Zhonghua yi xue za zhi
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Zhonghua yi xue za zhi · Nov 2019
[The relationship between acid reflux and esophageal motility, esophagitis and cardiac morphology in gastroesophageal reflux disease].
Objective: To analyze the relationship between the severity of esophageal acid reflux and esophageal motility, esophageal mucosal injury and morphological anatomy of gastroesophageal junction (GEJ) in patients with gastroesophageal reflux disease (GERD). Methods: The clinicaldata of GERD patients who underwent 24 h pH-impedance monitoring, gastroscopy and high-resolution manometry (HRM) from January 2016 to January 2019 in the Gastroesophageal Surgery Department of PLA Rocket Force Characteristic Medical Center were retrospectively analyzed. The patients were divided into non-pathological acid reflux group, mild pathological acid reflux group and moderate to severe pathological acid reflux group according to the DeMeester score. ⋯ Conclusions: The esophageal low motility (such as low LES pressure) and anatomical abnormalities (abdominal esophageal shortening, GEJ flabbiness, and even HH formation) of the GEJ regionare significantly associated with the severity of acid reflux. These factors may be important causes of increased acid reflux. In addition, the aggravation of acid reflux can also increase the incidence and severity of esophagitis.
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Zhonghua yi xue za zhi · Nov 2019
Comparative Study[Dosimetric comparison of the helical tomotherapy, intensity-modulated radiotherapy and volumetric-modulated arc therapy in radical radiotherapy for esophageal cancer].
Objective: To compare the dosimetric parameters of three different modern radiation techniques in radical radiotherapy for esophageal cancer. Methods: A total of 25 patients with pathologically confirmed esophageal squamous cell carcinoma in Zhejiang Cancer Hospital were included from September 2015 to May 2016 and three radiation treatment plans for helical tomotherapy (TOMO), intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) were designed respectively for each patient. Study patients included 24 males and 1 female,aged from 47 to 82 years old, with a median age of 63 years old. ⋯ TOMO (38.17±4.14) Gy was significantly superior to VMAT ((39.52±3.64)Gy,t=-2.219, P=0.040) and IMRT ((40.87±3.59)Gy,t=-4.528, P=0.000) at D(max) of the spinal cord. Conclusions: The VMAT plan is better than TOMO and IMRT in terms of the conformal degree and dose uniformity of the target volume. TOMO seems significantly better than VMAT and IMRT in protecting normal tissue.
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Zhonghua yi xue za zhi · Oct 2019
[Using next generation sequencing technology to analyze gene mutations in patients with acute myeloid leukemia and the impact on prognosis].
Objective: To analyze the distribution of gene mutations in newly diagnosed acute myeloid leukemia (AML) patients, based on next generation sequencing technology (NGS) and to evaluate their value in AML risk stratification. Methods: The study analyzed 453 newly diagnosed AML(excluded acute promyelocytic leukemia, APL) patients from seven hospitals in Shanghai, from January 1st 2014 to December 31th 2017. RNA and DNA were extracted from pretreatment bone marrow mononuclear cells and targeted sequencing of AML genes were performed. ⋯ Conclusions: The gene mutations frequencies in AML patients with different age and molecular risk stratification groups are different. Epigenetics gene mutation frequencies, such as DNMT3A, ASXL1, IDH1/IDH2 and TET2,are higher in patients older than 50 years. A shorter OS can be observed in older patients(>50 years) with epigenetics gene mutation.
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Zhonghua yi xue za zhi · Oct 2019
[The value of DCE-MRI in predicting IDH gene mutation of high-grade gliomas].
Objective: To investigate the value of quantitative and semiquantitative parameters of DCE-MRI in predicting IDH gene mutation of high-grade gliomas before the operation. Methods: Twenty-six individuals with surgically and pathologically proved WHO Ⅲ-Ⅳ gliomas collected from April 2016 to June 2019 in First People's Hospital of Changzhou, were divided into two groups, IDH mutation group (7 cases, 27-67 years, 3 males and 4 females,) and IDH gene wild group (19 cases, 42-75 years, 12 males and 7 females) according to the results of molecular pathology. All individuals underwent conventional plain (T(1)WI, T(2)WI), enhanced MR scanning (T(1)WI) and dynamic contrast enhancement (DCE). ⋯ The specificity of K(trans) was higher (73.7%), The sensitivity of TTP was the higher (100.0%). Combined K(trans)and TTP were the best for predicting IDH gene mutation of high-grade gliomas, AUC was 0.865. Conclusion: Quantitative and semiquantitative parameters of DCE-MRI can help to predict IDH gene mutation of high-grade gliomas before the operation.
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Zhonghua yi xue za zhi · Oct 2019
[Expression and clinical significance of CCL18 in bronchoalveolar lavage fluid of connective tissue disease-associated interstitial lung disease].
Objective: To explore the expression and clinical significance of chemokine ligand 18 (CCL18) in Bronchoalveolar Lavage Fluid (BALF) of patients with connective tissue disease-associated interstitial lung disease (CTD-ILD). Methods: From January 2016 to June 2017, BALF of patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD group), patients with dermatomyositis-associated interstitial lung disease (DM-ILD group), and patients with primary Sjögren syndrome-associated interstitial lung disease (pSS-ILD group) of Peking University People's Hospital were collected. According to the prognosis of each group of patients during hospitalization, they were divided into the discharged and the died. ⋯ Areas under the curve (AUCs) of CCL18 to predict mortality during hospitalization of RA-ILD and DM-ILD groups were 0.860, 0.851, respectively. Conclusions: Levels of CCL18 are elevated in BALF of CTD-ILD patients, and may be correlated with the severity and prognosis during hospitalization. CCL18 might be served as an indicator of the severity and prognosis of CTD-ILD.