ABSTRACT
Objective:To study the neuroprotective effect of nobiletin on the symptoms of postoperative cognitive impairment (POCD) induced by sevoflurane inhalation.Methods:Twenty-four aged SD rats (12 female mice and 12 male mice) were divided into three groups randomly: control group ( n=8), surgery group ( n=8) and surgery + nobiletin group ( n=8), with 4 females and 4 males in each group.The rats in surgery group and surgery+ nobiletin group were given normal saline(0.1 ml/10 g, once a day) and nobiletin(100 mg/kg, once a day) intragastrically for 6 weeks.Then the rats were anesthetized by sevoflurane and treated by abdominal exploration surgery, and then continued gavage for 1 week.The rats in control group were given normal saline(0.1 ml/10 g, once a day) intragastrically for 7 weeks without anesthesia or surgery.Sevoflurane inhalation anesthesia and abbreviated laparotomy were not done for control group.Morris water maze and open field experiment were used to measure the memory and cognitive ability and the independent exploration ability respectively.The changes of α-band electroencephalogram (EEG) were recorded by multi-channel physiological signal acquisition and processing system.The concentration of S100β, a marker of neurological impairment was detected by ELISA.Western blot was used to detect the expression level of IBA-1 in microglia.SPSS 20.0 software was used to analyze the data. Results:There were no significant differences in Morris water maze, positioning cruise test and open field test among the groups before operation (all P>0.05). The differences were statistically significant among the groups 7 days after operation (all P<0.05). Compared with the control group (the escape latency, path length and cross platform times were ((20.37±1.11)s, (552.37±14.19)cm, (6.75±0.43)times respectively), the escape latency ((40.87±2.03)s) and path length ((1 258.62±19.53)cm) of rats in surgery group were significantly longer (both P<0.01), and the cross platform times ((2.12±0.33)times) significantly reduced ( P<0.01). The differences between surgery + nobiletin group ((22.37±1.11)s, (584.50±10.90)cm, (6.62±0.48)times) and control group were not significant (all P>0.05). The open field experiment showed that the movement distance, the crossed square number, and activity times in surgery group ((1.78±0.55) m, (4.75±0.50), (14.87±0.33) times) decreased significantly compared with those in control group ((3.73±0.07) m, (11.10±0.78), (51.12±0.78) times, all P<0.01). No significant difference was found between surgery + nobiletin group ((3.76±0.07)m, (10.75±0.66), (50.75±0.43)times) and control group(all P>0.05). Before anesthesia, there was no significant difference in the power ratio of α-band among the three groups ( P>0.05), but the differences during anesthesia and operation were significant ( F=72.58, 101.50, P<0.01). During anesthesia and operation, the power ratio of α-band in anesthesia and in surgery group (2.51±0.04, 2.14±0.03) were significantly lower (both P<0.01) than those in control group (3.49±0.03, 3.49±0.03), while there was no obvious changes (both P>0.05) in the surgery + nobiletin group (3.50±0.04, 3.51±0.04). There were significant differences in Bcl-2 protein expression and caspase 3/7 protein activity among the three groups ( F=5.21, 7.84, P<0.01). Compared with control group (1.00±0.02, 1 557.46±3.63), Bcl-2 of rats in the surgery group(0.40±0.05) were significantly lower and Caspase3/7 expression of surgery group (3 689.58±10.46) was significantly higher (both P<0.01), while the rats in the surgery + nobiletin group had no significant difference in both Bcl-2 level (1.03±0.06) and caspase 3/7 activities (1 805.28±6.17, both P>0.05). The difference of S100 β protein expression was significant among the three groups ( F=490.80, P<0.01). Compared with the control group ((0.18±0.01)μg/L), the concentration of S100β protein in the surgery group ((2.13±0.02)μg/L) decreased ( P<0.01), while there was no significant difference in the surgery + nobiletin group ((0.16±0.01) μg/L, P>0.05). The expression levels of IBA-1 protein ( F=10.83) and TNF-α, IL-1, IL-1β and IL-6 ( F=996.20, 221.40, 73.02, 174.13) were significantly different among the three groups (all P<0.01). The expression level of the neuroglial marker IBA-1 in the surgery group(1.36±0.02) was significantly higher than that in the control group (1.00±0.01, P<0.01), while the surgery + nobiletin group (1.03±0.01) had no significant different compared with control group ( P>0.05). The levels of inflammatory factors, including TNF-α, IL-1, IL-1β and IL-6, in the brain of rats treated with nobiletin ((49.06±3.63)pg/mg, (2.09±0.43)pg/mg, (16.27±0.80)pg/mg, (2.11±0.19)pg/mg) were significantly lower than those in the surgery group((145.10±6.46)pg/mg, (5.67±0.43)pg/mg, (27.88±3.43)pg/mg, (4.74±0.32)pg/mg, all P<0.01). Conclusion:Nobiletin can obviously alleviate POCD symptoms caused by sevoflurane inhalation anesthesia.
