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In the past decades,a dramatic development of navigation technology in orthopaedic surgery has been witnessed. By assisting the localization of surgical region,verification of target bony structure,preoperative planning of fixation,intraoperative identification of planned entry point and direction of instruments or even automated insertion of implants,its ability and potential to reduce operation time,intraoperative radiation,surgical trauma,and improve accuracy has been proved. However,in contrast to the widespread use of navigation technology in arthroplasty,orthopaedic tumor,and spine surgery,its application in orthopaedic trauma is relatively less. In this manuscript,the main purpose is to introduce the technical principles of navigation devices,outline the current clinical application of navigation systems in orthopaedic trauma,analyze the current challenges confronting its further application in clinical practice and its prospect in the future.
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Humans , Orthopedics , Surgery, Computer-Assisted/methods , Orthopedic Procedures/methods , Operative TimeABSTRACT
Peritoneal metastases (PM) are defined as the primary or secondary occurrence/progression of malignant tumor in peritoneum. PM were previously thought to be a terminal disease without effective treatment, with short survival and poor prognosis. With the change in the understanding of PM, the oncology communities regard it as a curable regional cancer metastasis, and create a comprehensive treatment technology system with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy as the core, and establish professional PM treatment centers based on this. The professional PM treatment centers have significantly prolonged the survival of patients, and some patients can even achieve clinical cure. However, in China, there are very few professional PM treatment centers, but the number of PM patients is huge, and most of the patients can't receive professional treatment, resulting in poor survival and prognosis. Based on the cancer statistics in 2015 published by China National Cancer Center Registry and clinical outcome literature on peritoneal metastasis, this paper uses clinical epidemiology methodology to calculate the number of newly diagnosed patients with peritoneal metastasis, to estimate the number of specialized peritoneal cancer centers required, to provide data support for the promotion of professional treatment technology system for PM in our country, and to boost the development of peritoneal oncology.
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Objective To understand the current status of osteoporosis risk and influencing factors for residents from 30 to 65 years old in typical hot spring areas in Guizhou province, and to provide a theoretical basis for reducing the risk of osteoporosis and the prevention of osteoporosis in the population. Methods A health questionnaire for residents in typical hot spring areas in Guizhou, osteoporosis risk test questions, Pittsburgh sleep quality index(PSQI), etc were used. A face-to-face survey of 3 708 residents was conducted, and logistic regression was used to analyze the influencing factors of osteoporosis risk in hot spring areas. Results 2 403(64.81%)residents of 3 708 people surveyed were at risk of osteoporosis, of whom 1 434(87.4%)males and 969 females(47.1%)had a higher risk of osteoporosis (χ2=652.4, P < 0.001). As age increased, more residents were at risk of osteoporosis(χ2=273.4, P < 0.001), and numbers of residents of 30-39 years old, 40-59 years old, and above 60 years of age at risk of osteoporosis were 319(49.2%), 1 572(62.9%), and 512(93.6%). Male osteoporosis risk was negatively correlated with an education level of undergraduate and above(OR=0.37, 95%CI: 0.19-0.73). Age 40-59(OR=1.54, 95%CI: 1.07-2.22), 60 and above(OR=6.39, 95%CI: 2.76-14.79), and sleep disorders(OR=1.59, 95%CI: 1.08-2.35)may increase the risk of osteoporosis in male residents in hot spring areas. Less oil in daily diet may increase the risk of osteoporosis in women(OR=1.70, 95%CI: 1.23-2.36). Age 40-59(OR=1.54, 95%CI: 1.17-2.03), over 60 and above(OR=16.24, 95%CI: 10.10-26.12), and sleep disorders(OR=1.84, 95%CI: 1.48-2.28)were positively correlated with risk of osteoporosis in women. Women with junior high school degree(OR=0.61, 95%CI: 0.47-0.80), high school degree(OR=0.57, 95%CI: 0.37-0.89)and undergraduate degree and above(OR=0.59, 95%CI: 0.39-0.98)had a lower risk of osteoporosis than women who were illiterate or semi-illiterate. The osteoporosis risk test questions showed that smoking, heavy drinking, and erectile dysfunction and reduced sexual desire were the main sources of osteoporosis risk in men. Menopause before the age of 60, ≤45 years old, no milk and no calcium supplements, parents with osteoporosis or bone fractures were the major risk sources of osteoporosis in women. Conclusion The risk of osteoporosis among male residents from 30 to 65 years old in typical hot spring areas in Guizhou province is higher than that among women. Education of osteoporosis prevention should be strengthened among local residents to promote healthy behaviors and lifestyles.
