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Objective: To investigate the effect of Clerodendrum bungei-containing serum on liver cancer MHCC97-H cells and its possible mechanism from the perspective of phosphatidylinositol 3-kinase(PI3K)/protein kinase (Akt) signaling pathway. Method: The medicinal serum of 15% C. bungei was used to treat MHCC97-H cells. The effect of serum containing C. bungei on cell proliferation was observed by cell counting kit-8(CCK-8) method, in order to select the best time and concentration. The apoptosis was detected by Annexin V-FITC/PI double staining method. Western blot was used to detect the posphatase and tensin homologous gene deleted from chromosome 10 in key proteins (PTEN), phosphoprotein kinase B (p-Akt) and phosphatidylinositol 3-kinase (PI3K)-related protein expression of PI3K/Akt signaling pathway. Real-time PCR was used to detect C. bungei-containing serum on cells for 72 h after activation of nuclear factor-activated B cell kappa light chain(NF-κB) and tumor necrosis factor-α (TNF-α) mRNA expression. Result: The results of CCK-8 showed an inhibitory effect of the C. bungei-containing serum on the proliferation of tumor cells in a dose and time-dependent manner. Among them, the high-dose group had the most obvious inhibitory effect, and the maximum inhibition rates at 24, 48,72 h were 28%, 32%, and 43%, respectively. The results of flow cytometry showed that with the increase of drug-containing serum concentration, the cell growth was observed. The inhibition rate of cells was increased to different degrees, and the inhibition effect was significantly increased in the 72 h intervention group (PC. bungei-containing serum group was 19.48% and 19.72%, compared with the blank group. The difference was significant (PC. bungei-containing serum (PPC. bungei-containing serum could down-regulate the expression of NF-κB and up-regulate the expression of TNF-α mRNA (PConclusion: The medicinal serum of C. bungei can effectively inhibit the proliferation of MHCC97-H hepatoma cells and promote its apoptosis, which may be related to the PI3K/Akt signaling pathway and its key factors.
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Summary Objective: The present study aimed to investigate the analgesic effect and safety of using local incision analgesia to treat acute postoperative pain in patients with hepatocellular carcinoma (HCC). Method: A cohort of 60 patients undergoing liver cancer resection was randomly divided into three groups (n=20 per group): local incision analgesia (LIA) group, which received local infiltration with ropivacaine combined with a postoperative analgesia pump; intravenous patient-controlled analgesia (PCA) group, which received fentanyl intravenous analgesia postoperatively; and the control group, which received tramadol hydrochloride injection postoperatively according to the NRS scoring system. The postoperative analgesic effect in each group was compared and tumor recurrence (survival) was analyzed using the Kaplan-Meier method. Results: NRS scores, rate of analgesic usage, ambulation time (h) and intestinal function recovery time (h) were significantly reduced in LIA group compared with the control group at each postoperative time point (6, 12, 24 and 48 hours; p<0.05). Additionally, the NRS scores of LIA patients at 12 hours post-surgery was significantly reduced compared with PCA group (p<0.05), and the occurrence of postoperative adverse events in LIA group was significantly lower than that in PCA group (p<0.05). Survival analysis demonstrated that the mean survival time (tumor recurrence) was significantly increased in LIA group compared with the control group (χ2=4.749; p=0.029). Conclusion: Local incision analgesia improves the analgesic effect, causes fewer adverse reactions and increases postoperative survival time. Our study demonstrated that local incision analgesia is a safe and effective method of postoperative pain management following hepatectomy.
Subject(s)
Humans , Male , Female , Adult , Pain, Postoperative/drug therapy , Carcinoma, Hepatocellular/surgery , Acute Pain/drug therapy , Analgesics, Opioid/therapeutic use , Anesthetics, Local/therapeutic use , Pain Measurement , Survival Analysis , Treatment Outcome , Pain Management/adverse effects , Pain Management/methods , Middle Aged , Neoplasm Recurrence, LocalABSTRACT
Objective To investigate efficacy and safety of biliary metallic stent placement via endoscopic retrograde cholangiopancreatography (ERCP) for malignant extrahepatic biliary obstruction. Methods According to different methods, 40 patients with malignant biliary obstruction were divided into PTCD group and ERCP group. Patients in PTCD group received percutaneous puncture bile duct drainage (PTCD) treatment, patients in ERCP group received placement of metal stents under ERCP. Results The survival time of the two groups were significant difference (P < 0.05). Postoperative biliary patency time in ERCP group was significantly longer than that in PTCD group, the difference was statistically significant (P < 0.05). One week later, the index for liver function of ERCP group was significantly better than that in PTCD group (P < 0.05). Additionally, the incidence of complications of PTCD group amd ERCP group was 30.0% and 10.0%, respectively. The complication rate of ERCP group was significantly lower than PTCD group (P < 0.05). Conclusion The effect of ERCP stent implantation is similar to that of PTCD in the treatment of malignant biliary obstruction. However, after ERCP, the time of biliary tract patency is longer with less complications and the index of liver function is recovered quickier than that after PTCD. Therefore, for the patients with malignant extrahepatic biliary obstruction, ERCP holds better clinical efficacy and safety.
