ABSTRACT
Objective:To explore the peripheral blood levels changes of soluble glycosylation end product receptor (sRAGE), endotoxin and Toll-like receptor (TLR) in patients with severe acute pancreatitis (SAP) complicated with peritoneal cavity infection, and clarify the relationship between indexes and pathogenetic condition.Methods:The clinical data of 105 patients with SAP in Shanghai Pudong New Area People′s Hospital from January 2017 to December 2020 were retrospectively analyzed. Among them, 28 cases had peritoneal cavity infection (infection group), and 77 cases had peritoneal cavity infection symptoms but undiagnosed (non-infection group). The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) at admission was recorded. When patients had the suspected symptoms and signs of peritoneal cavity infection, the serum levels of sRAGE, endotoxin, TLR4 and TLR9 were detected by enzyme-linked immunosorbent assay. The correlation between serum levels of sRAGE, endotoxin, TLR-4, TLR-9 and APACHE Ⅱ was analyzed by Pearson analysis; the risk factors of peritoneal cavity infection in SAP patients were analyzed by multivariate Logistic regression; the receiver operating characteristic (ROC) curve was drawn, and the diagnostic efficacy of serum sRAGE, endotoxin, TLR-4 and TLR-9 in peritoneal cavity infection were evaluated in patients with SAP; the Kaplan-Meier survival curve was drawn, and the comparison used log-rank test.Results:The serum sRAGE, endotoxin, TLR-4 and TLR-9 in infection group were significantly higher than those in non-infection group: (822.16 ± 104.51) ng/L vs. (728.09 ± 96.47) ng/L, (62.59 ± 20.11) ng/L vs. (41.62 ± 13.64) ng/L, (45.17 ± 8.54) μg/L vs. (37.34 ± 6.22) μg/L, (26.35 ± 6.73) μg/L vs. (20.02 ± 5.49) μg/L, and there were statistical differences ( P<0.01). Pearson correlation analysis result showed that the serum sRAGE, endotoxin, TLR-4 and TLR-9 were positively correlated with APACHE Ⅱ in patients with SAP ( r = 0.632, 0.556, 0.521 and 0.631; P<0.05). Multivariate Logistic regression analysis result showed that the combined organ function damage, shock, hypoxemia and serum sRAGE, endotoxin, TLR-4 and TLR-9 were independent risk factors of peritoneal cavity infection in patients with SAP ( P<0.05). ROC curve analysis result showed that the area under the curve for the serum sRAGE, endotoxin, TLR-4 and TLR-9 combined diagnosis of peritoneal cavity infection in patients with SAP was the largest, which was 0.910 (95% CI 0.838 to 0.957, P<0.01), with a sensitivity of 82.14% and a specificity of 87.01%. According to the ROC curve cut-off value of serum sRAGE, endotoxin, TLR-4 and TLR-9 (764.58 ng/L, 58.01 ng/L, 40.24 μg/L and 22.61 μg/L), the 28 patients with SAP complicated with peritoneal cavity infection were divided into high levels patients (21, 14, 23 and 22 cases) and low levels patients (7, 14, 5 and 6 cases); Kaplan-Meier survival curve analysis result showed that the 28-day survival rates in patients with high levels of sRAGE, endotoxin, TLR-4 and TLR-9 were significantly lower than those in patients with low levels (61.90% vs. 71.43%, 50.00% vs. 78.57%, 60.87% vs. 80.00% and 59.09% vs. 83.33%), and there were statistical differences ( P<0.05). Conclusions:The serum sRAGE, endotoxin, TLR-4 and TLR-9 have a high combined diagnostic value in SAP complicated with peritoneal cavity infection, and they are all related to the severity of the disease and have a significant impact on survival.
