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In November 2019, we received and treated a patient with MTSCC of the left kidney. The tumor was located at the upper pole of the left kidney, with a size of 23.3 cm×18.0 cm×21.8 cm. She underwent transperitoneal radical nephrectomy. There was no local recurrence or distant metastasis during the follow-up of 3 years and 2 months. MTSCC of the kidney is a rare subtype of renal carcinoma, with slower disease progression, a clear and smooth rim, and fewer invasion or metastasis. Its final diagnosis should depend on pathology examination. Surgical treatment is the only effective intervention for this disease at present.
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BACKGROUND@#Management of tumors has become more complex owing to tumor heterogeneity. Fewer studies have been performed on intra-tumor heterogeneity of endometrial cancer (EC) until now. Therefore, it is of great clinical value to explore the intra-tumor heterogeneity of EC based on clinical features and gene expression profiles.@*METHODS@#A total of 1688 patients with EC were screened and 114 patients were finally selected, including specimens from 84 patients with primary EC without relapse (PE) and the paired metastases (P-M) specimens, as well as specimens from 30 patients with primary EC with relapse (RPE) and the paired relapsed EC (P-RE) specimens. Microarray and RNA-seq were used to detect gene expression of EC samples. Clinicopathological characteristics and molecular data were compared between PE and P-M groups and between RPE and P-RE groups to explore the intra-tumor heterogeneity of EC.@*RESULTS@#The clinical intra-tumor spatial heterogeneity of pathological type, grade, ER status, and PR status between PE and P-M were 17.9%, 13.1%, 28.6%, and 28.6%, respectively. The clinical intra-tumor spatiotemporal heterogeneity of pathological type, grade, ER status, and PR status between RPE and P-RE were 16.7%, 33.3%, 25.0%, and 37.5%, respectively. Cluster analysis sorts EC samples based on progression type of lesion and their pathological type. There were differentially expressed genes between PE and P-M and between RPE and P-RE, of which gene ontology and Kyoto Encyclopedia of Genes and Genomes analysis were mainly enriched in cell proliferation, the p53 signaling pathway, etc. CONCLUSIONS:: Clinical and molecular data showed that there was spatiotemporal heterogeneity in intra-tumor of EC, which may add to the complexity of diagnosis and therapeutics for EC. Considering the intra-tumor heterogeneity, sequential chemotherapy and precision medicine may be a more suitable treatment plan for EC.
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Background@#Management of tumors has become more complex owing to tumor heterogeneity. Fewer studies have been performed on intra-tumor heterogeneity of endometrial cancer (EC) until now. Therefore, it is of great clinical value to explore the intra-tumor heterogeneity of EC based on clinical features and gene expression profiles.@*Methods@#A total of 1688 patients with EC were screened and 114 patients were finally selected, including specimens from 84 patients with primary EC without relapse (PE) and the paired metastases (P-M) specimens, as well as specimens from 30 patients with primary EC with relapse (RPE) and the paired relapsed EC (P-RE) specimens. Microarray and RNA-seq were used to detect gene expression of EC samples. Clinicopathological characteristics and molecular data were compared between PE and P-M groups and between RPE and P-RE groups to explore the intra-tumor heterogeneity of EC.@*Results@#The clinical intra-tumor spatial heterogeneity of pathological type, grade, ER status, and PR status between PE and P-M were 17.9%, 13.1%, 28.6%, and 28.6%, respectively. The clinical intra-tumor spatiotemporal heterogeneity of pathological type, grade, ER status, and PR status between RPE and P-RE were 16.7%, 33.3%, 25.0%, and 37.5%, respectively. Cluster analysis sorts EC samples based on progression type of lesion and their pathological type. There were differentially expressed genes between PE and P-M and between RPE and P-RE, of which gene ontology and Kyoto Encyclopedia of Genes and Genomes analysis were mainly enriched in cell proliferation, the p53 signaling pathway, etc.@*Conclusions@#Clinical and molecular data showed that there was spatiotemporal heterogeneity in intra-tumor of EC, which may add to the complexity of diagnosis and therapeutics for EC. Considering the intra-tumor heterogeneity, sequential chemotherapy and precision medicine may be a more suitable treatment plan for EC.
