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Objective To study the influencing factors,treatment and prevention of venous thromboembolic (VTE) in elderly patients with malignant tumor.Methods The clinical findings in forty elderly patients with malignant tumor combined with VTE from our hospital within 5 years were analyzed retrospectively.The risk,site,time,prevention and treatment of VTE in these tumor patients were analyzed and summarized.Results After active treatment,the positive efficacy response was obtained in 26 cases (65.0％),no-response in 14 cases (35.0％).Specifically,14 cases died,7 cases cured,and 19 cases were improved.Besides cancer and aging,the elderly tumor patients were considered as the high-risk group because of the risk factors including hypertension,diabetes,hyperlipidemia,pulmonary infection,surgery,radiation,chemotherapy and so on.D-dimer level was significantly increased in elderly malignant tumor patients with VTE.Venous thrombosis could occur at any stage.Venous thrombosis was found before tumor in 1 case.The most common site of DVT was the lower limbs,especially the left lower extremities (14 cases,35％).Most of internal carotid vein and upper limb vein thrombosis were associated with peripherally inserted central catheter (PICC) Conclusions The elderly patients with malignant tumor is the extremely high risk groups for venous thrombosis,and their quality of life and survival will be seriously impacted.Anticoagulant therapy through the whole process of treatment in patients with VTE is beneficial.The prevention and treatment of VTE play an important role in the tumor patients with risk factors such as chronic diseases,high D dimer level,radiation and chemotherapy,which should attract the attention of clinicians.
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This study investigated the tight junction (TJ) protein expression of the intestinal mucosa in a rat tail-suspension model under simulated weightlessness. Twenty-four Wistar rats were randomly divided into three groups: CON group (n=8), control; SUS-14 d group (n=8), tail-suspension for 14 days; SUS-21 d group (n=8), tail-suspension for 21 days. Occludin and Zonula Occluden-1 (ZO-1) expression levels were determined by immunohistochemical analysis and mRNA fluorescent quantitative PCR. Plasma levels of diamine oxidase (DAO) and d-lactate were determined using enzymatic spectrophotometry. Immunohistochemical results for occludin and ZO-1 showed disruption of the TJs in the intestinal mucosa in SUS-14 d and SUS-21 d groups. The expression levels of occludin and ZO-1 in SUS-21 d group were lower than those in SUS-14 d group, and significantly lower than those in CON group (Occldin: 0.86±0.02 vs 1.01±0.03 vs 1.63±0.03 and ZO-1: 0.82±0.01 vs 1.00±0.02 vs 1.55±0.01, P<0.01). Moreover, the levels of plasma DAO and d-lactate in SUS-21 d group were higher than those in SUS-14 d group, and significantly higher than those in CON group (DAO: 27.58±0.49 vs 20.74±0.49 vs 12.94±0.21 and d-lactate: 37.86±0.74 vs 28.26±1.01 vs 17.76±0.91, P<0.01). There were significant negative correlations between occludin or ZO-1 expression levels and DAO (r (2)=0.9014, r (2)=0.9355, P<0.01) or d-lactate levels (r (2)=0.8989, r (2)=0.9331, P<0.01). Occludin and Zo-1 were reduced in intestinal mucosa both in mRNA and protein levels in the rat tail-suspension model. The significant negative correlations between expression levels of TJs and plasma levels of DAO or d-lactate support the hypothesis that intestinal permeability is increased due to a decrease in TJ protein expression during tail-suspension from 14 days to 21 days.
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Objective To explore the clinical application value of proton magnetic resonance spectroscopy (1H-MRS) in the metabolism of the hippocampus in non-demented Parkinson's disease(PD) patients. Methods 1H-MRS localized to both hippocampus,was carried out in 36 non-demented PD (14 patients with Hoehn-Yahr stage Ⅰ,8 patients with Hoehn-Yahr stage Ⅱ,8 patients with Hoehn-Yahr stage Ⅲ ,and 6 patients with Hoehn-Yahr stage Ⅳ) and 20 age-matched healthy control subjects. The metabolite ratios of N-acetylasparatate (NAA)/creatine (Cr),and choline-containing compounds (Cho)/Cr in PD patients were compared with those in the age-matched healthy control subjects. Results NAA/Cr ratios were reduced significantly and Cho/Cr ratios were increased sig-nificantly in both hippocampus of patients with Hoehn-Yahr stage Ⅳ compared to those in the age-matched healthy control subjects (P<0.05). However,no significant differences in NAA/Cr and Cho/Cr ratios were found between patients with Hoehn-Yahr stage Ⅰ-Ⅲ and the age-matched healthy control subjects (P>0.05). Conclusion 1H-MRS can provide the metabolic information ,and reflect the pathological changes of nerve cell in the hippocampus of non-demented PD patients with Hoehn-Yahr stage Ⅳ. It is helpful to predict the risk of dementia in PD.
