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ABSTRACT BACKGROUND: Transcatheter arterial chemoembolization (TACE) is thought to prevent recurrence of hepatocellular carcinoma (HCC), but its efficacy is a matter of controversy. OBJECTIVES: We investigated the effect of preventive TACE on the tumor, nodes, metastasis (TNM) classification in cases of stage II HCC (T2N0M0) after R0 resection. DESIGN AND SETTING: Case-control study conducted in a tertiary-level public hospital. METHODS: We analyzed recurrence rates and mortality rates over time for 250 consecutive cases of HCC in TNM classification cases of stage II HCC (T2N0M0) after R0 resection. These cases were divided into patients who underwent TACE (TACE+) and presented microvascular invasion (MVI+; n = 80); TACE+ but did not present MVI (MIV−; n = 100); MVI+ but did not undergo TACE (TACE−, n = 30); and TACE−/MVI− (n = 40). RESULTS: MVI+ patients in the TACE+ group had significantly lower recurrence rates and mortality rates at one, two and three years than those in the TACE- group (all P < 0.05). Among MVI- patients, the TACE+ group did not have significantly lower recurrence rates and mortality rates at one, two and three years than the TACE- group (all P > 0.05). Regardless of whether TACE was performed or not, MVI− patients had significantly lower recurrence rates and mortality rates at two and three years after their procedures than did MVI+ patients (all P < 0.05). CONCLUSION: Recurrence rates and mortality rates for MVI+ patients were significantly higher than for MVI− patients, beyond the first year after TACE. Postoperative adjuvant TACE may be beneficial for HCC patients with MVI.
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Humans , Chemoembolization, Therapeutic , Carcinoma, Hepatocellular , Liver Neoplasms , Case-Control Studies , Retrospective Studies , Neoplasm Invasiveness , Neoplasm Recurrence, LocalABSTRACT
@#Objective To investigate the effect of CYP2C9 and APOE on the dose of stable warfarin and model prediction in Hainan population. Methods From August 2016 to July 2018, 368 patients who required heart valve replacement and agreed to take warfarin anticoagulation at the second department of cardiothoracic surgery in our hospital were enrolled, including 152 males aged 48.5–70.5 (60.03±10.18) years and 216 females aged 43.5–65.6 (54.24±11.35) years. CYP2C9 and APOE were amplified by polymerase chain reaction. The gene fragment was sequenced by the Single Nucleotide Polymorphisms (SNP) site. The patients' age, sex, weight, history of smoking and drinking, and the dose of stable warfarin were recorded. Regression analysis of these clinical data was made to construct a dose prediction model. Results Among 368 patients, CYP2C9 genotype test results showed 301 patients (81.8%) with *1*1 genotype, and 67 patients (18.2%) with *1*3 type. For different CYP2C9 genotype patients, the difference was statistically significant in the dose of stable warfarin (P<0.05). The results of APOE genotype showed 93 patients (25.3%) with E2 genotype, 221 patients (60.1%) with E3 genotype, and 54 patients (14.7%) with E4 genotype; the dose of stable warfarin in patients with different APOE genotypes was statistically significant (P<0.05). Multiple regression analysis showed that patients' age, body weight, and CYP2C9 and APOE genotypes were correlated with the dose of stable warfarin. The correlation coefficient R2 was 0.572, and the prediction model was statistically significant (P<0.05). Conclusion CYP2C9 and APOE gene polymorphisms exist in Hainan population. There is significant difference in the dose of stable warfarin among different genotypes of patients. The model to predict stable warfarin can partly explain the difference of warfarin among different patients.
