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Objective To compare the therapeutic effect of preoperative chemoradiotherapy or postoperative adjutant chemoradiotherapy for locally advanced rectal cancer.Methods The clinical data of 76 patients with locally advanced rectal cancer from 2011 to 2016 in Guizhou Provincial People's Hospital were retrospectively analysed.A total of 30 cases received preoperative chemoradiotherapy (group A),5 of them received concurrent chemoradiotherapy combined with bevacizumab target treatment.The other 46 cases (group B) were given post-operative adjutant chemoradiotherapy.Both group A and group B were treated with intensity-modulated radiation therapy (IMRT).The chemoradiotherapy regime was as follows:the median of target volume dose was 50.4 Gy (45.0-55.8 Gy);the median of chemotherapy sessions was 26 times (24-28 times).Capecitabine tablets (825 mg/m2,twice a day) were also given on the date of chemotherapy.The clinical data and follow-up results of all patients were compared between the two groups.Results The five-year disease free survival rates of group A and group B were 66.7％ and 57.7％,respectively;and the five-year overall survival rates of group A and group B were 81.8％ and 73.0％,respectively,no statistically significant difference was found between the two groups (P=0.599,0.489).The anus-preserving rates of patients with tumor below peritoneal reflection in group A and group B were 56.52％ and 25.00％,there was statistically significant difference (P=0.045).In the group A,86.6 ％ patients resulted in down-staging,including 3 cases with complete pathologic response.Conclusion Preoperative chemotherapy could down tumor stage and improve rates of anal preservation and local control without increasing possibility of postoperative complications.Preoperative chemotherapy in combination with bevacizumab target treatment may be more effective in lowering tumor stage.
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ResumenJustificación y objetivo: el virus de inmunodeficiencia humana induce una activación inmune crónica que lleva a la progresión de la enfermedad por VIH. Estudios en primates han demostrado que el desarrollo de una infección retroviral patológica está determinada tanto por la respuesta del sistema inmunitario al virus, como por sus propiedades citopáticas. Esta revisión pretende resumir los conocimientos actuales acerca de los principales mecanismos envueltos en la activación inmune crónica durante la infección por VIH y sus repercusiones en la inmunidad virus-específica.Metodología: las referencias bibliográficas se obtuvieron en la base de datos PubMed. Se incluyeron todos los artículos publicados en lengua inglesa entre 1990 y 2016, hallados bajo las palabras clave "immunopathology and hiv" e "immune activation and hiv".Revisión:se discute la influencia de la inflamación persistente sobre el establecimiento de la enfermedad por VIH y la generación de condiciones patológicas no relacionadas con la infección. Tratamientos dirigidos a modular la inflamación podrían retardar el progreso de la enfermedad y reducir los daños colaterales de la estimulación inmunológica inducida por VIH.Conclusión: la evidencia parece indicar que la activación inmune crónica es la principal causa de la depleción de células T CD4+, la pérdida de inmunidad específica contra el virus y el establecimiento de enfermedades no relacionadas directamente con la infección viral en pacientes que reciben terapia antiretroviral.
AbstractBackground and purpose: The human immunodeficiency virus (HIV) induces chronic immune activation that leads to the worsening of HIV infection. Studies in primates have shown the development of pathological retroviral infection by immune system's response against the virus and its cytopathic properties. This review summarizes current facts about the main mechanisms of HIV chronic immune activation and its virus-related impairment on immunity.Methods: The references were obtained in the PubMed database, under the keywords: "immunopathology and HIV" and "immune activation and HIV". Also, all papers reviewed are in English and were published between 1990 and 2016.Review: Discussion of the persistent inflammation that establish the development of HIV disease and pathological conditions not directly related to HIV infection. Therefore, the treatments aimed to modulate inflammation could slow the disease progression and minimize collateral damage from HIV immune stimulation.Conclusion: Evidence suggests that chronic immune activation is the major cause of CD4+ T-cell depletion, loss of virus-specific immunity and the establishment of diseases not directly related to viral infection in patients on antiretroviral treatment.
