Determination of an Appropriate Endoscopic Monitoring Interval for Patients with Gastric Precancerous Conditions in China

Objective Gastric precancerous conditions such as atrophic gastritis(AG)and intestinal metaplasia(IM)are considered independent risk factors for gastric cancer(GC).The suitable endoscopic monitoring interval is unclear when we attempt to prevent GC development.This study investigated the appropriate monitoring interval for AG/IM patients.Methods Totally,957 AG/IM patients who satisfied the criteria for evaluation between 2010 and 2020 were included in the study.Univariate and multivariate analyses were used to determine the risk factors for progression to high-grade intraepithelial neoplasia(HGIN)/GC in AG/IM patients,and to determine an appropriate endoscopic monitoring scheme.Results During follow-up,28 AG/IM patients developed gastric neoplasia lesions including gastric low-grade intraepithelial neoplasia(LGIN)(0.7%),HGIN(0.9%),and GC(1.3%).Multivariate analysis identified H.pylori infection(P=0.022)and extensive AG/IM lesions(P=0.002)as risk factors for HGIN/GC progression(P=0.025).Conclusion In our study,HGIN/GC was present in 2.2%of AG/IM patients.In AG/IM patients with extensive lesions,a 1–2-year surveillance interval is recommended for early detection of HIGN/GC in AG/IM patients with extensive lesions.

Genetic predisposition to Helicobacter pylori-induced gastric precancerous conditions

Gastric cancer is the most common malignancy of the gastrointestinal tract in East Asian populations and the second most frequent cause of cancer-related mortality in the world. While previous studies have investigated the genetic factors involved in gastric carcinogenesis, there still exist relatively few studies that have investigated the genetic traits associated with the risk of gastric precancerous conditions. In this paper we will review the biology and genetic polymorphisms involved in the genesis of gastric precancerous conditions reported to date and discuss the future prospects of this field of study. The associations of gastric precancerous conditions with polymorphisms in the cytotoxin-associated gene A-related genes (e.g. PTPN11 G/A at intron 3, rs2301756), those in the genes involved in host immunity against Helico-bacter pylori (H. pylori) infection (e.g.TLR4 +3725G/C, rs11536889) or polymorphisms of the genes essential for the development/ differentiation of the gastric epithelial cells (e.g. RUNX3 T/A polymorphism at intron 3, rs760805) have been reported to date. Genetic epide-miological studies of the associations between H. pylori-induced gastric precancerous conditions and other gene polymorphisms in these pathways as well as polymor-phisms of the genes involved in other pathways like oxidative DNA damage repair pathways would provide useful evidence for the individualized prevention of these H. pylori-induced gastric precancerous conditions.

Gastric epithelial histology and precancerous conditions

The most common histological type of gastric cancer(GC)is gastric adenocarcinoma arising from the gastric epithelium.Less common variants include mesenchymal,lymphoproliferative and neuroendocrine neoplasms.The Lauren scheme classifies GC into intestinal type,diffuse type and mixed type.The WHO classification includes papillary,tubular,mucinous,poorly cohesive and mixed GC.Chronic atrophic gastritis(CAG)and intestinal metaplasia are recommended as common precancerous conditions.No definite precancerous condition of diffuse/poorly/undifferentiated type is recommended.Chronic superficial inflammation and hyperplasia of foveolar cells may be the focus.Presently,the management of early GC and precancerous conditions mainly relies on endoscopy including diagnosis,treatment and surveillance.Management of precancerous conditions promotes the early detection and treatment of early GC,and even prevent the occurrence of GC.In the review,precancerous conditions including CAG,metaplasia,foveolar hyperplasia and gastric hyperplastic polyps derived from the gastric epithelium have been concluded,based on the overview of gastric epithelial histological organization and its renewal.

