Effects of psychological intervention on negative emotions and psychological resilience in breast cancer patients after radical mastectomy

Breast cancer(BC)is the most common malignant tumor in women,and the treatment process not only results in physical pain but also significant psychological distress in patients.Psychological intervention(PI)has been recognized as an important approach in treating postoperative psychological disorders in BC patients.It has been proven that PI has a significant therapeutic effect on postoperative psychological disorders,improving patients'negative emotions,enhancing their psychological resilience,and effectively enhancing their quality of life and treatment compliance.

Intestinal tuberculosis with small bowel stricture and hemorrhage as the predominant manifestation: Three case reports

BACKGROUND Intestinal tuberculosis is a chronic disease caused by Mycobacterium tuberculosis that mainly affects the ileum and cecum.Small bowel tuberculosis,characterized by predominant involvement of the small intestine,is an extremely rare condition with highly atypical clinical presentations,making diagnosis even more challenging.CASE SUMMARY We report three cases of small intestinal tuberculosis,two of the patients pre-sented primarily with abdominal pain,and one presented with gastrointestinal bleeding.All patients underwent blood tests and imaging examinations.Small bowel endoscopy(SBE)revealed that the main lesions in these patients were in-testinal stenosis or gastrointestinal bleeding caused by small intestinal ulcers.One patient ultimately underwent surgical treatment.Following a complex diagnostic process and comprehensive analysis,all patients were confirmed to have small intestinal tuberculosis and received standard antituberculosis treatment,leading to an improvement in their condition.CONCLUSION Patients with SBTs present with nonspecific symptoms such as abdominal pain,weight loss,and occasional gastrointestinal bleeding.Accurate diagnosis requires a thorough evaluation of clinical symptoms and various tests to avoid misdiagno-sis and complications.

乙肝肝硬化患者门静脉宽度与门静脉血栓形成的关系

背景门静脉血栓(portal vein thrombosis,PVT)的早期诊断仍是临床上一个难题,急需要发现可早期预测诊断的无创指标.目的探讨门静脉宽度与PVT形成之间的关系.方法收集418例乙肝肝硬化患者.根据是否发生PVT分为PVT组(n=66)和非PVT组(n=352)组.比较两组患者的一般资料差异,使用多因素Logistic回顾分析影响PVT发生的危险因素.通过受试者工作特征(receiver operating characteristic,ROC)曲线评估不同危险因素预测PVT的效能.结果与非PVT组患者相比,PVT组患者的Child-Pugh评分更高、Child-Pugh A级比例更低、血小板水平更高、D-二聚体水平更高、门静脉宽度更宽、门静脉血流更慢,上述差异均存在统计学意义(P<0.05).Logistic回归显示门静脉宽度(OR=3.941,P=0.001)、门静脉血流(OR=0.841,P=0.007)、血小板水平(OR=1.024,P=0.008)和D-二聚体水平(OR=2.383,P=0.000)是肝硬化患者发生PVT的独立危险因素.门静脉宽度诊断PVT的ROC曲线下面积最大为0.874,最佳诊断值为>12.5 mm,此时的预测敏感性和特异性分别为78%和82%.结论门静脉直径增加是肝硬化患者PVT发生的危险因素,对PVT诊断具有一定价值.

Sperm chromatin structure assay results after swim-up are related only to embryo quality but not to fertilization and pregnancy rates following IVF

The aim of this study was to investigate whether the sperm chromatin structure assay （SCSA） results after swim-up are related to fertilization rates, embryo quality and pregnancy rates following in vitrofertilization （IVF）. A total of 223 couples undergoing IVF in our hospital from October 2008 to September 2009 were included in this study. Data on the IVF process and sperm chromatin structure assay results were collected. Fertilization rate, embryo quality and IVF success rates of different DNA fragmentation index （DFI） subgroups and high DNA stainability （HDS） subgroups were compared. There were no significant differences in fertilization rate, clinical pregnancy or delivery rates between the DFI and HDS subgroups. However, the group with abnormal DFI had a lower good embryo rate. So, we concluded that the SCSA variables, either DFI or HDS after swim-up preparation, were not valuable in predicting fertilization failure or pregnancy rate, but an abnormal DFI meant a lower good embryo rate following IVF.

Epidermal growth factor receptor-targeted immune magnetic liposomes capture circulating colorectal tumor cells efficiently

AIM To compare the capacity of newly developed epidermal growth factor receptor(EGFR)-targeted immune magnetic liposomes(EILs) vs epithelial cell adhesion molecule(Ep CAM) immunomagnetic beads to capture colorectal circulating tumor cells(CTCs).METHODS EILs were prepared using a two-step method, and the magnetic and surface characteristics were confirmed. The efficiency of capturing colorectal CTCs as well as the specificity were compared between EILs and Ep CAM magnetic beads. RESULTS The obtained EILs had a lipid nanoparticle structure similar to cell membrane. Improved binding with cancer cells was seen in EILs compared with the method of coupling nano/microspheres with antibody. The binding increased as the contact time extended. Compared with Ep CAM immunomagnetic beads, EILs captured more CTCs in peripheral blood from colorectal cancer patients. The captured cells showed consistency with clinical diagnosis and pathology. Mutation analysis showed same results between captured CTCs and cancer tissues. CONCLUSION EGFR antibody-coated magnetic liposomes show high efficiency and specificity in capturing colorectal CTCs.

