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Objective:To explore the difference between selective lobar bronchial block and main bronchial block in thoracoscopic surgery in children.Methods:A retrospective cohort study was conducted to analyze the clinical data of 150 children undergoing thoracoscopic surgery admitted to Henan Children's Hospital, Zhengzhou Children's Hospital, and Children's Hospital Affiliated to Zhengzhou University from December 2019 to December 2022. In the examination of the electronic medical record, 80 children were found to have selective lobar bronchial block, which was used as the study group, and 70 children were matched as the control group.Compare the general data of children in the two groups, such as age, gender, weight, surgical time, and other data. Compare the two groups with respect to hypoxemia, degree of pulmonary collapse, atelectasis, and number of bronchial blocker shifts. Compare the heart rate(HR), mean arterial pressure(MAP), degree of pulmonary collapse, and airway pressure(PAW) at different time points in the two groups[before single lung ventilation(OLV)(T1), 10 min after OLV(T2), and 10 min after OLV(T3)] Difference in alveolar arterial oxygen partial pressure(AaDO 2) levels. Results:Comparison of the incidence of hypoxemia, bronchial blocker displacement, and atelectasis in children in the study group were statistically significant( P<0.05). The results of repeated measurement of variance showed that there was statistically significant difference in the inter subject effects of HR and MAP levels at different time points between the two groups based on time factors( P<0.05). The results of repeated measurement of variance showed that there was statistical significance between the inter-subjective effects of the levels of PAW and AaDO 2 at different time points of the two groups with time factor as the source, group as the source, and intra-subjective effects with time and group interaction as the source( P<0.05). The levels of PAW and AaDO 2 in the study group at time points T2 and T3 were significantly lower than those in the control group, and the differences between the groups were statistically significant( P<0.05). Conclusion:The effect of selective lobobronchial blockade in thoracoscopic surgery in children is ideal, which can effectively improve the ventilation and related oxygenation of children, and reduce the occurrence of complications such as atelectasis and hypoxemia.
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The CRISPR/Cas system consists of clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated genes (Cas). The system forms an adaptive immune system in archaea and bacteria. The inherent defense mechanism enables these microorganisms to protect themselves against the invasion of foreign genetic material. The system functions of immune response including three main stages: adaptation, expression/maturation, and interference, each stage needs specific Cas proteins encoded by Cas gene located near the CRISPR sequences, along with other auxiliary proteins. In 2015, Zhang et al. reportedCas12a (Cpf1) as a member of the Class II type V CRISPR/Cas12a system, which possesses endonuclease activity. This finding holds great promise for its application in the field of biotechnology. In 2018, Doudna’s team first applied the CRISPR/Cas12a system for detecting HPV nucleic acid. The system comprises the following essential components in vitro detection: Cas12a, the crRNA sequence complementary to the target DNA, the PAM sequence, and the ssDNA reporter. Cas12a possesses a typical RuvC domain, displaying a canonical bilobed architecture that consists of a recognition (REC) lobe and a nuclease (NUC) lobe. The REC lobe contains the REC1 and REC2 domains, and the NUC lobe includes RuvC, PAM-interacting (PI), Wedge (WED), and bridge helix (BH) domains. The mature crRNA for Cas12a has a length of 42-44 nt, consists of repeat sequence (19/20 nt) and spacer sequence (23-25 nt). The crRNA spacer sequence has been found to require a length of 18 nt to achieve complete cleavage activity in vitro. Additionally, mutation in the bases of crRNA can indeed affect the activity of Cas12a. The PAM sequence plays a critical role in the recognition and degradation of DNA by the CRISPR/Cas system, enabling the system to distinguish between self and non-self genomic materials. Cas12a can effectively target the spacer sequence downstream of a T-rich PAM sequence at the 5' end. LbCas12a and AsCas12a both recognize the PAM sequences of 5'-TTTN-3', while FnCas12a recognizes the PAM sequences of 5'-TTN-3'. All of these PAM sequences are located upstream on the non-template strand (NTS) at the 5' end. Cas12a (Cpf1), guided by the crRNA, binds to the target DNA by recognizing the PAM sequence. It exhibits the ability to induce arbitrary cleavage of ssDNA within the system while cleaving the target ssDNA or dsDNA. According to this feature, an array of nucleic acid detection methods has been developed for tumor detection and infection