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Objective:To systematically review and evaluate the effect of intraoperative regional cerebral oxygen saturation (rSO 2) monitoring on perioperative neurocognitive disorders (PNDs) in elderly patients undergoing non-cardiac surgery. Methods:China National Knowledge Infrastructure, Wanfang Database, China Biomedical Literature Database, China Science and Technology Journal Database, PubMed, Cochrane Library, Embase and Web of Science databases were searched from inception to October 2022 for randomized controlled trials involving the effects of intraoperative rSO 2 monitoring on PND in elderly patients underwent non-cardiac surgery. The primary outcome measure was the incidence of PND (1-7 days after surgery), and secondary outcome measures were intraoperative minimum rSO 2 (rSO 2min), intraoperative mean rSO 2 (rSO 2mean), maximum percentage of decrease (rSO 2% max) in rSO 2 from baseline (rSO 2baseline), and the Montreal Cognitive Assessment Scale was used to evaluate the quality of references that met the inclusion criteria, and data were extracted for meta-analysis using RevMan5.4 software. Results:Thirteen randomized controlled trials were enrolled, involving 1 134 patients with 557 patients in experimental group (anesthesia under rSO 2 monitoring) and 577 patients in control group. The results of meta-analysis showed that the incidence of PND was significantly lower in experimental group than in control group ( RR=0.32, 95% confidence interval [ CI] 0.25-0.41, P<0.001), the intraoperative rSO 2min was significantly higher in experimental group than in control group ( MD=7.46, 95% CI 5.05-9.86, P<0.001), and the intraoperative rSO 2mean was significantly higher in experimental group than in control group ( MD=5.49, 95% CI 3.97-7.02, P<0.001), the intraoperative rSO 2% max was significantly lower in experimental group than in control group ( MD=-6.55, 95% CI-9.03--4.07, P<0.001), and the postoperative Montreal Cognitive Assessment Scale score was significantly higher in experimental group than in control group ( MD=1.37, 95% CI 0.74-1.99, P<0.001). Conclusions:Intraoperative application of rSO 2 monitoring can reduce the occurrence of PND in elderly patients undergoing non-cardiac surgery.
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According to the etiological characteristics of the SARS-CoV-2, our hospital specially sets up a ' Sterilized exclusive cabin ' for the personal hygiene treatment of patients, which is used for the disinfection of discharged patients and their clothes. We adopt different disinfection methods for different items and establish relevant standard procedures. A reasonable end-sterilized process at discharge can effectively eliminate the source of infection, cut off the transmission route, and relieve patients' ideological concerns.
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2019 Novel coronavirus (2019-nCoV) infection caused a pandemic in the world. From the reported cases in the literatures, the level of D-dimer in patients with coronavirus disease 2019 (COVID-19) is positively correlated with the severity of illness, which needs the attention of clinical workers. According to Western medicine, the increase of D-dimer is related to the hyperactivity of fibrinolytic system and the shortening of prothrombin time (PT), resulting in excessive production and degradation of plasma fibrin and hypercoagulable state of blood, while traditional Chinese medicine (TCM) believes that the above syndromes belong to the pathogenesis of "blood stasis" according to TCM theories. Over the years, TCM has a significant effect on promoting blood circulation, removing blood stasis and improving microcirculation. This article reviews the mechanism, clinical significance, understanding of TCM and common methods of promoting blood circulation and removing blood stasis caused by 2019-nCoV, in order to provide ideas for the prevention and treatment of impaired blood coagulation in patients with COVID-19.
