The Wnt/β-catenin signaling pathway is the main target of tooth regeneration regulation.Treatment of cells with AZD2858 stimulates the Wnt/β-catenin signaling pathway,yet the function of this pathway in tooth regene...The Wnt/β-catenin signaling pathway is the main target of tooth regeneration regulation.Treatment of cells with AZD2858 stimulates the Wnt/β-catenin signaling pathway,yet the function of this pathway in tooth regeneration remains unclear.Here,we found that AZD2858 promotes the accumulation ofβ-catenin in the nuclei of stem cells from the apical papilla(SCAPs)and enhances cell proliferation.Single-cell sequencing was performed on SCAPs treated with AZD2858.Eight clusters were identified,namely SCAPs-CNTNAP2,SCAPs-DTL,SCAPs-MYH11,SCAPs-MKI67,SCAPs-CXCL8,SCAPs-TPM2,SCAPs-IFIT2 and SCAPs-NEK10.The pseudo-time trajectory analysis showed that AZD2858 enhanced the evolution of SCAPs from SCAPs-TMP2 clusters to SCAPs-MYH11,SCAPs-CNTNAPs and SCAPs-NEK10 clusters via up-regulation of PRKCA,SMURF2,MAGI2,RBMS3,EXT1,CAMK2D,PLCB4,and PLCB1.These results demonstrate that AZD2858 enhances the proliferation of SCAPs-TPM2 cluster by activating the non-canonical Wnt/β-catenin signaling pathway.展开更多
AIM To evaluate the feasibility of side-to-side anastomosis of the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass(LRYGB).METHODS Seventy-seven patients received side-to-side anastomos...AIM To evaluate the feasibility of side-to-side anastomosis of the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass(LRYGB).METHODS Seventy-seven patients received side-to-side anastomosis of the lesser curvature of stomach and jejunum by utilization of linear stapler in LRYGB from April 2012 to July 2015 were retrospectively analyzed.RESULTS All patients were successfully completed laparoscopic gastric bypass with the side-to-side anastomosis of the lesser curvature of stomach and jejunum. No patient was switched to laparotomy during operation. No early complications including gastrointestinal anastomotic bleeding, fistula, obstruction, deep vein thrombosis, incision infections, intra-abdominal hernia complications were found. One patient complicated with stricture of gastrojejunal anastomosis(1.3%) and six patients complicated with incomplete intestinal obstruction(7.8%). BMI and Hb A1 c determined at 3, 6, 12, 24 mo during follow up period were significantly reduced compared with preoperative baselines respectively. The percentage of patients who maintain HbA 1c(%) < 6.5% without taking antidiabetic drugs reached to 61.0%, 63.6%, 75.0%, and 63.6% respectively. The outcome parameters of concomitant diseases were significantly improved too.CONCLUSION Present surgery is a safety and feasibility procedure. It is effective to lighten the body weight of patients and improve type 2 diabetes and related complications.展开更多
Objective Obesity is recognized as a significant risk factor for diabetes and hypertension. The present study aimed to examine the associations between adults' obesity risk and childhood and parental obesity. Meth...Objective Obesity is recognized as a significant risk factor for diabetes and hypertension. The present study aimed to examine the associations between adults' obesity risk and childhood and parental obesity. Methods A total of 204 children aged 6-17 years were recruited in 2002 with an average follow-up period of 13.2 years. Height and body weight were measured by trained staffs. Overweight and obesity were defined based on the Chinese standard for children and adults. T-test, analysis of variance, and Chi-square analysis were used for single factor analysis. Multiple linear and logistic regression analyses were used to perform multifactor analysis. Results The percentage of non-obese children who grew up to be non-obese adults was 62.6%, and that of obese children who grew up to be obese adults was 80.0%. There was a significant association between childhood body mass index(BMI) and adulthood BMI with a β regression coefficient of 3.76 [95% confidence interval(CI): 1.36-6.16], and between childhood obesity and adulthood obesity with an odds ratio of 5.76(95% CI: 1.37-24.34). There was no statistical difference between parental obesity at baseline and children's adulthood obesity, after adjustment of confounders. Male participants and those aged 10.0-13.0 years had a higher risk of adulthood obesity with odds ratios of 2.50(95% CI: 1.12-5.26) and 3.62(95% CI: 1.17-11.24), respectively. Conclusion Childhood obesity is an important predictor of adulthood obesity.展开更多
Benign cicatricial airway stenosis（BCAS） is a potentially life-threatening disease.Recurrence occurs frequently after endoscopic treatment.Paclitaxel is known to prevent restenosis,but its clinical efficacy and safe...Benign cicatricial airway stenosis（BCAS） is a potentially life-threatening disease.Recurrence occurs frequently after endoscopic treatment.Paclitaxel is known to prevent restenosis,but its clinical efficacy and safety is undetermined.Therefore,in this study,we investigated the efficacy and associated complications of paclitaxel as adjuvant treatment for BCAS of different etiologies.The study cohort included 28 patients with BCAS resulting from tuberculosis,intubation,tracheotomy,and other etiologies.All patients were treated at the Department of Respiratory Diseases,Beijing Tian Tan Hospital,Capital Medical University,China,between January 2010 and August 2014.After primary treatment by balloon dilation,cryotherapy,and/or high-frequency needle-knife treatment,paclitaxel was applied to the airway mucosa at the site of stenosis using a newly developed local instillation catheter.The primary outcome measures were the therapeutic efficacy of paclitaxel as adjuvant treatment,and the incidence of complications was observed as well.According to our criteria for evaluating the clinical effects on BCAS,24 of the 28 cases achieved durable remission,three cases had remission,and one case showed no remission.Thus,the durable remission rate was 85.7%,and the combined effective rate was 96.4%.No differences in outcomes were observed among the different BCAS etiologies（P=0.144）,and few complications were observed.Our results indicated that paclitaxel as an adjuvant treatment has greater efficacy than previously reported BCAS treatment methods.展开更多
Objective: To discuss the ef ect of BRMS1 on the proliferation, migration and adhesion of mouse forestomach carcinoma(MFC). Methods: The constructed p CMV-myc-BRMS1 recombinant plasmid and blank plasmid were transfect...Objective: To discuss the ef ect of BRMS1 on the proliferation, migration and adhesion of mouse forestomach carcinoma(MFC). Methods: The constructed p CMV-myc-BRMS1 recombinant plasmid and blank plasmid were transfected into mouse forestomach carcinoma. MTT method was employed to measure the activity of gastric cancer cell; the scratch assay and Transwell assay to measure the migration and invasion of gastric cancer cell; the adhesion assay to measure the adhesion of gastric cancer cell; while the Western blot assay to measure the expression of The NF-毷B signal pathway, downstream matrix metalloproteinase(MMP-2), MMP-9 and osteopontin and E-cadherin in the gastric cancer cell. Besides, the transplanted animal model of gastric cancer in mice was constructed to measure the size of tumor xenograft. Results: Results of MTT assay showed that, compared with the empty vector control group, the activity of gastric cancer cell was not af ected in the BRMS1 transfection group. The improved expression of BRMS1 could inhibit the adhesion, migration and invasion of gastric cancer cell(P<0.01). Besides, compared with the empty vector control group, the phosphorylation of NF-毷B p65 and I毷Bα was reduced in the BRMS1 transfection group, with the decreased expression of MMP 2, MMP 9 and osteopontin and the increased expression of E-cadherin(P<0.01). Results of animal experiment also showed that the expression of BRMS1 did not af ect the transplanted tumor. Conclusions: The expression of BRMS1 can signii cantly inhibit the adhesion, migration, invasion and metastasis of MCF gastric cancer cell, which is related to The NF-毷B signal pathway.展开更多