diagnostics, such as the DETECTR (RPA-CRISPR/Cas12a method) and HOLMES (PCR-CRISPR/Cas12a method) in 2018. Then, in 2019, Cas12aVDet (one-step detection method), where Cas12a protein was immobilized on the upper wall of the reaction tube. This not only prevented contamination from opening the tube but also reduced the detection reaction time. In 2021, the dWS-CRISPR (digital warm-start CRISPR) was developed as a one-pot detection method. It serves as an accurate approach for quantitatively detectingSARS-CoV-2 in clinical specimens. With the innovation of scientific technology, the high-sensitivity signal transduction technology has also been integrated with the CRISPR/Cas12a system, enabling direct detection of nucleic acids, and eliminating the need for nucleic acid amplification steps. Here, we elaborated the detection principles of CRISPR/Cas12a in in vitro detection. We discussed the different stages leading to the catalytic pathway of target DNA, and the practical applications of Cas12a in nucleic acid detection. These findings revealed a target interference mechanism that originates from the binding of Cas12a-guided RNA complex to complementary DNA sequences within PAM-dependent (dsDNA) regions. The crRNA-DNA binding activates Cas12a, enabling site-specific dsDNA cleavage and non-specific ssDNA trans-cleavage. The release of Cas12a ssDNase activity provides a novel approach to enhance the sensitivity and specificity of molecular diagnostic applications. Before these CRISPR/Cas12a-based nucleic acid detection methods can be introduced into clinical use, substantial work is still required to ensure the accuracy of diagnosis. Nevertheless, we believe that these innovative detection tools based on CRISPR/Cas will revolutionize future diagnostic technologies, particularly offering significant assistance in pathogen infection diagnosis for developing countries with relatively poor healthcare conditions and high prevalence of infectious diseases.
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To systematically review the efficacy and safety of Yangxin Dingji Capsules in the treatment of arrhythmia. PubMed, EMbase, Cochrane Library, CNKI, VIP, CBM and Wanfang databases were electronically retrieved to collect randomized controlled trial(RCT) on the efficacy of Yangxin Dingji Capsules in the treatment of arrhythmia from the time of database establishment to October 20 th, 2020. Two reviewers independently screened out the literatures, input the data, and evaluated the literature quality of the included studies. RevMan 5.3 software was used for Meta-analysis. A total of 127 studies were retrieved, and 15 articles were included after screening, involving 1 371 cases, with 685 cases in the treatment group and 686 cases in the control group. Yangxin Dingji Capsules combined with anti-arrhythmia western medicine was adopted for intervention in the treatment group, while the patients in the control group were treated with the anti-arrhythmia western medicine alone. Meta-analysis results showed that in arrhythmia patients, the combination of Yangxin Dingji Capsules and conventional western medicine significantly increased the clinical efficacy(RR=1.23, 95%CI[1.17, 1.30], P<0.000 01)and left ventricular ejection fraction(MD=4.31, 95%CI[3.10, 5.52], P<0.000 01), reduced heart rate(MD=-3.79, 95%CI[-7.42,-0.15], P=0.04), left ventricular end-diastolic diameter(MD=-7.06, 95%CI[-11.91,-2.21],P=0.004), left ventricular end-systolic diameter(MD=-4.78, 95%CI[-6.63,-2.93],P<0.000 01), N-terminal B-type natriuretic peptide precursor(MD=-200.51, 95%CI[-254.52,-146.51], P<0.000 01)and high-sensitivity C-reactive protein(MD=-1.74, 95%CI[-3.23,-0.24], P=0.02), all with statistically significant differences. Compared with the control group, Yangxin Dingji Capsules had fewer adverse reactions(RR=0.53, 95%CI[0.36, 0.79], P=0.002). The existing evidences showed that Yangxin Dingji Capsules had certain effect in the treatment of arrhythmia, with a safety. However, due to the limitation in sample size, outcome measures and quality of the included studies, more high-quality studies are required to verify the above conclusion.
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Humans , Bradycardia , Capsules , Drugs, Chinese Herbal , Stroke Volume , Ventricular Function, LeftABSTRACT
Liver cancer is one of the most common malignant tumors in China. Surgical resection is still the preferred radical treatment method for patients with liver cancer; however, most patients cannot tolerate surgical resection due to the influence of tumor size, tumor location, liver function, and general condition. In recent years, local ablation techniques, such as radiofrequency ablation and microwave ablation, have developed rapidly and are widely used in clinical practice, and they are even known as new techniques comparable to surgical resection for the radical treatment of liver cancer. This article briefly introduces the application and selection of local ablation and surgical resection in the treatment of liver cancer.