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<p><b>PURPOSE</b>To evaluate the quality of life among survivors after sepsis in 2 years, comparing with critical patients without sepsis and the general people, analyze the changes and the predictors of quality of life among septic survivors.</p><p><b>METHODS</b>This prospective case-control study screened the intensive care unit (ICU) patients in Tianjin Third Central Hospital from January 2014 to October 2017, and the Chinese general population in the previous studies was also included. According to inclusion criteria and exclusion criteria, 306 patients with sepsis were enrolled as the observation group, and another 306 patients without sepsis in ICU during the same period, whose ages, gender and Charlson Comorbidity Index matched with observation group, were enrolled as the control group. At 3 mo, 12 mo, and 24 mo after discharge, the Mos 36-item Short Form Health Survey (SF-36), the Euroqol-5 dimension (EQ-5D), and the activities of daily living (ADL) were evaluated in face-to-face for the quality of life among survivors.</p><p><b>RESULTS</b>There were 210 (68.6%) septic patients and 236 (77.1%) non-septic critically ill patients surviving. At 3 months after discharge, the observation and control groups had the similar demographic characteristics (age: 58.8 ± 18.1years vs. 57.5 ± 17.6 years, p = 0.542; male: 52.0% vs. 51.4%, p = 0.926). However, the observation group had higher acute physiology and chronic health evaluation II (APACHEII) scores, higher sequential organ failure assessment (SOFA) scores, longer hospital stay, and longer ICU stay than the control group did (p < 0.05). There were no significant differences in the eight dimensions of the SF36 scale, the EQ-5D health utility scores, and the activities of daily life scores between septic survivors and non-septic survivors (p > 0.05). In addition, compared with the quality of life of the Chinese general population (aged 55-64 years), the quality of life of septic patients were significantly lower at 3 months after discharge (p < 0.05). Comparing the quality of life of the ill patients who had been discharged at 3 mo and 24 mo, the general health improved statistically (p = 0.000) and clinically (score improvement > 5 points). Older age (OR, 1.050; 95% CI, 1.022-1.078, p = 0.000), female (OR, 3.375; 95% CI, 1.434-7.941, p = 0.005) and longer mechanical ventilation time (OR, 3.412; 95% CI, 1.413, 8.244, p = 0.006) were the risk factors for the quality of life of septic survivors.</p><p><b>CONCLUSION</b>The long-term quality of life of septic survivors was similar to that of non-sepsis critically ill survivors. After discharge, the general health of sepsis improved overtime. Age, female and mechanical ventilation time (>5 days) were the predictors of the quality of life after sepsis.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Prospective Studies , Quality of Life , Risk Factors , Sepsis , Mortality , Psychology , SurvivorsABSTRACT
Objective To analyze the subjective well-being of the aged and to explore its influencing factors in Hangzhou City to provide evidence for improving the subjective well-being of the aged. Method A total of 60 years old and above healthy people in Hangzhou were selected as research objects. Stratified random sampling was used according to age and gender. Face to face interview was conducted using a structured questionnaire. The content of the interview included subjective well-being,behavioral habits,and demographics. Statistical methods contains Wilcoxon signed-rank test, Kruskal-Wallis H test and Spearman rank correlation. Logistic regression was used to select influencing factors of subjective well-being. Results A total of 429 samples were used in the analysis according to inclusion and exclusion criterion. The mean score of subjective well-being was 14.0±2.0,and the result of logistic regression shows that gender,marriage status,the number of people living together,whether experienced negative life events,the number of people that can provide information were important factors of subjective well-being. Conclusions The level of subjective well-being of elderly people in Hangzhou was high. The government and society should improve SWB among the aged by providing more psychological guidance and more social support.