AIM: To study the clinical features, microbial spectrum, associated factors and prognosis of endogenous endophthalmitis(EE) in a group of Chinese patients.METHODS: The medical records from 32 eyes of 29 patients diagn...AIM: To study the clinical features, microbial spectrum, associated factors and prognosis of endogenous endophthalmitis(EE) in a group of Chinese patients.METHODS: The medical records from 32 eyes of 29 patients diagnosed with EE in Peking Union Medical College Hospital from January 2009 to October 2019 were reviewed. RESULTS: The initial visual acuity(VA) of 30 eyes in this study was worse than 20/400. Twenty-three eyes were diagnosed with fungal endophthalmitis and nine with bacterial endophthalmitis. The most common fungal and bacterial isolates were Candida and Klebsiella pneumoniae, respectively. Several rare fungi and bacteria species were also isolated from our patients, including Cryptococcus, Paecilomyces, Brucella, and Bacillus licheniformis. The leading risk factor for EE was diabetes. The most common extraocular infection locus was genitourinary tract. Vitrectomy was performed on twenty-nine eyes. Eight eyes achieved final VA of 20/400 or better. EE caused by Candida had a better prognosis.CONCLUSION: The visual outcome of EE is based on pathogens and prompt intervention. Early vitrectomy and antimicrobial treatment are beneficial for EE.展开更多
Previous animal studies of cauda equina injury have primarily used rat models, which display significant differences from humans. Furthermore, most studies have focused on electrophysio- logical examination. To better...Previous animal studies of cauda equina injury have primarily used rat models, which display significant differences from humans. Furthermore, most studies have focused on electrophysio- logical examination. To better mimic the outcome after surgical repair of cauda equina injury, a novel animal model was established in the goat. Electrophysiological, histological and magnetic resonance imaging methods were used to evaluate the morphological and functional outcome after cauda equina injury and end-to-end suture. Our results demonstrate successful establish- ment of the goat experimental model of cauda equina injury. This novel model can provide detailed information on the nerve regenerative process following surgical repair of cauda equina injury.展开更多
Objective This study aimed to assess the association of waist circumference(WC)with all-cause mortality among Chinese adults.Methods The baseline data were from Shanxi Province of 2002 China Nutrition and Health Surve...Objective This study aimed to assess the association of waist circumference(WC)with all-cause mortality among Chinese adults.Methods The baseline data were from Shanxi Province of 2002 China Nutrition and Health Survey.The death investigation and follow-up visit were conducted from December 2015 to March 2016.The visits covered up to 5,360 of 7,007 participants,representing a response rate of 76.5%.The Cox regression model and floating absolute risk were used to estimate hazard ratio and 95%floating CI of death by gender and age groups(≥60 and<60 years old).Sensitivity analysis was performed by excluding current smokers;participants with stroke,hypertension,and diabetes;participants who accidentally died;and participants who died during the first 2 years of follow-up.Results This study followed 67,129 person-years for 12.5 years on average,including 615 deaths.The mortality density was 916 per 100,000 person-years.Low WC was associated with all-cause mortality among men.Multifactor-adjusted hazard ratios(HR)were 1.60(1.35–1.90)for WC<75.0 cm and 1.40(1.11–1.76)for WC ranging from 75.0 cm to 79.9 cm.Low WC(<70.0 cm and 70.0–74.9 cm)and high WC(≥95.0 cm)groups had a high risk of mortality among women.The adjusted HRs of death were 1.43(1.11–1.83),1.39(1.05–1.84),and 1.91(1.13–3.22).Conclusion WC was an important predictor of death independent of body mass index(BMI).WC should be used as a simple rapid screening and predictive indicator of the risk of death.展开更多
Introduction The high metabolic rate of oxygen in the human brain accounts for its extreme susceptibility to ischemic-hypoxic conditions.Ischemic brain injury such as stroke is a potential neurologic complication in a...Introduction The high metabolic rate of oxygen in the human brain accounts for its extreme susceptibility to ischemic-hypoxic conditions.Ischemic brain injury such as stroke is a potential neurologic complication in a variety of surgeries,including cardiac surgery,neurosurgery,and vascular surgery,particularly in patients at high risk for ischemic stroke^（[2]）.In addition,ischemic brain injury accounts for展开更多
Aimed to explore the trends in physical activity among Chinese children,data of 4,341 children aged6-17 years who participated in at least one round of"China Health and Nutrition Survey"from 2004 to2015 were...Aimed to explore the trends in physical activity among Chinese children,data of 4,341 children aged6-17 years who participated in at least one round of"China Health and Nutrition Survey"from 2004 to2015 were analyzed.Repeated measures mixed models were applied to test the trends in physical activity,which were further analyzed after applying stratification on gender,age,urbanization level,residential area and region.展开更多
Objective To investigate the potential involvement of DMT1（IRE） protein in the brain vascular system in vivo during Pb exposure. Methods Three groups of male Sprague-Dawley rats were exposed to Pb in drinking water,...Objective To investigate the potential involvement of DMT1（IRE） protein in the brain vascular system in vivo during Pb exposure. Methods Three groups of male Sprague-Dawley rats were exposed to Pb in drinking water, among which two groups were concurrently administered by oral gavage once every other day as the low and high Fe treatment group, respectively, for 6 weeks. At the same time, the group only supplied with high Fe was also set as a reference. The animals were decapitated, then brain capillary-rich fraction was isolate from cerebral cortex. Western blot method was used to identify protein expression, and RT-PCR to detect the change of the m RNA. Results Pb exposure significantly increased Pb concentrations in cerebral cortex. Low Fe dose significantly reduced the cortex Pb levels, However, high Fe dose increased the cortex Pb levels. Interestingly, changes of DMT1（IRE） protein in brain capillary-rich fraction were highly related to the Pb level, but those of DMT1（IRE） m RNA were not significantly different. Moreover, the consistent changes in the levels of p-ERK1/2 or IRP1 with the changes in the levels of DMT1（IRE）. Conclusion These results suggest that Pb is transported into the brain through DMT1（IRE）, and the ERK MAPK pathway is involved in DMT1（IRE）-mediated transport regulation in brain vascular system in vivo.展开更多