Effect of garlic on micronucleus frequency of peripheral blood lymphocytes in MNNG-induced gastric carcinoma and precancerous lesion in rats

IM To investigate the effects of garlic on micronuclei frequency (MNF) of peripheral blood lymphocytes (PBL) in gastric carcinoma (GC) and precancerous lesion (PL) in Wistar rats induced by NmethylN′nitroNnitrosoguanidine (MNNG). METHODS Gastric carcinoma and precancerous lesions were induced by MNNG 125mg/5ml per day for 10 months. 10% garlic 10ml per day were given to the experimental group, and running water to control group. MNF of PBL in the control CG (n=16), MNNG (n=30), prevention (n=30) and treatment groups (n=20) were detected at 10 and 16 months by the technic of micronucleus cell culture. RESULTS MNF of MNNG group at the 10th and 16th month was similar; that of MNNG, GC and PL was remarkably higher than the control group (P<001), respectively; and that of PL was lower than GC (P<001). MNF of prevention and treatment groups was decreased, with significant difference from MNNG group (P<001). MNF of the prevention group at the 16th month was lower than that at the 10th month (P<001), the difference between the prevention and treatment groups was not significant. CONCLUSION MNNG was a continuous mutagenicity and carcinogenicity, and garlic has a remarkable antimutagenic and anticarcinogenic effect. The micronucleus frequency of PBL may be a new marker of earlystage gastric carcinogenesis.

A preliminary study on ras protein expression in human esophageal cancer and precancerous lesions

INTRODUCTIONThe esophageal carcinoma is a common malignanttumor in Linzhou City (Linxian) of Henan Provincein northern China.Although the etiology andnatural history of csophageal carcinoma are notclear,a substantial amount of evidence has beenprovided to suggest that the development of humanesophageal squamous cell carcinomas (SCC) is amultistage progressive process.An

Effect of garlic and garlic-green tea mixture on serum lipids in MNNG-induced experimental gastriccarcinoma and precancerous lesion

ＥｆｅｃｔｏｆｇａｒｌｉｃａｎｄｇａｒｌｉｃｇｒｅｅｎｔｅａｍｉｘｔｕｒｅｏｎｓｅｒｕｍｌｉｐｉｄｓｉｎＭＮＮＧｉｎｄｕｃｅｄｅｘｐｅｒｉｍｅｎｔａｌｇａｓｔｒｉｃｃａｒｃｉｎｏｍａａｎｄｐｒｅｃａｎｃｅｒｏｕｓｌｅｓｉｏｎＳＵＱｉ，ＬＵＯＺｈ...

Clinical and experimental study of therapeutic effect of Weixibaonizhuan pills on gastric precancerous lesions