ABSTRACT
Objective:To analyze the clinical characteristics of patients with ulcerative colitis (UC)-associated neoplasia, including UC-associated dysplasia and ulcerative colitis-associated colorectal cancer (UC-CRC).Methods:From January 2010 to July 2019, the clinical data of 56 patients with UC-associated neoplasia at Xijing Hospital of Digestive Diseases were retrospectively analyzed. The patients with UC-associated neoplasia were divided into low-grade dysplasia (LGD) group (38 cases) and advanced neoplasia group (18 cases), the advanced neoplasia group included five patients with high-grade dysplasia and 13 patients with UC-CRC. Mann-Whitney U test, chi-square test and Fisher′s exact test were used for statistical analysis. Results:The age of patients with UC-associated neoplasia was (47.4±14.7) years old. The main type of lesion was extensive colitis (71.4%, 40/56). There were five patients (8.9%) complicated with colorectal stricture. The disease course of the advanced neoplasia group was longer than that of LGD group (10.5 years, 3.5 years to 14.5 years vs. 2.0 years, 1.0 year to 5.0 years), and the difference was statistically significant ( U=155.000, P=0.001). Four of the 18 patients of the advanced neoplasia group had colorectal stricture, the ratio was higher than that of LGD group (2.6%, 1/38), and the difference was statistically significant (Fisher exact test, P=0.033). In advanced neoplasia group, there were seven patients with multifocal lesions. Among 13 patients with UC-CRC, the lesions of five patients located in rectum, and the pathological type was mainly moderately differentiated adenocarcinoma (nine cases). Conclusions:The disease course of patients with advanced neoplasia is longer than that of patients with LGD, and the proportion of patients complicated with colorectal stricture is higher than that of patients with LGD. The proportion of multifocal lesions in patients with advanced neoplasia is higher, and the surveillance of neoplasia in UC patients should be strengthened.
ABSTRACT
Objective:To investigate the risk factors of dysplasia in patients with ulcerative colitis (UC) in China.Methods:From March 1st, 2012 to December 30th, 2013, a total of 154 UC patients were prospectively enrolled from the following 11 hospitals, Xijing Hospital of Digestive Diseases, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Peking Union Medical College Hospital, Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Nanfang Hospital affiliated to Southern Medical University, China-Japan Friendship Hospital, The Second Hospital of Hebei Medical University, West China Hospital affiliated to Sichuan University, The Seventh Medical Center of PLA General Hospital, Zhongshan Hospital affiliated to Xiamen University, and the First Affiliated Hospital of Anhui Medical University. The patients were followed up till December 1st, 2017. All the UC patients underwent colon endoscopy and histopathological evaluation. T test and Chi-square test were used for statistical analysis. Cox proportional risk model was used for identifying the risk factors of dysplasia in UC patients. Results:Finally, 133 UC patients were enrolled, the age was (50.0±11.9) years, the diagnosis age was (35.5±11.6) years, the course of disease was (14.5±6.7) years, and the number of endoscopic examinations was (3.4±1.6) times. A total of 21 patients were detected with dysplasia. No patients were detected with colorectal cancer. The results of univariate analysis revealed that the diagnosis age (hazard ratio ( HR)=1.05, 95% confidence interval ( CI) 1.01 to 1.10, P=0.009) and extensive colitis ( HR=2.92, 95% CI 0.97 to 8.79, P=0.057) were factors with statistically significant difference. The results of multivariate analysis revealed that the old age at diagnosis ( HR=1.06, 95% CI 1.02 to 1.11, P=0.003) and extensive colitis ( HR=3.68, 95% CI 1.21 to 11.19, P=0.022) were independent risk factors of dysplasia in UC patients. The cumulative incidence of dysplasia of UC patients with extensive colitis was higher than that of patients with left-sided colitis (24.3%, 17/70 vs. 6.3%, 4/63), and the difference was statistically significant ( χ2=8.023, P=0.005). Conclusions:Extensive colitis and older age at diagnosis are two independent risk factors of dysplasia in UC patients of our country. The cancer monitoring should be strengthened in UC patients with long course of disease and extensive colitis.