ABSTRACT
Objective:To evaluate the changes in electroencephalogram (EEG) during cognitive dysfunction induced by multiple inhalation of sevoflurane anesthesia in aged rats.Methods:Twenty-one SPF healthy male Sprague-Dawley rats, aged 20-22 months, weighing 450-550 g, were divided into 2 groups using a random number table method: control group (group C, n=8) and repeated inhalation of sevoflurane anesthesia group (group S, n=13). In group S, the rats were put into an anesthesia box and inhaled a mixture of 3% sevoflurane and 30% oxygen for anesthesia, the oxygen flow rate was set at 3 L/min, maintaining for 3 h, and anesthesia was performed once every week for 3 times in total.The rats only inhaled a mixture of 70% air and 30% oxygen in group C. Two weeks later, cognitive function was assessed using Morris water maze test, the EEG was collected and analyzed by the multi-channel physiological signal system, and the recording time of EEG signal was 30 min.The rats were sacrificed, and the brains were collected for determination of the count of apoptotic nerve cells (by TUNEL staining), and the apoptotic rate of nerve cells was calculated. Results:Compared with group C, the escape latency was significantly prolonged at 3rd and 4th days of training, the number of crossing the original platform was decreased at 5th day, the percentage of high-frequency waves was decreased, the percentage of low-frequency waves was increased, and the apoptosis rate of nerve cells was increased in group S ( P<0.05). Conclusion:The percentage of high-frequency waves is decreased, and the percentage of low-frequency waves is increased during cognitive dysfunction induced by multiple inhalation of sevoflurane anesthesia, which may be related to apoptosis in nerve cells of aged rats.
ABSTRACT
Objective To explore the curative effect and adverse reaction of applying stereotactic radiotherapy to primary lesion inside chest cavity of patients with oligometastasis non-small cell lung cancer and rendering radical radiotherapy to all metastases. Methods 43 patients with≤5 metastases of non-small cell lung cancer received initial treatment during 2009-2015 in our department were analyzed;the stereotactic radiotherapy was adopted to implement radical radiotherapy on primary lesion and all metastases. The average and neutral position BED10 respectively were 101416 Gy and 102700 Gy,the number of neutral position chemotherapy period was 4. Kaplan-Meier method, survival analysis, Cox model, multi factor Prognosis analysis were used. Results By the end of January 10,2017 in 36 months' neutral position follow-up visit, the total effective rate of lesion treatment of 86%;the survival rates after 1,2 and 3 years respectively were 74%, 70% and 51%. Neutral survival time was 48 months, and the progression-free time of neutral position was 15 months. Multi-factor analysis indicated that,ECOG<2 and ECOG≥2(P=0000),BED10<100 Gy and BED10≥100 Gy ( P=0006) generated obvious influence on survival prognosis. About 90% of the patients only got 1-2 degree of adverse reaction without emerging treatment related death. Conclusions On the premise of systematic therapy of oligometastasis non-small cell lung cancer, combined with radical radiotherapy of primary lesion and metastasis can obviously improve patients ' overall survival and progression-free survival,the adverse reaction is durable.