IMS To observe the therapeutic effect of Weixibaonizhuan pills on gastric precancerous lesions.METHODS Thirty patients with gastric precancerous lesions were treated with Weixibaonizhuan pills for 3 months. Of the 36 cases, 13 (361%) were mild atrophic gastritis, 14 (389%) moderate atrophic gastritis and 9 (250%) severe atrophic gastritis; among them 22 (611%) and 27 cases (750%) were accompanied with intestinal metaplasia (IM) and dysplasia (DYS) respectively. Of the 36 patients, 20 were men and 16 women, aged from 30-60 years and those aged 30-59 years accounted for 611%. The course of disease ranged from 3 months to 21 years, and 20 (556%) of them had a course of 5-10 years. The clinical manifestations were fullness of the abdomen (31 cases), abdominalgia (27 cases), anorexia (30 cases), gas eructation (26 cases), acid regurgitation (6 cases) and loose stool (9 cases). When treatment ended, the improvement of patients′ clinical symptoms, atrophy of gastric mucosa, IM and DYS were analysed.RESULTS After 3 months′ treatment with Weixibaonizhuan pills, 7 cases recovered, 11 cases were much improved, 13 cases showed some improvement, and 5 cases were ineffective; the total rate of symptomatic improvement was 861%. Of the 13 cases with mild atrophic gastritis, 11 cases changed into superficial gastritis, and 2 cases had no changes. Of the 14 cases of moderate atrophic gastritis, 4 cases changed into superficial gastritis, 7 cases changed into mild atrophic gastritis, and 3 cases had no changes. Five of 9 cases of severe atrophic gastritis were reduced to moderate atrophic gastritis, and 4 cases had no changes. The total effective rate was 778% in chronic atrophic gastritis. Of the 9 cases with mild IM, IM disappeared in 6 cases and 3 showed no change. Of the 10 cases with moderate IM, it disappeared in 2 cases, 5 cases changed to mild IM, and 3 cases had no change. One of the 4 cases of severe IM changed to moderate IM and 3 had no change. The total effective rate was 636% in IM. Of the 16 cases of mild DYS, 11 cases showed disappearance of DYS and 5 had no change. In 9 cases of moderate DYS, 2 showed disappearance, 5 changed to mild DYS and 2 had no change. Two cases of severe DYS, both showed no change. The total effective rate was 667% in DYS. Before treatment, the Ⅰ, Ⅱ, Ⅲ and Ⅳ degree positive expressions of CEA were present in 13, 12, 9 and 2 cases, respectively, whereas after treatment, the positive expressions were present in 25, 7, 3 and 1, respectively. Before treatment, the Ⅰ, Ⅱ, Ⅲ and Ⅳ degree positive expressions of PCNA were present in 16, 11, 10 and 4 respectively, but after treatment, they were present in 21, 9, 5 and 1 respectively. In short, the positive expressions of CEA and PCNA of gastric mucosa were significantly decreased after treatment (P<001).CONCLUSION Weixibaonizhuan pill has a therapeutic effect in gastric precancerous lesions..

Effects of San Qi on Gastric Secretion and Protective Factors of Gastric Mucosa in the Rat with Precancerous Lesion of Stomach

In the model rat with precancerous lesion of stomach induced by the combined method of insertion of a spring into the pylorus and high salt hot paste,effects of San Qi (三七 Radix Notoginseng) on gastric secretion and protective factors of stomach were investigated.The results indicated that gastric secretion,gastric mucosal blood flow (GMBF) and aminohexose content lowered significantly,and malondialdehyde (MDA) increased significantly (P<0.01) in the model group as compared with the normal group;after treatment with San Qi Powder for 12 weeks,both gastric secresion and GMBF increased,and MDA content decreased as compared with the negative control group (P<0.01),with no significant increase of aminohexose content.It is suggested that San Qi (三七 Radix Notoginseng) may improve gastric secretion,and that increase of GMBF and antagonism against the lesion of oxygen free radicals are possibly one of its mechanisms.

Tumor suppressor gene p16 and Rb expression in gastric cardia precancerouslesions from subjects at a high incidence area in northern China

AIM:To further understand the molecular basis for gastric cardia carcinogenesis and to provide etiological clues. METHODS: Endoscopic mucosa biopsy and histopathological examinations were made on 37 subjects from a high incidence area for both esophageal and gastric cardia carcinomas in northern China. All the biopsy samples were fixed in 850 ml. (-1)L alcohol and embedded in paraffin. Each block contained one piece of tissue and was serially section at 5 microm. Immunohistochemistry (ABC) was carried out on these gastric cardia samples to determine the alterations of p16 and Rb. RESULTS: Based on the histopathlogical examination there were 11 cases of chronic superficial gastritis, 12 cases of chronic atrophic gastritis and 14 cases of dysplasia. The immunostaining demonstrated different levels of unclear immunostaining of p16 and Rb in normal gastric cardia tissue and the tissues with different severity of lesions. With the lesions progressing, the positive immunostaining rates for p16 protein had a decreasing tendency. In contrast, the positive immunostaining rate for Rb protein had an increasing tendency. There was a significant negative relationship between the two parameters. Changes of p16 was CSG 11(100%), CAG 7(58%), DYS 4(29%) and changes of Rb was CSG 2(18%), CAG 8(67%) and DYS 12(86%), (P【0.05). CONCLUSION: The alterations of p16 and Rb protein may play a role in the early stages of gastric cardia carcinogenesis.