ABSTRACT
Objective To explore the expression and clinical significance of plasma methylated Septin 9 gene ( mSEPT9) in patients with gastric cancer .Methods From March to October in 2018, 380 patients visited Xijing Hospital of Digestive Diseases were selected .The patients were divided into gastric cancer (GC) group, atrophic gastritis (AG) group and non-atrophic gastritis (NAG) group.The positive expression rate of plasma circulating mSEPT9 of the three groups were detected by polymerase chain reaction (PCR) fluorescence probe method, its correlation with clinicopathological characteristics of gastric cancer were analyzed and also compared with the positive rate of carcinoembryonic antigen ( CEA), carbohydrate antigen 19-9 ( CA19-9). Chi-square test and continuity correction chi-square test were performed for statistical analysis .Results The actual number of valid samples was 357 including 147 of GC group, 83 of AG group and 127 of NAG group.The positive rate of plasma mSEPT9 of GC group was higher than those of AG group and NAG group (46.9%, 69/ 147 vs.4.8%, 4/83 and 3.9%, 5/127), and the differences were statistically significant ( χ2 ＝43.438 and 63.912, both P?0.016).The sensitivity and specificity of plasma m SEPT9 in patients with gastric cancers were 46.9%(69/147) and 95.7%(201/210), respectively.The positive rate of mSEPT9 was higher in gastric cancer patients with tumor maximum diameter over 5.0 cm, intestinal-type gastric cancer in Lauren classification, lymphatic metastasis, vascular and neurological invasion , middle-late stage (stageⅢandⅣ) in clinical classification, which were 57.6%(38/66) vs.35.6%(26/73), 52.6%(51/97) vs.31.0%(13/42), 53.0%(61/115) vs.25.0%(8/32), 55.6%(65/117) vs.13.3%(4/30), 50.8%(65/128) vs. 4/19 and 53.5%(61/114) vs.24.2%(8/33), respectively; and the differences were statistically significant (χ2 ＝6.728, 5.517, 7.905, 17.091, 5.871 and 8.998, all P?0.05).The positive rate of plasma mSEPT9 in gastric cancer patients was higher than those of CEA and CA 19-9 (46.9%, 69/147 vs.32.0%, 47/147 and 17.7%, 26/147, respectively), and the differences were statistically significant (χ2 ＝6.892 and 17.437, both P?0.016).Conclusions The positive expression of plasma m SEPT9 in gastric cancer patients has not only high sensitivity but good specificity as well , and it is also related to the clinical stage .The detection of this gene may have important clinical significance in non-invasive diagnosis and prognosis evaluation in patients with advanced gastric cancer .
ABSTRACT
Objective@#To explore the expression and clinical significance of plasma methylated Septin9 gene (mSEPT9) in patients with gastric cancer.@*Methods@#From March to October in 2018, 380 patients visited Xijing Hospital of Digestive Diseases were selected. The patients were divided into gastric cancer (GC) group, atrophic gastritis (AG) group and non-atrophic gastritis (NAG) group. The positive expression rate of plasma circulating mSEPT9 of the three groups were detected by polymerase chain reaction (PCR) fluorescence probe method, its correlation with clinicopathological characteristics of gastric cancer were analyzed and also compared with the positive rate of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9). Chi-square test and continuity correction chi-square test were performed for statistical analysis.@*Results@#The actual number of valid samples was 357 including 147 of GC group, 83 of AG group and 127 of NAG group. The positive rate of plasma mSEPT9 of GC group was higher than those of AG group and NAG group (46.9%, 69/147 vs. 4.8%, 4/83 and 3.9%, 5/127), and the differences were statistically significant (χ2=43.438 and 63.912, both P<0.016). The sensitivity and specificity of plasma mSEPT9 in patients with gastric cancers were 46.9%(69/147) and 95.7%(201/210), respectively. The positive rate of mSEPT9 was higher in gastric cancer patients with tumor maximum diameter over 5.0 cm, intestinal-type gastric cancer in Lauren classification, lymphatic metastasis, vascular and neurological invasion, middle-late stage (stage Ⅲ and Ⅳ) in clinical classification, which were 57.6% (38/66) vs. 35.6% (26/73), 52.6%(51/97) vs. 31.0% (13/42), 53.0% (61/115) vs. 25.0% (8/32), 55.6% (65/117) vs. 13.3% (4/30), 50.8% (65/128) vs. 4/19 and 53.5% (61/114) vs. 24.2% (8/33), respectively; and the differences were statistically significant (χ2=6.728, 5.517, 7.905, 17.091, 5.871 and 8.998, all P<0.05). The positive rate of plasma mSEPT9 in gastric cancer patients was higher than those of CEA and CA19-9 (46.9%, 69/147 vs. 32.0%, 47/147 and 17.7%, 26/147, respectively), and the differences were statistically significant (χ2=6.892 and 17.437, both P<0.016).@*Conclusions@#The positive expression of plasma mSEPT9 in gastric cancer patients has not only high sensitivity but good specificity as well, and it is also related to the clinical stage. The detection of this gene may have important clinical significance in non-invasive diagnosis and prognosis evaluation in patients with advanced gastric cancer.
ABSTRACT
Ulcerative colitis (UC) is a chronic nonspecific intestinal inflammatory disease with unknown etiology and the treatment is difficult. Many consensus on the diagnosis and treatment of UC have been published in many countries in recent years. This article reviewed the treatment of UC on the basis of the European consensus and Chinese consensus.
