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Objective To investigate the efficacy of double cannula with an early oral diet as nutritional support treatment on non-high output enterocutaneous fistulas. Methods Clinical data from patients with non-high output enterocutaneous fistula, who treated with double cannula with an early oral diet (n = 39) and double cannula with enteral nutrition therapy (n = 43), were retrospectively analyzed. The fistulas status and its closure time were recorded. In order to investigate the effect of oral diet on fistula, the inflammation index and nutritional status indicators before and after therapy were recorded. Results Totally 33 cases of the 39 patients with non-high output fistula were cured after therapy on the average (16.4土7.2) days. The distal non-high output fistula patients had better results(93.1％ closed, 15.8 days)than that of the proximal fistula patients(60.0％, 19.8 days). Laboratory inflammation index(TNF-alpha, IL-6, plasma endotoxin and C-reactive protein) were improved significantly (P＜ 0.05) after therapy. The nutrition status of these patients, such as body weight, hemoglobin, serum total protein, albumin, transferrin, and prealbumin increased at the end of fistula compared to that at the beginning of treatment (P＜ 0.05). Prealbumin and retinol binding protein were significantly higher than that in the control group (P＜0.05). Conclusion With double cannula treatment, early normal eating for enteral nutrition is safe and effective, especially in distal enterocutaneous fistulas. Normal oral diet can achieve the results of fistula closure, reduction of the inflammatory reaction, improvement of the nutrition status, avoiding the infliction of the operation and lowering the cost.
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Long non-coding RNAs (lncRNAs) are a group of regulatory and non-coding RNA molecules which are longer than 200 nucleotides. They are involved in a variety of biological processes such as cell proliferation, differentiation and apoptosis mainly by regulation of gene expression at various levels, including epigenetics, transcription and post-transcription. The evidence has demonstrated that many lncRNAs are dysregulated and closely related to tumorigenesis, progression and prognosis in gastric cancer. Based on an introduction to lncRNAs and the domestic and foreign research status, this review summarizes the function, regulatory mechanisms, potential diagnostic and therapeutic values of lncRNAs in gastric cancer.
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Programmed death-1 (PD-1) and its ligand 1 (PD-L1) play critical roles in the identification and elimination of tumor cells evading the host's immune system.Tumor model in mice which is given anti-PD-L1 monoclonal antibody shows obviously host anti-tumor response.Currently,immunotherapy drugs of PD-1/PD-L1 signaling pathways receive good effects in a variety of tumors failure of the traditional method,and with less adverse reaction,which provide valuable clinical experiences in advanced tumor immunotherapy.
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Programmed death-1 (PD-1) and its ligand PD-L1 are the major members of inhibitory costimulatory molecules and express high in a variety of tumor cells and their associated cells surface,while the proportion of regulatory T cells (Tregs) are abnormally elevated in tumor infiltrating T lymphocytes cells.PD-L1 combined with PD-1 and Treg help tumors evade immune clearance,weaken immune responses and induce immune tolerance.New researches find that PD-L1 plays an important role in the development and function maintenance of inducible Treg (iTreg),and PD-L1 signal can change initial CD4 + CD25-T cells into iTreg to play a role of immunosuppression.Research on PD-1 signaling pathway can provide a new theoretical basis for the inhibition of tumor immune escape in clinical application of immunotherapy and better treatments.
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Objective To establish the mice model of immunological tolerance,and investigate the significance of haploidentical allogeneic lymphocytes infusion in induction of graft versus host disease and graft versus tumor in mice.Methods Sixty-four BALB/C female mice were randomly divided into 4 groups with 16 mice in each group.Control group:no special treatment was given after inoculation of tumor cells at the 4th day (CT26 colorectal cancer cell lines with mixture of 1 × 107/mL tumor cells suspension was inoculated to the right subcutaneous axillary of mice) ; Chemotherapy group:chemotherapy was applied at the 7th day after inoculation of tumor cells at the 4th day; DLI group:tumor cells were inoculated at the 4th day,and then haploid donor cells were infused at the 13th,15th and 17th day; Chemotherapy + DLI group:tumor cells were inoculated at the 4th day,chemotherapy was applied at the 7th day,and haploid donor cells were infused at the 13th,15th and 17th day.The pretreatment scheme included haploidentical allogeneic lymphocyte + ring ling amide + haploidentical allogeneic lymphocyte,and the chemotherapy regimen included peritoneal infusion of cyclophosphamide at the 3rd day after inoculation of tumor cells in mice.The time from the first day after vaccination to the day of death of mice and the mass of the tumors were detected to calculate the tumor inhibition rate.The clinical indexes of GVHD were observed,and clinical evaluation was made.The numbers of T lymphocytes in peripheral blood were detected by flow cytometry.Three mice were sacrificed in each group at the 15th day to make the tissue specimens,and they were observed under light microscope after HE staining.All data were analyzed using the analysis of variance or LSD-t test.Results The symptoms of GVHD of mice in the chemotherapy + DLI group were milder than those in other groups.The GVHD scores of the control group,chemotherapy group and the chemotherapy + DLI group were 2.3 ±0.6,1.5 ± 1.1,6.7 ±0.9 and 3.4 ±0.5,respectively,with significant difference between the 4 groups (F =148.68,P ＜ 0.05).The tumor