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Objective To investigate the prevalence of osteoarthrosis and the association between hot spring bathing and osteoarthrosis among local adults in typical hot spring areas of Guizhou Province. Methods A face-to-face questionnaire survey was conducted among residents aged from 30 to 65 in five typical hot spring areas, including Xifeng(Xifeng County, Guiyang), Jianhe(Jianhe County, Qiandongnan), Fodingshan(Shiqian County, Tongren), Guiyu(Wudang District, Guiyang)and Huishangu(Suiyang County, Zunyi). Residents' basic information, bone and joint diseases prevalence, hot spring bathing, and other health-related behaviors were investigated in this study. The prevalence of local bone and joint diseases was analyzed, and binary logistic regression was used to calculate OR(95%CI)to analyze the association between hot spring bathing and bone and joint diseases. Results A total of 3 708 adults(1 648 males and 2 060 females)were included as the statistical analysis survey subjects, and 794 people reported bone and joint diseases, accounting for a prevalence rate of 21.41%, 95% CI: 0.201-0.227. The prevalence of females(24.56%)was higher than that of males(17.48%)(P < 0.001). The prevalence rates of diseases increased with age(χtrend2=130.265, P < 0.001). There were also statistically significant differences in the prevalence rate of bone and joint diseases among different genders, age groups, occupations, education levels, and smoking behaviors(P < 0.05). After gender, age, occupation, education and smoking were adjusted for, compared with the group who never took hot spring baths, participants who took hot spring baths occasionally(OR=0.793, 95%CI: 0.631-0.996)and frequently(OR=0.713, 95%CI: 0.536-0.948)were associated with a lower risk of bone and joint diseases. Conclusion The prevalence of osteoarthrosis is 21.41% in the typical hot spring areas of Guizhou Province. Older or females have a higher risk of prevalence of bone and joint diseases. Hot spring bathing may be associated with a lower risk of bone and joint diseases.
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Objective To investigate the association between hot spring bathing behavior and hypertension and understand the mediation effect of sleep quality problems on the association. Methods A cross-sectional survey was conducted among adults aged 30 to 65 living and working around five hot springs in Guizhou Province, employing a self-designed questionnaire on the health status and hot spring bathing, and 3 708 qualified questionnaires were collected. Participants were divided into three groups according to their frequency of hot spring bathing: never, occasionally, and frequently. Stratified via sex and sleep quality, the binary logistic regression model was used to analyze the association between different hot spring bathing frequencies and self-reported hypertension. Results Significant difference was detected in the self-reported hypertension between groups who never bathe(13.7%), who occasional bathe(9.4%)and who frequently bathe(8.5%)among female participants(χ2=10.460, P=0.005). However, no significant difference was found among different bathing groups in males. Furthermore, multivariate analysis showed that compared with no bathing, occasional(OR=0.692)and frequent (OR=0.594)hot spring bathing were associated with lower hypertension prevalence among female population, and female groups of occasional and frequent bathing with sleep quality problems had smaller OR(OR=0.571 and 0.406, respectively). After sleep quality problems were included, hot spring bathing was still associated with lower hypertension risk, and the OR values of occasional bathing and frequent bathing groups were 0.723 and 0.611, respectively. The sleep quality problems of female population played a partial mediating role in the association between hot spring bathing and hypertension, and the relative mediating effects of occasional bathing and frequent bathing with hypertension were both statistically significant(Zm=-2.022 and -1.995, P < 0.05), which accounted for 34.34% and 30.15% of the total effects, respectively. Conclusion Regular hot spring bathing may play an auxiliary role in the prevention of hypertension, and it may provide a stronger protection for women, and especially those with sleep quality problems. Sleep quality problems may explain part of the association between hot spring bathing and hypertension in female population.