Subject(s)
Humans , Acquired Immunodeficiency Syndrome/immunology , HIVABSTRACT
Justificación: la uveítis es un proceso de inflamación intraocular de etiologías muy diferentes, que representa una importante causa de pérdida visual a nivel mundial. Es fundamental para el personal médico reconocer síntomas y signos clínicos de inflamación del tracto uveal, pues la pronta referencia al especialista en Oftalmología es un factor determinante en la evolución y el pronóstico de la enfermedad. En Costa Rica no se había publicado hasta la fecha ningún registro de pacientes con uveítis y la casuística nacional se desconoce.Objetivos:describir las características y cuadros clínicos de los pacientes con uveítis no infecciosas referidos a la Clínica de Uveítis del Hospital México, entre 2010 y 2013.Métodos:estudio retrospectivo de 58 pacientes referidos desde enero de 2010 hasta septiembre de 2013, a la Clínica de Uveítis de dicho centro médico.Resultados:los adultos jóvenes constituyeron el grupo más afectado, con una media de edad de presentación de 42,6 años. Fueron referidos alrededor de 14 casos nuevos por año. La relación hombre/mujer fue de 1: 1,32. El diagnóstico de uveítis anterior fue establecido en 63.8% de loscasos. Predominaron los síndromes de etiología idiopática.Conclusión:la investigación brinda una perspectiva acerca de las principales causas de uveítis en Costa Rica, aunque la pequeña muestra de casos analizados y la naturaleza retrospectiva del estudio limitan sus aportes epidemiológicos.
Introduction: Uveitis is a major cause of vision loss worldwide. It is essential for medical personnel to recognize early clinical symptoms and signs of uveal tract inflammation, for a timely referral to an ophtalmologist for an early assessment, which is of crucial importance in the evolution and prognosis of the disease. There ir no published data about uveitis in Costa Rica and the number of patients with this condition is not knwon either.Objective: To describe the clinical characteristics of patients with uveitis referred to the Uveitis Clinic, Hospital Mexico, Costa Rica, between 2010 and 2013.Methods: Retrospective analysis of data obtained from 58 patients referred between January 1, 2010 to September 30, 2013 to the Uveitis Clinic, Hospital Mexico, Costa Rica.Results: Young adults were the largest group with uveitis with a mean age of onset at 42.6 years. A mean of 14 new cases per year were referred to the clinic. The male/female ratio for uveitis was of 1:1.32. Anterior uveitis was the most frequent condition, being diagnosed in 63.8% of cases. Mostof the cases had an idiopatic ethiology.Conclusion: This research provides a perspective on the most frequent types of uveitis in Costa Rica. Both, the small size of the sample analyzed and the retrospective nature of the study are somewhat limitation in its epidemiological value.
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Humans , Male , Adult , Female , Allergy and Immunology , Concurrent Symptoms , Costa Rica , Ophthalmology , UveitisABSTRACT
<p><b>OBJECTIVE</b>Set up a method to isolate and identify the small pulmonary arterial smooth muscle cells (PASMCs) in vitro.</p><p><b>METHODS</b>In sterile conditions, separated the male SD rat pulmonary artery, digested by collagenase I and cultured primary PASMCs. Measured cell viability; observed by phase contrast microscope; identified by immunocytochemistry and immunofluorescence staining as a label for smooth muscle alpha-actin.</p><p><b>RESULTS</b>PASMCs were identified by morphology and immunocytochemistry, immunofluorescence staining, with the cell viability is over 96.5%. The primary culture could be subcultured after 4-7 days and successfully passaged without change in morphology and growth characteristic.</p><p><b>CONCLUSION</b>This technique has advantage of the method is simple, short cultivate, good reproducibility, the primary cultured PASMCs quantity and the rapid growth.</p>
Subject(s)
Animals , Male , Rats , Arterioles , Cell Biology , Cell Separation , Methods , Lung , Muscle, Smooth, Vascular , Cell Biology , Myocytes, Smooth Muscle , Cell Biology , Primary Cell Culture , Methods , Pulmonary Artery , Cell Biology , Rats, Sprague-DawleyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effect of etodimate infusion on serum cortisol in patients undergoing radical resection of lung cancer operations during the perioperative period.</p><p><b>METHODS</b>Forty ASA I-II patients undergoing radical resection of lung cancer were randomly divided into etomidate group (Group E) and propofol group (Group P) (n=20). The serum cortisol was measured at 8:00 am (T(0)) before anesthesia, 4:00 pm (T(1)) on the day of operation and 24 h after the operation (T(2)) by radioimmunoassay.</p><p><b>RESULTS</b>Compared with that at T0, the serum level of cortisol significantly increased at 24 h after the operation in both groups (P<0.01); serum cortisol decreased lightly at T1, which was not statistically significant (P>0.05), and remained higher than the normal level. At each of the time points, serum cortisol levels were comparable between the two groups (P>0.05).</p><p><b>CONCLUSION</b>Etomidate infusion can not inhibit the synthesis of cortisol in patients undergoing radical resection of lung cancer.</p>