Gastric ulcer treated using an elastic traction ring combined with clip: A case report

BACKGROUND There is a high annual incidence of acute,nonvariceal upper gastrointestinal bleeding in Chinese adults.Early endoscopic intervention can reduce rates of rebleeding,surgery,and mortality.The metal clip is the most common method for establishing homeostasis;however,it possesses several limitations.In patients with bleeding secondary to large gastric ulcers,the clip will often fail to stop the bleeding.This article highlights the use of an elastic traction ring as a novel hemostatic method for patients with upper gastrointestinal bleeding.CASE SUMMARY An elderly male presented to the emergency room with complaints of hematemesis and melena.Endoscopic examination revealed an ulcer(Forrest IIa)in the lesser curvature of the gastric antrum.Six tissue clips and one elastic traction ring were inserted into the stomach cavity to suture the ulcer.The patient recovered quickly without postoperative gastrointestinal bleeding.Two months later,the patient's ulcer was significantly healed.CONCLUSION To our best knowledge,this is the first report to demonstrate the safety and efficacy of elastic traction rings for upper gastrointestinal bleeding.Elastic traction rings should be considered a routine therapeutic modality for patients with upper gastrointestinal bleeds.

Submucosal esophageal abscess evolving into intramural submucosal dissection:A case report

BACKGROUND Here we report a rare case of submucosal esophageal abscess evolving into intramural submucosal dissection.CASE SUMMARY An 80-year-old woman was admitted to our emergency department with a chief complaint of dysphagia and fever.Laboratory tests showed mild leukocytosis and elevated C-reactive protein level.Computed tomography showed thickening of the esophageal wall.Upper endoscopy showed a laceration of the esophageal mucosa and a submucosal mass.Spontaneous drainage occurred,and we could see purulent exudate from the crevasse.We closed the laceration with endoscopic clips.The patient did not remember swallowing a foreign body;however,she ate crabs before the symptoms occurred.We prescribed the patient with antibiotic,and the symptoms were gradually relieved.Two months later,upper endoscopy showed that the laceration was healed,and the submucosal abscess disappeared.However,intramural esophageal dissection was formed.We performed endoscopic incision of the septum using dual-knife effectively.CONCLUSION In conclusion,we are the first to report the case of esophageal submucosal abscess evolving into intramural esophageal dissection.The significance of this case lies in clear presentation of the evolution process between two disorders.In addition,we recommend that endoscopic incision be considered as one of the routine therapeutic modalities of intramural esophageal dissection.

Sperm DNA fragmentation in Chinese couples with unexplained recurrent pregnancy loss

We aimed to study the association between sperm DNA fragmentation and recurrent pregnancy loss(RPL)in the Chinese population via a retrospective observational study of Chinese couples who had experienced RPL between May 2013 and August 2018.The study population included 461 men from couples with RPL and 411 men from a control group(couples with clinical pregnancy via in v/tro fertiIization owing to female causes).Routine semen analysis,sperm chromatin analysis,and microscopic(high-power)morphological analysis were performed using semen samples.Semen samples were assessed for volume,sperm count,and motility.The sperm DNA fragmentation index(DFI)was calculated,and the median DFI was obtained.Men were categorized as having normal(37.8%;DFI<15.0%),moderate(33.6%;15.0%<DFI<30.0%),or severe(28.6%;DFI A30.0%)DNA fragmentation levels.The percentage of men with severe DNA fragmentation was significantly higher in the RPL(42.3%)group than that in the control group(13.1%),whereas the percentage of men with normal levels of DNA fragmentation was significantly lower in the RPL group(22.8%)tha n that in the control group(54.7%).Subsequent analysis also dem on strated that the sperm DNA fragmentation rate had a moderate reverse correlation with the sperm progressive motility rate(r=-0.47,P<0.001)and the total motile sperm count(r=-0.31,P<0.001).We found a positive correlation between RPL and sperm DNA fragmentation.The results suggest that increased sperm DNA damage is associated with RPL.

Jinbei Oral Liquid ameliorates bleomycin-induced idiopathic pulmonary fibrosis in rats via reversion of Th1/Th2 shift