Expression of bcl-2 oncogene in gastric precancerous lesions and its correlation with syndromes in traditional Chinese medicine

AIM: To observe the protein and mRNA expression of bcl-2 oncogene in gastric precancerous lesions (GPL) and to analyze its correlation with syndromes in traditional Chinese medicine (TCM). METHODS: Sixty-seven patients with GPL confirmed by gastroscopy and pathology were studied,including 39 cases of moderate gastric mucosal dysplasia,19 cases of severe gastric mucosa dysplasia, 9 cases of incomplete colon metaplasia. In syndrome differentiation of TCM,17 cases belonged to the syndrome of qi and yin deficiency of the spleen and stomach complicated by qi stagnation, 21 cases belonged to the syndrome of qi and yin deficiency of the spleen and stomach complicated by stomach heat, 29 cases belonged to the syndrome of qi and yin deficiency of the spleen and stomach complicated by blood stasis. Protein and mRNA expression of bcl-2 oncogene were detected by labeled streptavidin biotin (LSAB) immunohist-ochemistry and in situ hybridization respectively. RESULTS: Abnormal expression of protein and mRNA on bcl-2 oncogene was found in GPL,which increased gradually with the course of lesions. In moderate and severe gastric mucosal dysplasia and incomplete colon metaplasia,there was no difference in the expression of bcl-2 oncogene (P>0.05).In different accompanying syndromes, the expression of protein and mRNA on bcl-2 oncogene increased gradually in the following order: deficiency of both qi and yin of the spleen and stomach accompanying qi stagnation→stomach heat→blood stasis. In GPL, compared with accompanying blood stasis, there was an obvious difference in the expression of bcl-2 oncogene between the syndrome of qi and yin deficiency of the spleen and stomach and accompanying stomach heat, so did accompanying qi stagnation (the level of protein: X2=8.45, P<0.05;the level of mRNA: X2=7.35, P<0.05). CONCLUSION: Apoptosis-associated bcl-2 oncogene is abnormally expressed in GPL,which correlates with different accompanying syndromes in TCM.

Possibility of non-invasive diagnosis of gastric mucosal precancerous changes

AIM: To assess the possibility of non-invasive screening of atrophic chronic gastritis for preventing further development of gastric cancer.METHODS: One hundred and seventy-eight consecutive Helicobacter pylori ( H pylori)-positive dyspeptic patients after detection of serum levels of pepsinogen-1 (PG-1) and gastrin-17 (G-17) by enzyme immunoassay were proposed for endoscopy and histology. The serologic and morphologic results were compared with estimating the sensitivity, specificity and prognostic values of the tests.RESULTS: There was statistically significant reverse dependence between the grade of stomach mucosal antral or corpus atrophy and the proper decreasing of serum G17 or PG1 levels. The serologic method was quite sensitive in the diagnosis of non-atrophic and severe antral and corpus gastritis. Also, it was characterized by the high positive and negative prognostic values.CONCLUSION: Detection of serum G-17 and PG1 levels can be offered as the screening tool for atrophic gastritis. The positive serologic results require further chromoendoscopy with mucosal biopsy, for revealing probable progressing of atrophic process with development of intestinal metaplasia, dysplasia or gastric cancer.

Relationship between gastric cancer and precancerous lesions

ＲｅｌａｔｉｏｎｓｈｉｐｂｅｔｗｅｅｎｇａｓｔｒｉｃｃａｎｃｅｒａｎｄｐｒｅｃａｎｃｅｒｏｕｓｌｅｓｉｏｎｓＭＡＪｕｎＬｉｎｇ１，ＬＩＵＷｅｉＤｏｎｇ２，ＺＨＡＮＧＺａｉＺｈｅｎ１，ＺＨＡＮＧＬｉａｎ３，ＹＯＵＷｅｉＣｈｅｎｇ３ａｎｄＣＨＡＮ...