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<p><b>PURPOSE</b>This prospective observational study aims to evaluate the accuracy of dead-space fraction derived from the ventilator volumetric capnography (volumetric CO₂) or a prediction equation to predict the survival of mechanically ventilated patients with acute respiratory distress syndrome (ARDS).</p><p><b>METHODS</b>Consecutive VD/VT measurements were obtained based upon a prediction equation validated by Frankenfield et al for dead-space ventilation fraction: VD/VT = 0.320 + 0.0106 (PaCO₂-ETCO₂)⁺ 0.003 (RR)⁺0.0015 (age) in adult patients who had infection-related severe pneumonia and were confirmed as having ARDS. Here PaCO₂ is the arterial partial pressure of carbon dioxide in mmHg; ETCO₂, the end- tidal carbon dioxide measurement in mmHg; RR, respiratory rate per minute; and age in years. Once the patient had intubation, positive end expiratory pressure was adjusted and after Phigh reached a steady state, VD/VT was measured and recorded as the data for the first day. VD/VT measurement was repeated on days 2, 3, 4, 5 and 6. Meanwhile we collected dead-space fraction directly from the ventilator volu- metric CO₂ and recorded it as Vd/Vt. We analyzed the changes in VD/VT and Vd/Vt over the 6-day period to determine their accuracy in predicting the survival of ARDS patients.</p><p><b>RESULTS</b>Overall, 46 patients with ARDS met the inclusion criteria and 24 of them died. During the first 6 days of intubation, VD/VT was significantly higher in nonsurvivors on day 4 (0.70 ± 0.01 vs 0.57 ± 0.01), day 5 (0.73 ± 0.01 vs. 0.54 ± 0.01), and day 6 (0.73 ± 0.02 vs. 0.54 ± 0.01) (all p =0.000). Vd/Vt showed no significant difference on days 1e4 but it was much higher in nonsurvivors on day 5 (0.45 ± 0.04 vs. 0.41 ± 0.06) and day 6 (0.47 ± 0.05 vs. 0.40 ± 0.03) (both p=0.008). VD/VT on the fourth day was more accurate to predict survival than Vd/Vt. The area under the receiver-operating characteristic curve for VD/VT and Vd/Vt in evaluating ARDS patients survival was day 4 (0.974 ± 0.093 vs. 0.701 ± 0.023, p = 0.0024) with the 95% confidence interval being 0.857-0.999 vs. 0.525-0.841.</p><p><b>CONCLUSION</b>Compared with Vd/Vt derived from ventilator volumetric CO₂, VD/VT on day 4 calculated by Frankenfield et al's equation can more accurately predict the survival of ARDS patients.</p>
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Adult , Female , Humans , Male , Middle Aged , Capnography , Prospective Studies , ROC Curve , Respiration, Artificial , Respiratory Dead Space , Physiology , Respiratory Distress Syndrome , MortalityABSTRACT
Information of metabolic enzymes and transporters, physiological parameters of animals and demography of Chinese people were integrated to establish a digital liver model (DLM) based on metabolism and transporter and coded with VBA. Clearance and drug-drug interaction (DDI) of candidate drugs in animal and human could be predicted based on the pharmacokinetic data obtained from in vitro and in vivo experiments. Pravastatin and pitavastatin were selected as the samples to examine this model, where their clearance and their DDI with cyclosporine were predicted. The results showed that the predicted values of median parameters in same species were within twofold of observed values for 83.3% (5/6). The program's successful prediction in DDI tendency might indicate its application in optimizing the dosage regimen and reducing the risk of clinical trial.
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Animals , Humans , Area Under Curve , Biological Transport , Computer Simulation , Cyclosporine , Pharmacokinetics , Drug Interactions , Liver , Metabolism , Metabolic Clearance Rate , Models, Biological , Pravastatin , Blood , Pharmacokinetics , Quinolines , Blood , PharmacokineticsABSTRACT
Glutathione is a tripeptide comprised by L-glutamate, L-cysteine, and glycine, that serves antioxygenation and deintoxication functions within the cell. Recent study has found that glutathione is the main driving force for bile salt-independent bile flow, impaired biliary excretion of glutathione can lead to cholestasis. This review focuses on hepatobiliary transport of glutathione and its role in cholestasis. Based on the evidence of choleretic effect of glutathione, enhancement of biliary excretion of glutathione may be a good strategy for prevention and treatment of cholestasis.
