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Cirrhosis of the liver results in portal hypertension, which is a tortuous and dilated portal vein. The hemorrhage of digestive tract caused by dilation and rupture of lower esophagus and gastric fundus is the main cause of death in patients with cirrhosis. The treatment methods of digestive tract hemorrhage in liver cirrhosis include drug therapy, endoscopic hemostasis, interventional therapy to control hemorrhage and surgical hemostasis. These methods are mainly used to control hemorrhage and solve hypersplenism, but cannot solve the fundamental problem of cirrhosis. Stem cells can repair damaged liver cells and help restore liver function. Under the guidance of B-ultrasound, precise intrahepatic portal vein puncture and infusion of autologous bone marrow nucleated cells can improve cirrhosis through autologous bone marrow stem cells. Little damage to patients, little risk. Cell therapy combined with conventional therapy can treat both the symptoms and the root causes of digestive tract hemorrhage in cirrhosis.
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Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.
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Objective To investigate the efficacy of nutritional support for human immunodeficiency virus (HIV)-infected and malnutritional patients during perioperative period.Methods The clinical data of 283 HIV-infected patients who were admitted to the Shanghai Public Health Clinical Center from October 2008 to February 2012 were retrospectively analyzed.All patients were divided into malnutritional group and non-malnutritional group according to nutritional condition before operation.Twenty-eight patients with malnutrition (7 patients did not receive perioperative nutritional support due to emergency operation,and they were excluded from the study) and 248 patients in normal nutritional status were enrolled in the study.Nutritional support was given for 5-7 days before operation for patients with malnutrition,and all patients received nutritional support after operation.Differences in the immune function,nutrional status,the incidences of surgical incisional infection and sepsis,and perioperative mortality between the 2 groups were compared.Measurement data were analyzed using the paired t test,and the enumeration data were analyzed using the chi-square test.Results The levels of CD4,CD8 and hemoglobin in patients with malnutrition were (205 ± 24)× 106/L,(559 ± 55)× 106/L and (103 ± 24)g/L after perioperative nutritional support,which were significantly higher than (150 ± 33) × 106/L,(491 ± 45) × 106/L and (97 ± 19)g/L before nutritional support (t =-2.561,-1.302,-1.349,P ＜ 0.05).The levels of CD4,CD8 and hemoglobin were (197 ± 43) × 106/L,(547 ± 52) × 106/L and (103 ± 22) g/L at postoperative day 14,which were decreased compared with those after nutritional support,while no significant difference was detected (t =-1.108,0.600,-0.148,P ＞ 0.05).The incidence of incisional infection in patients with malnutrition was 42.9％ (12/28),which was lower than 45.2％ (112/248) of patients in normal nutritional status,with no significant difference (P ＞0.05).The incidence of postoperative sepsis and perioperative mortality were 75.0％ (21/28)and 3.6％ (1/28) in patients with malnutrition after operation,which were significantly higher than 32.7％ (81/248)and 0.8％ (2/248) in patients in normal nutritional status (P ＜ 0.05).Conclusion The mobidity of HIV-infected patients is high,and nutritional support for HIV-infected patients during perioperative period can improve their immunity.
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Objective To investigate the effects of Hsp90 inhibitor 17-DMAG on proliferation and apoptosis of human colon cancer cell line HT-29.Methods HT-29 cells were treated with 17-DMAG.The cell proliferation inhibition rate was evaluated by CCK-8 assay.Apoptosis of HT-29 cells by 17-DMAG was delineated by DAPI staining assay and Annexin V PI double labeling FCM was used to determine cell apoptotic rate.Furthermore,Westen blotting analysis was used to determine caspase-3 and cleaved caspase-3 protein expression.Results 17-DMAG time-dose-dependently inhibited the proliferation of HT-29 cells.After 0.1μmol/L,0.25μmol/L,0.5μmol/L,1.0μmol/L,2.5μmol/L and 5μmol/L 17-DMAG exposured for 24 hours,the cell proliferation inhibition rate was (14.36±0.95)％,(22.17± 1.15)％,(28.45±1.16)％,(35.04±1.58)％,(46.85 ±2.44)％,(57.19 ± 2.06)％ respectively,after exposured for 48 hours,the cell proliferation inhibition rate was increased to (20.80±1.17)％,(27.55 ±0.65)％,(33.33 ±1.23)％,(46.20±4.76)％,(55.45 ±4.47)％,(61.75 ±2.72) ％ respectively,after exposure for 72 hours,the cell proliferation inhibition rate was to (29.62 ± 2.27) ％,(39.19 ± 1.74)％,(44.29 ±2.00)％,(50.66 ±2.17)％,(58.84 ±3.18)％,(70.74 ±2.65)％.DAPI staining showed that HT-29 cells treated with 17-DMAG displayed chromatin condensation and nuclear fragmentation which are typical changes of apoptosis.Annexin V PI double labeling FCM showed that when HT-29 cells were exposed to 0,0.25,0.5,1.0 and 2.5(μmoL/L) 17-DMAG for 24 hours,the total apoptotic rate for 24 hours was (2.72 ±0.57)％,(5.38 ±0.46)％,(6.88 ±0.52)％,(10.44 ±0.32)％ and (17.87 ±4.66)％ respectively.(P ＜0.05).In addition,the expression of procaspase-3 decreased,while cleaved caspase-3 increased in the presence of 17-DMAG at different concentrations for 24 hours.Conclusion 17-DMAG can time-dose-dependently inhibit proliferation and promote apoptosis of HT-29 cells in vitro.