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Objective To investigate the relationship between serum uric acid levels and long-term prognosis in patients with neurologically asymptomatic carotid atherosclerotic.Methods Six hundred and thirty-seven cases of carotid atherosclerosis treated in Wulanchabu Central Hospital from January 2013 to January 2017 were enrolled in the study.The clinical data of the patients were collected and the patients were divided into four groups according to the serum uric acid level.Kaplan-Meier method was used to calculate the survival rate of all deaths and cardiovascular diseases in each group,and the survival curve was drawn.Log-rank test was applied to compare the survival curve.Multivariate Cox proportional hazards model was used to assess the risk of serum uric acid levels in the prognosis of patients.Results The differences of hypertension, smoking history, hyperlipidemia,serum uric acid(SUA)and serum homocysteine were statistically significant among the four groups(P<0.05).There were significant differences in all-cause death(P=0.000)and cardiovascular-cause death(P=0.000)among the four groups.Cox regression analysis showed that serum acid was an independent risk factor of all-cause mortality(RR=1.262,95%CI:1.084-2.119,P=0.025)and cardiovascular-cause mortality in patients with neurologically asymptomatic carotid atherosclerosis(RR=1.364,95%CI:1.063-1.750,P=0.013).Conclusion Elevated serum uric acid level is an independent risk factor for patients with neurologically asymptomatic carotid atherosclerosis,which can increase the rate of all-cause mortality and mortality of cardiovascular disease,and has a significant impact on long-term prognosis.
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Objective To investigate the relationship between serum uric acid levels and long-term prognosis in patients with neurologically asymptomatic carotid atherosclerotic.Methods Six hundred and thirty-seven cases of carotid atherosclerosis treated in Wulanchabu Central Hospital from January 2013 to January 2017 were enrolled in the study.The clinical data of the patients were collected and the patients were divided into four groups according to the serum uric acid level.Kaplan-Meier method was used to calculate the survival rate of all deaths and cardiovascular diseases in each group,and the survival curve was drawn.Log-rank test was applied to compare the survival curve.Multivariate Cox proportional hazards model was used to assess the risk of serum uric acid levels in the prognosis of patients.Results The differences of hypertension, smoking history, hyperlipidemia,serum uric acid(SUA)and serum homocysteine were statistically significant among the four groups(P<0.05).There were significant differences in all-cause death(P=0.000)and cardiovascular-cause death(P=0.000)among the four groups.Cox regression analysis showed that serum acid was an independent risk factor of all-cause mortality(RR=1.262,95%CI:1.084-2.119,P=0.025)and cardiovascular-cause mortality in patients with neurologically asymptomatic carotid atherosclerosis(RR=1.364,95%CI:1.063-1.750,P=0.013).Conclusion Elevated serum uric acid level is an independent risk factor for patients with neurologically asymptomatic carotid atherosclerosis,which can increase the rate of all-cause mortality and mortality of cardiovascular disease,and has a significant impact on long-term prognosis.
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Objective To explore the development of the cross sign of olivepontocerebellar atrophy(OPCA) and its diagnostic value.Methods The clinical and imaging data of 8 patients with OPCA were analyzed retrospec-tively.MRI imaging used SE sequence,plain T1 WI,T2 WI,axial,coronal,sagittal imaging.Results All patients were hide onset.The major clinical presentation was cerebellar atsxia and autonomic nerve dysfunction.Positive radiographic findings were consistent with clinical presentation,mainly for the brain stem atrophy,8 patients of the group had this performance,followed by cerebellar atrophy,6 patients had symmetrical atrophy and 2 patients had asymmetric atro-phy.6 patients after onset of 1.5 -3 years showed a typical cross.Conclusion The cross sign gradually appears at a certain stage of development,and it has high specificity.So the combination of clinical and MRI is valuable for the diagnosis and differential diagnosis of OPCA.
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<p><b>OBJECTIVE</b>To evaluate the early management of intracranial ruptured vertebral dissecting aneurysms.</p><p><b>METHODS</b>Twenty-two patients with ruptured vertebral dissecting aneurysms were managed by various treatment modalities according to their conditions. One aneurysm was treated by proximal vertebral artery coiling, 15 aneurysms by aneurysm and parent artery coiling, and 5 aneurysms by stent-assisted coiling (4 of 5 by stent-within-a-stent technique), one by single double-stent. Bloody cerebrospinal fluid was drained by postoperative lumbar subarachnoid drainage in order to prevent cerebral vasospasm.</p><p><b>RESULTS</b>All 22 cases were successful without bleeding complication during the operation.There was 1 case of early postoperative non-aneurysmal hemorrhage, 2 cases of posterial group cranial nerves palsies, 1 case harbored Hunt & Hess IV who gave up treatment. After follow-up for 3-18 months, there was no rebleeding and infarction. Twenty patients recovered well, except 1 having posterial group cranial nerves palsies. Fourteen cases were followed up by angiography. In 3 patients treated by stent-assisted coiling, DSA showed that aneurysms disappeared and loading vessel passed freely.DSA of 11 cases with aneurysm and parent artery coiling demonstrated complete obliteration of the dissection without aneurysm imaging.</p><p><b>CONCLUSION</b>Early endovascular treatment of ruptured vertebral dissecting aneurysms is essential. The selective method of endovascular management according to the characteristics of aneurysm is safe and effective. Double stent-assisted coiling should be the first choice.</p>