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Objective To explore the changes and its clinical significance of frontal lobe magnetic resonance spectroscopy(1H-MRS) in patients with Parkinson's disease(PD).Methods 1H-MRS localized to both frontal lobe,was carried out in 36 patients with PD(14 patients with Hoehn-Yahr stageⅠ,8 patients with Hoehn-Yahr stage Ⅱ,8 patients with Hoehn-Yahr stage Ⅲ,and 6 patients with Hoehn-Yahr stage Ⅳ) and 20 age-matched healthy control subjects.The metabolite ratios of N-acetylasparatate(NAA)/creatine(Cr),and choline-containing compounds(Cho)/Cr in patients with PD on different stage were compared with those in normal control group.Results NAA/Cr ratios were reduced significantly and Cho/Cr ratios were increased significantly in both frontal lobe in patients with Hoehn-Yahr stageⅢ and Ⅳ compared to those in normal control group(P
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AIM To observe the effect of intravenous injection of erythromycin (EM) on interdigestive migrating motor complex (MMC) and postprandial gastrointestinal contraction in conscious dogs , and to study its possible mechanism. METHODS Gastrointestinal contractile activity was recorded using low compliance capillary water perfusion manometric system. EM was administered intravenously during phaseⅠ and after meal, and blood samples were drawn for measuring plasma motilin concentrations. RESULTS ①Plasma motilin levels showed cyclical fluctuations in different phases of MMC, and plasma motilin reached peak during phaseⅢ and lowest during phaseⅠ.②EM induced phaseⅢ-like contractions in the antrum and duodenum, which was not accompanied by a peak in plasma motilin level. The optimum dose of EM for resulting in a premature phaseⅢ with the same characteristics as the spontaneously occurring phaseⅢ was established to be 0.5 mg*kg-1. The dose of 10 mg*kg-1 EM induced gastrointestinal continuous contractions and duodeno-gastric retrograde peristalsis which was associated with retching and vomiting. ③Atropine obviously inhibited EM-induced phaseⅢ activity in the antrum and duodenum. ④EM powerfully enhanced postprandial gastrointestinal contractile activity. CONCLUSIONS The results suggests that EM is a potent prokinetic agent. The mechanism is not related to the release of motilin, but may be mediated partially by cholinergic pathway.
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AIM To observe the effect of intra- venous injection of erythromycin (EM) on interdigestive migrating motor complex (MMC) and postprandial gastrointestinal contraction in conscious dogs, and to study its possible mechanism. METHODS Gastrointestinal contractile activity was recorded using low compliance capillary water per fusion manometric system. EM was administered intravenously during phase I and after meal, and blood samples were drawn for measuring plasma motilin concentra- tions. RESULTS ①Plasma motilin levels showed cyclical fluctuations in different phases of MMC, and plasma motilin reached peak during phaseⅢ and lowest during phase Ｉ. ②EM induced phase Ⅲ -like contractions in the antrum and duodenum, which was not accompanied by a peak in plasma motilin level. The optimum dose of EM for resulting in a premature phaseⅢ with the same characteristics as the spontaneously occurring phaseⅢ was established to be 0. 5 mg.kg-1. The dose of 10 mg.kg-1 EM induced gas- trointestinal continuous contractions and duodeno-gas-tric retrograde peristalsis which was associated with retching and vomiting. ③Atropine obviously inhibited EM-induced phase Ⅲ activity in the antrum and duodenum. GEM powerfully enhanced postprandial gastrointestinal contractile activity. CONCLUSIONS The results suggests that EM is a potent prokinetic agent. The mechanism is not related to the release of motilin, but may be mediated partially by cholinergic pathway.