ObjectiveTo investigate the changes of plasma platelet activating factor (PAF) interleukin-8(IL-8) and interferon-γ (IFN-γ) in patients after surgery with extracorporeal circulation (ECC) and their clinical significance. MethodsSeventy-five patients undergoing surgery with ECC in the First College of Clinical Medicine,China Three Gorges University from June 2012 to June 2013 were enrolled in this study. According to the presence of postoperative acute lung injury/acute respiratory distress syndrome (ALI/ARDS) all the 75 patients were divided into 2 groups. In ALI/ARDS group, there were 28 patients including 20 male and 8 female patients with their age of 53.6±8.2 years. In the control group,there were 47 patients without postoperative ALI/ARDS,including 32 male and 15 female patients with their age of 56.9±11.8 years. Dynamic variations of plasma PAF,IL-8 and IFN-γ of these patients were examined with enzyme-linked immunosorbent assay (ELISA) and compared between the 2 groups. ResultsIn ALI/ARDS group,plasma IL-8 and IFN-γ reached peak levels at 48 hours after surgery and gradually decreased after that;plasma PAF reached the peak level at 96 hours after surgery and gradually decreased after that. Postoperative plasma PAF (96 hours after surgery:16 029.5±4 203.7 mU/ml vs. 4 520.1±312.2 mU/ml,P<0.05) IL-8 (48 hours after surgery:48 580.5±8 095.8 pg/ml vs. 5 990.5±1 179.0 pg/ml,P<0.05) and IFN-γ (48 hours after surgery:258.5±76.1 pg/ml vs. 26.1±11.5 pg/ml,P<0.05) of ALI/ARDS group were significantly higher than those of the control group at 48 hours,96 hours and 144 hours after surgery. ConclusionPlasma PAF,IL-8 and IFN-γ change significantly after surgery with ECC,which may play an important role in the pathogenesis of postoperative ALI/ARDS.
Objective To summarize the current research advances of colorectal signet-ring cell carcinoma (SRCC). Methods In this paper, the related literatures of colorectal SRCC in recent years were collected and reviewed. Results Colorectal SRCC was a pathological subtype of colorectal adenocarcinoma, with extremely low incidence but high malignancy and poor prognosis. At present, its molecular mechanism was still not very clear and the clinicopathological manifestations were not specific. Surgical treatment was the major treatmen. Conclusions Although we already have a certain degree of understanding about colorectal SRCC, due to the limitations in the results of some related researches because of the small sample size or the single-center study, we still need more researches to improve the cognition of colorectal SRCC.
ObjectiveTo investigate the existence of persistent systemic inflammation (PSI) among patients with chronic obstructive pulmonary disease (COPD) in local areas, and identify the risk factors of PSI.MethodsA total of 150 patients with stable COPD and 70 non-smoking healthy individuals were enrolled in our study. The levels of interleukin-6 (IL-6), IL-18 and activin A in serum were detected. Pulmonary function was tested, and basic information of the candidates was acquired at the same time. All of the patients were followed-up at 6 months, 12 months and 24 months for two years. The value at the 95th percentile of the concentration of inflammation markers of non-smoking healthy samples was defined as the threshold value, also known as normal ceiling limit value. Existence of PSI was defined as the condition that two or more kinds of inflammation markers exceed the threshold at each follow-up visit. The COPD patients were categorized into three classes, in which there were respectively none, one and two or more kinds of inflammation markers with over-threshold values. Based on a 2-year followup, patients with two or more kinds of inflammation markers exceeding threshold values were classified as PSI subgroup, and patients without inflammation markers exceeding threshold values as never inflamed subgroup.ResultsThere were 22 patients (14.7%) had persistent systemic inflammation, whereas 60 patients (40.0%) did not show evidence of systemic inflammation. Single factor analysis of two subgroups showed that the patients in PSI subgroup had higher body mass index (BMI), higher smoking index, higher prior frequency of time to exacerbation, higher proportion of patients at high risk for recurrent acute exacerbation during 2-year followup, higher SGRQ total score, lower FEV1%pred and lower FEV1/FVC ratio significantly (all P<0.05). Higher BMI and higher risk of recurrent acute exacerbation were independent risk factors leading to PSI, of which the higher risk of recurrent acute exacerbation had a more important effect on PSI.ConclusionsSome COPD patients have PSI in this region, which may constitute a novel COPD phenotype (called systemic inflammatory phenotype). Higher BMI and higher risk of recurrent acute exacerbation are independent risk factors leading to PSI. Individualized treatment to prevent acute exacerbation and appropriate weight control may be a better intervention for these patients.