Objective To investigate the association between blood pressure and all-cause mortality in Shanxi,China.Methods The‘2002 China Nutrition and Health Survey’baseline data in Shanxi province was used.A retrospective in...Objective To investigate the association between blood pressure and all-cause mortality in Shanxi,China.Methods The‘2002 China Nutrition and Health Survey’baseline data in Shanxi province was used.A retrospective investigation was performed in 2015.The effects of SBP and DBP on the all-cause mortality were analyzed using the Cox regression model.The hazard ratio(HR)and 95%confidence interval(CI)were estimated by the sex and age groups.Results The follow-up rate was 76.52%over 13 years,while the cumulative mortality rate for all participants was 917.12/100,000 person-years.The mortality rose with an increasing SBP(χ_(trend)^(2)=270.537,P<0.001)or DBP level(χ_(trend)^(2)=57.240,P<0.001).After adjustment for the confounding factors,a significant association between mortality and high SBP(≥160 mm Hg)and high DBP(≥100 mm Hg),with adjusted HR ranging from 1.405-to 2.179-fold for SBP and 1.550-to 2.854-fold for DBP,was noted.Significant HRs for most DBP subgroups were found in>60-year-old participants.Males with DBP≥100 mm Hg had a significantly higher mortality,with an HR(95%CI)of 2.715(1.377–5.351).Conclusion Adults with SBP>160 mm Hg and DBP>100 mm Hg had a higher mortality risk.Sex and age difference was noted in both DBP and mortality risk.展开更多
To the Editor:Postmenopausal osteoporosis is a typical bone metabolic disruption disease caused by estrogen deficiency,characterized by deteriorated bone structure,reduced bone mineral density(BMD),and thinned sclerot...To the Editor:Postmenopausal osteoporosis is a typical bone metabolic disruption disease caused by estrogen deficiency,characterized by deteriorated bone structure,reduced bone mineral density(BMD),and thinned sclerotin,which has troubled millions of menopausal women worldwide.[1]Additionally,estrogen deficiency is accompanied by oxidative stress and inflammation,thus causing the occurrence and deterioration of osteoporosis.[2]Conventional treatment options have limited efficacy and cannot meet the requirements of long-term treatment.[3]Therefore,in order to alleviate the problem of osteoporosis in human health,innovative strategies should explore the possibilities and alternatives to current ones.In this study.展开更多
Background: With the publication of Sepsis-3 definition, epidemiological data based on Sepsis-3 definition from middle-income countries including China are scarce, which prohibits understanding of the disease burden o...Background: With the publication of Sepsis-3 definition, epidemiological data based on Sepsis-3 definition from middle-income countries including China are scarce, which prohibits understanding of the disease burden of this newly defined syndrome in these settings. The purpose of this study was to describe incidence and outcome of Sepsis-3 in Yuetan sub-district of Beijing and to estimate the incidence rate of Sepsis-3 in China. Methods: The medical records of all adult residents hospitalized from July 1, 2012 to June 30, 2014 in Yuetan sub-district of Beijing were reviewed. Patients with sepsis-3 and severe sepsis/septic shock were identified. The incidence rates and mortality rate of sepsis-3 and sepsis/septic shock were calculated, incidence rates and in-hospital mortality rates were normalized to the population distribution in the 2010 National Census. Population incidence rate and case fatality rate between sexes were compared with the Z test, as the data conformed to Poisson distribution. Results: Of the 21,191 hospitalized patients, 935 patients were diagnosed with Sepsis-3, and 498 cases met severe sepsis/septic shock criteria. The crude annual incidence rate of Sepsis-3 in Yuetan sub-district was 363 cases per 100,000 population, corresponding to standardized incidence rates of 236 cases per 100,000 population per year, respectively. The overall case fatality rate of Sepsis-3 was 32.0%, the crude population mortality rates of Sepsis-3 was 116 cases per 100,000 population per year, the standardized mortality rate was 67 cases per 100,000 population per year, corresponding to a speculative extrapolation of 700,437 deaths in China. The incidence rate and mortality rate of Sepsis-3 were significantly higher in males, elderly people, and patients with more comorbidities. The 62.1% of patients with Sepsis-3 had community-acquired infections, compared with 75.3% of infected patients without Sepsis-3 (P < 0.001). The most common infection in patients with Sepsis-3 was lower respiratory tract infection. When compared with patients with Sepsis-3, patients diagnosed as severe sepsis/septic shock were more likely to have higher case fatality rate (53.4% vs. 32.0%, P < 0.001) Conclusions: This study found the standardized incidence rate of 236 cases per 100,000 person-year for Sepsis-3, which was more common in males and elderly population. This corresponded to about 2.5 million new cases of Sepsis-3 per year, resulting in more than 700,000 deaths in China.展开更多
With the progress of society, there is an increasing need to tackle disorders of the central nervous system. Human brain tissue, unlike animal tissues, is an irreplaceable resource for the study of neurological diseas...With the progress of society, there is an increasing need to tackle disorders of the central nervous system. Human brain tissue, unlike animal tissues, is an irreplaceable resource for the study of neurological diseases (1)Aimed at scientific research and education, the roles of human brain tissue repositories are to acquire brain tissue from donors, prepare, process, and preserve collected samples,provide tissue to specific eligible facilities, and determine the characteristics of each tissue sample.展开更多
Estrogen impacts neural development;meanwhile, it has a protective effect on the brain. Bisphenols, primarily bisphenol A (BPA), can exert estrogen-like or estrogen-interfering effects by binding with estrogen recepto...Estrogen impacts neural development;meanwhile, it has a protective effect on the brain. Bisphenols, primarily bisphenol A (BPA), can exert estrogen-like or estrogen-interfering effects by binding with estrogen receptors. Extensive studies have suggested that neurobehavioral problems, such as anxiety and depression, can be caused by exposure to BPA during neural development. Increasing attention has been paid to the effects on learning and memory of BPA exposure at different developmental stages and in adulthood. Further research is required to elucidate whether BPA increases the risk of neurodegenerative diseases and the underlying mechanisms, as well as to assess whether BPA analogs, such as bisphenol S and bisphenol F, influence the nervous system.展开更多
Background：Scarring airway stenosis is commonly seen in China as compared to other developed countries,due to the high prevalence of tuberculosis.Nowadays,interventional bronchoscopy treatment has been widely used to...Background：Scarring airway stenosis is commonly seen in China as compared to other developed countries,due to the high prevalence of tuberculosis.Nowadays,interventional bronchoscopy treatment has been widely used to treat this disease in China.This study demonstrated the characteristics of scarring airway stenosis in Chinese adults and retrospectively evaluated the efficacy of interventional bronchoscopy treatment of this disease.Methods：Patients with scarring airway stenosis from 18 tertiary hospitals were enrolled between January 2013 and June 2016.The causes,site,and length of scarring airway stenosis were analyzed,and the efficacy of the interventional bronchoscopy treatment was evaluated.Results：The final study cohort consisted of 392 patients.Endotracheobronchial tuberculosis （EBTB） was the most common cause of scarring airway stenosis （305/392,77.8%） in Chinese adults with a high rate of incidence in young women.The left main bronchus was most susceptible to EBTB,and most posttuberculosis airway scarring stenosis length was 1.1-2.0 cm.The average clinical success rate of interventional bronchoscopy treatment for scarring airway stenosis in Chinese patients is 60.5%.The stent was inserted in 8.7% scarring airway stenosis in China.Conclusions：Scarring airway stenosis exhibits specific characteristics in Chinese patients.Interventional bronchoscopy is a useful and safe treatment method for the disease.展开更多