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Animals , Humans , Biological Transport , Cholestasis , Metabolism , Estrogens , Glutathione , Metabolism , Jaundice, Chronic Idiopathic , Genetics , Liver , Metabolism , Multidrug Resistance-Associated Proteins , Genetics , Metabolism , Mutation , Phalloidine , Ursodeoxycholic Acid , Therapeutic UsesABSTRACT
To develop a HPLC-DAD-ESI-TOF/MS analysis method for the determination of gentiopicroside and loganic acid in Radix gentianae samples and for the research of their fingerprints. The samples were extracted using ASE for 10 min under 100 degrees C and 9.65 MPa, and divided into water phase and chloroform phase and analyzed them with HPLC-DAD-ESI-TOF/MS method respectively. Based on this method, the HPLC fingerprints of Radix gentianae were established. Comparing the spectrogram and mass spectrum of the chromatogram peak with the reference value, three compounds in water phase were identified as gentiopicroside, asafetida acid and loganic acid. There is no report of the compounds in chloroform phase. The content of gentiopicroside and loganic acid in samples of different groups were determined, separately. The fingerprints were compared by the software of the similarity evaluation system for chromatographic fingerprint. The water phase fingerprint congruence coefficients of samples from six different areas were above 0.90, however, the chloroform phase fingerprint congruence coefficients were within 0.62 -0.99. This method can be used for determination of potent component in Radix gentianae and its quality control. Radix gentianae from different producing areas have the largest diversities, and the diversities embodied in the content of chloroform phase compounds.
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Chromatography, High Pressure Liquid , Methods , Ecosystem , Gentiana , Chemistry , Glucosides , Chemistry , Iridoid Glucosides , Iridoids , Chemistry , Plant Roots , Chemistry , Plants, Medicinal , Chemistry , Reproducibility of Results , Sensitivity and Specificity , Spectrometry, Mass, Electrospray Ionization , MethodsABSTRACT
Anti-HIV-1 gp120 single chain antibody(scFv) gene and staphylococcus extoxin A(SEA) gene were inserted into vector pPIC9K. The recombinant plasmid was integrated into Pichia pastoris by electroporation. High level expression was performed by determining the Muts phenotype and screening muti-copy integrants. The recombinant protein was about 57kD and the production was 50.1 mg/L. It was shown that the two kinds of protein affected the conformation of each other by antibody affinity assay, but the recombinant targeting toxins could highly mediate CTLs to kill HIV-1 target cells.
Subject(s)
Enterotoxins , Genetics , Genetic Vectors , HIV Envelope Protein gp120 , Genetics , Allergy and Immunology , HIV-1 , Genetics , Allergy and Immunology , Immunoglobulin Variable Region , Genetics , Allergy and Immunology , Pichia , Genetics , Metabolism , Recombinant Proteins , Genetics , Allergy and ImmunologyABSTRACT
<p><b>AIM</b>To study the effect of catechin, the active component of Spatholobus suberectus Dunn, on bone marrow cell cycle and the expression of IL-6 and GM-CSF mRNA in spleen cells of normal and marrow-depressed mice in order to clarify the mechanism of hematopoietic-supportive effect of catechin.</p><p><b>METHODS</b>Flow cytometry was adopted to investigate the influence of catechin on bone marrow cell cycle in mice and the expression of IL-6 and GM-CSF mRNA induced by catechin in spleen cells was detected by RT-PCR technique simultaneously.</p><p><b>RESULTS</b>The cell proportion of normal and marrow-depressed mice in G0/G1 phase was reduced significantly, while that in S + G2/M phase increased significantly. Being induced by catechin, IL-6 mRNA and GM-CSF mRNA in spleen cells were markedly up-regulated.</p><p><b>CONCLUSION</b>Catechin (2 g x L(-1), intraperitoneally injected to mice daily immediately after irradiation for 7 consecutive days) was shown to promote the expression of IL-6 mRNA and GM-CSF mRNA in spleen cells of mice, through which it can accelerate bone marrow cells of normal mice into cell cycle and help those of marrow-depressed mice to get out of "G1-phase-block", enter into cell cycle and radically accelerate the proliferation and differentiation of hematopoietic stem cell/hematopoietic progenitor cell (HSC/HPC).</p>