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"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions. .
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OBJECTIVE@#To study the clinical effect of individualized controllable stress external fixator in the treatment of open tibial fractures.@*METHODS@#From December 2018 to July 2020, 60 patients with open tibial fractures were treated, including 35 males and 25 females;The age ranged from 23 to 58 years;The course of disease was 1.2 to 10.0 h. According to the stress stimulation on the fracture end after operation, all patients were divided into 4 groups, including non stress group (15 cases) and 3 groups with different stress stimulation(15 cases in each group). All patients with open tibial fractures were treated with controllable stress external fixator. Four weeks after operation, the stress group adjusted the elastic external fixator to apply axial stress of 1/6, 2/6 and 3/6 of their own weight to the fracture end based on the patient's weight. The wound healing of all patients after operation was observed, the plain CT images of fracture ends at 4, 6, 8, 10 and 12 weeks after operation were followed up, the average valueof callus area per 10 scanning planes was calculated, and the differences between the groups were compared. The fracture healing was observed and statistically analyzed.@*RESULTS@#The wounds of all patients healed well, of which 7 patients underwent secondary free skin grafting and transferred myocutaneous flap. All patients were followed up for 12 to 24 months, with an average of 16.5 months. The final follow-up results showed that the fracture healing of stress groups and non stress group had significant difference(@*CONCLUSION@#When the controllable stress external fixation technique is used to treat open tibial fractures, the elastic external fixator is adjusted according to the patient's own weight after 4 weeks, and a certain axial stress is applied to the fracture end, which is conducive to the fracture healing of patients, and can reduce the incidence of delayed union or nonunion of open fractures, which has a certain application value.
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Adult , Female , Humans , Male , Middle Aged , Young Adult , External Fixators , Fracture Fixation , Fracture Healing , Fractures, Open/surgery , Tibial Fractures/surgery , Treatment OutcomeABSTRACT
As a treatment option for cancer, thermal ablation has satisfactory effects on many types of solid tumors (such as liver and renal cancers). However, its clinical applications for the treatment of thyroid nodules and metastatic cervical lymph nodes are still under debate both in China and abroad. In 2015, the “Zhejiang Expert consensus on thermal ablation for thyroid benign nodules, microcarcinoma, and metastatic cervical lymph nodes (2015 edition),” was released by the Thyroid Cancer Committee of Zhejiang Anti-Cancer Association, China. To further standardize the application of thermal ablation for thyroid tumors, the Thyroid Tumor Ablation Experts Group of Chinese Medical Doctor Association has organized many seminars and finally produced a consensus to formulate the “Expert consensus workshop report: Guidelines for thermal ablation of thyroid tumors (2019 edition).”
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The coronavirus disease 2019 (COVID-19) has become a global pandemic since its outbreak in December 2019, which posed a threat to the safety and well-being of people on a global scale. Cancer patients are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and their critical morbidity and case fatality rates are high. The ablation expert committee of the Chinese Society of Clinical Oncology compiled corresponding expert recommendations. These recommendations summarize the preventive measures and management of tumor ablation treatment in medical institutions, including outpatient clinics, oncology wards, ablation operation room, and postablation follow-ups in accordance with the guidelines and protocols imposed by the National Health Commission of the People's Republic of China and the experience in management and prevention according to various hospitals. This consensus aims to reduce and prevent the spread of SARS-CoV-2 and its cross-infection between cancer patients in hospitals and provide regulatory advice and guidelines for medical personnel
