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Objective To investigate the application value of susceptibility weighted imaging (SWI) combined with platelet distribution width (PDW) in intravenous thrombolysis for treatment of patients with acute cerebral infarction (ACI). Methods One hundred and ten patients with ACI treated by intravenous thrombolysis admitted to the Department of Radiology of the Second Affiliated Hospital of Medical College of Zhejiang University from February 2017 to June 2018 were enrolled as the subjects. Before treatment, all patients were detected by routine magnetic resonance imaging (MRI), SWI scanning and PDW detection. The patients were divided into hemorrhage group (77 cases) and non-hemorrhage group (33 cases) according to the presence or absence of hemorrhage shown in SWI, and according to the amount of bleeding, the hemorrhage group patients were subdivided into light (24 cases), medium (32 cases) and severe (21 cases) three groups. After intravenous thrombolysis, the patients were scanned by SWI to show whether bleeding being present or not, the cerebral microbleeding (CMBs) after 24 hours treatment in two groups, and after treatment of 14 days, modified Rankin score (MRS), PDW and hemorrhagic transformation (HT) situation in the two groups were evaluated and compared, the differences in hemorrhagic infarction 1 (HI1), hemorrhagic infarction 2 (HI2), parenchymal hemorrhage 1 (PH1) and parenchymal hemorrhage 2 (PH2) in different bleeding volume groups were compared. Results Before treatment, 129 lesions detected by SWI were significantly greater than 14 lesions detected by T1 weighted imaging, 22 lesions detected by T2 weighted imaging and 86 lesions detected by diffusion weighted imaging. After treatment for 24 hours, the number of CMBs (number: 10 vs. 0), after treatment for 14 days, the incidence of HT [36.36% (28/77) vs. 12.12% (4/33)], MRS (1.78±0.39 vs. 1.51±0.42) and PDW [(12.34±5.29)% vs. (6.79±3.27)%] in the hemorrhagic group were higher than those in non-hemorrhagic group (all P < 0.05). After treatment of 14 days, the incidences of HT [71.43% (15/21) vs. 20.83% (5/24), 25.00% (8/32)], PDW [(14.52±4.11)% vs. (10.78±3.67)%, (11.34±3.89)%] in severe group were higher than those in light group and moderate groups (all P < 0.05), and the rate of good prognosis was significantly lower than those in mild and moderate groups [42.86% (9/21) vs. 70.83% (17/24), 71.88% (23/32), P < 0.05]. The incidence of HT in severe group was also significantly higher than those in the non-hemorrhage group [71.43% (15/21) vs. 11.76% (4/34), P < 0.05]. Conclusion SWI combined with PDW can guide the intravenous thrombolysis very well for patients with ACI, and has relatively high clinical value.
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Objective At present, the traditional model of urinary tract infection is not only complex in operation process but also easy to be infected, and the model with simple transurethral bacterial injection is not stable enough. This study established a rat model of foreign body-associated urinary tract infection. A spiral polyethylene tube (PT) was placed transurethrally into the bladder by transurethral inoculation with extended-spectrum β-lactamases-producing Escherichia coli (ESBLs E.coli).Methods SD female rats were randomly divided into blank control group, no foreign body groups at 7d and 14d, foreign body groups at 7d and 14d. ESBLs E.coli was injected transurethrally by foreign body into the bladder in foreign body groups. The same volumes of ESBLs E.coli and sterile saline were injected respectively in no foreign body and blank groups. Examination was made on bilateral renal gravity index, the numbers of white blood cells and neutrophils, the bacteriological and pathological changes in urine and kidney.Results The bilateral renal gravity index, the percentage of neutrophils and and the positive rates of renal and urine bacteria culture in foreign body groups at 7d and 14d were significantly higher than those in blank control group and no foreign body groups(P＜0.05). The number of white blood cells in foreign body group at 7d was significantly higher than those of blank control and no foreign body group(P＜0.05). The positive rates of renal and urine bacteria culture were 100% in the foreign body groups at 7d and 14d. The positive rate of urine bacteria culture in no foreign body at 7d was 33.3%. Under the light microscope, there were inflammatory changes in the kidney and bladder tissues of the rats in foreign body groups, and a few fibrous tissues were formed around glomeruli in foreign body group at 14d.Conclusion The establishment of a highly successful and stable rat model of urinary tract infection can be successfully achieved by injection of ESBLS E.coli through transurethral foreign body placed in bladder.