ABSTRACT
Objective To explore the curative effect and adverse reaction of applying stereotactic radiotherapy to primary lesion inside chest cavity of patients with oligometastasis non-small cell lung cancer and rendering radical radiotherapy to all metastases. Methods 43 patients with≤5 metastases of non-small cell lung cancer received initial treatment during 2009-2015 in our department were analyzed;the stereotactic radiotherapy was adopted to implement radical radiotherapy on primary lesion and all metastases. The average and neutral position BED10 respectively were 101416 Gy and 102700 Gy,the number of neutral position chemotherapy period was 4. Kaplan-Meier method, survival analysis, Cox model, multi factor Prognosis analysis were used. Results By the end of January 10,2017 in 36 months' neutral position follow-up visit, the total effective rate of lesion treatment of 86%;the survival rates after 1,2 and 3 years respectively were 74%, 70% and 51%. Neutral survival time was 48 months, and the progression-free time of neutral position was 15 months. Multi-factor analysis indicated that,ECOG<2 and ECOG≥2(P=0000),BED10<100 Gy and BED10≥100 Gy ( P=0006) generated obvious influence on survival prognosis. About 90% of the patients only got 1-2 degree of adverse reaction without emerging treatment related death. Conclusions On the premise of systematic therapy of oligometastasis non-small cell lung cancer, combined with radical radiotherapy of primary lesion and metastasis can obviously improve patients ' overall survival and progression-free survival,the adverse reaction is durable.
ABSTRACT
Stereotactic body radiation therapy had a history for over 20 years since it was applied in elinical treatment,with promising outcomes in early-stage non-small cell lung cancer (NSCLC) and lung metastases.Air Force General Hospital was one of the earliest institutes which had launched SBRT in China.Our self-developed γ-ray SBRT technology was used to treat early-stage NSCLC and lung metastases.The adverse effects and cost of γ-ray SBRT were less than those for foreign technology.In conclusion,it is suitable for our national situation and worth to be widely introduced.
ABSTRACT
Objective To analyze the result of dose-escalated radiotherapy vs conventional radiotherapy for spinal metastases. Methods Ninety patients (118 lesions) underwent radiotherapy..There were 52 patients (63 lesions) in target in target radiotherapy (TIT) receiving PTV 30~40 Gy, GTV 50~60 Gy/15~25 f. 38 patients (55 lesions) received PTV 30~40 Gy/10~20 f in the conventional radiotherapy. Results The overall responses were 90.4% and 81.6%,respectively.but no significant difference was found. There were 31 and 25 improved lesions, 28 and 20 steady lesions, 4 and 10 worsening lesions,in two goups, respectively. 1-year local control rates and survival were 84.7%vs 68.6%and 49.4%vs 32.2%, respectively. The significant differences were found in 1-year local control rates and survival. The main acute adverse reactions were mainly hematologic toxicities , no significant difference was found. Conclusion TIT for spinal metastases is a more safe and effective treatment, with better efficacy and fewer side-reactions.
ABSTRACT
Objective To compare the efficacy of conventional radiotherapy and Tomo radiotherapy com -bined with zoledronic acid in spinal metastase .Methods Seventy -nine patients with spinal metastases in our department of Air Force General Hospital were recruited from January 2011 to December 2012 .All patients were divided into two groups:group A:39 cases were treated with conventional radiotherapy combined with zoledronic ( PTV:30~40 Gy/10~20 f);40 patients with target in target Tomo radiotherapy combined with zoledronic acid were separated into group B(PTV/GTV/40~50 Gy/50~60 Gy/15~20 f).Results The overall following -up rate was 96.2%.The total response rate was 88.61%,the analgesic effect of radiotherapy in group A and group B were 84.62%、92.5%,respectively.The average pain scores were decreased by 2.55 and 3.54 in two gourps u-sing a numerical rating scale;the average pain relieve time were 7.25d and 8.32d,respectively;the median last-ing time of pain relieves were 6.68 and 8.41months;and the pain recurrence rate were 25.81% and 5.41% in corresponding group A and group B .The main acute side effects were hematologic toxicity , in which occurring rates were 12.82%and 12.5%in RTOG gradeⅠ,23.08% and 20%in RTOG grade Ⅱ,2.56% and 2.5% in RTOG gradeⅢ,2.46%and 0%in RTOG grade Ⅳin group A and group B,respectively.There were no signifi-cant differences in pain relief rate ,start-effect time,lasting time and acute side effects between the two different radiotherapy methods .However ,the decreased degree of pain relief and recurrence rate were obviously decreased in group B when compared with group A ,and the differences were statistically significance (P<0.05).Conclu-sion Target in target Tomo radiotherapy combined with zoledronic acid in the treatment of spinal metastasies is safe and effective,mild toxicity,and the degree of pain relief was significantly improved .Moreover,pain recurrence rate is lower than conventional radiotherapy .Hence ,it is worth of recommendation in clinical practice .