Background Therapeutic approaches for tracheal stenosis caused by the formation of exuberant granulation tissues usually include electrocautery, mechanical dilation, laser therapy, argon plasma coagulation （APC）, cr...Background Therapeutic approaches for tracheal stenosis caused by the formation of exuberant granulation tissues usually include electrocautery, mechanical dilation, laser therapy, argon plasma coagulation （APC）, cryotherapy and stent placement. However, restenosis after stent insertion remains a significant limitation. We examined the efficacy of three different approaches, including induction of mechanical lesions, APC performed with different powers or durations and cryotherapy, to identify the method that limited the formation of granulation tissue. Methods Twelve specially bred research mongrel dogs were divided into three groups. In group 1 （four dogs） mild （procedure 1; two dogs） or moderate （procedure 2; two dogs） damage was induced mechanically. Group 2 （six dogs） received APC at different powers or durations （procedure 3：30 W, 1 cm/s; procedure 4：30 W, 2 cm/s; procedure 5：25 W, 3 cm/s）. Group 3 （two dogs） received cryotherapy （procedure 6： two freeze-thaw cycles of 30 seconds）. Uncovered self-expandable metallic stents were inserted in all dogs to maintain a continuous stimulus to the trachea mucosa. Dogs were monitored for 4 weeks and the relationship between granulation tissue proliferation and method used was analyzed. Results In group 1, granulation tissue growth increased with more severe mechanical damage. The growth of granulation tissue in group 2 was more pronounced than in group 1, and both dogs in procedure 3 died because of severe stenosis. In this group, the formation of granulation tissue decreased with decreasing power and duration. In group 3, no obvious granulation tissue was found at week 4. Conclusions Lesions and stimuli from a foreign body （the stent） are two important factors that lead to overgrowth of granulation tissue. Thermal lesions, such as APC, seem to induce greater granulation tissue growth and cartilage damage compared with mechanical and cryotherapy lesions. Cryotherapy in combination with mechanical dilation may be a safe and effective treatment method for managing tracheal stenosis caused by the formation of granulation tissue.展开更多
Background：Benign cicatricial airway stenosis （BCAS） is a life-threatening disease.While there are numerous therapies,all have their defects,and stenosis can easily become recurrent.This study aimed to investigate ...Background：Benign cicatricial airway stenosis （BCAS） is a life-threatening disease.While there are numerous therapies,all have their defects,and stenosis can easily become recurrent.This study aimed to investigate the efficacy and complications of nonstent combination interventional therapy （NSCIT） when used for the treatment of BCAS of different causes and types.Methods：This study enrolled a cohort of patients with BCAS resulting from tuberculosis,intubation,tracheotomy,and other origins.The patients were assigned to three groups determined by their type of stenosis：Web-like stenosis,granulation stenosis,and complex stenosis,and all patients received NSCIT.The efficacy and complications of treatment in each group of patients were observed.The Chi-square test,one-factor analysis of variance （ANOVA）,and the paired t-test were used to analyze different parameters.Results：The 10 patients with web-like stenosis and six patients with granulation stenosis exhibited durable remission rates of 100%.Among 41 patients with complex stenosis,36 cases （88%） experienced remission and 29 cases （71%） experienced durable remission.When five patients with airway collapse were eliminated from the analysis,the overall remission rate was 97%.The average treatment durations for patients with web-like stenosis,granulation stenosis,and complex stenosis were 101,21,and 110 days,respectively,and the average number of treatments was five,two,and five,respectively.Conclusions：NSCIT demonstrated good therapeutic efficacy and was associated with few complications.However,this approach was ineffective for treating patients with airway collapse or malacia.展开更多
Background: Primary pulmonary malignancies (PPMs) and non-pulmonary malignancies (PNPMs) may result in airway stenosis requiring stenting. This study aimed to compare and evaluate the clinical features and stent place...Background: Primary pulmonary malignancies (PPMs) and non-pulmonary malignancies (PNPMs) may result in airway stenosis requiring stenting. This study aimed to compare and evaluate the clinical features and stent placement outcomes of airway stenosis caused by PPMs and PNPMs. Methods: A total of 141 patients with malignant airway stenosis who underwent Micro-Tech stent placements between January 2004 and October 2017 at Department of Respiratory Medicine, Beijing Tian Tan Hospital, Capital Medical University were divided into PPM (n= 100) and PNPM groups (n = 41). Patients’ clinical features and stent placement outcomes were collected and analyzed. Chi-square test was used to compare the categorical variables, while independent- or paired-sample t test was used to compare the continuous variables. Results: There were no significant differences in age, sex, treatment history, respiratory symptoms, and incidence of obstructive pneumonia between groups. Multiple airway involvement (63.0% vs. 31.7%;χ^2=11.459, P= 0.001) and atelectasis (17.0% vs. 2.4%;χ^25.536, P= 0.019) were more common in the PPM group, while extraluminal obstruction (24.4% vs. 6.0%;χ^28.033, P= 0.005) was more common in the PNPM group. Before stenting, the American Thoracic Society Dyspnea Index (ADI) and Karnofsky Performance Scale (KPS) scores showed no significant differences between groups (all P > 0.05). After stenting, a satisfactory rate of symptom improvement was achieved in both groups (98.0% and 100.0% in the PPM and PNPM groups, respectively;χ^2 0.016, P= 0.898);ADI and KPS scores, which showed no significant differences between groups (all P > 0.05), were significantly improved in each group (all P < 0.001). Complications after stenting could be effectively managed using bronchoscopic procedures. Conclusions: Among cases of malignant airway stenosis requiring stenting, those caused by PPM are more likely to involve multiple airways and are associated with atelectasis, while those caused by PNPM are more likely to cause extraluminal obstruction. Micro- Tech stent placement has the same immediate effect in terms of improvement in respiratory symptoms and performance status for both malignant airway stenosis caused by PPM and that caused by PNPM.展开更多
基金the fund of National Natural Science Foundation of China(82170951)Beijing Natural Science Foundation(7222079).
