of breast carcinoma and 40 cases of paracancerous tissues from Taihe Hospital. The Luminal A, Lumianl B, HER-2 over-expression, and basal-like subtypes was 51, 26, 17, and 14 cases, respectively. Then the correlation of DLL4 and S100A4 expression with patients’ clinical and pathological features were analyzed. Results The positive expression rates of DLL4 and S100A4 in breast carcinoma was 67.6%(73/108)and 62.0%(67/108)respectively, which were significantly higher than those in paracancerous tissues〔22.5%(9/40) and 45.0%(18/40)〕, P<0.05. The positive expression rates of DLL4 and S100A4 in breast carcinoma tissues of HER-2 over-expression and basal-like subtypes were significantly higher than those in breast carcinoma tissues of Luminal A and Luminal B subtypes (P<0.05). The expressions of DLL4 and S100A4 in breast carcinoma tissues with lymph node metastasis and without lymph node metastasis were significantly different(P<0.05). There was positiver elationship between the expressions of DLL4 and S100A4 in breast carcinoma tissues(rs=0.217,P<0.01). Conclusions DLL4 and S100A4 are highly expressed in breast carcinoma tissues of HER-2 over-expression and basal-like subtypes, and are all related with prognosis of breast carcinoma. These results suggest that they might be important factors in breast carcinogenesis and tumor development, metastasis. These proteins are indicators of metastasis and predictors for prognosis of breast carcinoma.

    Release date:2016-09-08 10:38 Export PDF Favorites Scan
  • 白细胞介素-1β与外伤后癫痫发生的联系——一个遗传学和生物标记物的队列研究

    外伤后癫痫(Post-traumatic epilepsy, PTE)是创伤性脑损伤(Traumatic brain injury, TBI)后的一个主要的并发症, 但遗传变异在调节PTE发生中的作用尚不清楚。假设TBI诱导的炎症可能是导致癫痫发生的原因, 对白细胞介素-1β(Interleukin-1β, IL-1β)基因的遗传变异情况, 脑脊液和血清中IL-1β水平和IL-1β的脑脊液/血清比值能否预测TBI后PTE的发生进行了评估。共调查了256例中度至重度TBI后患PTE的成年白种人。对IL-1β标记和功能性单核苷酸多态性(SNPs)进行基因分型。对遗传变异性和PTE的发生进行评估。在调查患者中抽取一部分患者(n=59)在其外伤后1周内收集血清和脑脊液的IL-1β, 并评估它们与IL-1β基因变异及PTE的关系。临时配对IL-1β的脑脊液/血清比值以反映血清IL-1β水平对脑脊液IL-1β的影响。多变量分析显示随着时间推移, 高脑脊液/血清IL-1β比值与PTE风险增加有关(P=0.008)。rs1143634的多变量分析揭示了CT基因型与PTE风险增加有关(P=0.005)。CT基因型组其血清IL-1β水平较低(P=0.014), 脑脊液/血清IL-1β比值较高(P=0.093)。这是第一个揭示PTE风险中的IL-1β基因变异, 及TBI后IL-1β基因变异与血清IL-1β水平的关系和IL-1β比值与PTE风险的关系。根据这些发现, 提出基因和IL-1β比值与PTE的相关性可能归因于TBI恢复期的血脑屏障完整性的生物变异性包括。为进一步的研究提供了理论依据, 验证遗传变异性对TBI后IL-1β产生的影响, 评估造成脑脊液/血清IL-1β比值与PTE相关性的基因介导的信号传导机制, 及评估减少PTE的靶向IL-1β治疗。

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  • 反应性神经刺激治疗成人局灶性药物难治性癫痫的中心试验结果

    为了验证在癫痫灶进行反应性神经刺激作为减少成人癫痫起源于一个或两个致痫灶的药物难治性部分性癫痫发作频率的辅助治疗方法的安全性及有效性。反应性局灶皮层刺激(Responsive focal cortical stimulation, RNS)的多中心随机对照双盲试验。对起源于一个或两个致痫灶的药物难治性部分性癫痫受试者进行皮下植入, 植入后1个月按1∶1随机分为真刺激及假刺激组。植入后第5个月过后, 所有受试者在一个开放标签期(Open label period, OLP)接受反应性神经刺激开放标签来完成2年的植入后随访。所有191例受试者进行了随机化。盲法期结束时真刺激组癫痫发作改变的百分比为37.9%, 假刺激组为17.3%(P=0.012, 广义估计方程)。开放标签期癫痫发作减少百分比中位数第1年为44%, 第2年为53%, 代表随着时间呈进行性且显著的改善(P<0.000 1)。严重不良事件发生率在真刺激及假刺激组间无差异。不良事件与植入医疗设备、癫痫发作及其它癫痫治疗方法的已知风险是一致的。未出现神经心理功能或情绪方面的不良效应。反应性神经刺激治疗局灶性癫痫快速减少了部分性癫痫发作的频率, 显示了随时间癫痫发作减少率的改善, 耐受性良好, 安全性可接受。RNS系统为药物难治性部分性癫痫发作患者提供了一种新的治疗选择

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  • 经颅直流电刺激治疗癫痫研究进展

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  • 颞叶癫痫动物模型

    癫痫是一种神经系统常见疾病,绝大多数癫痫患者可以通过药物控制发作,但是仍有约1/3患者为药物难治性癫痫,在难治性癫痫中绝大多数为颞叶癫痫。对颞叶癫痫动物模型的研究有助于了解其发病机制、脑电改变及病理生理特点,为寻找其治疗方法有一定帮助。现就颞叶癫痫动物模型的制作方法、行为学表现、脑电改变及病理特征进行总结。目前常用颞叶癫痫动物模型有海人酸模型和匹罗卡品模型,两种模型均可以通过系统给药和局部给药方式实现,可以诱发急性癫痫持续状态,之后出现反复自发发作从而形成慢性癫痫模型。两种模型均可引发海马起源的痫样放电,造成海马神经元变性、胶质细胞增生及苔藓纤维出芽,与人类颞叶癫痫相似。

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  • 生酮饮食治疗癫痫作用机制研究进展

    生酮饮食(Ketogenic diet,KD)是一种高脂肪、低碳水化合物,适量蛋白质、维生素和矿物质的饮食。KD用于治疗癫痫已有很长的历史,其疗效明确但作用机制尚不清楚。基于临床观察和研究,最初人们认为KD的作用机制与脱水、酸中毒相关。近几年,基于越来越多的动物实验和临床研究,人们逐渐提出了更多假说。KD减少了葡萄糖的摄入,机体利用葡萄糖受限,而酮体、脂肪酸升高,这可能与其产生抗癫痫作用相关。此外研究发现,KD的抗癫痫机制可能与神经递质、神经元兴奋性及突触传递有关。KD还有神经保护功能,如抗炎、氧化应激等,这与其抗癫痫作用也有关联。但是上述机制并不明确,目前关于KD的抗癫痫机制仍在探索之中。

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  • 癫痫的发病机制研究

    癫痫是神经系统的常见疾病之一,其发病机制十分复杂,目前尚未完全阐明。近年来关于癫痫发病机制的研究表明,癫痫的发生与离子通道、神经递质、突触连接、神经血管单元以及神经胶质细胞等均存在密切联系。为深入理解癫痫发病机制,为癫痫的诊断、预防与治疗提供必要的理论依据,文章将从以上方面对癫痫发生机制的研究作一综述。

    Release date:2017-04-01 08:51 Export PDF Favorites Scan
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