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Objective To develop an ideal hypertension combined hyperlipidemia(HP/HL)rat model by feeding spontaneously hypertensive rats(SHRs)with high fat diet, and to evaluate the pathological changes in target organs including heart and kidney. Methods Twenty 3-week old male SHRs were randomly divided into two groups: normal fat control group(SHR-NC)and high fat group(SHR-HF). Moreover,ten 3-week old male Wistar-Kyoto rats(WKY)were taken as the model control group(WKY-NC). The rats in SHR-HF group were fed with high-fat diet to induce HP/HL, while rats of WKY-NC and SHR-NC groups were fed with normal diet. The systolic blood pressure(SBP)and body weight were measured every week. At the end of the experiment, the rats were sacrificed to take serum samples for blood lipid analysis including high density lipoprotein(HDL-C), low density lipoprotein(LDL-C), total cholesterol(TC)and triglyceride(TG). Heart and kidney tissue samples were collected to examine the pathological changes using HE and Masson staining. Results Compared with the SHR-NC group, the SHRs fed with high-fat diet for 23 weeks presented significant increase of blood pressure and TC, TG, LDL-C, and decrease of HDL-C. The HP/HL rat model showed pathological changes in the HP/HL target organs, heart and kidney. Renal tissues were severely damaged and showed a large area of fibrosis. Besides, left ventricular hypertrophy and myocardial fibrosis were also observed. Conclusions A HP/HL rat model is successfully constructed by feeding SHRs with high-fat diet for 23 weeks. Most importantly,this model exhibits progressive renal and cardiac alterations, similar to those of patients with HP/HL. This HP/HL rat model may become widely used for evaluation of HP/HL therapeutic drugs.
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Objective To investigate the effects of desflurane on postoperative nausea and vomiting in patients undergoing gynecological laparoscopic surgery.Methods Patients who underwent gynecological laparoscopic surgery in the hospital from Dec.2016 to Nov.2017 were selected and divided into two groups,64 cases in the observation group and 68 cases in the control group.The observation group were treated by desflurane,and the control group were treated by desflurane combined with propofol.General information and intraoperative information of patients were collected.The time of eye opening,extubation,staying in postanesthesia care unit (PACU),postoperative stay were recorded.The incidence and severity of nausea and vomiting from 0 to 6 hours and 6 to 24 hours after surgery were also recorded.Results There was no significant difference in general information between the two groups such as anesthesia time,fluid input and total amount of opioids in operation (P＞ 0.05).The incidence and severity of PONV after surgery from 0 to 6 hours and 6 to 24 hours was similar (P＞ 0.05).The eye opening time,extubation time,staying time in PACU was meaningfully lower in observation group compared with control group(P＜0.05),but the duration of hospitalization after surgery was insignificant(P＞0.05).Conclusion Anesthesia with desflurane doesn't lead to more often or more severe nausea or vomiting,while it help patients wake up faster,which is worthy of clinical promotion.
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Objective To investigate the effects of 1,25-dihydroxy vitamin D3 [1,25 (OH)2D3] on immune mechanism of RBC and spleen in colitis model mice.Methods Thirty mice were randomly grouped as follows:blank control group,model group and 1,25(OH)2D3 group.The animal models were established.Then the general condition and colon pathological changes in mice were observed,the changes of the RBC immune compound(RCIC) and RBC surface C3b receptor(RC3bR) wreath were detected by the yeast wreath method,the weight and length of spleen were measured,the positive rates of spleen immune cells were detected by flow cytometry.Results Compared with the model group,RBC-C3bR in the 1,25(OH)2D3 group and blank control group was significantly increased and RBC-ICR was significantly decreased (P＜0.01).Compared with the blank control group,the positive rates of CD3,CD4,CD8 and CD45R in spleen mononuclear cell were significantly increased (P＜0.01);after the 1,25 (OH) 2D3 intervention,the positive rates of CD3,CD4,CD8 and CD56R in spleen mononuclear cells were significantly decreased compared with the model group(P＜0.01).Conclusion 1,25(OH)2D3 has the immune regulatory effect on RBC and peripheral spleen lymphocytes in chronic colitis mice.
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Objective To investigate the protective role of Gingko Biloba extract (EGB 761) in intestinal mucosal barrier of intestinal inflammation model mouse.Methods Thirty mice were randomly divided into the control group,model group and EGB 761 group;the animal model was established;the general condition,body mass change,fecal occult blood and colon histopatho1ogical changes were observed,the expressions of occludin-1 proteins in colon tissue were detected by immunofluorescence.Results The body mass in the model group appeared to decrease,drinking water and eating food were significantly decreased compared with that in the control group.However after the EGB 761 intervention,the body mass of the model mice was significantly risen again;little inflammatory cells infiltration could be seen in the EGB 761 group,the inflammatory degree was significantly alleviated compared with the model group.The fluorescence distribution of the claudin-1,occludin and zo-1 in colonic tissues of the model group was more disperse compared with the normal group,the fluorescence intensity was weakened with rough edge;after EGB 761 intervention,the fluorescence in the EGB7 61 group was distributed along with the cellular membrane,the intensity was slightly weakened compared with the normal control group,but was still stronger than that in the model group.Conclusion EGB 761 can improve the inflammatory reaction in mouse colonic tissue,its mechanism may be related with its strengthening the protective effect of intestinal mucosal barrier.