ABSTRACT
Objective To analyze the clinical characteristics of the elderly acute pulmonary embolism(APE) patients with normal blood pressure and right ventricular dysfunction(RVD).Methods A total of 133 elderly APE patients with normal blood pressure and RVD were retrospectively analyzed.According to whether or not to merge RVD,patients were divided into the RVD group(n=42)and the non-RVD group(n=91).The incidence of clinical symptoms and signs,the incidence of pulmonary embolism,clinical indicators after thrombolytic therapy,and the incidence of bleeding were compared and analyzed between RVD and non-RVD groups.Results The incidences of syncope(33.3％ or 14/42 vs.7.8％ 7/91),P2 accentuation(45.2％ or 19/42 vs.25.3％ or 23/91),tachycardia(40.5％ or 17/42 vs.20.9％ or 19/91),cyanosis(26.2％ or 11/42 vs.8.8％ or 8/91)and jugular vein filling(11.9％ or 5/42 vs.1.1％ or 1/91)had significant differences between RVD and non-RVD groups(x2 =4.928,4.644,5.410,4.971 and 4.163,all P＜0.05).The incidence of proximal pulmonary embolism was higher in RVD group than in non-RVD group[25(59.5％)vs.8(8.8％),x2 =13.636,P＜0.01],and the incidence of lobar artery embolism was higher in RVD group than in non-RVD group[32 (76.2％)vs.47(51.6％),x2 =9.530,P＜0.01].Thirteen RVD patients received low-molecular-weight heparin anticoagulation combined with thrombolytic therapy,and 29 RVD patients took low-molecular-weight heparin anticoagulant therapy.The pulmonary artery systolic pressure(PASP) and tricuspid regurgitation pressure levels were higher in the thrombolytic therapy group than in the anticoagulant therapy group(t =2.894,2.518 and 1.957,P =0.004,0.015 and 0.026).The incidence of bleeding was higher in the thrombolytic therapy group than in the anticoagulant therapy group (23.1％ vs.10.3 ％,x2 =3.498,P =0.015).Conclusions The right ventricular dysfunction should be confirmed in APE patients with embolism involving proximal pulmonary artery or(and)presenting clinical symptoms or signs such as syncope and tachycardia.The anticoagulation therapy is effective and safe for elderly patients with normal blood pressure and right heart dysfunction without risks for further deterioration.
ABSTRACT
Objective To explore the expression and clinical pathological significance of long non-coding transcription factor 7 (lncTCF7) in gastric cancer tissues and to investigate the role of lncTCF7 in the invasion and metastasis of gastric cancer by in vitro experimental study.Methods From January to June 2011,one hundred patients with gastric cancer who underwent radical gastrectomy were selected from Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.The expression of lncTCF7 at mRNA level was detected by quantitative real-time polymerase chain reaction (qRT-PCR).The patients were divided into high expression group (50 cases) and low expression group (50 cases) according to the lncTCF7 mRNA expression level.The stable interferenced lncTCF7 cell line (stable interference group) and blank control lncTCF7 cell line (blank control group) were established.Then the relationship between lncTCF7 expression level and clinical pathological characteristics and prognosis was analyzed.The interferenced lncTCF7 cell line was constructed and utilized,and the role of lncTCF7 in the invasion and metastasis of gastric cancer was detected by wound healing,Transwell and Western blotting method.The Chi square test and t test were performed for statistical analysis.The Kaplan-Meier curve was used for survival analysis.Univariate and multivariate analyses were used for screening the independent factors affecting prognosis.Results The results of qRT-PCR showed that the expression levels of lncTCF7 mRNA in high expression group and low expression group were 0.019 ± 0.003 and 0.002 ± 0.001,respectively.The survival rate of high expression group was lower than that of low expression group (46％,23/50 vs.72％,36/50),and the difference was statistically significant (P =0.002 5).The expression level of lncTCF7 was correlated with intravascular tumor thrombus formation,nerve invasion,depth of invasion and lymph node metastasis (x2 =7.862,7.162,11.903 and 8.280,all P ＜ 0.05).The results of univariate and multivariate analyses showed that the expression level of lncTCF7 was significantly correlated with the depth of invasion (hazard ratio (HR) =4.205,P =0.002;HR =3.125,P =0.018).The results of wound healing assay indicated that lncTCF7 interference could significantly inhibit wound healing ((92.90 ± 1.51) ％ vs.(12.33 ± 0.67) ％,t =48.72,P ＜ 0.01).The results of Transwell assay demonstrated that after 24 hours of culture the number of cells passed through the membrane of the chamber of blank control group was higher than that of stable interference group (83.6 ± 12.5 vs.26.6 ± 4.3),and the difference was statistically significant (t =9.65,P ＜ 0.01).The results of Western blotting showed that the expression of E-cadherin,a marker of epithelial origin,of stable interference group was significantly increased compared with that of blank control group (0.32 ±0.01 vs.0.76 ± 0.01),however the expression levels of vimentin and N-cadherin,markers of mesenchymal origin,were significantly decreased (0.56 ±0.01 vs.0.39 ± 0.01 and 0.67 ± 0.01 vs.0.33 + 0.01),and the differences were all statistically significant (t =26.68,10.09 and 24.14,all P ＜ 0.05).Conclusions The prognosis of gastric cancer patients with high expression of lncTCF7 is poor.lncTCF7 may promote the invasion and metastasis of gastric cancer by influencing eoithelial-mesenchymal transition in gastric cancer cells.