文摘The Wnt/β-catenin signaling pathway is the main target of tooth regeneration regulation.Treatment of cells with AZD2858 stimulates the Wnt/β-catenin signaling pathway,yet the function of this pathway in tooth regeneration remains unclear.Here,we found that AZD2858 promotes the accumulation ofβ-catenin in the nuclei of stem cells from the apical papilla(SCAPs)and enhances cell proliferation.Single-cell sequencing was performed on SCAPs treated with AZD2858.Eight clusters were identified,namely SCAPs-CNTNAP2,SCAPs-DTL,SCAPs-MYH11,SCAPs-MKI67,SCAPs-CXCL8,SCAPs-TPM2,SCAPs-IFIT2 and SCAPs-NEK10.The pseudo-time trajectory analysis showed that AZD2858 enhanced the evolution of SCAPs from SCAPs-TMP2 clusters to SCAPs-MYH11,SCAPs-CNTNAPs and SCAPs-NEK10 clusters via up-regulation of PRKCA,SMURF2,MAGI2,RBMS3,EXT1,CAMK2D,PLCB4,and PLCB1.These results demonstrate that AZD2858 enhances the proliferation of SCAPs-TPM2 cluster by activating the non-canonical Wnt/β-catenin signaling pathway.
文摘AIM To evaluate the feasibility of side-to-side anastomosis of the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass(LRYGB).METHODS Seventy-seven patients received side-to-side anastomosis of the lesser curvature of stomach and jejunum by utilization of linear stapler in LRYGB from April 2012 to July 2015 were retrospectively analyzed.RESULTS All patients were successfully completed laparoscopic gastric bypass with the side-to-side anastomosis of the lesser curvature of stomach and jejunum. No patient was switched to laparotomy during operation. No early complications including gastrointestinal anastomotic bleeding, fistula, obstruction, deep vein thrombosis, incision infections, intra-abdominal hernia complications were found. One patient complicated with stricture of gastrojejunal anastomosis(1.3%) and six patients complicated with incomplete intestinal obstruction(7.8%). BMI and Hb A1 c determined at 3, 6, 12, 24 mo during follow up period were significantly reduced compared with preoperative baselines respectively. The percentage of patients who maintain HbA 1c(%) < 6.5% without taking antidiabetic drugs reached to 61.0%, 63.6%, 75.0%, and 63.6% respectively. The outcome parameters of concomitant diseases were significantly improved too.CONCLUSION Present surgery is a safety and feasibility procedure. It is effective to lighten the body weight of patients and improve type 2 diabetes and related complications.
基金sponsored by National Key R&D Program [2016YFC1305201] of ChinaNational Science and Technology Support Program [2008BAI56B04] of China
文摘Objective Obesity is recognized as a significant risk factor for diabetes and hypertension. The present study aimed to examine the associations between adults' obesity risk and childhood and parental obesity. Methods A total of 204 children aged 6-17 years were recruited in 2002 with an average follow-up period of 13.2 years. Height and body weight were measured by trained staffs. Overweight and obesity were defined based on the Chinese standard for children and adults. T-test, analysis of variance, and Chi-square analysis were used for single factor analysis. Multiple linear and logistic regression analyses were used to perform multifactor analysis. Results The percentage of non-obese children who grew up to be non-obese adults was 62.6%, and that of obese children who grew up to be obese adults was 80.0%. There was a significant association between childhood body mass index(BMI) and adulthood BMI with a β regression coefficient of 3.76 [95% confidence interval(CI): 1.36-6.16], and between childhood obesity and adulthood obesity with an odds ratio of 5.76(95% CI: 1.37-24.34). There was no statistical difference between parental obesity at baseline and children's adulthood obesity, after adjustment of confounders. Male participants and those aged 10.0-13.0 years had a higher risk of adulthood obesity with odds ratios of 2.50(95% CI: 1.12-5.26) and 3.62(95% CI: 1.17-11.24), respectively. Conclusion Childhood obesity is an important predictor of adulthood obesity.
基金supported by the Clinical Medicine Development Project of the Administration Bureau of Beijing Hospital(No.XMLX201314)
文摘Benign cicatricial airway stenosis（BCAS） is a potentially life-threatening disease.Recurrence occurs frequently after endoscopic treatment.Paclitaxel is known to prevent restenosis,but its clinical efficacy and safety is undetermined.Therefore,in this study,we investigated the efficacy and associated complications of paclitaxel as adjuvant treatment for BCAS of different etiologies.The study cohort included 28 patients with BCAS resulting from tuberculosis,intubation,tracheotomy,and other etiologies.All patients were treated at the Department of Respiratory Diseases,Beijing Tian Tan Hospital,Capital Medical University,China,between January 2010 and August 2014.After primary treatment by balloon dilation,cryotherapy,and/or high-frequency needle-knife treatment,paclitaxel was applied to the airway mucosa at the site of stenosis using a newly developed local instillation catheter.The primary outcome measures were the therapeutic efficacy of paclitaxel as adjuvant treatment,and the incidence of complications was observed as well.According to our criteria for evaluating the clinical effects on BCAS,24 of the 28 cases achieved durable remission,three cases had remission,and one case showed no remission.Thus,the durable remission rate was 85.7%,and the combined effective rate was 96.4%.No differences in outcomes were observed among the different BCAS etiologies（P=0.144）,and few complications were observed.Our results indicated that paclitaxel as an adjuvant treatment has greater efficacy than previously reported BCAS treatment methods.