Objective:Idiopathic pulmonary fibrosis(IPF)is a progressive and lethal interstitial lung disease with high mortality.The pivotal role of Th1/Th2 immunological balance in the development and progression of IPF has been demonstrated previously.This study aimed to evaluate the effect of Jinbei Oral Liquid(JBOL)on IPF and its relationship with Th1/Th2 shift.Methods:Rats were divided into six groups:control group,model group(bleomycin),pirfenidone group(positive group,54 mg/kg,i.g.)and JBOL(5.4,10.8 and 21.6 mL/kg,i.g.)groups.The rat model was established by an intratracheal instillation of bleomycin(BLM,5 mg/kg).One day after injection of BLM,pirfenidone or JBOL was given to rats once daily within 28 consecutive days,respectively.Positron emission tomography/computed tomography(PET/CT)was performed on the treated rats.The extent of alveolitis and fibrosis was observed by H&E and Masson trichrome staining.The contents of TGF-β1,TNF-α,IL-4 and IFN-γwere further quantified by ELISA assay.Results:PET/CT and histopathological evidence showed the ability of JBOL to attenuate bleomycininduced alveolitis and fibrosis extent,and the alveolitis lesion score was markedly decreased compared with the model group.The increased expression of inflammatory cytokines TGF-β1 and TNF-αinduced by bleomycin was also suppressed by JBOL.The Th1 response was limited by the reduced IFN-γafter BLM administration,and the Th2 response predominated significantly marked by the increased IL-4.JBOL could increase the level of IFN-γand markedly increased the ratio of IFN-γ/IL-4.Conclusion:These findings suggested that JBOL may attenuate BLM-induced idiopathic pulmonary fibrosis via reducing inflammatory cell infiltration,pro-inflammatory cytokine release and excessive collagen deposition in rats.One of the mechanisms is the reversion of Th1/Th2 shift caused by BLM.

Which is the Best Protocol of Ovarian Stimulation Prior to Artificial Insemination by Donor

Objective To compare the different ovarian stimulation protocols, clomiphene citrate （CC）, letrozole, human menopausal gonadotropin （hMG） only or combined with CC or letrozole in women undergoing artificial insemination by donor （AID）. Methods In this prospective clinical trial, 671 couples prepared for AID cycles were randomly allocated to 6 groups according to receive different protocols for the first time, natural cycle （group A, n=l14）, CC （group B, n=lOl）, CC and hMG （group C, n=124）, letrozole （group D, n=97）, letrozole and hMG （group E, n=123） and hMG only （group F, n=l12）. Outcomes including total dose of hMG, duration of hMG therapy, dominant follicles number, endometrial thickness, rates of clinical pregnancy, miscarriage, ovarian hyperstimulation syndrome （OHSS）, multiple pregnancy and can- celation were compared among the 6 groups. Results The total doses and duration of administered hMG were significantly lower in group C and group E than in group F. Dominant follicle number was significantly less in group A and more in group C than in other groups. Endometrial thickness of group B was significantly lower than that of other groups. Clinical pregnancy rate, multiple pregnancy rate, miscarriage rate, OHSS rate and cancelation rate were not statistically different among the stimulation groups. Conclusion AID cycles in which both CC and letrozole had been administered may require shorter duration and a lower total gonadotropin dose, while the clinical out-comes were similar.

An Impact of Suspected Peritubal Adhesions by Hysterosalpingography on Outcomes of Intrauterine Insemination

Objective To assess the fertility prospect of women with suspected peritubal adhesions diagnosed by hysterosalpingography （HSG） treated with intrauterine insemination （IUI）. Methods The study group consisted of 93 patients diagnosed as bilateral suspected peritubal adhesions by HSG, and 175 patients with no tubal pathology were classified as control group. A total of 496 cycles of lUI were finished in 268 infertile women. Results There were no differences in basic clinical parameters between the two groups. Cumulative pregnancy rates after two cycles of lUI were 19.4%for the study group, and 34.3%for the control. Cumulative pregnancy rate in the women with abnormal contrast media loculation was significantly lower than that in women of the control （7.4% vs 34.3%, P=0.037）. The cumulative pregnancy rates were similar between the women with abnormal tubal contour and the normal ones （36. 7% vs 34.3%, P=0.800）. Conclusion Suspected peritubal adhesions in HSG were worthy more attention, since the outcome of lUI in women with loculation of contrast material, combined with or without abnormal tubal contour resulted in a significantly lower pregnancy rate than the normal ones. IUI should be delayed before tubal patency was confirmed during these patients.

Effect of the P1 Medium and the ECM Medium on Embryo Quality in IVF

Objective To investigate the effect of the glucose-free preimplantation stage one （P1） medium and the ECM medium on embryo development quality in IVF. Methods The patients with ≥4 zygotes of 2PN were studied. A total of 201 retrieval cycles were included in a prospective randomized study. Each patient was herself control. Half of zygotes of 2PN were transferred into ECM medium （group A） and half into P1 medium （group B）for further culture. Embryo development was evaluated on the day of embryo transfer. The efficacy of ECM was compared with P1 as culture medium for the development of preimplantation embryos. Results No statistically significant differences were noted between the two groups regarding embryo-cleavage rate （97.13% vs 97.55%） and rate of normal-cleaving embryos （58.29% and 58.37%）. The rate of top-quality embryos was statistically higher in group A than in group B （27.59% vs 19.75%, P〈O.05）. Embryo quality, as assessed by morphological parameters （the amount of detached anuclear fragments 〉30%）, was better in group A than in group B （19.86% vs 21.75%）, however, there was no statistically significance. Both the rate of good-quality embryos （47.95% vs 46.17%） and available embryos （63.22% vs 61.19%） were higher in group A than in group B, but there was also no statistically significance. Conclusion The ECM medium may be associated with a better embryo quality compared with the P1 medium.