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Objective: Transarterial chemoembolization (TACE) is the standard treatment for unresectable intermediate hepatocellular carcinoma. Drug-eluting beads (DEB)-TACE is a promising approach expected to improve the efficiency and safety of conventional (c) TACE. However, controversy remains whether DEB-TACE performs better than cTACE. This meta-analysis aimed to compare cTACE and DEB-TACE in terms of overall survival (OS), adverse events, and response rate. Literature search was performed in PubMed, Cochrane, Embase, and Web of Science. Complete response (CR), partial response (PR), disease control (DC), stable disease (SD), OS, and major complications were compared between these two modalities. The pooled relative risk and 95% confidence interval were calculated for assessment. Six randomized controlled trials were included for further analysis after a comprehensive search. No significant difference was found in overall response at 3, 6, 9, and 12 months, CR, PR, DC (SD), OS and complications between cTACE and DEB-TACE. Conclusion: DEB-TACE had similar therapeutic effects to those of cTACE. Furthermore, major complications in both therapies were similar. The superiority of DEB-TACE over cTACE remains unclear, and further research with high-quality evidence is needed
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Objective@#To investigate the effect of thymopoietin (TMPO) gene deleted by small interfering RNA (RNAi) on the proliferation and apoptosis of lung cancer cell A549 and its mechanism.@*Methods@#TMPO siRNA was transfected into A549 cells by lipofection. The transfected siRNA control was used as a negative control, and the parent cells were used as blank control. Forty-eight hours later, the expression of TMPO in the transfected cells was detected by real-time fluorescent quantitative polymerase chain reaction (RT-PCR) and Western blot. Cell proliferation was detected by 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide (MTT) assay, cell cycle and apoptosis were detected by flow cytometry, the protein levels of proliferating cell nuclear antigen (PCNA), cleaved caspase-3, notch receptor 1 (Notch1) and mammalian rapamycin target protein (mTOR) were detected by Western blot analysis.@*Results@#The results of RT-PCR and Western blot showed that the expression levels of TMPO mRNA in the blank control group, the negative control group and TMPO siRNA transfected group were (1.01±0.11), (0.99±0.10), (0.36±0.04), respectively, the protein levels were (0.27±0.02), (0.29±0.03), (0.08±0.10), respectively. The expression levels of TMPO mRNA and protein in the transfected group were significantly lower than those in the blank control and negative control group (P<0.05). The results of MTT assay showed that the OD values of the blank control group, the negative control group and the transfected group were (0.35±0.04), (0.37±0.04) and (0.34±0.03) at 24 h of transfection, respectively. The OD values at 48 h were (0.47±0.06), (0.46±0.08), (0.37±0.04), the OD values at 72 h were (0.75±0.08), (0.73±0.07), (0.49±0.05), respectively, and the OD values at 96 h were (1.09±0.07), (1.06±0.08), (0.56±0.06). The proliferation abilities of the transfected cells at 48, 72, 96 h were significantly lower than those of the blank control and the negative control group (P<0.05). The results of flow cytometry showed that the proportion of G0/G1 phase cells in blank control group, negative control group and transfection group were (62.55±2.03)%, (61.24±3.15)%, (47.35±2.44)%, respectively. The proportion of cells in S phase were (17.12±1.31)%, (17.70±2.01)%, and (20.81±2.06)%, respectively. The proportion of cells in G2/M phase were (20.33±1.43)%, (21.06±1.52)%, (31.84±2.76)%, respectively. The proportion of cells in G0/G1 phase of transfection group was significantly lower than those of blank control and negative control group (P<0.05). The proportion of cells in G2/M phase of transfection group was significantly higher than those of blank control and negative control group (P<0.05). The apoptosis ratio of the transfection group was (34.10±2.69)%, significantly higher than (2.96±0.03)% of the blank control and (3.01±0.04)% of the negative control group (P<0.05). Western blot analysis showed that PCNA, Notch1 and mTOR proteins were down-regulated while cleaved caspase-3 protein was up-regulated in A549 cells after deletion of TMPO.@*Conclusion@#The inhibition of TMPO gene expression induced by small interfering RNA can significantly inhibit the proliferation and induce apoptosis of A549 cells, and the mechanism is associated with the inhibition of the activation of Notch1/mTOR signaling pathway.