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<p><b>OBJECTIVE</b>To explore anti-cancer effect and mechanism of green tea extract (GTE) in three human oral squamous carcinoma cell lines (CAL-27, SCC-25 and KB).</p><p><b>METHODS</b>The cell lines were in vitro cultured and its growth inhibition was detected by MTT. After screening most sensitive cell line, effect of GTE on CAL-27 cell cycle was analyzed by flow cytometry. The protein expression of GTE on CAL-27 cell strain was determined by protein chip technique. The protein expression of CDK4, CDK6, and p-PDK1 was verified by using Western blot.</p><p><b>RESULTS</b>Compared with the control group, the inhibition rate on CAL-27 increased significantly after treated by 50, 100, 200, and 400 μg/mL GTE; the inhibition rate on KB increased after treated by 100, 200, and 400 μg/mL GTE; the inhibition rate on SCC-25 increased after treated by 25, 50, 100, 200, and 400 μg/mL GTE, all with statistical difference and in dose dependant manner (P < 0.01). Flow cytometric analysis showed that, when compared with the control group, 50 μg/mL GTE arrested CAL-27 cells in the G2/M phase (P < 0.05), and 100 μg/mL GTE arrested CAL-27 cells in the G2/M phase with concurrent decreased cells in the G0/G1 phase (P < 0.01). Totally 107 proteins were analyzed by protein chip technique. After treated by GTE, a total of 13 proteins significantly changed in CAL-27 cell line. Western blot showed that 25, 50, and 100 μg/mL GTE inhibited the expression of phopho-phosphoinositide-dependent protein kinase 1 (p-PDK1), cyclin-dependent kinase 4 (CDK4), and CDK6 of CAL-27 cell line with statistical difference (P < 0.05). The higher the drug concentration, the higher the inhibition rate (P < 0.05).</p><p><b>CONCLUSIONS</b>GTE could inhibit the proliferation of different human oral squamous carcinoma cell lines. CAL-27 is a sensitive cell line. GTE significantly affected EGFR and Notch signal network, and influenced changes of cell cycle related protein expression levels through the aforesaid channels, resulting in cell cycle arrest in S and G2/M phases.</p>
Subject(s)
Humans , Antineoplastic Agents, Phytogenic , Pharmacology , Therapeutic Uses , Antioxidants , Carcinoma, Squamous Cell , Cell Cycle , Cell Line, Tumor , Cyclin-Dependent Kinase 4 , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , G1 Phase , Mouth Neoplasms , TeaABSTRACT
Objective To investigated the serum level of carcinoma antigen 125 (CA-125) and its clinical significance in patients with Budd-Chiari syndrome.Methods We reviewed medical records and laboratory tests of patients with BCS first diagnosed in our hospital between August 2011 and April 2013.235 patients were included as experiment group,while 120 healthy adult volunteers were randomly selected as control group.The serum level of CA-125 were detected by electrochemilumescence immunization assay in this single-center retrospective control study.Results The average serum level of CA-125 in experiment group is higher than that of control group [(147.9 ±246.6) kU/L vs (16.0 ±7.2) kU/L,P ＜0.001].In experiment group,the relative coefficient for serum CA-125 with ascites,alanine aminotransferase,aspartate aminotransferase,albumin and Rotterdam BCS scores was 0.79,0.45,0.29,-0.393 and 0.71,respec tively,P ＜0.001.As of October 2013,we found that the 68 BCS patients with serum CA-125 level 5-fold higher than the upper limit of normal (＞ 175 kU/L) presented much lower survival rates and asymptomatic survival rates than the rest 167 BCS patients after intervention therapy:(95.6％ and 79.8％) vs (98.8％ and 92.0％),P ＜ 0.05.Conclusions The serum level of CA-125 in BCS patients have positive correlation with ascites volume,liver injury degree and Rotterdam BCS scores.Serum CA-125 evaluation appears to be a valuable examination option in BCS as CA-125 levels negatively correlate with worse prognosis,thus could be applied as an efficient tool for prognostication.