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Objective To analyze the association between hot spring bathing and the quality of life of smokers living in typical hot spring areas of Guizhou to make suggestions on improving their quality of life. Methods The study is a cross-sectional study whose data was collected by questionnaires. The WHO Quality of Life Scale(WHO QOL-BREEF)was used to measure quality of life. Results The quality of life in the psychological domain(14.09±1.83 vs 13.79±1.82, P < 0.05)and the environmental domain(12.70±1.84 vs 12.37±1.67, P < 0.05)among smokers who took hot spring baths was significantly higher than that among those who did not. After adopting ordinary logistic regression model to adjust for other factors, for the physical domain, the odd of scoring"good"in the WHO scale in group of smokers who took hot spring baths less that once a month was 0.70 lower than that in those who took baths at least once a month(OR=0.70, 95%CI: 0.54-0.91). In psychological domain, the odd of the group of smokers who did not take hot spring baths was 0.65 lower than that in those who took baths at least once a month(OR=0.65, 95%CI: 0.47-0.90). And the odd of the group of smokers who bathed less than once in a month was 0.71 lower than those who bathed at least once a month(OR=0.71, 95%CI: 0.54-0.92). Conclusion There is a positive relationship between hot spring bathing and quality of life, which prompts that people who smoke take hot spring baths to improve their quality of life.
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Objective To investigate hot spring bathing behavior and chronic disease prevalence of residents aged 30 to 65 in typical hot spring areas of Guizhou Province. Methods Totally 3 708 individuals between 30 and 65 in five typical hot spring areas of Guizhou Province were included in this study. Their hot spring bathing behavior and chronic disease prevalence were recorded. Unconditional logistic regression was used to analyze the association between hot spring bathing and the incidence of chronic diseases. Results 71.3% of the residents in the hot spring areas had bathed in hot springs, with the proportion higher in males than females(χ2=92.856, P < 0.001). 76.3% of people took hot spring baths fewer than or equal to 6 times per year, 30.8% of residents often chose to take hot spring baths in the evening, and 37.6% of the residents took hot spring baths for 21-40 minutes. Bathing was more common in winter. 11.5% and 17.9% of the residents added other substances and used hot spring facilities, and most of them added traditional Chinese medicine and used the sauna. 46.6% and 41.6 % of the residents took hot spring baths to relax and relieve fatigue. The self-reported prevalence rate of chronic diseases was 522.1‰, and the top five single diseases were lumbar intervertebral disc disease(119.7‰), hypertension(118.1‰), urinary calculus(77.7‰), cervical intervertebral disc disease(53.7‰)and osteogenesis(44.5‰). Compared with those who never bathed in hot springs, taking hot spring baths 7-11 times a year was negatively correlated with chronic diseases.(OR=0.551, 95%CI: 0.345-0.879). Conclusion Hot spring bathing is popular in typical hot spring areas of Guizhou Province, but its frequency is not high. The overall prevalence of chronic diseases is relatively high, and the order of most prevalent chronic diseases is different from that in other areas. Proper hot spring bathing is negatively correlated with chronic diseases.
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Objective: Peritoneal carcinomatosis refers to a group of heterogeneous (primary or secondary) malignancies in the surface of the peritoneum. Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) is a comprehensive treatment strategy aiming at peritoneal carcinomatosis. This study analyzed the efficacy and safety of CRS+HIPEC in patients with peritoneal carcinomatosis, and explored prognostic factors. Methods: In this descriptive case-series study, the clinicopathological data of 1384 consecutive patients with peritoneal carcinomatosis treated in Zhongnan Hospital of Wuhan University (330 patients) and Shijitan Hospital of Capital Medical University (1054 patients) from January 2004 to January 2020 were collected retrospectively. Treatment patterns of CRS+HIPEC characteristics (operative time, number of resected organs, number of stripped peritoneum, number of anastomosis, and HIPEC regimens), safety [blood loss volume, postoperative severe adverse event (SAE) and treatment outcome], survival time and prognostic factors influencing survival were analyzed. The SAE was defined as grade III-IV adverse event according to the Peritoneal Surface Oncology Group International Textbook. Perioperative period was defined from the day of CRS+HIPEC to postoperative 30th day. OS was calculated from the day of CRS+HIPEC to the date of death or the last follow-up. Kaplan-Meier method was used for survival analysis, and log-rank test was used for comparison between groups. Cox regression model was used