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To systematically review the efficacy and safety of Tongmai Yangxin Pills in treatment for angina pectoris of coronary heart disease. CNKI, WanFang, VIP, SinoMed, PubMed, EMbase and the Cochrane Library databases were retrieved online to collect randomized controlled trials(RCTs) of Tongmai Yangxin Pills for angina pectoris of coronary heart disease since the establishment to November 2018. Two investigators screened out literatures independently, extracted data and assessed the risk of bias of included studies. The risk assessment of included references was made according to criteria recommended by Cochrane Handbook 5.3. Meta-analysis was then performed by RevMan 5.3 software. A total of 9 RCTs were included. The results of Meta-analysis showed that compared with the single application of chemotherapy, the combined administration with Tongmai Yangxin Pills and Western medicine could significantly improve the clinical efficacy of angina(RR=1.22, 95%CI[1.13, 1.31]), the improvement rate of electrocardiogram(RR=1.31, 95%CI[1.21, 1.42]), and the clinical efficacy of traditional Chinese medicine(TCM) syndrome(RR=1.17, 95%CI[1.02, 1.35]). Only one study reported adverse events, while 5 studies reported no adverse event. According to current evidences, in the treatment of angina pectoris of coronary heart disease, Tongmai Yangxin Pills has a better clinical efficacy in the treatment of angina pectoris of coronary heart disease in terms of the improvement rate of electrocardiogram and the clinical efficacy of TCM syndrome. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
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Humans , Angina Pectoris , Drug Therapy , Coronary Disease , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Electrocardiography , Medicine, Chinese Traditional , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND@#Syndrome is one of the most important concepts in Chinese medicine (CM) theory. However, it was not well accounted in most of randomized controlled trials (RCTs).@*OBJECTIVES@#To determine whether CM syndrome differentiation affects the treatment results, functional constipation (FC) was selected as a target disease, and MaZiRenWan (, MZRW), a classic CM formula commonly used for constipation with excessive heat syndrome, was selected for study.@*METHODS@#It is an 18-week prospective double-blinded, doubledummy RCT, including 2-week run-in, 8-week treatment and 8-week post treatment follow-up. A total of 120 FC patients diagnosed as excessive heat syndrome will be recruited from the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and the Baokang Affiliated Hospital of Tianjin University of Traditional Chinese Medicine. Patients will be randomly allocated into fixed MZRW (f_MZRW) granule group, modified MZRW (m_MZRW) granule group or bisacodyl group. For m_MZRW group, no more than two herbal granules can be added according to the syndrome differentiation for individual participants. The primary end point is the mean of complete spontaneous bowel movements (CSBMs) per week during the treatment period. Secondary end points include mean of CSBMs per week during follow-up, stool form, global symptom improvement, constipation and constipation-related symptoms assessment, CM syndrome change, and reported adverse events.@*DISCUSSION@#This trial is designed to evaluate the effectiveness of these three interventions for FC patients with the CM syndrome of excessive heat, and to determine the change of CM syndrome and the progress of disease during the treatment course. The results are important to explore whether syndrome differentiation is important for the therapeutic effect of a formula on a disease. [Trial registration: Chinese Clinical Trial Registry (Reg No. ChiCTR-TRC-13003742); protocol version: MZRW/NSFC-81173363 (2015.05.04)].
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Humans , Constipation , Diagnosis , Drug Therapy , Double-Blind Method , Drugs, Chinese Herbal , Therapeutic Uses , Medicine, Chinese Traditional , Outcome Assessment, Health Care , Prospective Studies , Randomized Controlled Trials as TopicABSTRACT
BACKGROUND: Vitrified cryopreservation is a novel method for specimen preservation, which has a potential application value in the establishment of tumor biopsy biobank. OBJECTIVE: To investigate the effectiveness of vitrified cryopreservation and the feasibility in the establishment of tumor biopsy biobank. METHODS: The fresh biopsy specimens of liver metastasis from rectal cancer were randomized into vitrified cryopreservation and control groups. Then, the biopsy specimens from each group were implanted subcutaneously into the mouse back to establish the humanized mouse xenograft model. The biological characteristics and histological changes of tumor tissues in each group were detected by Calcein-AM/Hoechst33342 staining, as well as immunohistochemistry and hematoxylin-eosin staining. Totally 105 biopsy tissues of liver metastasis from rectal cancer were preliminarily collected and cryopreserved to establish the tumor biopsy biobank. RESULTS AND CONCLUSION: No significant differences in biological viability or histological features of tumor biopsy was detected before and after cryopreservation (P > 0.05), suggesting that vitrified cryopreservation can effectively preserve tumor biopsy and is favorable for the establishment of tumor biopsy biobank.