基金supported by The National Science Fund for Distinguished Young Scholars(No.:0602150028)
文摘Objective: To discuss the ef ect of BRMS1 on the proliferation, migration and adhesion of mouse forestomach carcinoma(MFC). Methods: The constructed p CMV-myc-BRMS1 recombinant plasmid and blank plasmid were transfected into mouse forestomach carcinoma. MTT method was employed to measure the activity of gastric cancer cell; the scratch assay and Transwell assay to measure the migration and invasion of gastric cancer cell; the adhesion assay to measure the adhesion of gastric cancer cell; while the Western blot assay to measure the expression of The NF-毷B signal pathway, downstream matrix metalloproteinase(MMP-2), MMP-9 and osteopontin and E-cadherin in the gastric cancer cell. Besides, the transplanted animal model of gastric cancer in mice was constructed to measure the size of tumor xenograft. Results: Results of MTT assay showed that, compared with the empty vector control group, the activity of gastric cancer cell was not af ected in the BRMS1 transfection group. The improved expression of BRMS1 could inhibit the adhesion, migration and invasion of gastric cancer cell(P<0.01). Besides, compared with the empty vector control group, the phosphorylation of NF-毷B p65 and I毷Bα was reduced in the BRMS1 transfection group, with the decreased expression of MMP 2, MMP 9 and osteopontin and the increased expression of E-cadherin(P<0.01). Results of animal experiment also showed that the expression of BRMS1 did not af ect the transplanted tumor. Conclusions: The expression of BRMS1 can signii cantly inhibit the adhesion, migration, invasion and metastasis of MCF gastric cancer cell, which is related to The NF-毷B signal pathway.
文摘AIM: To study the clinical features, microbial spectrum, associated factors and prognosis of endogenous endophthalmitis(EE) in a group of Chinese patients.METHODS: The medical records from 32 eyes of 29 patients diagnosed with EE in Peking Union Medical College Hospital from January 2009 to October 2019 were reviewed. RESULTS: The initial visual acuity(VA) of 30 eyes in this study was worse than 20/400. Twenty-three eyes were diagnosed with fungal endophthalmitis and nine with bacterial endophthalmitis. The most common fungal and bacterial isolates were Candida and Klebsiella pneumoniae, respectively. Several rare fungi and bacteria species were also isolated from our patients, including Cryptococcus, Paecilomyces, Brucella, and Bacillus licheniformis. The leading risk factor for EE was diabetes. The most common extraocular infection locus was genitourinary tract. Vitrectomy was performed on twenty-nine eyes. Eight eyes achieved final VA of 20/400 or better. EE caused by Candida had a better prognosis.CONCLUSION: The visual outcome of EE is based on pathogens and prompt intervention. Early vitrectomy and antimicrobial treatment are beneficial for EE.
基金supported by grants from the National Program on Key Basic Research Project of China(973 Program),No.2014CB542200Program for Innovative Research Team in University of Ministry of Education of China,No.IRT1201+2 种基金the National Natural Science Foundation of China,No.31271284,31171150,81171146,30971526,31040043,31371210,81372044,31471144Program for New Century Excellent Talents in University of Ministry of Education of China,No.BMU20110270the Natural Science Foundation of Beijing of China,No.7142164
文摘Previous animal studies of cauda equina injury have primarily used rat models, which display significant differences from humans. Furthermore, most studies have focused on electrophysio- logical examination. To better mimic the outcome after surgical repair of cauda equina injury, a novel animal model was established in the goat. Electrophysiological, histological and magnetic resonance imaging methods were used to evaluate the morphological and functional outcome after cauda equina injury and end-to-end suture. Our results demonstrate successful establish- ment of the goat experimental model of cauda equina injury. This novel model can provide detailed information on the nerve regenerative process following surgical repair of cauda equina injury.
基金supported by National Key R&D Program of China[2016YFC0901001]National Key Technology R&D Program in China[No.2008BAI56B04]。
文摘Objective This study aimed to assess the association of waist circumference(WC)with all-cause mortality among Chinese adults.Methods The baseline data were from Shanxi Province of 2002 China Nutrition and Health Survey.The death investigation and follow-up visit were conducted from December 2015 to March 2016.The visits covered up to 5,360 of 7,007 participants,representing a response rate of 76.5%.The Cox regression model and floating absolute risk were used to estimate hazard ratio and 95%floating CI of death by gender and age groups(≥60 and<60 years old).Sensitivity analysis was performed by excluding current smokers;participants with stroke,hypertension,and diabetes;participants who accidentally died;and participants who died during the first 2 years of follow-up.Results This study followed 67,129 person-years for 12.5 years on average,including 615 deaths.The mortality density was 916 per 100,000 person-years.Low WC was associated with all-cause mortality among men.Multifactor-adjusted hazard ratios(HR)were 1.60(1.35–1.90)for WC<75.0 cm and 1.40(1.11–1.76)for WC ranging from 75.0 cm to 79.9 cm.Low WC(<70.0 cm and 70.0–74.9 cm)and high WC(≥95.0 cm)groups had a high risk of mortality among women.The adjusted HRs of death were 1.43(1.11–1.83),1.39(1.05–1.84),and 1.91(1.13–3.22).Conclusion WC was an important predictor of death independent of body mass index(BMI).WC should be used as a simple rapid screening and predictive indicator of the risk of death.
基金supported by the Inaugural Anesthesia Department Awards for Seed Funding for Clinically Oriented Research Projects from the Department of Anesthesia and Perioperative Care,University of California San Francisco,San Francisco,California,U.S.A.(to Dr.Meng)
文摘Introduction The high metabolic rate of oxygen in the human brain accounts for its extreme susceptibility to ischemic-hypoxic conditions.Ischemic brain injury such as stroke is a potential neurologic complication in a variety of surgeries,including cardiac surgery,neurosurgery,and vascular surgery,particularly in patients at high risk for ischemic stroke^（[2]）.In addition,ischemic brain injury accounts for
基金supported by National Scientific and Technological Basic Resources Investigation Program “Research and application of nutrition and health system for children aged 0–18 years in China” [2017FY101100]The China Health and Nutrition Survey was funded by the NIH to Carolina Population Center at the University of North Carolina at Chapel Hill[P2C HD050924, T32 HD007168]+1 种基金research grants from the NIH [R01 HD30880, P30DK056350, R01 HD38700]the NIH Fogarty grant [D43 TW009077] for their financial support for the CHNS data collection and relative files from 2004 to 2015。
文摘Aimed to explore the trends in physical activity among Chinese children,data of 4,341 children aged6-17 years who participated in at least one round of"China Health and Nutrition Survey"from 2004 to2015 were analyzed.Repeated measures mixed models were applied to test the trends in physical activity,which were further analyzed after applying stratification on gender,age,urbanization level,residential area and region.