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<p><b>OBJECTIVE</b>To prospectively study clinical features and etiology in patients with incident Budd-Chiari syndrome (BCS) in China.</p><p><b>METHODS</b>Taking consecutive case series of patients with incident BCS as who were diagnosed in our hospital, enrolled from September 2010 to January 2012 as the object of research, and the follow-up was lasting until June 2012. Taking records for all patients' symptoms, signs, laboratory findings, radiology findings, treatment, interventional treatment survival and symptom-free period.</p><p><b>RESULTS</b>There are total 149 incident cases of BCS. In which, the median age was 46 years old (range 10 to 82); 61.7% of them were male patients, 38.3% were female patients; 85.9% of them were chronic, the other patients (14.1%) were diagnosed during acute or subacute periods; the median duration of symptoms before diagnosis was 96 months (range 1 day to 360 months). In terms of causes, 30.9% of the patients caused by hepatic venous block, 5.4% of them resulted from inferior vena cava block, and the rest 63.8% were suffered from combined hepatic venous and inferior vena cava block. 80.5% patients have at least one etiological factor, Furthermore, the most common cause was the web (61.1%), only 4.8% have myeloproliferative diseases (JAK2 V617F mutation), and none Factor V Leiden mutation cases was found. 144 patients were treated by percutaneous transluminal angioplasty, the technical success rate was 95.1%, and took oral anticoagulation therapy for 12 months. At 18 months, The survival rate and the symptom-free survival rate after percutaneous transluminal angioplasty were 97.8% and respectively.</p><p><b>CONCLUSION</b>Web is the most prevalent etiological factor for BCS in China. It is different in western countries; the common reasons of BCS are risk factors related to thrombosis, such as myeloproliferative disease and Factor V Leiden mutation, etc., which are seldom found in Chinese BCS patients. In China, most chronic BCS patients were treated with percutaneous transluminal angioplasty and have excellent clinical outcome.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Budd-Chiari Syndrome , DiagnosisABSTRACT
<p><b>OBJECTIVE</b>To study the association of human epidermal growth factor receptor family molecules expression in gastric cancer tissues with the prognosis of patients with gastric cancer.</p><p><b>METHODS</b>Clinical data of 161 patients with gastric cancer undergoing gastrectomy in Jiangsu Cancer Hospital between January 2006 and January 2007 were analyzed retrospectively. The expression of HER1, HER2, HER3 and HER4 was detected by immunohistochemistry. Association of the expression of HER family with the prognosis of patients was examined. Kaplan-Meier method was used to analyze the survival.</p><p><b>RESULTS</b>High expression rates of HER1, HER2, HER3 and HER4 were 46.0% (74/161), 10.6% (17/161),55.9% (90/161) and 68.3% (110/161) respectively. Univariate analysis revealed that high expression of HER3 was associated with tumor invasion depth, lymph node metastasis, stage, neurovascular invasion, and overall 4-year survival. High expression of HER4 was associated with tumor distant metastasis and stage. High co-expression of HER2 and HER3 was associated with overall 4-year survival (P=0.023). Multivariate analysis revealed that high expression of HER3 and stage were prognostic independent factors.</p><p><b>CONCLUSION</b>Up-regulated expression of HER3 is associated with the poor prognosis in gastric cancer patients.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Gene Expression Regulation, Neoplastic , Prognosis , ErbB Receptors , Metabolism , Receptor, ErbB-2 , Metabolism , Receptor, ErbB-3 , Metabolism , Receptor, ErbB-4 , Retrospective Studies , Stomach Neoplasms , Metabolism , PathologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of hyperthermic intraoperative intraperitoneal chemotherapy(HIIC) and postoperative nutritional support on the intestinal permeability and the cellular immunity function in patients with advanced gastric cancer.</p><p><b>METHODS</b>All the patients diagnosed as advanced gastric cancer in the Gastric Tumor Diagnosis and Treatment Center of Jiangsu Cancer Hospital were randomly divided into three groups using random digit table:(1)EN group treated with enteral nutrition during postoperative period; (2)HIIC+EN group treated with HIIC combined with postoperative enteral nutrition;(3)HIIC+PN group treated with HIIC combined with postoperative parenteral nutrition. Index of lactulose/mannitol(L/M) ratio was used to evaluate the permeability of intestinal mucosa. The percentage of CD4(+), CD8(+) and NK cell, the ratio of CD4/CD8 T cell in peripheral blood were tested by flow cytometry. The time points of these measurements were the day before surgery, postoperative days (POD) 3, 7, and 12.