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Objective: To investigate the effects of dexamethasone on transforming growth factor [TGF]-beta1/Smads signaling pathway in benign biliary stricture [BBS] fibroblasts
Study Design: An experimental study
Place and Duration of Study: Guizhou Medical University, Guiyang, Guizhou, China, from January to August 2016
Methodology: Fibroblasts derived from rabbit BBS model were cultured and identified, then treated by different concentration of dexamethasone [0.02, 0.1 and 0.5 mg/ml]. Dexamethasone-treated cells and non-treated control groups were incubated respectively for 48 hours. Cell proliferation was assessed using cell counting kit-8. Relative mRNA expression of TGF-beta1, Smad4 and Smad7 were assessed by quantitative RT-PCR. Protein expression of TGF-beta1 and Smad4 were investigated by Western blotting
Results: Treatment with dexamethasone significantly inhibited the proliferation of BBS fibroblasts, significantly attenuated both the mRNA and protein expression of TGF-beta1 and Smad4, and significantly up-regulated the mRNA expression of Smad7 in BBS fibroblasts [all p<0.05, 0.1-0.5 mg/ml], and exhibited in a dose-dependent manner
Conclusion: TGF-beta1/Smads signaling pathway may play an important role in BBS progression; dexamethasone significantly altered the expression of TGF-beta1/Smads signaling pathway and significantly inhibited cell proliferation in rabbit BBS fibroblasts. Therefore, dexamethasone may be a therapeutic option for the prevention of BBS
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BACKGROUND:Lithium chloridecan promote the proliferation and osteogenic capacity of bone marrow mesenchymal stem cels in the necrotic region after avascular necrosis of the femoral head, which has become an issue of concern. OBJECTIVE:To compare the advantages and disadvantages of bone marrow stem cel transplantation combined with lithium chloride in the treatment of rabbit femoral head necrosis. METHODS: Passage 2 bone marrow mesenchymal stem cels from 1-week-old New Zealand rabbits were cultured in 0, 5, 10, 20, 40 mmol/L lithium chloride. Forty-eight healthy adult New Zealand rabbits were selected to make femoral head necrosis models in the right femoral head using liquid nitrogen freezing method and then randomized into four groups: model group with no implantation; lithium chloride group given lithium chloride treatment at 3 days after modeling; cel transplantation group given gelatin sponge implantation and bone marrow mesenchymal stem cel suspension injection into the femoral head after modeling; combined group given bone marrow mesenchymal stem cel suspension injection and lithium chloride treatment. Intraperitoneal injection of lithium chloride (45.2 mg/kg) was given daily beginning at the postoperative 3rdday, and the treatment duration was 4 weeks. RESULTS AND CONCLUSION:Lithium chloride at 10 mmol/L had the maximum effect on the proliferation of rabbit bone marrow mesenchymal stem cels, and if the concentration of lithium chloride was > 10 mmol/L, the promotion role of lithium chloride began to decline. After combined treatment, the morphology of the femoral head was restored a little, with increased bone density and thickened trabecular bone; the level of β-catenin in the femoral head was significantly increased in the combined group compared with the cel transplantation group or the lithium chloride group. These findings show that bone marrow stem cel transplantation combined with lithium chloride treatment can promote the recovery from femoral head necrosis by increasing bone mass of the trabecular bone and bone density of the femoral head in the necrotic region.