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Objective To investigate MRI features and its clinical value in the pigmented nodular synovitis (PVNS) of the knee joint in order to improve the accuracy of diagnosis of the disease.Methods MRI signs of 9 cases with PVNS of knee joint confirmed by operation and pathology were analyzed retrospectively.Results In 9 patients, joint effusion and marginal bone erosion were found.Diffuse thickening of the synovial membrane, multiple soft tissue nodules showed hypointense on T1WI and mixed hypointense and hyperointense on T2WI,were revealed on MRI.Conclusion MRI features of PVNS of the knee joint are characteristic, which reflects the pathological basis and helps to improve the diagnostic accuracy of the disease.
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Objective To investigate the effects of 1,25-dihydroxy vitamin D3 [1,25 (OH)2D3] on immune mechanism of RBC and spleen in colitis model mice.Methods Thirty mice were randomly grouped as follows:blank control group,model group and 1,25(OH)2D3 group.The animal models were established.Then the general condition and colon pathological changes in mice were observed,the changes of the RBC immune compound(RCIC) and RBC surface C3b receptor(RC3bR) wreath were detected by the yeast wreath method,the weight and length of spleen were measured,the positive rates of spleen immune cells were detected by flow cytometry.Results Compared with the model group,RBC-C3bR in the 1,25(OH)2D3 group and blank control group was significantly increased and RBC-ICR was significantly decreased (P＜0.01).Compared with the blank control group,the positive rates of CD3,CD4,CD8 and CD45R in spleen mononuclear cell were significantly increased (P＜0.01);after the 1,25 (OH) 2D3 intervention,the positive rates of CD3,CD4,CD8 and CD56R in spleen mononuclear cells were significantly decreased compared with the model group(P＜0.01).Conclusion 1,25(OH)2D3 has the immune regulatory effect on RBC and peripheral spleen lymphocytes in chronic colitis mice.
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Objective To investigate the protective role of Gingko Biloba extract (EGB 761) in intestinal mucosal barrier of intestinal inflammation model mouse.Methods Thirty mice were randomly divided into the control group,model group and EGB 761 group;the animal model was established;the general condition,body mass change,fecal occult blood and colon histopatho1ogical changes were observed,the expressions of occludin-1 proteins in colon tissue were detected by immunofluorescence.Results The body mass in the model group appeared to decrease,drinking water and eating food were significantly decreased compared with that in the control group.However after the EGB 761 intervention,the body mass of the model mice was significantly risen again;little inflammatory cells infiltration could be seen in the EGB 761 group,the inflammatory degree was significantly alleviated compared with the model group.The fluorescence distribution of the claudin-1,occludin and zo-1 in colonic tissues of the model group was more disperse compared with the normal group,the fluorescence intensity was weakened with rough edge;after EGB 761 intervention,the fluorescence in the EGB7 61 group was distributed along with the cellular membrane,the intensity was slightly weakened compared with the normal control group,but was still stronger than that in the model group.Conclusion EGB 761 can improve the inflammatory reaction in mouse colonic tissue,its mechanism may be related with its strengthening the protective effect of intestinal mucosal barrier.
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Pinellia ternata in traditional Chinese medicinal herbs,planted and wide application range,with great development value.Medicinal components of pinellia ternata have obviously anti-tumor effect.In this paper,the author summarized the research result of anti-tumor effect of medicinal components of pinellia ternata,sought for a proven foundation of anti-tumor mechanism of medical components of pinellia ternata.