基金supported by National Natural Science Foundation of China(No.81472478)Medical Science Youth Breeding Project of PLA(13QNP161)
文摘Objective To investigate the potential involvement of DMT1（IRE） protein in the brain vascular system in vivo during Pb exposure. Methods Three groups of male Sprague-Dawley rats were exposed to Pb in drinking water, among which two groups were concurrently administered by oral gavage once every other day as the low and high Fe treatment group, respectively, for 6 weeks. At the same time, the group only supplied with high Fe was also set as a reference. The animals were decapitated, then brain capillary-rich fraction was isolate from cerebral cortex. Western blot method was used to identify protein expression, and RT-PCR to detect the change of the m RNA. Results Pb exposure significantly increased Pb concentrations in cerebral cortex. Low Fe dose significantly reduced the cortex Pb levels, However, high Fe dose increased the cortex Pb levels. Interestingly, changes of DMT1（IRE） protein in brain capillary-rich fraction were highly related to the Pb level, but those of DMT1（IRE） m RNA were not significantly different. Moreover, the consistent changes in the levels of p-ERK1/2 or IRP1 with the changes in the levels of DMT1（IRE）. Conclusion These results suggest that Pb is transported into the brain through DMT1（IRE）, and the ERK MAPK pathway is involved in DMT1（IRE）-mediated transport regulation in brain vascular system in vivo.
基金supported by National Key R&D Program of China[2016YFC0901001]National Key Technology R&D Program in China[No.2008BAI56B04]。
文摘Objective To investigate the association between blood pressure and all-cause mortality in Shanxi,China.Methods The‘2002 China Nutrition and Health Survey’baseline data in Shanxi province was used.A retrospective investigation was performed in 2015.The effects of SBP and DBP on the all-cause mortality were analyzed using the Cox regression model.The hazard ratio(HR)and 95%confidence interval(CI)were estimated by the sex and age groups.Results The follow-up rate was 76.52%over 13 years,while the cumulative mortality rate for all participants was 917.12/100,000 person-years.The mortality rose with an increasing SBP(χ_(trend)^(2)=270.537,P<0.001)or DBP level(χ_(trend)^(2)=57.240,P<0.001).After adjustment for the confounding factors,a significant association between mortality and high SBP(≥160 mm Hg)and high DBP(≥100 mm Hg),with adjusted HR ranging from 1.405-to 2.179-fold for SBP and 1.550-to 2.854-fold for DBP,was noted.Significant HRs for most DBP subgroups were found in>60-year-old participants.Males with DBP≥100 mm Hg had a significantly higher mortality,with an HR(95%CI)of 2.715(1.377–5.351).Conclusion Adults with SBP>160 mm Hg and DBP>100 mm Hg had a higher mortality risk.Sex and age difference was noted in both DBP and mortality risk.
基金supported by grants from the Fundamental Research Funds for the Central Universities(No.JD2231)the National Natural Science Foundation of China(No.82102038).
文摘To the Editor:Postmenopausal osteoporosis is a typical bone metabolic disruption disease caused by estrogen deficiency,characterized by deteriorated bone structure,reduced bone mineral density(BMD),and thinned sclerotin,which has troubled millions of menopausal women worldwide.[1]Additionally,estrogen deficiency is accompanied by oxidative stress and inflammation,thus causing the occurrence and deterioration of osteoporosis.[2]Conventional treatment options have limited efficacy and cannot meet the requirements of long-term treatment.[3]Therefore,in order to alleviate the problem of osteoporosis in human health,innovative strategies should explore the possibilities and alternatives to current ones.In this study.
文摘Background: With the publication of Sepsis-3 definition, epidemiological data based on Sepsis-3 definition from middle-income countries including China are scarce, which prohibits understanding of the disease burden of this newly defined syndrome in these settings. The purpose of this study was to describe incidence and outcome of Sepsis-3 in Yuetan sub-district of Beijing and to estimate the incidence rate of Sepsis-3 in China. Methods: The medical records of all adult residents hospitalized from July 1, 2012 to June 30, 2014 in Yuetan sub-district of Beijing were reviewed. Patients with sepsis-3 and severe sepsis/septic shock were identified. The incidence rates and mortality rate of sepsis-3 and sepsis/septic shock were calculated, incidence rates and in-hospital mortality rates were normalized to the population distribution in the 2010 National Census. Population incidence rate and case fatality rate between sexes were compared with the Z test, as the data conformed to Poisson distribution. Results: Of the 21,191 hospitalized patients, 935 patients were diagnosed with Sepsis-3, and 498 cases met severe sepsis/septic shock criteria. The crude annual incidence rate of Sepsis-3 in Yuetan sub-district was 363 cases per 100,000 population, corresponding to standardized incidence rates of 236 cases per 100,000 population per year, respectively. The overall case fatality rate of Sepsis-3 was 32.0%, the crude population mortality rates of Sepsis-3 was 116 cases per 100,000 population per year, the standardized mortality rate was 67 cases per 100,000 population per year, corresponding to a speculative extrapolation of 700,437 deaths in China. The incidence rate and mortality rate of Sepsis-3 were significantly higher in males, elderly people, and patients with more comorbidities. The 62.1% of patients with Sepsis-3 had community-acquired infections, compared with 75.3% of infected patients without Sepsis-3 (P < 0.001). The most common infection in patients with Sepsis-3 was lower respiratory tract infection. When compared with patients with Sepsis-3, patients diagnosed as severe sepsis/septic shock were more likely to have higher case fatality rate (53.4% vs. 32.0%, P < 0.001) Conclusions: This study found the standardized incidence rate of 236 cases per 100,000 person-year for Sepsis-3, which was more common in males and elderly population. This corresponded to about 2.5 million new cases of Sepsis-3 per year, resulting in more than 700,000 deaths in China.
文摘With the progress of society, there is an increasing need to tackle disorders of the central nervous system. Human brain tissue, unlike animal tissues, is an irreplaceable resource for the study of neurological diseases (1)Aimed at scientific research and education, the roles of human brain tissue repositories are to acquire brain tissue from donors, prepare, process, and preserve collected samples,provide tissue to specific eligible facilities, and determine the characteristics of each tissue sample.
基金supported by a grant from the National Natural Science Foundation of China(No.21577095).
文摘Estrogen impacts neural development;meanwhile, it has a protective effect on the brain. Bisphenols, primarily bisphenol A (BPA), can exert estrogen-like or estrogen-interfering effects by binding with estrogen receptors. Extensive studies have suggested that neurobehavioral problems, such as anxiety and depression, can be caused by exposure to BPA during neural development. Increasing attention has been paid to the effects on learning and memory of BPA exposure at different developmental stages and in adulthood. Further research is required to elucidate whether BPA increases the risk of neurodegenerative diseases and the underlying mechanisms, as well as to assess whether BPA analogs, such as bisphenol S and bisphenol F, influence the nervous system.