</p><p><b>RESULTS</b>Compared with the day before surgery(POD-1), the ratio of L/M on POD+3 increased significantly in all the three groups(0.1235±0.0611 vs. 0.0280±0.0183, 0.1648±0.0571 vs. 0.0305±0.0208, 0.1702±0.0628 vs. 0.0298±0.0229)(P<0.05) and then decreased gradually. The L/M ratio of EN(0.0278±0.0217) and HIIC+EN(0.0336±0.0235) groups recovered to the baseline on POD+12, however HIIC+PN group still had elevated L/M ratio(0.0616±0.0430). The percentage of CD4(+)T cell and the ratio of CD4/CD8 in HIIC+EN group and HIIC+PN group were significantly lower than those in EN group(P=0.033, P=0.002, respectively). Compared with the POD-1,the percentage of CD4(+)T cell and the ratio of CD4/CD8 in HIIC+EN group and EN group on POD+12 were increased significantly(P<0.05).</p><p><b>CONCLUSIONS</b>HIIC may cause significant increase in intestinal permeability and inhibit cellular immunity in patients undergoing radical resection for advanced gastric cancer. Mucosal permeability can be reversed by enteral nutrition.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Abdominal Cavity , Chemotherapy, Cancer, Regional Perfusion , Immunity, Cellular , Intestinal Mucosa , Allergy and Immunology , Intraoperative Care , Nutritional Support , Methods , Permeability , Postoperative Period , Stomach Neoplasms , Allergy and Immunology , TherapeuticsABSTRACT
<p><b>OBJECTIVE</b>To explore the clinicopathologic characteristics, treatment and prognosis of differentiated thyroid carcinoma (DTC) in adolescents.</p><p><b>METHODS</b>The data of 46 patients with DTC under the age of 18 years were retrospectively reviewed.</p><p><b>RESULTS</b>Twenty patients were misdiagnosed in this group (43.5%). All patients received operation, including 39 unilateral neck dissection and 6 bilateral neck dissection, followed by postoperative thyrotropin suppressive therapy. There were 42 cases of papillary carcinoma (91.3%) and 4 cases of follicular carcinoma (8.7%). Cervical lymph node metastasis was found in 39 cases (84.8%). In the follow-up period of 1 to 25 years (mean 10 years), no death of thyroid carcinoma occurred.</p><p><b>CONCLUSIONS</b>The most common DTC in adolescents is papillary carcinoma with better prognosis regardless of the higher incidence of cervical lymph node metastasis. The optimal extent of primary thyroidectomy and neck dissection followed by postoperative thyrotropin suppressive therapy in adolescents with DTC may improve the quality of life and decrease the incidence of complications.</p>
Subject(s)
Adolescent , Child , Female , Humans , Male , Adenocarcinoma, Follicular , Diagnosis , Therapeutics , Carcinoma, Papillary , Diagnosis , Therapeutics , Follow-Up Studies , Lymphatic Metastasis , Prognosis , Retrospective Studies , Thyroid Gland , Pathology , Thyroid Neoplasms , Diagnosis , TherapeuticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship between polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) C677T or A1298C and the response to fluoropyrimidine (5-FU)-based chemotherapy in advanced stomach cancer (SC).</p><p><b>METHODS</b>75 cases with advanced SC were analyzed. All patients were treated with 5-FU-based chemotherapy and DNA of peripheral blood leukocytes was obtained before therapy. MTHFR genotypes were detected by PCR-RFLP method.</p><p><b>RESULTS</b>(1) Of all the cases, the frequencies of MTHFR C677T C/C, C/T and T/T genotype were 32.0%, 44.0% and 24.0%, while the frequencies of MTHFR A1298C A/A, A/C and C/C genotype were 69.3%, 29.3% and 1.3%, respectively. The overal response rate to 5-FU-based chemotherapy was 29.3%. (2) The response rate to therapy among MTHFR C677T T/T genotype patients (83.3%) was significantly higher than the C677T C/T genotype (15.2%, chi(2) = 22.27, P = 0.000) or the C677T C/C genotype (8.3%, chi(2) = 23.44, P = 0.000). As compared with patients with C677T C allele, patients with C677T T/T genotype had a 7.64-fold sensitivity to 5-FU-based chemotherapy (adjusted for sex, age, prior adjuvant therapy and chemotherapy program, 95% CI: 3.14 - 18.62). The response rate to therapy among patients with MTHFR A1298C A/A genotype (36.5%) was significantly higher than patients with A1298C C allele (13.0%, chi(2) = 4.19, P = 0.041, adjusted OR = 3.75, 95% CI: 0.94 - 14.87). The response rate to therapy among patients with MTHFR C677T T/T and A1298C A/A genotypes (86.7%) was significantly higher than other groups of C677T and A1298C genotypes (15.0%, Fisher exact: P = 0.000, adjusted OR = 6.57, 95% CI: 2.8 - 15.6). (3) The incidence rates of nausea/vomiting in MTHFR C677T T/T, C/T or A1298C A/A genotypes were significantly higher than other genotypes, but the incidence rates of other treatment-related adverse reaction in MTHFR C677T or A1298C genotypes were not significantly different.</p><p><b>CONCLUSION</b>These results in the present study suggested that the polymorphisms of MTHFR were associated with clinical response to 5-FU-based chemotherapy, suggesting that MTHFR genotypes could identify advanced SC patients that would be responsive to 5-FU-based chemotherapy.</p>