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Some anti -scientific views on cancer treatment on network have serious adverse effects on some cancer patients:impacting the health promotion , patients′compliance , patients′positive psychology , patients′so-cial supports and people′s correct understanding to medical staff .And put forward the following two solutions to this effect:improve medical science website , improve the understanding of cancer prevention and control of masses , hired authoritative expert lectures on site or television , government , medical institutions and hospitals should ac-tively resist vulgar anti-science view , shoulder the moral responsibility .
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Objective To explore the concentration of mannan-binding lectin(MBL ) of patients with chronic hepatitis B virus (HBV) .Methods Serum MBL concentrations of 250 patients(case group) with HBV and 150 healthy controls(control group) were measured .Results The serum MBL concentration in case group was higher than that in control group(t=7 .097 ,P<0 .01) . The serum MBL concentration in high HBV-DNA loading group was higher than that in control group(t=7 .179 ,P<0 .01) .The serum MBL concentration in low HBV-DNA loading group was higher than that in control group(t=4 .404 ,P<0 .01) .Conclusion Detection of serum MBL in patients with HBV will be clinically useful for understanding state of an illness and observing the cur-ative effect .
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Objective To investigate the expression of Notch1,Delta-like ligand 4 (DLL4),hairy and enhancer of split-1 (HES-1),microvessel density (MVD),lymphatic vessel density (MLD) in gastric carcinoma,so as to discuss their roles in the development of gastric carcinoma.Methods Gastric carcinoma,paracancer tissues which was apart from the edge of cancer tissue ＞ 60 mm obtained during operation and normal gastric mucosa obtained during gastroscopy were used as controls.All specimens were made tissue microarray.The expressions of Notchl,DLL4,HES-1 were detected by immunohistochemistry.Immunohistochenical double taining was used to detect MVD and MLD.The relationships between Notch1,DLL4,HES-1 expression and angiogenesis,lymphangiogenesis and their significances were analyzed.Results The positive rate of Notch1 in gastric carcinoma was 48.30％,significantly higher than that of paracancerous (25.00％,x2 =6.38,P ＜ 0.05) and control group (16.67％,x2 =10.18,P ＜0.05).The differences of the positive rate of DLL4 in gastric carcinoma (55.94％),paracancerous (45.70％) and control group (56.67％) were not significant (x2 =1.18,P ＞0.05 ; x2 =0.005,P ＞ 0.05).The differences of the positive rate of HES-1 in gastric carcinoma (36.64％),paracancerous (34.40％) and control group (33.33％) were not significant (x2 =0.05,P ＞ 0.05 ;,x2 =0.11,P ＞ 0.05).The mean of MVD in gastric carcinoma group was 28.84 ± 14.17,which was significantly higher than that in paracancerous group (17.02 ±8.54,t =4.03,P＜0.05) and control group (16.69 ±7.21,t =5.01,P＜0.05).The mean of MLD in gastric carcinoma group was 8.55 ±4.98,which was significantly higher than that in paracancerous group (4.05 ± 2.48,t =9.30,P ＜ 0.05) and control group (3.99 ± 1.56,t =10.32,P ＜ 0.05).The expression of DLL4 was correlated with MVD (t =2.77,P ＜ 0.05),but wasn't correlated with MLD (t =1.89,P ＞0.05).There were no correlations between the expression of Notch1,HES-1 and tissues MVD,MLD (P ＞0.05).Conclusion Notch1 plays important roles in the development of gastric carcinoma.There are many angiogenesis and lymphangiogenesis in gastric carcinoma.The expression of DLL4 in gastric carcinoma has certain effect in the formation of microvessel.
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Objective To investigate the significance of aldehyde dehydrogenase 1 (ALDH1)expression in appraising the prognosis of nasopharyngeal squamous carcinoma (NPC).Methods The expression of ALDH1 protein was detected by immunohistochemistry in human specimens obtained from 120 NPC patients without the history of radiotherapy or chemothetapy.Results A relatively high expression of ALDH1 were observed in 40.0 ％ (48/120) patients of NPC,the expression of ALDH1 in the edge of the cancer nests and stroma,particularly spindle cancer cells were strongly positive.The positive expression of ALDH1 was closely associated with patients' nasopharyngeal tumor size (P =0.011),lymphatic metastasis (P =0.005) and clinic stage (P =0.001),but not associated with their gender and age (both P ＞ 0.05).The Kaplan-Merier and Cox regression analysis indicated that ALDH 1 closely correlated with clinical progrosis of the patients.It showed that ALDH1 was an independent risk factor which may affect the prognosis of NPC patients.Conclusion The expression of ALDH1 protein closely correlate with clinic outcome of NPC,suggesting that ALDH1 is a risk factor for clinic progrosis of NPC patients.