ABSTRACT
OBJECTIVES: The energy consumption process of cochlea and neural signal transduction along the auditory pathway are highly dependent on blood oxygen supply. At present, it is under debate on whether the obstructive sleep apnea syndrome (OSAS) would affect the auditory function since the patients suffer from low oxygen saturation. Moreover, it is difficult to detect the functional state of auditory in less severe stage of OSAS. Recently, speech-evoked auditory brainstem response (speech-ABR) has been reported to be a new electrophysiological tool in characterizing the auditory dysfunction. The aim of the present study is to evaluate the auditory processes in adult patients with mild and moderate OSAS by speech-ABR. METHODS: An experimental group of 31 patients with mild to moderate OSAS, and a control group without OSAS diagnosed by apnea hypopnea index in polysomnogram were recruited. All participants underwent otologic examinations and tests of pure-tone audiogram, distortion product otoacoustic emissions, click-evoked auditory brainstem response (click-ABR) and speech-ABR, respectively. RESULTS: The results of pure-tone audiogram, distortion product otoacoustic emissions, and click-ABR in OSAS group showed no significant differences compared with the control group (P>0.05). Speech-ABRs for OSAS participants and controls showed similar morphological waveforms and typical peak structures. There were significant group differences for the onset and offset transient peaks (P < 0.05), where OSAS group had longer latencies for peak V (6.69± 0.33 ms vs. 6.39±0.23 ms), peak C (13.48±0.30 ms vs. 13.31±0.23 ms), and peak O (48.27±0.39 ms vs. 47.60± 0.40 ms) compared to the control group. The latency of these peaks showed significant correlations with apnea hypopnea index for peak V (r=0.37, P=0.040), peak C (r=0.36, P=0.045), as well as peak O (r=0.55, P=0.001). CONCLUSION: These findings indicate that some auditory dysfunctions may be present in patients with mild and moderate OSAS, and the damages were aggravated with the severity of OSAS, which suggests that speech-ABR may be a potential biomarker in the diagnosis and evaluation at early stage of OSAS.
Subject(s)
Adult , Humans , Hypoxia , Apnea , Auditory Pathways , Cochlea , Diagnosis , Evoked Potentials, Auditory, Brain Stem , Oxygen , Polysomnography , Signal Transduction , Sleep Apnea, ObstructiveABSTRACT
Objective To explore the clinical effects and influence factors in the treatment of lumbar disc herniation (LDH) by the application of modified transforaminal endoscopic surgical system. Methods Clinical data of 178 cases with LDH from November 2013 to May 2016 was retrospectively analyzed and totally followed-up after surgery. Compare the scores of VAS and JOA preoperative and in the follow-up, the efficacy evaluation was performed using modified MacNab system, the effectiveness was observed and the factors that might affect the efficacy were analyzed. Results The VAS score in the back pain, leg pain and JOA of lumbar vertebral function, those three indexes were significantly improved (P < 0.01). Modified MacNab system: 57 cases in excellent, 85 cases in good, 20 cases in fair and 16 cases in poor, with an excellent and good rate of 79.8% and 91.0% efficiency; The results of single factor analysis showed that there was a correlation between age, course of disease, history of surgery in the same segment, symptoms and calcification of prolapse objects (P < 0.05). The results of multi-factor analysis showed that age above 45 years old, history of surgery in the same segment and numbness were the independent risk factors (OR
ABSTRACT
Juvenile idiopathic arthritis (JIA)is a type of chronic rheumatism in children. It is mainly charac-terized by joint damage,accompanied by systemic symptoms and result in significant morbidity. The application of bio-logical agents has altered the traditional treatment pattern of JIA and significantly improved the condition of JIA pa-tients. JIA is a heterogeneous disease. Treatment recommendations issued by American College of Rheumatology(ACR) in 2011 have become an important reference for JIA treatment. There is a best response window for JIA treatment. Thus, the clinic application of biological agents should be used as soon as possible after the diagnosis of JIA. Meantime,it should be noted when a preparation is invalid,it need to use another possible biological agent in time to control disease progression.