ABSTRACT
<p><b>BACKGROUND</b>The aim of this research was to analyze the perioperative factors of regular hepatectomy and irregular hepatectomy. The superiority of the clinical application of the two methods was compared in the perioperative period.</p><p><b>METHODS</b>From 1986 to 2011, 1798 patients underwent consecutive liver resections with regular hepatectomy and irregular hepatectomy at the Air Force General Hospital of People's Liberation Army and the General Hospital of Chinese People's Liberation Army. Their medical documentation was investigated retrospectively.</p><p><b>RESULTS</b>In patients on whom regular hepatectomy and irregular hepatectomy were performed, there was no significant difference in perioperative blood loss, complications, in-hospital mortality, hospital stay, and so on. But in regular hepatectomy, operating time was an independent risk factor (P < 0.001, OR = 1.004).</p><p><b>CONCLUSIONS</b>There was no significant difference between the perioperative risk of regular hepatectomy and that of irregular hepatectomy.</p>
Subject(s)
Female , Humans , Male , Hepatectomy , Methods , Perioperative Period , Retrospective StudiesABSTRACT
Objective To preliminarily evaluate the feasibility,therapeutic effect and normal tissue complications of stereotactic γ-ray body radiation therapy for patients with asynchronous bilateral renal cell carcinoma.Methods Nine patients with inoperable asynchronous bilateral renal cell carcinoma with a median time from the resection of the primary focus and discovery of the contralateral focus underwent stereotactic γ-ray body radiotherapy with OUR-QGD stereotactic γ-ray whole body therapeutic planning system.50％ isodose line,as the prescription dose line,was to cover the planning target volume (PTV) and the 70％ isodose line was to cover the gross target volume (GTV).Radiotherapy was delivered,with a single dose of 3-5 Gy per fraction,one fraction per day,5 fractions per week,and totally 10-17 fractions.The PTV edge total dose was 36-51 Gy,and the GTV edge total dose was 60-85 Gy.The patients were followed up for a median time of 24 months to evaluate the local control rate and overall survival rate.Results Of the 9 patients,1 presented complete remission (11.1％) and 4 partial remission (44.5％),with a total effective rate of 55.6％.The 1-,3-,and 5-year local control rates were 64.8％,43.2％,and 43.2％ respectively.The 1-,3-,and 5-year overall survival rates were 66.7％,53.3％,and 35.6％ respectively.Four patients (44.4％) had acute radiation reaction:2 cases with grade l leukocytopenia and 2 cases with grade 1 gastrointestinal reactions.Two patients showed grade 2 late radiation-induced reaction in gastrointestinal system.The Karnofsky score was significantly increased and the renal function was normal after radiotherapy.Conclusions Stereotactic γ-ray body radiation therapy is safe and effective in the treatment of asynchronous bilateral renal cell carcinoma.