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Objective: To evaluate the potential dosimetric beneifts and optimal indications of intensity modulated radiation therapy (IMRT) and hybrid intensity modulated radiation therapy (Hybrid IMRT) for the left side breast cancer patients after breast-conservation therapy. Methods: Eight patients with left breast carcinoma who received breast-conservation surgery were selected for this study. Two plans were designed in 3-dimensional treatment planning system. The dose distributions of target volume and normal tissues, conformal index (CI) and heterogeneous index (HI) were analyzed by dose-volume histogram (DVH). Results: The PTV coverage was the same in the two radiotherapy plans. A better dose uniformity throughout the whole breast in Hybrid IMRT plan was achieved. The CI, the percentage of PTV receiving more than 105% prescribed dose (V105%), the percentage of PTV receiving more than 110% prescribed dose (V110%), and the Dmax, Dmin and Dmean of PTV were similar in the two plans. We compared the Hybrid IMRT with IMRT: V13of the ipsilateral lung decreased from 27.66% to 20.7%, V5 of the contralateral lung decreased from 8.01% to 2.25%, V10 and V20 of the heart decreased from 35.23% and 16.77% to 19.22% and 10.6% respectively, V5 and V10 of the contralateral breast decreased from 35% and 10.39% to 20.38% and 5.7% respectively, all with significant difference. V30 and V40 of the ipsilateral lung and V40 of the heart increased by 1.28%, 1.48%, and 2.48%, with signiifcant difference. Conclusion: Hybrid IMRT is a better choice for patients whose treatment position is inaccurate or cannot be repeated well.
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OBJECTIVE@#To observe the clinical results and the toxicities of normal tissues in untreated nasopharyngeal carcinoma (NPC) treated with intensity modulated radiation therapy (IMRT).@*METHODS@#A total of 90 patients with untreated NPC received IMRT. According to the 1992 Fuzhou staging system, 3 patients were in stage I, 29 in stage II, 26 in stage III, and 32 in stage IVa. For IMRT,the prescription dose was 71.94-77.88 Gy/33f for the planning target volume of the gross tumor volume in the nasopharynx (PGTVnx); 69.96 Gy/33f for the positive neck lymph nodes (GTVnd); 60-66 Gy/33f for the planning target volume of the high risk regions (PTV1); and 50.4-56 Gy/28f for the planning target volume of the low risk regions (PTV2). Chemotherapy included concurrent and adjuvant protocols. The overall survival rate, local control rate, and distant metastasis-free survival rate were estimated by Kaplan-Meier method. Cox regression was used for multivariate analysis. Acute and 1ate toxicities were graded according to RTOG radiation morbidity scoring criteria.@*RESULTS@#The median follow-up time was 33 months (12-56 months). The 1-, 2-, 3- and 4-year survival rate was 97.8%, 90.6%, 86% and 80%; the local control tate was 98.8%, 97.5%, 92.1% and 77.4%; and the distant metastasis-free survival rate was 95.3%, 90.7%, 88.4% and 85.8%, respectively. The most serious acute toxicity was irradiated inflammation of mocosa with Grade 1 to 4 of 16.7%, 60%, 23.3% and 0, respectively. In the multivariate analysis, clinical stages were the prognostic factors for the survival rate. The most serious toxicity was salivary gland. The rate of grade xerostomia 1-year after the radiotherapy with Grade 1 to 4 was 18.1%, 9.6%, 0 and 0, respectively.@*CONCLUSION@#IMRT combined chemotherapy can improve the survival rate, and late adverse reaction is obviously decreased. Local recurrence and distant metastasis are the main reasons for low survival rate.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Combined Modality Therapy , Nasopharyngeal Neoplasms , Drug Therapy , Radiotherapy , Radiotherapy, Intensity-Modulated , Retrospective Studies , Survival AnalysisABSTRACT
In recent years, ultrasonographic ultrasonographic ultrasonographic resolution level of gastrointestinal anatomy has been improved significantly due to perfection of ultrasonic instrument and development of ultrasound diagnostic technology. Currently, ultrasonographic ultrasonographic ultrasonography plays an effective role of evaluation of children's gastrointestinal obstruction diseases, especially congenital hypertrophic pyloric stenosis, gastroesophageal reflux, malrotation, midgut volvulus, superior mesenteric artery syndrome,duplication, intussusception, meconium peritonitis, meconium ileus, and congenital giant colon. The clinical manifestation and the ultrasonographic feature of all these diseases mentioned above are reviewed in this paper.