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Objective:To investigate the role of NRF2 pathway in the drug resistance to sorafenib in hepatocellular carcinoma (HCC).Methods:Two sorafenib-resistant cells HepG2-SR and Huh7-SR were established by incubating human HCC HepG2 and Huh7 cells at a increasing concentration of sorafenib,and verify resistant cell properties by detecting the cell apoptosis.The levels of NRF2 were detected by Western blot and Real-time PCR.SiRNA was used to silence NRF2,then the cell apoptosis were detected by flow cytometry to explore the effect of reversing the drug resistance and synergy in combination with sorafenib.Results:Sorafenib induced pro-apoptosis effect was significantly in Huh7 and HepG2 cells than the corresponding Huh7-SR and HepG2-SR cells.The NRF2 expression levels were significantly higher in sorafenib-resistant cells and the parental cells treated with sorafenib than the corresponding untreated parental cells,while the NFR2 mRNA expression levels were no significant.When in combination with sorafenib,NRF2 siRNA showed the synergistic effect in inducing cell apoptosis in sorafenib-resistant cells and parental cells.Conclusion:NRF2,activated by post-transcriptional level after sorafenib exposure,is responsible for the drug resistance to sorafenib in HCC.Inhibiting NRF2 could reverse the drug resistance to sorafenib in HCC.
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<p><b>BACKGROUND</b>It is currently believed that triple oral antithrombotic therapy in patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI) should be recommended if there are no contraindications. However, selecting triple therapy for AF patients undergoing PCI is still challenging when bleeding risk is considered. This study aimed to investigate the current use of oral anticoagulants (Vitamin K antagonists [VKA]) and perform prognostic analysis in real-world patients with AF undergoing coronary stenting.</p><p><b>METHODS</b>A total of 276 consecutive coronary artery disease (CAD) patients with or without AF undergoing coronary stenting were retrospectively evaluated and analyzed. The univariate and multivariate analyses were conducted to explore the current use of VKA and prognosis of patients with AF undergoing coronary stenting. The primary end-point was composite of all-cause death, nonfatal recurrent myocardial infarction, stroke, serious bleeding events, unplanned repeat revascularization, and worsening heart failure at 12-month follow-up after coronary stenting.</p><p><b>RESULTS</b>AF patients undergoing coronary stenting have more clinical concomitant diseases. Only 9.0% AF patients after coronary stenting received triple antithrombotic therapy (VKA, aspirin, and clopidogrel) at discharge. AF was independently associated with increased risk of the 12-month composite end-points (relative risk = 5.732, 95% confidence interval 1.786-18.396, P = 0.003).</p><p><b>CONCLUSIONS</b>In real-life AF patients undergoing coronary stenting, guideline-recommended VKA was less used. AF patients had adjusted worse prognosis during 12-month follow-up after discharge. It is of utmost importance to improve the current status of oral anticoagulants use.</p>
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Objective To investigate the feasibility,safety and effectiveness of percutaneous biliary stenting combined with brachytherapy in treating unresectable Klatskin's tumor,and to discuss the effect of this combination treatment on jaundice recurrence and survival.Methods The clinical data of 21 patients with unresectable Klatskin's tumor (combination group),who were admitted to Department of Interventional Oncology,Shanghai Renji Hospital during the period from February 2014 to December 2015 to receive percutaneous biliary stenting combined with brachytherapy,were retrospectively analyzed;and other 28 patients,who were admitted to hospital to receive pure biliary drainage or bare metal stent implantation during the same period,were collected and used as the control group.The success rate of operation,the effect of reducing jaundice and postoperative complication rate were calculated,and the differences in survival time and jaundice recurrence time were compared between the two groups.Results A total of 32 bare metal stent sand 580 125I seeds were implanted in the 21 patients of the combination group,the success rate of operation was 100％,and the effective rate of treatment was 85.7％.The early postoperative complication rate was 9.5％,and no procedure-related death occurred.The median jaundice recurrence time in the combination group was 344 days,while it was 193 days in the control group (P=0.035).The median survival time in the combination group was 387 days,which was strikingly longer than 256 days in the control group (P=0.022).Conclusion For the treatment of unresectable Klatskin's tumor,percutaneous biliary stentingcombined with brachytherapy,used as a palliative therapeutic regimen,is safe,effective and feasible,it can delay the recurrence of jaundice and prolong the survival time.(J Intervent Radiol,2017,26:243-248)
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Objective:To explore the relationship between YKL-40 and the proliferation of breast cancer and its mechanism.Methods:The expression of YKL-40 in breast cancer MCF-7 cells was detected by immunofluorescence assay.Fluorescence microscope was used to observe the conversion efficiency,and Real-time PCR was used to screen the most effective YKL-40 siRNA.Expression levels of PI3K,P-PI3K,AKT,P-AKT of the PI3K/AKT pathway associated proteins was test by Western blot.At the same time,MTT and flow cytometry were validated by YKL-40 siRNA treatment of human breast cancer MCF-7 ceils,the differences of 24h,48h and 72h groups of cell proliferation ability and cell cycle.Result:MCF-7 cell express YKL-40 protein,mainly located in the cytoplasm.Real-time PCR show that siRNA01,siRNA02,siRNA03 compared with NC group YKL-40 gene silencing effect is remarkable.Among of them the strongest silencing effect is siRNA02 (P＜0.01),Western blot show the experimental group than the control group,Total PI3K and AKT remain unchanged while P-PI3K,P-AKT expression decreased (P＜0.05).In the experimental group,the number of G1 cells in the control group was increased (P＜0.01),while the S phase cells decreased (P＜0.01).MTT results showed that the experimental group compared with the control group,the proliferation ability is decreased(P＜0.01).Conclusions This study suggests that YKL-40 can be used as the upstream regulatory factor of PI3K/AKT signaling pathway and affect the process of cell cycle in breast cancer,and then regulate the proliferation of breast cancer,YKL-40 may be a crucial target for the treatment of breast cancer.