ABSTRACT
ObjectiveTo further evaluate the value of the stereotactic gamma-ray body radiation therapy ( γ-SBRT ) for patients with stage Ⅰ / Ⅱ non-small cell lung cancer ( NSCLC ) basing on the preliminary studies.MethodsTwenty-nine eligible patients with stage Ⅰ / Ⅱ NSCLC who is unable or unwilling to receive surgery underwent treatment prospectively with γ-SBRT (OUR-QGD).Patients were fixed by vacuum bag.Each patient underwent slow CT simulation at 5 s/slide with thickness of 5 mm and interval of 5 mm to take into consideration tumor motion.A total dose of 50 Gy was delivered at 5 Gy/fraction to 50％ isodose line covering 100％ of the PTV,with 60 Gy at 6 Gy/fraction to 60％ isodose line covering 90％ of the CTV,70 Gy at 7 Gy/fraction to 70％ isodose line covering 80％ of the GTV,and 10 times finished in 2 weeks,5 fractions per week.ResultsThe follow-up rate was 97％.The 6 month local tumor response rate was 93％,with CR 86％,and PR 7％.The 1-,2-year local control rates were both 93％.The 1-,2-year overall survival rates for the whole group,stage Ⅰ and stage Ⅱ were 97％ and 89％,100％ and 92％,67％ and 67％,respectively.The 1-,2-year progression-free survival were 90％ and 86％,respectively.34％ of the patients had acute radiation toxicities ( grade 1,2 and 3 in 6,2 and 2patients,respectively),and 38％ late radiation toxicities ( grade 1 and 2 in 10 and 1,patients).Conclusions γ-SBRT is a safe and effective treatment regimen,resulted in promising local control and survival with minor toxicity.
ABSTRACT
Objective To evaluate the efficacy and side effects of whole body γ/-knife in patients with limited pancreatic carcinoma. Methods 111 patients with limited pancreatic carcinoma treated with the Stereotactie Gamma Ray Whole-Body Therapeutic System (Whole Body T-knife) were retrospectively an-alyzed. Patients were supine, fixed with a stereotactic body frame and vacuum bag, and then simulated by low-speed computed tomography. GTV, CTV and PTV were defined on the contrast-enhanced CT scans. It was required that 50% isedose line covered 100% of PTV and 70% isedose line covered more than 80% of GTV. The prescription dose was defined as 50% isodose. All patients were treated 5 fractions per week. The fractionated dose was 3-4 Gy for pancreatic head carcinoma, and 4-5 Gy for pancreatic body/tail carcino-ma. Irradiation of 40-51 Gy and 60-70 Gy were delivered to PTV and GTV margins, respectively. Re-suits The complete response rate, partial response rate and overall response rate of the primary tumors were 29.7%, 42.3% and 72.1%, respectively. The follow-up rate was 95.5%. The number of patients fol-lowed-up at 1-,2- and 3-year was 105,89 and 60. The 1-, 2- and 3-year overall survival rates were 49.3%,24.5% and 18.1%. For patients with stage Ⅰ/Ⅱ disease,the number of patients followed-up at 1-,2-,3-,4-and 5-year was 55,44,29,16 and 11 ;The 1-, 2-, 3-,4- and 5-year overall survival rates were 68%,34%, 30%, 21% and 17%, respectively. For patients with stage Ⅲ disease,the number of patients fol-lowed-up at 1-,2- and 3-year was 50,45 and 31 ;The 1-, 2- and 3-year overall survival rates were 28%,14% and 4%, respectively (χ~2=16.67, P=0.000). The acute side effects including nausea, vomiting and diarrhea were 71.2% of RTOG grade 1 -2 and 3.6% of RTOG grade 3. No treatment delay occurred.Conclusions With fractionated dose of 3-5 Gy,5 fractions per week and 40-51 Gy as total dose to PTV,whole body γ-knife is safe and effective to treat limited pancreatic carcinoma. The local control and overall survival could be improved.
ABSTRACT
@#ObjectiveTo observe the neuroprotective effect of basic fibroblast growth factor(bFGF)on cerebral diffuse axonal injuries (DAI)of rats.Methods40 male SD rats were randomly divided into control group, DAI injury group, bFGF group and DAI saline group. According to the survival time of rats, DAI injury group were divided into five groups, the 6h, 12h, 24h, 72h and 7th day group, The changes of bFGF expression in cerebral cortex were detected by immunohistochemical method from 6h to 7d after DAI. Two hours before DAI, bFGF 10μl was injected into right ventricle in bFGF group. ResultsThe bFGF expression appeared at 6h after DAI, increased at 12h, reached the highest level at 72h, and kept in a high level at 7d.There were obvious differences between 72h group and other groups in DAI injury group (P<0.01),cerebral cortex neurons were obviously decreased by HE staining. In each time group,injured neurons were decreased in bFGF group combined with DAI injury group(P<0.05). ConclusionsbFGF has obvious neuroprotective effect on cerebral diffuse axonal injuries of rats.