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OBJECTIVE@#To establish 2-dimensional electrophoresis (2-DE) graph of A549 and A549/DDP cell lines, to identify the differentially expressed proteins, and to screen multidrug resistance (MDR) related proteins in human lung adenocarcinoma.@*METHODS@#The total proteins of A549 and A549/DDP cells were obtained, and were extracted and separated by 2-DE. PDQuest software was applied to analyze the 2-DE images, and the differential proteins of the 2 types of cells were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS). Western blot was used to determine the expression levels of the 4 proteins.@*RESULTS@#We established 2-DE maps of total proteins from A549 and A549/DDP. A total of 40 differential protein spots in the 2 cell lines were found, and 23 differential expression proteins were identified by MALDI-TOF-MS. Western blot showed that heat shock protein beta-1, annexin A4, cofilin l, vimentin were differential expression proteins in A549 and A549/DDP, which was consistent with the results of the comparative proteomic analysis.@*CONCLUSION@#The 23 differential expression proteins in human lung adenocarcinoma are useful for studying the MDR mechanism of lung adenocarcinoma.
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Humans , Adenocarcinoma , Genetics , Metabolism , Pathology , Annexin A4 , Antineoplastic Agents , Pharmacology , Cell Line, Tumor , Drug Resistance, Multiple , Genetics , Drug Resistance, Neoplasm , Genetics , Electrophoresis, Gel, Two-Dimensional , HSP27 Heat-Shock Proteins , Lung Neoplasms , Genetics , Metabolism , Pathology , Neoplasm Proteins , Classification , Proteome , Proteomics , MethodsABSTRACT
OBJECTIVE@#To investigate the inhibitive effect of E1A gene carried by PEI-Fe(3)O(4) nanometer particle (NP) on the cell growth of human cervical carcinoma cell in vitro and its mechanism, and to provide the experimental evidence for the feasibility of gene therapy for human cervical carcinoma.@*METHODS@#E1A gene conjugated to PEI-Fe3O4 NP was transfected into human cervical carcinoma cell line Hela. The cell growth curve of Hela was drawn, the doubling time and the number of colony formations on the soft agar were calculated based on the cell count. RT-PCR and Western blot were used to detect the expression of the E1A and HER-2/neu in Hela cells.@*RESULTS@#The cell doubling time of Hela cells transfected with E1A gene (Hela-E1A) was 1.53 times and 1.58 times longer than that of the Hela transfected with blank vector (Hela-vector) and blank Hela control (Hela), respectively. The E1A transfected Hela cells grew slower than those of the control group. The cell colony formation efficiency in the Hela-E1A (6.62%) group was significantly lower than that of Hela (30.48%) and Hela-vector (28.3%) groups (P<0.05). As compared to Hela and Hela-vector, the inhibition rate of Hela-E1A was 78.28% and 76.62% respectively. RT-PCR and Western blot demonstrated that the overexpression of E1A through gene transfection significantly inhibited mRNA and protein expression of HER-2/neu in Hela cells.@*CONCLUSION@#E1A gene can suppress the cell growth of human cervical carcinoma cell Hela in vitro. Down-regulated expression of HER-2/neu gene by E1A overexpression in Hela might contribute to the Hela growth inhibitive effect of E1A.