文摘Background：Scarring airway stenosis is commonly seen in China as compared to other developed countries,due to the high prevalence of tuberculosis.Nowadays,interventional bronchoscopy treatment has been widely used to treat this disease in China.This study demonstrated the characteristics of scarring airway stenosis in Chinese adults and retrospectively evaluated the efficacy of interventional bronchoscopy treatment of this disease.Methods：Patients with scarring airway stenosis from 18 tertiary hospitals were enrolled between January 2013 and June 2016.The causes,site,and length of scarring airway stenosis were analyzed,and the efficacy of the interventional bronchoscopy treatment was evaluated.Results：The final study cohort consisted of 392 patients.Endotracheobronchial tuberculosis （EBTB） was the most common cause of scarring airway stenosis （305/392,77.8%） in Chinese adults with a high rate of incidence in young women.The left main bronchus was most susceptible to EBTB,and most posttuberculosis airway scarring stenosis length was 1.1-2.0 cm.The average clinical success rate of interventional bronchoscopy treatment for scarring airway stenosis in Chinese patients is 60.5%.The stent was inserted in 8.7% scarring airway stenosis in China.Conclusions：Scarring airway stenosis exhibits specific characteristics in Chinese patients.Interventional bronchoscopy is a useful and safe treatment method for the disease.
文摘Background Therapeutic approaches for tracheal stenosis caused by the formation of exuberant granulation tissues usually include electrocautery, mechanical dilation, laser therapy, argon plasma coagulation （APC）, cryotherapy and stent placement. However, restenosis after stent insertion remains a significant limitation. We examined the efficacy of three different approaches, including induction of mechanical lesions, APC performed with different powers or durations and cryotherapy, to identify the method that limited the formation of granulation tissue. Methods Twelve specially bred research mongrel dogs were divided into three groups. In group 1 （four dogs） mild （procedure 1; two dogs） or moderate （procedure 2; two dogs） damage was induced mechanically. Group 2 （six dogs） received APC at different powers or durations （procedure 3：30 W, 1 cm/s; procedure 4：30 W, 2 cm/s; procedure 5：25 W, 3 cm/s）. Group 3 （two dogs） received cryotherapy （procedure 6： two freeze-thaw cycles of 30 seconds）. Uncovered self-expandable metallic stents were inserted in all dogs to maintain a continuous stimulus to the trachea mucosa. Dogs were monitored for 4 weeks and the relationship between granulation tissue proliferation and method used was analyzed. Results In group 1, granulation tissue growth increased with more severe mechanical damage. The growth of granulation tissue in group 2 was more pronounced than in group 1, and both dogs in procedure 3 died because of severe stenosis. In this group, the formation of granulation tissue decreased with decreasing power and duration. In group 3, no obvious granulation tissue was found at week 4. Conclusions Lesions and stimuli from a foreign body （the stent） are two important factors that lead to overgrowth of granulation tissue. Thermal lesions, such as APC, seem to induce greater granulation tissue growth and cartilage damage compared with mechanical and cryotherapy lesions. Cryotherapy in combination with mechanical dilation may be a safe and effective treatment method for managing tracheal stenosis caused by the formation of granulation tissue.
文摘Background：Benign cicatricial airway stenosis （BCAS） is a life-threatening disease.While there are numerous therapies,all have their defects,and stenosis can easily become recurrent.This study aimed to investigate the efficacy and complications of nonstent combination interventional therapy （NSCIT） when used for the treatment of BCAS of different causes and types.Methods：This study enrolled a cohort of patients with BCAS resulting from tuberculosis,intubation,tracheotomy,and other origins.The patients were assigned to three groups determined by their type of stenosis：Web-like stenosis,granulation stenosis,and complex stenosis,and all patients received NSCIT.The efficacy and complications of treatment in each group of patients were observed.The Chi-square test,one-factor analysis of variance （ANOVA）,and the paired t-test were used to analyze different parameters.Results：The 10 patients with web-like stenosis and six patients with granulation stenosis exhibited durable remission rates of 100%.Among 41 patients with complex stenosis,36 cases （88%） experienced remission and 29 cases （71%） experienced durable remission.When five patients with airway collapse were eliminated from the analysis,the overall remission rate was 97%.The average treatment durations for patients with web-like stenosis,granulation stenosis,and complex stenosis were 101,21,and 110 days,respectively,and the average number of treatments was five,two,and five,respectively.Conclusions：NSCIT demonstrated good therapeutic efficacy and was associated with few complications.However,this approach was ineffective for treating patients with airway collapse or malacia.
文摘Background: Primary pulmonary malignancies (PPMs) and non-pulmonary malignancies (PNPMs) may result in airway stenosis requiring stenting. This study aimed to compare and evaluate the clinical features and stent placement outcomes of airway stenosis caused by PPMs and PNPMs. Methods: A total of 141 patients with malignant airway stenosis who underwent Micro-Tech stent placements between January 2004 and October 2017 at Department of Respiratory Medicine, Beijing Tian Tan Hospital, Capital Medical University were divided into PPM (n= 100) and PNPM groups (n = 41). Patients’ clinical features and stent placement outcomes were collected and analyzed. Chi-square test was used to compare the categorical variables, while independent- or paired-sample t test was used to compare the continuous variables. Results: There were no significant differences in age, sex, treatment history, respiratory symptoms, and incidence of obstructive pneumonia between groups. Multiple airway involvement (63.0% vs. 31.7%;χ^2=11.459, P= 0.001) and atelectasis (17.0% vs. 2.4%;χ^25.536, P= 0.019) were more common in the PPM group, while extraluminal obstruction (24.4% vs. 6.0%;χ^28.033, P= 0.005) was more common in the PNPM group. Before stenting, the American Thoracic Society Dyspnea Index (ADI) and Karnofsky Performance Scale (KPS) scores showed no significant differences between groups (all P > 0.05). After stenting, a satisfactory rate of symptom improvement was achieved in both groups (98.0% and 100.0% in the PPM and PNPM groups, respectively;χ^2 0.016, P= 0.898);ADI and KPS scores, which showed no significant differences between groups (all P > 0.05), were significantly improved in each group (all P < 0.001). Complications after stenting could be effectively managed using bronchoscopic procedures. Conclusions: Among cases of malignant airway stenosis requiring stenting, those caused by PPM are more likely to involve multiple airways and are associated with atelectasis, while those caused by PNPM are more likely to cause extraluminal obstruction. Micro- Tech stent placement has the same immediate effect in terms of improvement in respiratory symptoms and performance status for both malignant airway stenosis caused by PPM and that caused by PNPM.