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Objective: To investigate the effects of tetramethylpyrazine [TMP] on transforming growth factor-beta1 [TGF- beta1], alpha-smooth muscle actin [alpha-SMA], and neuronal regeneration related protein [P311] in benign biliary stricture fibroblasts of rabbit. Study Design: An experimental study. Place and Duration of Study: Guizhou Medical University, Guiyang, Guizhou, China, from April to December 2015
Methodology: Fibroblasts isolated from rabbits following benign biliary stricture were cultured and treated with different concentrations of TMF [0.08, 0.4. and 2.0 mg/ml]. TMP-treated cells and non-treated control groups were incubated for 48-hours, and proliferation was assessed using the cell counting kit-8 assay. The mRNA expressions of TGF-beta1, alpha-SMA, and P311 were assessed by quantitative RT-PCR. Protein expressions of TGF-beta1 and alpha-SMA were investigated by Western blotting
Results: Treatment with TMP significantly reduced the proliferation of benign biliary stricture fibroblasts, and significantly attenuated both the mRNA and protein expressions of TGF-beta1, alpha-SMA, and P311 [p <0.05] in a dose-dependent manner
Conclusion: TMP significantly reduced the proliferation of benign biliary stricture fibroblasts, and significantly down- regulated the mRNA/protein expression of TGF-beta1, alpha-SMA, and P311. Therefore, TMP may be a therapeutic option for the prevention of benign biliary stricture
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BACKGROUND:Previous therapies for diabetic foot are not ideal with large cost, and moreover, amputation is often required. OBJECTIVE: To perform the Ilizarov bone transport in the treatment of patients with diabetic foot (Wanger grades 3-4), and to observe the limb salvage conditions. METHODS: Eighteen patients with diabetic foot, Wanger grades 3-4, admitted in the Department of Bone and Joint Surgery, First Affiliated Hospital of Guangxi Medical University from December 2013 to June 2015 were enroled in this trial. Al of patients were subjected to Ilizarov bone transport. RESULTS AND CONCLUSION: Al the 18 patients were folowed up for 3 to 20 months, and presented with ulcer healing. Scores on ankle-brachial index and 10-g nylon line test were both increased significantly in the patients after treatment, but the visual analog scale scores were reduced. These findings indicate that the Ilizarov bone transport is an effective method for treating ulcer of diabetic foot at Wanger grades 3-4.
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MicroRNAs (miRNAs) are a family of non-coding RNA that are able to adjust the expression of many proteins, including ATP-binding cassette transporter and organic cation transporter. We sought to evaluate the effect of miR-511 on the regulation of OATP1B1 expression by free fatty acids. When using free fatty acids to stimulate Chang liver cells, we found that the expression of miR-511 increased significantly while the expression of OATP1B1 decreased. We also proved that SLCO1B1 is the target gene of miR-511 with a bioinformatics analysis and using the dual luciferase reporter assay. Furthermore, the expressions of SLCO1B1 and OATP1B1 decreased if transfecting Chang liver cells with miR-511, but did not increase when transfecting the inhibitors of miR-511 into steatosis cells. Our study indicates that miR-511 may play an important role in the regulation of OATP1B1 expression by free fatty acids.
Subject(s)
Humans , Computational Biology , Fatty Acids, Nonesterified , Liver , Luciferases , MicroRNAs , RNA, UntranslatedABSTRACT
A 34-year-old man admitted to our department with complex blunt pancreaticoduodenal injury after a car accident. The wall of the first, second, and third portions of the duodenum was extensively lacerated, and the pancreas was longitudinally transected along the superior mesenteric vein-portal vein trunk. The pancreatic head and the uncinate process were devitalized and the distal common bile duct and the proximal main pancreatic duct were completely detached from the Vater ampulla. The length of the stump of distal common bile located at the cut surface of remnant pancreas was approximately 0.6 cm. A simplified Kausch-Whipple's procedure was performed after debridement of the devitalized pancreatic head and resection of the damaged duodenum in which the stump of distal common bile duct and the pancreatic remnant were embedded into the jejunal loop. Postoperative wound abscess appeared that eventually recovered by conservative treatment. During 16 months follow-up the patient has been stable and healthy. A simplified pancreaticoduodenectomy is a safe alternative for the Whipple procedure in managing complex pancreaticoduodenal injury in a hemodynamically stable patient.