Objective To investigate the status quo and influencing factors of depression and anxiety in postoperative patients with thoracic neoplasms. Methods The general information questionnaire and Huaxi emotional-distress index scale (HEI) were adopted to survey 70 patients after surgery of thoracic neoplasms at the thoracic nursing outpatients from September to November 2016. There were 43 males and 27 females with age of 18-78 (56.20±11.34) years. Results The prevalence rate of depression and anxiety among postoperative patients with thoracic neoplasms was 50.0%, and moderate to severe negative emotions predominated. There was significant difference in educational levels, postoperative hospitalization and postoperative complications (P<0.05), while no significant difference in age, gender, disease types, complicated diseases, surgical procedures, pathological stages and hospitalization expenditures between patients with unhealthy emotions and normal emotions (P>0.05). Conclusion There is a high prevalence rate of negative emotion among postoperative patients with thoracic neoplasms. Educational levels, postoperative hospitalization and postoperative complications are important factors for negative emotion.
ObjectiveTo analyze the related factors of cognitive impairment in patients with post-traumatic epilepsy. MethodsFrom January 2016 to January 2019, 45 patients with post-traumatic epilepsy (epilepsy group) and 48 patients with physical examination (control group) at the Department of Neurosurgery, the 904th Hospital of PLA were analyzed retrospectively. Cognitive assessment were evaluated by the following scales: Montreal cognitive assessment (MoCA), Mini-mental state examination (MMSE), Audio verbal memory test (AVMT), Rey-osterrieth complex figure test (CFT) and Trail making test (TMT). Then we analyzed the influences of gender, age, course of disease, cause, type, degree and location of injury, seizure frequency and Anti-seizure medications (ASMs) on cognitive impairment. ResultsThe results showed that there were significant differences between the epilepsy group and the control group in all scales (P<0.01). Analysis of influencing factors in epilepsy group showed: MoCA and MMSE scores: there were statistical significance in the comparison of seizure frequency and injury degree (P<0.05); AVMT, CFT and TMT scores: there were statistical significance in the comparison of seizure frequency, injury degree and location, ASMs within the group (P<0.05). ConclusionPost-traumatic epilepsy can cause cognitive impairment. The more frequent epileptic seizures and the more severe the degree of trauma, the more serious the cognitive impairment. Different injury sites affect the scope of cognitive impairment, temporal lobe injury is easy to cause memory function decline, frontal lobe injury is easy to cause spatial structure and executive ability decline, at the same time, the combined use of ASMs has an impact on cognitive function.
ObjectiveTo analyze of the extent of neuropsychological damage in post-traumatic epilepsy patients. MethodsOne hundred and thirty-five patients treated at the Department of Neurosurgery, the 904th Hospital of PLA from January 2016 to December 2018 were analyzed retrospectively, including 94 males and 41 females, with an average age of (32.94 ± 9.51) years. They were divided into 3 groups: 40 patients with post-traumatic epilepsy (epilepsy group): 53 trauma patients without post-traumatic epilepsy (trauma group) and 42 patients with health examination (control group). Neuropsychological assessment using the following scales: Mini-mental State Examination (MMSE): Montreal Cognitive Assessment-Basic (MoCA-B): Audio Verbal Memory Test (AVMT): Rey-Osterrieth Complex Figure Test (CFT): Trail Making Test (TMT): Hamilton Depression Scale (HAMD): Activity of Daily Living (ADL). ResultsThe results of one-way ANOVA showed that there was significant difference between all scales of epilepsy group, trauma group and control group (P<0.01). MMSE and MoCA-B scores: Compared with trauma group, epilepsy group decreased significantly, but there was no significant difference between groups (P>0.05); Memory and spatial structure ability: AVMT short/long delayed memory, CFT recall and copy test results showed that epilepsy group decreased more significantly than trauma group, and there was statistical significance between groups (P<0.05); Executive ability: TMT-A and TMT-B showed that epilepsy group spent longer time than trauma group, and there was significant difference between groups (P<0.01); Depressive symptoms: HAMD scale showed significant difference between epilepsy group and trauma group (P<0.01): while there was no statistical difference between trauma group and control group (P>0.05); Activity of daily living: ADL scale results showed that there was no significant difference between epilepsy group and trauma group (P>0.05). ConclusionPost-traumatic epilepsy can aggravate the cognitive impairment of patients, mainly in the decline of memory, spatial structure and executive ability, and prone to depressive symptoms. At the same time of treating epilepsy seizures, patients with post-traumatic epilepsy should be screened and assessed early in neuropsychology to improve their quality of life and return to society as soon as possible.