ABSTRACT
SIRT is a family of highly conserved nicotine adenine dinucleotide ( NAD+)-dependent protein deacetylase which regulates several processes including cell gene stability , metabolism , aging and apoptosis . Studies have shown that SIRT has protective effects on intestinal barrier , which influences the structure and function of intestinal barrier by controlling the release of inflammatory cytokines , regulating the expression of tight junction protein in intestinal epithelial , and changing the number of Paneth and goblet cells in the intestine .
ABSTRACT
Objective · To investigate the effect of a new type of allene compound, 1-phenylpropadienyl phosphine oxide (PHPO), on proliferation and apoptosis of lung cancer cell line A549. Methods · A549 cells were treated with different concentrations of PHPO. The effects of PHPO on cell proliferation, apoptosis and cell cycle were detected by CCK-8 and flow cytometry assay. Wound healing test was used to measure the migration ability of A549 cells. Real-time PCR was used to detect the expression of apoptosis and cell cycle related gene. The expression of proteins in MAPK pathway was assayed by the Western blotting. The nude mice xenograft model of human lung cancer A549 cells was established. After tumor formation, PHPO was injected daily for treatment, and the tumor size was observed. Results · Compared to the control group, PHPO significantly inhibited the cell viability of A549 cells and induced apoptosis of them, and the IC50 value of 24 h is 44.23 μmol/L. PHPO blocked the cell cycle in the G1 phase significantly. The migration capacity of PHPO-treated cells was decreased. The mRNA levels of Bax and P21 were up-regulated in PHPO-treated group, and the mRNA lever of Bcl-2 was down-regulated (P<0.05). PHPO increased the phosphorylation levels of p38, ERK and JNK. Injection of PHPO could significantly inhibit the growth of tumor in the xenograft model compared to the control group (P<0.05). Conclusion · PHPO can induce the apoptosis and inhibit the proliferation of A549 cells, block the cell cycle in the G1 phase and decrease the migration ability of A549 cells significantly. The mechanism may be related to the activation of MAPK signaling pathway by PHPO and the increase of phosphorylation of p38, ERK and JNK.
ABSTRACT
Objective · To investigate the effect of a new type of allene compound, 1-phenylpropadienyl phosphine oxide (PHPO), on proliferation and apoptosis of lung cancer cell line A549. Methods · A549 cells were treated with different concentrations of PHPO. The effects of PHPO on cell proliferation, apoptosis and cell cycle were detected by CCK-8 and flow cytometry assay. Wound healing test was used to measure the migration ability of A549 cells. Real-time PCR was used to detect the expression of apoptosis and cell cycle related gene. The expression of proteins in MAPK pathway was assayed by the Western blotting. The nude mice xenograft model of human lung cancer A549 cells was established. After tumor formation, PHPO was injected daily for treatment, and the tumor size was observed. Results · Compared to the control group, PHPO significantly inhibited the cell viability of A549 cells and induced apoptosis of them, and the IC50 value of 24 h is 44.23 μmol/L. PHPO blocked the cell cycle in the G1 phase significantly. The migration capacity of PHPO-treated cells was decreased. The mRNA levels of Bax and P21 were up-regulated in PHPO-treated group, and the mRNA lever of Bcl-2 was down-regulated (P<0.05). PHPO increased the phosphorylation levels of p38, ERK and JNK. Injection of PHPO could significantly inhibit the growth of tumor in the xenograft model compared to the control group (P<0.05). Conclusion · PHPO can induce the apoptosis and inhibit the proliferation of A549 cells, block the cell cycle in the G1 phase and decrease the migration ability of A549 cells significantly. The mechanism may be related to the activation of MAPK signaling pathway by PHPO and the increase of phosphorylation of p38, ERK and JNK.