Life Is Quantum Biology Effects Explained from the Schrödinger Equation, Serious or Life-Threatening Conditions or Diseases, and COVID-19 Results

Background: A plant based approach was undertaken to ascertain the efficacy of the Technology/Innovation of a new medical Technology based on similar activity to the circulatory system of plants. Basic Technology formulations were introduced into plant structures to evaluate the responses for cell division and plant growth which ultimately lead to the final product. This Technology/Innovation transforms and enhances common botanical/herb products such that they can be used to treat COVID-19 infection and Serious or Life-threatening conditions or diseases. They can restore the diseased cell’s abnormal metabolism to homeostasis and return it to normal function by slowing or reversing the cell’s malfunctioning metabolism, or in other words, slowing or reversing the disease process. Methods: A systematic treatment for COVID-19 infection and Serious or Life-threatening illness in patients is based on theories of traditional Chinese medicine. The Technology/Innovation is developed as dietary supplement products for treatment of Serious or Life-threatening conditions or diseases. Results: The results consist of over one hundred Serious or Life-threatening patient medical records. The U.S. Food and Drug Administration (FDA) reviewed/evaluated/accepted the Technology/Innovation patient medical record results, which included fifty-four COVID-19 patients with Prioritized Review Expedited No.: 2020-2867 CR2020-2596 information on September 16, 2020 and twenty-seven cancer patients Cancer Survival Rate Results in (Table 1) with FDA Establishment Identification No.: 3012327979 information on March 25, 2019 as FDA-Regulated medical products and meet the requirement under FDA Significant Scientific Agreement standards.

Physiological Analysis for Universal Design of Public Seat Under Diverse Conditions

Public vehicle seats are used under diverse conditions, therefore, the design of these seats is desired to be universal design. In the past study, seat swing function used in public vehicle seats, and it was optimized from the mechanical aspect under diverse conditions. Seat swing function is the function to prevent hip-sliding force, which causes sitting uncomfortable feeling. Recent study clarified that the reduction of blood flow in the legs causes physiological dysfunction, which is one of the causes of Long Flight Thrombosis, and the social issue. Thus, in the design of seat swing function, it is necessary to consider not only mechanical aspects but also physiological aspects. For the universal design of seat swing function considering the physiological aspect （blood flow）, the influence of blood flow on seat swing function in diverse conditions was analyzed. The method of this study was measuring blood flow and body pressure distribution on seat cushion of seat swing function under diverse conditions. From the analysis, it was indicated that it was necessary to reduce the compressive force behind the knees of the user conditions; the short physique and the high weight physique in standard sitting posture, for the universal design of seat swing function to prevent reduction of blood flow in the legs.

ESD与EMR治疗早期结直肠癌、癌前病变的手术效果及并发症观察

目的探究内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)与黏膜切除术(endoscopic mucosal resection,EMR)对早期结直肠癌、癌前病变患者的手术效果及并发症的影响。方法回顾性我院治疗的早期结直肠癌、癌前病变患者120例,根据手术方式分组,对照组55例,观察组65例。对照组行EMR治疗,观察组行ESD手术。对2组患者的手术指标进行比较,观察两组术前及术后7 d的氧化应激水平,术后对患者进行6个月随访,比较其术前及术后的生活质量水平,统计患者术后发生穿孔、感染及出血的情况,并记录患者术后6个月内是否复发。结果与对照组相比,观察组手术时间较长,术中出血量较多,切除的标本厚度及创面直径均大于对照组,差异均有统计学意义(P<0.05)。观察组病灶整块切除率及治愈性切除率与对照组比较,差异无统计学意义(P>0.05)。治疗后,患者的丙二醛(malondialdehyde,MDA)、氧化型谷胱甘肽(glutathione disulfide,GSSG)、皮质醇(cortisol,Cor)水平均有所上升,与术前比较差异有统计学意义(P<0.05),但2组比较差异无统计学意义(P>0.05)。2组术前的生活质量各维度评估结果差异无统计学意义(P>0.05)。经治疗,对患者术后3个月的生活质量再次评估,其生活质量评分均有提高,且观察组患者的升高幅度高于对照组(P<0.05)。观察组穿孔、术中出血、感染的发生率为12.31%,低于对照组(34.55%),术后6个月内,观察组复发1例(1.54%),与对照组复发率(8例14.55%)比较,差异有统计学意义(P<0.05)。结论与EMR相比,对早期结直肠癌、癌前病变患者行ESD治疗,操作难度较大,手术时间较长,但患者术后氧化应激水平变化相当,可以有效降低患者术后复发率,改善术后并发症的发生情况,提高患者生活质量。