to identify the prognostic factors. Results: Among 1384 peritoneal carcinomatosis patients, 529 (38.2%) were male; median age was 55 (10-87) years old; median body mass index (BMI) was 22.6 kg/m(2); peritoneal carcinomatosis of 164 (11.8%) patients were from gastric cancer, 287 (20.7%) from colorectal cancer, 356 (25.7%) from pseudomyxoma peritonei, 90 (6.5%) from malignant peritoneal mesothelioma, 300 (21.7%) from gynecological cancer or primary peritoneal carcinoma, and 187 (13.5%) from retroperitoneal sarcoma, lung cancer, breast cancer, and other rare tumors. The median duration of CRS+HIPEC was 595 (90-1170) minutes, median number of resected organs was 2 (0-10), median number of resected peritoneal area were 4 (0-9), median peritoneal cancer index (PCI) was 21(1-39). Completeness of cytoreduction (CC) score of 0-1 was observed in 857 cases (61.9%). Regarding HIPEC regimens, there were 917 cases (66.3%) with cisplatin plus docetaxel, 183 cases (13.2%) with cisplatin plus mitomycin, 43 cases (3.1%) with adriamycin plus ifosfamide, and the other 240 cases (17.3%) with modified regimens. Perioperative SAE developed in 331 peritoneal carcinomatosis patients (23.9%) with 500 cases, of whom 21 patients (1.5%) died during the perioperative period due to ineffective treatment, while the others recovered after active treatment. During median follow-up time of 8.6 (0.3-82.7) months, there were 414 deaths (29.9%). The median OS was 38.2 months (95% CI: 30.6-45.8), and the 1-, 3-, 5-year survival rate was 73.5%, 50.4% and 39.3%, respectively. The median OS of peritoneal carcinomatosis patients from gastric cancer, colorectal cancer, pseudomyxoma peritonei, malignant peritoneal mesothelioma and female genital cancer or primary peritoneal carcinomatosis was 11.3 months (95% CI: 8.9-13.8), 18.1 months (95% CI: 13.5-22.6), 59.7 months (95% CI: 48.0-71.4), 19.5 months (95% CI: 6.0-33.0) and 51.7 months (95% CI: 14.6-88.8), respectively, and the difference among groups was statistically significant (P<0.001). Univariate and multivariate analyses revealed that the primary gastric cancer (HR=4.639, 95% CI: 1.692-12.724), primary colorectal cancer (HR=4.292, 95% CI: 1.957-9.420), primary malignant peritoneal mesothelioma (HR=2.741, 95% CI: 1.162-6.466), Karnofsky performance status (KPS) score of 60 (HR=4.606, 95% CI: 2.144-9.895), KPS score of 70 (HR=3.434, 95% CI: 1.977-5.965), CC score of 1 (HR=2.683, 95% CI: 1.440~4.999), CC score of 2-3 (HR=3.661,95% CI: 1.956-6.852) and perioperative SAE (HR=2.588, 95% CI: 1.846-3.629) were independent prognostic factors influencing survival with statistically significant differences (all P<0.05). Conclusions: CRS+HIPEC is an effective integrated treatment strategy for patients with peritoneal carcinomatosis, which can prolong survival with acceptable safety. Preoperative evaluation of patients' general condition is necessary and CRS+HIPEC should be carefully considered to perform for patients with preoperative KPS score <80. During the operation, the optimal CRS should be achieved on condition that safety is granted. In addition, it is necessary to prevent perioperative SAE to reduce the risk of death in peritoneal carcinomatosis patients.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Colorectal Neoplasms , Combined Modality Therapy , Cytoreduction Surgical Procedures , Hyperthermia, Induced , Hyperthermic Intraperitoneal Chemotherapy , Peritoneal Neoplasms/drug therapy , Retrospective Studies , Survival RateABSTRACT
Gastrointestinal cancer peritoneal metastasis(GICPM) is one of the biggest challenges of clinical treatment. The ultimate solution to the problem requires the clinicians to accurately understand cytologic and molecular pathological mechanisms behind GICPM, and apply such knowledge in the clinical decision-making process for diagnosis and treatment of individual patient, so as to realize "prevention" and "treatment" proactively. The core cytopathological mechanisms behind GICPM, which are closely related to clinical treatment decisions, are as follows: (1) free cancer cells or clusters in peritoneal cavity colonize the peritoneum, resulting in irreversible pathological damage to peritoneal mesothelial cells; (2) the colonized cancer cells further invade the specific structure of the peritoneal milky spots and initiate an accelerated invasive growth process; (3) the process of peritoneal interstitial fibrosis aggravates the structural destruction of the peritoneum; (4) the interaction between cancer cells and immune cells in the milk spots forms a permissive immune microenvironment that promotes the growth of peritoneal metastatic cancer. These four core cytopathological mechanisms are mutually causal and promote each other, forming a vicious circle of GICPM development. As long as clinicians accurately understand these four points, it is possible to grasp the opportunity of clinical diagnosis and treatment, change reactive and passive treatment into preventive and proactive treatment, and improve the clinical diagnosis and treatment landscape of GICPM.