ABSTRACT
Background: Mast cell activation is a characteristic of irritable bowel syndrome (IBS).Study on mast cell and the related inflammatory mediators in colonic mucosa is helpful for the evaluation and treatment of IBS.Aims: To assess the effect of mesalazine combined with trimebutine on colonic mucosal mast cell and related inflammatory mediators in patients with IBS.Methods: Forty patients with diarrhea-predominant IBS (IBS-D) and 40 patients with constipation-predominant IBS (IBS-C) from Oct.2014 to June 2016 at Shanghai Jiading District Central Hospital were enrolled, 20 healthy volunteers were served as controls.Forty patients with IBS-D and 40 patients with IBS-C were randomly divided into mesalazine+trimebutine group and trimebutine group, the treatment courses were all 4 weeks.Number of mast cell was counted by modified toluidine blue staining.Score of related inflammatory mediators were evaluated by immunohistochemistry.Clinical efficacy was assessed.Results: Compared with healthy controls, number of mast cell at baseline was significantly increased both in IBS-D and IBS-C patients (P<0.05).After treatment with mesalazine+trimebutine, number of mast cell was significantly decreased (P<0.05).At baseline, immunohistochemical staining score of 5-HT, IL-1, TNF-α, histamine, tryptase were significantly increased in IBS patients than in healthy controls (P<0.000 1).After treatment with mesalazine+trimebutine, above-mentioned inflammatory mediators were significantly decreased (P<0.05).In IBS-D patients, the total efficacy rate in mesalazine+trimebutine group was significantly increased than that in trimebutine group (85.0% vs.45.0%, P=0.008).In IBS-C patients, no significant difference in total efficacy rate was found between mesalazine+trimebutine group and trimebutine group (55.0% vs.25.0%, P=0.053).Conclusions: Mesalazine combined with trimebutine is an effective and safe approach to reduce mast cell infiltration and release of related inflammatory mediators, and is more efficient for patients with IBS-D.
ABSTRACT
Objective To evaluate the hemostasis effect of balloon urinary catheter after vacuum-assisted breast biopsy (VABB).Methods From May.2016 to May.2017,270 patients undergoing VABB were randomized into study group (135 cases) and control group (135cases).Patients in the study group received VABB postoperative indwelling catheter balloon hemostasis,while patients in the control group received VABB postoperative conventional thoracic pressure bandage to stop bleeding.Postoperative bleeding and hematoma were recorded and compared between the two groups.Results The rates of postoperative bleeding and hematoma in the study group were significantly lower than that in the control group (6.7％ vs 16.3％,P＜0.05;8.9％ vs 24.4％,P＜0.05).Among patients with lesions ≤ 1.5 cm,the rates of postoperative bleeding and hematoma were 1.6％ and 4.7％ in the study group,and 6.5％ and 8.1％ in the control group.There was no significant difference between the two group (P＞0.05).Among patients with lesions ＞1.5 cm,the rates of postoperative bleeding and hematoma in the study group were significantly lower than those in the control group (11.3％ vs 24.7％,P＜0.05;12.7％ vs 32.9％,P＜0.05).Conclusion Hemostasis with balloon urinary catheter is a safe and effective method for postoperative bleeding and hematoma control after VABB.
ABSTRACT
BACKGROUND: Treatment strategy for vertebral burst fracture remains controversial because of its complex morphological changes. There is a lack of knowledge concerning the fixation of thoracolumbar burst fracture (A3.3 by AO classification). OBJECTIVE: To investigate the biomechanical characteristics of thoracolumbar burst fracture (A3.3 by AO classification) after screw fixation, thereby providing reference for choosing an appropriate placement method. METHODS: (1) Three-dimensional motion test: the samples were divided into complete set (group A), L1burst fracture (A3.3 by AO classification) (group B), trans-vertebral fixation (group C), screw fixation at the unilateral fracture level (group D), screw fixation at the bilateral fracture levels (group E), and screw fixation at the bilateral upper fracture levels (F). Several swine spinal specimens served as group A, L1was modeled into A3.3 by AO classification fracture after three-dimensional motion. (2) The compressive stiffness test: one fresh specimen served as complete group (group A), B, C, D, E, and F groups underwent compressive stiffness test. RESULTS AND CONCLUSION: (1) Three-dimensional motion tests: the range of motion in the group B was significantly decreased after C, D, E, and F fixations (P < 0.05). Compared with groups C, D and E, the range of motion at the directions of anteflexion, left flexion, right flexion, left and right rotation in the group F was significantly increased in the group F (P < 0.05); the range of motion in the groups E and D was significantly smaller than that in the groups C and F (P< 0.05); there was no significant difference between groups D and E (P > 0.05). (2) The stiffness in the other groups was significantly higher than that in the group B, especially group E, and the groups D and A did not differ significantly. (3) These results indicate that the fixation at the unilateral fracture level and bilateral fracture levels both can significantly improve the stability of thoracolumbar burst fracture (A3.3 by AO classification), and the former can reduce the economical burden and placement complications.