masses of the control group,chemotherapy group,DLI group and the chemotherapy + DLI group were (3.40 ± 0.20) g,(0.80 ± 0.10) g,(2.20 ± 0.20) g and (0.50 ± 0.30) g,respectively,with significant difference between the 4 groups (F =149.17,P ＜ 0.05).The tumor inhibition rates of the control group,chemotherapy group,DLI group and the chemotherapy + DLI group were 0,77％ ± 9％,35％ ± 3％,85％ ± 44％.The levels of CD3 + of the control group,chemotherapy group,DLI group and the chemotherapy + DLI group were 52.3％ ± 2.9％,44.8％ ± 3.1％,62.9％ ± 3.5％,65.9％ ± 3.3％,respectively,with significant difference between the 4 groups (F =28.04,P ＜ 0.05).The levels of CD3 + CD4 + of the control group,chemotherapy group,DLI group and the chemotherapy + DLI group were 32.1％ ± 2.6％,27.1％ ± 1.1％,42.6％ ± 1.8％ and 41.7％ ± 2.4％,respectively,with significant difference between the 4 groups (F =40.29,P ＜ 0.05).The levels of CD3 + CD8 + of the control group,chemotherapy group,DLI group and the chemotherapy + DLI group were 22.7％ ± 2.2％,20.7％ ± 1.8％,26.7％ ± 0.8 ％ and 26.1％ ± 0.7％,respectively,with significant difference between the 4 groups (F =10.74,P ＜ 0.05).The levels of CD3 + CD4 + CD25 + of the control group,chemotherapy group,DLI group and the chemotherapy + DLI group were 8.7％ ±0.6％,6.6％ ±0.6％,11.2％ ±0.4％ and 13.3％ ± 0.7％,respectively,with significant difference between the 4 groups (F =82.88,P ＜ 0.05).Necrosis and bleeding of the tumor tissues were observed in all the 4 groups.Necrosis,shrinking of the tumor cells,inflammatory infiltration were observed in the DLI group and the chemotherapy + DLI group.Proliferation of lymphoid follicles was observed in the chemotherapy + DLI group.The survival time of mice in the control group,chemotherapy group,DLI group,chemotherapy + DLI group were (16.8 ± 2.5) days,(26.3 ± 2.9) days,(23.4 ± 2.5) days and (33.7 ± 4.6) days,respectively,with significant difference between the 4 groups (F =46.45,P ＜ 0.05).Conclusions (1) Pretreatment can induce specific immune tolerance in mice.(2) Haploidentical allogeneic lymphocyte infusion and chemotherapy have synergistic effects,joint application of haploidentical allogeneic lymphocyte infusion and chemotherapy can inhibit the proliferation of tumor cells and prolong the survival time of mice.(3) Chemotherapy can reduce the GVHD of haploidentical allogeneic lymphocyte infusion and enhance the GVT.(4) CD3 + CD4 + CD25 + T lymphocytes play important roles in decreasing GVHD.
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Objective To study the morphological character of blood-spleen barrier in patients with hypersplenism,and to discuss the relevance and pathogenesis of hypersplenism.Methods The spleens of 33 patients with cirrhosis with portal hypertension were collected as the experimental group,and 20 patients with traumatic spleen as the matched group.Five pieces of tissues in each spleen were sampled.The samples were made into pathological sections,stained with H.E.and examined microscopically for the total number of germinal centers (GC).The data of patients before operation were collected which included:blood routine (count of RBC,WBC,PLT and HB) and splenic weight.The correlation of blood routine values and sum of GC was studied using relative linear analysis.Results In the experimental group:The blood routine values were remarkably lower,splenic weight (average 764.2 g) and the quantity of the germinal center (average 8817/case) were higher.There was a reverse relationship between the total quantity of germinal centers and the PLT.There was a close relationship between the quantity of germinal center and the extent of the hypersplenism,i.e.the lower the preoperative platelet number,the greater the total number of germinal center; the heavier the splenic weight,the greater the number of germinal center.Conclusions The total number of germinal center increased dramatically in patients with cirrhosis with portal hypertension.The change is accompanied by changes in morphology of the germinal centers and dysfunction in blood-spleen barrier.It is likely that hypersplenism develops on the basis of dysfunction of blood-spleen barrier.
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Objective To investigate the correla tion between the plasma endothelin (ET) and gastric mucosal pathology.Methods In this experiment,seven dogs who exper ienced common bile-duct ligation were in experiment group, the other three dogs who underwent sham-operation were control group. By using specific radio immun ological method, the plasma ET levels were determined in dogs before and after 1 ,4,7 d. The total bilirubin levels were determined before and after 1,4,7 d afte r operation by using carbazotic acid method.The gastric mucosa,7 d after operati on, was cut into slices and was examined under the electron microscope and the l ight microscope.Results In the experiment group,the levels of ET and total bilirubin rose continually and were higher than those in control gr oup. Vascular congestion and oedema were seen in gastric mucosa of common bile- duct ligated dogs. Under the electron microscope, we could see the dilated bloo d capillary and sludging of blood,the intenstitial mucusa cells oedema. Conclusion The increase of plasma ET might lea d to impairment of mucosal micro-circulation,which might be one of the pathogen s that could induce the gastric mucosal damages in common bile-duct ligated dog s.
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Objective To investigate the clinical values of surgical drainage for hepatectomy.Methods Drainage tube was implanted under diaphragm and/or liver intraoperatively for 172 cases patients undergone hepatectomy since recent 10 years.The complications,including bleeding,bile seeping and subdiaphragmatic infection,were observed postoperatively through the drainage tube.Results 4 cases of bleeding and 5 bile seeping and 5 subdiaphragmatic infection were found.Conclusions The surgical drainage technology had important clinical significance for monitoring,preventing and treating of bleeding and bile seeping and subdiaphragmatic infection after hepatetomy.