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Objective To compare the efficacy of arterial stenting with that of traditional B -T shunt for neo-natal pulmonary atresia with intact ventricular septum.Methods Twenty -six cases of neonatal pulmonary atresia with intact ventricular septum were treated at Children′s Hospital of Zhengzhou from December 2005 to December 201 5,aged 3 to 23 days[(8.20 ±4.80)days],and weighted 2.80 -3.88 (3.41 ±0.27)kg.Accompanied with pulmonary hypo-plasia,all these patients were combined with PDA and ASD or PFO.Before operation,the peripheral oxygen saturation was kept in 61 % -75%,averaged at 67%.Among them,1 2 cases underwent arterial catheter stenting,and 1 4 cases re-ceived B -T shunt (including modified B -T shunt and central shunt)ductus ligation.After operation,the oxygen satu-ration in these children was observed,and they were examined by echocardiography and true lateral chest X -ray,blood flow situations in stents and shunts were assessed,and follow -up examinations were conducted in 1 ,3,6 and 1 2 months postoperatively.Results Stents were successfully inserted into these 1 2 cases.After traditional pulmonary shunt,pa-tients′peripheral oxygen saturation was (82.73 ±5.59)%,compared with that of patients after arterial catheter sten-ting (86.1 8 ±3.1 9)%,there was significant difference(t =1 0.71 ,P <0.05).In pulmonary shunt group,2 cases died,1 case died of postoperative heart failure,and the other case was complicated with pulmonary infection and died of respiratory failure;in catheter stent group,1 case was complicated with postoperative supraventricular tachycardia and recovered after drug intervention.For the follow -up examinations 1 ,3,6 and 1 2 months after the operation,1 case of B -T shunt in pulmonary shunt group was improved by central shunt due to slow blood flow,less shunt volume,and ox-ygen saturation decreased to 69%.For the catheter stent group,1 case was improved by stent balloon dilatation due to declined peripheral oxygen saturation 2 months postoperatively,and after the operation,transcutaneous oxygen saturation was improved.No patients died in the catheter stent group.Conclusions In traditional B -T shunts,the operation is extensive,and complications are common,and the recovery turns slowly.Arterial catheter stenting can be used as the preferred method of treatment for one -stage surgical pulmonary atresia with intact ventricular septum to reduce the weakness feasibly and effectively.
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Objective To investigate the significance of miR-193b to biological behaviors of hepatocellular carcinoma (HCC). Methods 48 cases of HCC specimens and corresponding adjacent tissues were collected, and the miR-193b expression levels in these specimens were measured by real-time quantitative PCR. The miR-193b expression was measured by the same way in HepG2 and SMMC-7721 cells. The HepG2 and SMMC-7721 were transfected with miR-193b mimics or negative control miRNA mimic with Lipofectamine 2000, and the non-transfected cells were taken as blank control. The proliferation ability of the HCC cells were detected by MTT method, and the apoptosis rate was tested by flow cytometry. Results The expression level of miR-193b in HCC tissues (2.441 ±0.569) was significantly lower than that in the corresponding adjacent tissues (15.488±4.326) (P < 0.05). Compared with normal liver cell line L-O2, the expression levels of miR-193b were significantly lower in HepG2 and SMMC-7721 cells. Transfected with miR-193b mimic, the proliferation ability of HepG2 and SMMC-7721 cells were reduced, while their apoptosis were increased. Conclusion miR-193b may be negative to regulate the proliferation of HCC and increase its apoptosis.