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Adult , Humans , Male , Accidents, Traffic , Duodenum , Wounds and Injuries , Pancreas , Wounds and Injuries , Pancreaticoduodenectomy , Methods , Wounds, Nonpenetrating , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To study the effects of pulsed magnetic field on insulin-like growth factor-1 (IGF-1) level in the cerebrospinal fluid (CSF) and the association of IGF-1 alterations with the activities of daily living (ADL) of patients with brain injury.</p><p><b>METHODS</b>Sixty-five patients with brain injury were divided randomly into the control group (n=30) and magnetic therapy group (n=35), both receiving conventional therapy and in the latter group, daily pulsed magnetic field treatment (20-40 mT, 50 Hz, 20 min per time, 1 time per day) for 14 consecutive days were administered. On the first and 14th days of the treatment, 2 ml CSF was collected from the cases patients for IGF-1 measurement by radioimmunoassay, and Barthel index (BI) was used to assess the ADL of the patients.</p><p><b>RESULTS</b>After a 14-day treatment, IGF-1 level in the CSF were significantly increased in the magnetic group in comparison with the level before the treatment and with those in the control group (P<0.05). IGF-1 in the CSF underwent no significant changes in the control group (P>0.05). The scores of BI increased significantly in both groups after the treatment (P<0.01), but the increment was more obvious in the magnetic therapy group (P<0.05). A significant positive correlation was found between IGF-1 level in the CSF and BI in these patients (r=0.283, P=0.022).</p><p><b>CONCLUSION</b>Pulsed magnetic field might increase IGF-1 level in the CSF of patients with brain injury to promote the recovery of the patients ADL, suggesting its potential clinical value in the treatment of brain injury.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Brain Injuries , Cerebrospinal Fluid , Rehabilitation , Therapeutics , Insulin-Like Growth Factor I , Cerebrospinal Fluid , Magnetic Fields , Recovery of FunctionABSTRACT
Objective To evaluate surgical indications and methods for regional pancreatoduodenectomy combined with blood vessel reconstruction. Method Eight patients underwent pancreatoduodenectomy combined with superior mesenteric vein and portal vein (SMV/PV) resection and reconstruction from May 2001 to December 2004,respectively. Results The overall mortality was 0 during perioperative period,no complications occurred. Histological specimen examinations demonstrated adenocarcinoma of pancreas head in all patients. The resected endothelium or margins of the blood vessel and pancreas were microscopically tumor free in all cases. Patients were followed-up from six months to four years.Two patients were died within one year. Four patients had survived for more than two years. Conclusion Regional pancreatoduodenectomy combined with blood vessel reconstruction could increase tumor resection rate in properly selected patients, and could be performed safely without increased morbidity and mortality.
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<p><b>OBJECTIVE</b>To investigate the relationship between mRNA expression of inducible nitric oxide synthase (iNOS) and organ injury, and the effect of Salviae Miltiorrhizae on iNOS mRNA in severe acute pancreas (SAP) rats.</p><p><b>METHODS</b>Forty-five Wistar rats were randomly divided into 3 groups, the model group (MG), the Salviae Miltiorrhizae group (SMG), and the control group (CG), with 15 rats in each group. Rats in MG and SMG were established to SAP model by intraductal injection with 5% sodium taurocholate in a dose of 1.0 ml/kg, while rats in CG were merely performed sham-operation. Immediately after modeling, rats in SMG were injected with Salviae Miltiorrhizae injection (SMI) 2 ml/kg every 6 h for 4 times in total, but to rats in other two groups same volume of normal saline were administered. The level of serum amylase (AMY), nitric oxide (NO) and the volume of ascites of rats were determined 24h after modeling, and intensity of iNOS mRNA expression in pancreas, lung and kidney were detected in the same time using in situ hybridization and image analysis. The pathologic change was observed as well.</p><p><b>RESULTS</b>The volume of ascites and serum levels of AMY and NO in MG were significantly higher then those in SMG and CG (P < 0.05 and P <0.01). The expression of iNOS mRNA in pancreas, lung and kidney increased in MG and SMG, it was significantly higher in MG than that in SMG. And the pathological change of pancreas, lung and kidney in SMG was milder than that in MG.</p><p><b>CONCLUSIONS</b>Over-expression of iNOS mRNA could cause excessive synthesis of NO, and lead to injury of pancreas, lung and kidney in SAP. Salviae Miltiorrhizae in early stage of the disease can inhibit the over-expression of iNOS mRNA to ameliorate the injury of the pancreas, lung and kidney.</p>