ABSTRACT
Objective To investigate the levels and clinical significance of serum miR-150 in children with primary nephrotic syndrome(NS).Methods Serum samples were collected from 78 NS children and 79 age-and sex-matched control children in Nanjing General Hospital,Jiangsu Province Hospital of TCM and Nanjing Children Hospital from March 2010 to May 2014.Quantitive Real-time PCR(qRT-PCR)assays were used to determine the concentrations of serum miR-150 in NS and control children.The other lipid and renal function parameters including serum TP,ALB,GLO,TC,TG,Urea,Cr,Uric acid and Uric protein were also assessed.Statistical analyzes were used to evaluate the clinical value of serum miR-150 for NS as well as to assess the clinical association between the levels of serum miR-150 and other clinical parameters.Results The ser-um levels of miR-150 were significantly elevated in NS children[101.4(21.29~336.6)fmol/L(F=3.658,P<0.001)]as compared with controls[34.11(5.53~134.2)fmol/L].ROC curve analysis showed that the area under the receiver operat-ing characteristic curve(AUCROC)was 0.892(95% CI=0.843~0.940).Spearman rank correlations analyzes showed that the levels of serum miR-150 were significantly negatively associated with GLO(r=-0.231,P=0.042)and TG(r=-0.233,P=0.040)in NS children.Multiple linear regression analyses showed that serum miR-150 was independently associ-ated with serum ALB levels(β=0.241,P=0.034;adjusted r2=0.046)after adjustment of other related factors.Further-more,multivariate logistic regression analysis showed that serum miR-150 an independent risk factor for NS after adjusting other factors including age and gender[OR=16.07(95% CI=5.35~48.28),P<0.001].Conclusion The serum levels of miR-150 were markedly elevated in NS children and closely associated with with impaired kidney function as well as lipid pa-rameters,and may have the potential as a novel auxiliary diagnosis marker for assessing the development of NS.
ABSTRACT
Objective Resarech on the value of body mass index (BMI) predicting efficacy of neoadjuvant chemotherapy and prognostic in breast cancer.Methods Clinical data of 99 patients who received neoadjuvant chemotherapy Ⅱ B-Ⅲ C stage breast cancer patients was collected between January 2007 and December 2013 in Women and Children Hospital of Guangdong Province.Anaslysing the relation of BMI and efficacy of neoadjuvant chemotherapy and prognosis.Results In the study, Clinaical complete ressiom was 12.1％ (12/99), partal ressiom was 68.7％ (68/99), stable disease or disease progression was 19.2％ (19/99), respone rate was 80.8％ (80/99), pathlogic complete ression was 9.1％ (9/99).BMI was significantly associated with response rate(P =0.039), but not with pathlogic complete ression (P =0.454).Univariate and multivariate analysis showed that BMI was not significantly associated with disease free survival and overall survival(P ＞ 0.05).Conclusions BMI was significantly associated with response rate, overweight or obese patients would prodict poorly efficacy of neoadjuvant chemotherapy.The relationg of BMI and prognosis of breast cancer who accepted neoadjuvant chemotherapy is not clear, for further study.
ABSTRACT
Objective The purpose of the study was to investigate clinical manifestation and the characters of diagnosis and treatment among children with primary angiitis of the central nervous system (cPACNS) in order to improve awareness of the disease.Methods Clinical data of 5 children with cPACNS in the First People's Hospital of Yunnan Province from January 2009 to December 2013 were collected,and the clinical manifestations and laboratory test results were analyzed and summarized.Results Five cases of children with cPACNS were misdiagnosed at the first clinic visit,and were confirmed a clear diagnosis on the average of (4±6) months; clinical manifestations of five cases of varying degrees of headache,one case with severe headache,2 patients with decreased visual acuity,a cases with hearing were loss,two cases with secondarily generalized seizures; five cases with mild abnormal cerebrospinal fluid examination; 1 case with elevated ESR and CRP level,1 case with elevated immunoglobulin IgG level; 5 cases with abnomal MRI examinations,which showed multiple bilateral lesions,diffuse,lesions,involving the cortex and deep white matter; 4 cases had vascular abnormalities on MRA,treated with corticosteroids alone or in combination with cyclophosphamide and achieved good results.Conclusion Children of primary central nervous system vasculitis is ar are autoimmmune disease primarily involving the central nervous system.It is difficult for the clinical diagnosis.Children need to be wary of the major manifestation of headache associated with vision loss,hearing loss,seizures and other focal neurological system damage.