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Animals , Female , Male , Mice , Bone Marrow Cells , Cell Biology , Metabolism , Catechin , Pharmacology , Cell Cycle , Fabaceae , Chemistry , Gene Expression Regulation , Granulocyte-Macrophage Colony-Stimulating Factor , Genetics , Hematopoietic Stem Cells , Cell Biology , Interleukin-6 , Genetics , Plants, Medicinal , Chemistry , RNA, Messenger , Genetics , Spleen , Cell Biology , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To study the effects and mechanism of Yishenjiangyafang, a prescription of Chinese traditional herbs used for renal hypertension, on blood pressure and protecting renal function of RPH rats.</p><p><b>METHOD</b>The 5/6 kidney of rat was resected to set up the RPH rat model. Blood pressure, Cr(creatinine), Ccr(creatinine clearance) and BUN(urea nitrogen) were measured dynamically. After eight weeks treatment, plasma content of PAR A II TXB2, 6-keto-PGF1 were measured. At same time, The change of renal pathology was observed.</p><p><b>RESULT</b>Yishenjiangyafang could reduce blood pressure Cr, but had no effect on BUN of RPH rat. The indexes of PAR, A II of each different dosage group of Yishenjiangyafang were decreased. At the same time, it reduced plasma content of TXB2, and increased 6-keto-PGF1 alpha. Glomerulosclerosis and atrophy of renal tubule in Yishenjiangyafang group RPH rats were better than those of the contrast group and the Capten group.</p><p><b>CONCLUSION</b>Yishenjiangyafang can reduce blood pressure of RPH rats and has protective effects on its kidney. Yishenjiangyafang can perform its effects of reducing blood pressure and protecting kidney by influencing the RAS of RPH rats.</p>
Subject(s)
Animals , Male , Rats , Angelica sinensis , Chemistry , Antihypertensive Agents , Pharmacology , Astragalus propinquus , Chemistry , Blood Pressure , Blood Urea Nitrogen , Drug Combinations , Drugs, Chinese Herbal , Pharmacology , Hypertension, Renal , Blood , Pathology , Kidney , Pathology , Paeonia , Chemistry , Plants, Medicinal , Chemistry , Rats, Sprague-DawleyABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of SS8, a monomer extracted from Spatholobus suberectus Dunn used for invigorating the circulation of blood, on proliferation of hematopoietic progenitor cells in mice with bone marrow depression.</p><p><b>METHOD</b>The method of semi-solid culture with methylcellulose of CFU-GM, CFU-E, BFU-E, CFU-Meg was adopted in bone marrow depressed mice which were treated with SS8 for a long time.</p><p><b>RESULT</b>The experimental data demonstrated that the numbers of CFU-GM, CFU-E, BFU-E, CFU-Meg in bone marrow depressed mice were raised distinctly under the control of SS8 as compared with those of contrast group. The effect of SS8 became stronger as time went on and the dosage rose.</p><p><b>CONCLUSION</b>SS8 can distinctly stimulate the proliferation of hematopoietec progenitor cells in mice with bone marrow depression in a time-and-dosagedependent manner.</p>
Subject(s)
Animals , Female , Male , Mice , Bone Marrow Cells , Radiation Effects , Cell Division , Drugs, Chinese Herbal , Pharmacology , Erythroid Precursor Cells , Radiation Effects , Fabaceae , Chemistry , Hematopoietic Stem Cells , Cell Biology , Radiation Effects , Plants, Medicinal , Chemistry , Whole-Body IrradiationABSTRACT
Several methods for the qualitative screening of fungi to degrade lignin were introduced in this paper, with detailed protocols and discussing for each assay.