活血化瘀中药联合富血小板血浆改善激素性股骨头坏死的作用机制

背景:目前发现活血化瘀中药、富血小板血浆技术都能够修复受损血管,促进血管再生,重建股骨头内血运,恢复正常血供,进一步促进成骨作用,在早期干预激素性股骨头坏死方面均表现出一定的优势,可更加深入了解活血化瘀中药及富血小板血浆技术改善激素性股骨头坏死的作用机制,为今后治疗提供新思路。目的:根据国内外相关文献,综述活血化瘀中药联合富血小板血浆技术改善激素性股骨头坏死作用机制的研究进展。方法:检索PubMed、Web of Science、Metstr、中国知网及万方数据库收录的相关文献。以“中药、信号通路、激素性股骨头坏死、血管内皮生长因子、富血小板血浆”及“traditional Chinese medicine、signal pathways、steroid induced necrosis of femoral head、vascular endothelial growth factor、platelet rich plasma”分别作为中、英文检索词,检索文献时限为2000年1月至2022年7月,最终纳入相关文献75篇。结果与结论:活血化瘀中药及富血小板血浆技术在干预早期激素性股骨头坏死方面均表现出一定的优势。对于中医药而言,无论是活血化瘀单体药还是复方药都可以有效缓解激素性股骨头坏死疾病进一步发展,具体作用机制如下:①活血化瘀中药有显著抗凝作用,可以拮抗激素药物造成的血液异常(高凝)状态,进一步恢复股骨头内的正常血供;②活血化瘀中药可修复受损的血管内皮,通过激活血管内皮生长因子,使血管再生,重塑股骨头内血运;③活血化瘀中药祛瘀效果明显,可减少骨髓腔内的脂肪细胞堆积,缓解股骨头内压力;④活血化瘀中药可调控相关信号通路,维持骨代谢,促进成骨细胞、破骨细胞分化平衡,有效减轻激素性股骨头坏死。此外,富血小板血浆中含有大量高浓度细胞生长因子,对成骨作用及血管再生均起到正向作用,同时也可改善血液异常状态。活血化瘀中药联合富血小板血浆技术可发挥二者自身生物作用,干预效果更加显著。

调教训练对伊犁马2000 m速步赛血气指标的影响

【目的】研究调教训练对伊犁马2000 m速步赛血气指标的影响,为制定科学调教训练方案提供数据参考。【方法】选取未经专项速步赛调教训练的健康伊犁马(2岁)12匹,进行为期12周的速步专项训练,训练期间每4周组织一次速步测试赛,记录比赛成绩,并采集马匹赛前、赛后即刻、赛后30 min及赛后60 min的血液测定血气指标。【结果】优秀组和普通组马匹训练中期和训练后期的比赛用时极显著低于训练前期(P<0.01)。pH训练中期显著低于训练前期(P<0.05)。乳酸(lactic acid,Lac)训练中期极显著高于训练前期(P<0.01)。Na+训练中期极显著低于训练前期和后期(P<0.01)。Ca^(2+)训练后期极显著低于训练前期(P<0.01),显著低于训练训练中期(P<0.05)。Cl^(-)训练后期显著低于训练前期(P<0.05),训练中期极显著低于训练前期(P<0.01)。阴离子间隙(anion gap,AG)训练后期显著高于训练前期(P<0.05)。血糖(glucose,Glu)训练后期极显著高于训练前期和训练中期(P<0.01)。肌酐(creatinine,Crea)训练中期极显著高于训练前期和训练后期(P<0.01)。【结论】调教训练后2000 m伊犁马速步赛的成绩、酸碱平衡能力、气体交换能力及葡萄糖供应能力均显著提高。在训练过程中,适当补充电解质来维持机体离子水平。血气指标可以作为马匹运动训练中的健康监测手段。