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Colon cancer is a common and deadly disease with high rising incidence rate.Proteomics has already become one of the hot topic and maken great progress in the research of colon cancer pathogenesis,early diagnosis,treatment and prognosis.In recent years,more and more colon cancer-associated biomarkers have been identified through proteomics-based approaches.This review will summarize the research progress of proteomics in colon cancer.
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CD4 + CD25 + regulatory T- cell (Treg) play essential roles in maintaining self- tolerance, immune homeostasis and cancer immune system. Treg can suppress immune responses against self antigens or non-selfantigens such as tumor antigens. The immunosuppressive functions of Treg are widely acknowledged and have been extensively studied. Recent studies demonstrate the existence of Treg at tumor sites, implying that these Treg may induce antigen-specific and local immune tolerance. This review will discuss the ligands, mechanisms of immune suppression of Treg and its potential roles in cancer therapy.
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Objective To explore the association between tumor necrosis factor receptor associated factor 6 (TRAF6) polymorphisms and the susceptibility to sepsis. Method Haplotype tagging single nucleotide polymorphisms (htSNPs) were selected from the HapMap database. The htSNPs were genotyped in 255 patients with sepsis and 260 control subjects by the Beckman SNP stream genotyping platform. The association with susceptibility to and severity of sepsis were estimated by logistic regression with adjustment for age, sex, smoking, drinking,chronic diseases status, APACHE Ⅱ score and critical illness. Results Of 13 TRAF6 ANPs, 7 were tagged by htSNPs. Of them, 5 htSNPs (rs5030496, rs5030411, rs5030416, rs5030445 and rs3740961) were used for final genotyping analysis. Genotype frequencies of those htSNPs were conformed to the Hardy-Weinberg law in both patients and controls. There were no significant association found between the 5 htSNPs and susceptibility to sepsis.Also, there was no significant association between the TRAF6 polymorphisms and the septic shock, death from sepsis as well as organ dysfunction. Conclusions The TRAF6 gene polymorphisms might not play a major role in severity of sepsis.
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Although significant advances have been made in both the development of therapeutic strate-gies and the understanding of pathophysiological mechanisms of sepsis, the mortality of severe sepsis and septic shock still remains unacceptably high worldwide. Current prediction models based on socio-demo-graphic and clinical risk factors fail to explain fully why a particular patient either develops or succumbs to sepsis. In recent years epidemiological studies have suggested a strong genetic relationship on the suscepti-bility and outcome of sepsis. With the completion of Human Genome Project and International HapMap Pro-ject, the identification of susceptibal genes contributing to sepsis may allow more precise use of interven-tions, such as targeted therapy of sepsis is an appealing strategy. In this review, we summarize a broad over-view of genetic nomenclature, study designs, and problems of these genetic association studies.
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Objective Probe the value and the operation risk for HIV/AIDS patients with surgical compli-cations. Methods Investigated 27 HIV-infected patients(male 26, female 1, age 27-74 years) were investi-gated. All patients had pre-operative detection of immune function, standardized surgical procedures, careful surgical process to reduce the operation damage, continuous infusion of coagulation factors for haemophilia during operation, conventional application of antibiotics to prevent infection and prompt treatment of compli-cations. Results No incision infected in 8 cases of class one incision, 1 incision infected in 6 cases of class two incision, 3 cases were not healed in 30 days after operation in 13 cases of class three incision. One case died of severe sepsis 12 days after operation, the others discharged with recovery or improvement. Conclu-sion Suitable operation and treatment method may obtain curative effect for HIV-infected patients.
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Objective To study the dynamic change and prognostic significance of serum IL-18 in acute pancreatitis,and to explore the relationship between the APACHE Ⅱ score and prognosis of. Acute pancreati-tis. Methods According to the clinical diagnosis and criteria for acute pancreatitis, 34 patients with AP were divided into severe acute pancreatitis (SAP) group( n = 12 ) and mild acute pancreatitis (MAP) group (n = 22). Sixteen normal individuals were used as the control group ( n = 16.). The serum IL-18 was detected by ELISA. Results IL-18 in the SAP group was higher than that in the MAP group. In the MAP group, there was significant positive correlation between APACHE Ⅱ and IL-18 ( r = 0.98 ,P < 0.01 ). Conclusion IL-18 plays an important role in the development of acute pancreatitis, and it may be a valuable index to predict the severity of AP.
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Adjustment of epigenetics is closely related with transfer modulation of tumor-related genes. DNA methylation is one of the significant functions of modulation of genetic epigenetics. Abnormal DNA methylation is intensively involved in generation and development of tumor while DNA methylation is cata- lyzed and maintained by DNA methyltransferase(DNMT). So profound study on funetions of DNMT is of great significance to realize generation of abnormal methylation and functions of abnormal methylation in tumor generation and development.