声带癌前病变组织中基质金属蛋白酶抑制剂-1、果蝇母亲DDP同源物4表达水平与术后复发和恶变的相关性研究

目的探讨声带癌前病变组织中基质金属蛋白酶抑制剂-1(tissue inhibitor of metalloproteinases 1,TIMP-1)、果蝇母亲DDP同源物4(drosophila mothers against DDP homolog 4,Smad4)表达水平与术后复发和恶变的相关性。方法回顾性分析2018年8月~2021年8月郑州大学第一附属医院收治的162例声带癌前病变患者的临床和病理资料,收集手术切除癌前病变组织(癌前病变组)及病变旁正常黏膜组织(对照组),采用免疫组织化学法检测组织中TIMP-1、Smad4表达情况。分析TIMP-1、Smad4阳性率与临床病理特征的关系,并采用Kaplan-Meier法和Cox回归分析法分析其对术后复发和恶变的影响。结果与对照组正常黏膜组织比较,癌前病变组的TIMP-1阳性率较高,Smad4阳性率较低(P<0.05)。不同病变范围、是否累及前连合、不同程度上皮异常增生患者的TIMP-1、Smad4阳性率存在差异(P<0.05)。术后随访时间24~60个月,中位随访时间36个月,随访期间失访患者6例,随访率96.30%(156/162),随访期间术后复发35例(21.60%),术后恶变16例(9.88%);Kaplan-Meier生存分析显示,TIMP-1阳性患者术后复发率和恶变率高于TIMP-1阴性患者(P<0.05);Smad4阴性患者术后复发率和恶变率高于Smad4阳性患者(P<0.05)。多因素Cox回归分析显示,喉咽反流、病变范围>1/2、中/重度异型增生、TIMP-1阳性、Smad4阴性是复发的独立危险因素(P<0.05),年龄>60岁、累及前连合、TIMP-1阳性、Smad4阴性是恶变的独立危险因素(P<0.05)。结论声带癌前病变组织中TIMP-1高表达、Smad4低表达,且TIMP-1阳性、Smad4阴性表达者术后复发和恶变风险较高。

综合护理干预在老年糖尿病伴急性心肌梗死患者中的应用

目的:研究综合护理干预应用于老年糖尿病伴急性心肌梗死患者的效果。方法:选取2021年1月—2022年1月昭通市第一人民医院140例老年糖尿病伴急性心肌梗死患者为研究对象。采用随机数表法分为两组,各70例。对照组患者给予常规护理干预,观察组患者在对照组的基础上给予综合护理干预。两组患者均干预2周并观察8周。比较两组患者护理效果及合并症发生率,并对干预前后血糖水平、西雅图心绞痛量表评分(SAQ)、抑郁自评量表(SDS)评分及焦虑自评量表(SAS)评分进行对比。结果:观察组的总有效率为91.43%,高于对照组的71.43%,差异有统计学意义(P<0.05)。干预后,两组血清空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平均降低,且观察组均低于对照组,差异有统计学意义(P<0.05)。干预后,两组各项SAQ评分均升高,且观察组高于对照组,差异有统计学意义(P<0.05)。干预后,两组抑郁自评量表(SDS)评分及焦虑自评量表(SAS)评分均降低,且观察组低于对照组,差异有统计学意义(P<0.05)。干预后,观察组合并症总发生率为5.71%,低于对照组的24.29%,差异有统计学意义(P<0.05)。结论:老年糖尿病伴急性心肌梗死患者应用综合护理干预可改善其心理状况,降低血糖水平,同时可提高患者的生活质量,减少合并症,护理效果显著。