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Humans , Intestinal Neoplasms , Peritoneal Cavity , Peritoneal Neoplasms , Peritoneum , Tumor MicroenvironmentABSTRACT
Objective:To evaluate the clinical efficacy and safety of cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) for patients with advanced ovarian cancer as the first-line surgical treatment.Methods:The ovarian cancer patients with completed clinical data diagnosed as stage Ⅲ C-Ⅳ according to Federation International of Gynecology and Obstetrics (FIGO) who underwent CRS+HIPEC as the first-line treatment from December 2007 to November 2019 in Beijing Shijitan Hospital were retrospectively analyzed. Survival status was analyzed by using Kaplan-Meier method, and prognostic factors were analyzed by using Cox multivariate regression model. The primary endpoints were median overall survival (mOS) time and median progress-free survival (mPFS) time, and the secondary endpoint was safety in perioperative period. Results:Of 100 patients with advanced ovarian cancer, the median follow-up time was 18.4 months, and 75 (75.0%) patients were alive and 25 (25.0%) patients died, of which the mOS time was 87.6 months (95% CI 72.1-103.1 months), and 1-, 2-, 3-, 4- and 5-year survival rate was 94.1%, 77.2%, 68.2%,64.2% and 64.2%, respectively. Univariate analysis showed that the patients with age≤58 years old ( P = 0.023), Karnofsky≥80 scores ( P = 0.026), ascites ≤1 000 ml ( P = 0.041), peritoneal carcinomatosis index (PCI) score <19 ( P = 0.044) and completeness of cytoreduction (CC) score 0-1 ( P = 0.001) had better prognosis. Multivariate analysis showed that CC score 0-1 was independent prognostic factor, the mortality risk of resectable patients with CC score 2-3 was 3.2 times higher than that in patients with CC score 0-1 ( HR = 3.2, 95% CI 1.4-7.6, P = 0.008), and mPFS time was 23.3 months (95% CI 0-50.7 months) for patients with CC score 0-1. Grade Ⅲ-Ⅳ adverse event rate during perioperative period and mortality rate was 4.0% (4/100) and 2.0% (2/100), respectively. Conclusion:CRS+HIPEC could improve the survival of advanced ovarian cancer patients with good safety.
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Objective@#To establish patient derived xenograft (PDX) model of malignant peritoneal mesothelioma (MPM), and to identify the key characteristics of tumor biology of the model, so as to provide an experiment platform for studying the pathologic mechanisms and new therapeutic strategies for MPM.@*Methods@#Surgically excised MPM tumor tissues were inoculated subcutaneously in BALB/c-nu/nu mice for 3 stable passages. In the 4th passage, the subcutaneous tumors were harvested under aseptic conditions, cleaned and made into MPM tumor cell homogenate. Four nude mice (two males and two females) were selected and one male and one female nude mouse were inoculated in the abdominal cavity at the dose of 100 μL, others were inoculated at a dose of 200 μL. The PDX model of MPM was established. The changes of body mass in nude mice were measured regularly, the extent of abdominal and pelvic tumors was judged by experimental peritoneal cancer index (ePCI) score, and the pathologic characteristics of tumors were analyzed.@*Results@#The subcutaneous and abdominal animal models of MPM were successfully established. The subcutaneous tumor model grew into tumor on the 20th day, followed by a slow growth stage between the 20th and 29th day, then a rapid growth stage between the 30th and 57th day. According to the dose of tumor cells (100, 200 μL) and timing (14th and 69th days after grafting), the abdominal tumor model successfully simulated the early and late clinical stages of MPM. The HE staining results of the MPM nude mice model showed that the tumor was epithelial mesothelioma and invaded most of the organs, including liver, spleen, pancreas, mesentery. Immunohistochemical staining for calretinin, cytokeratin 5/6, WT1 and Ki-67 were positive. Whole-genome exon sequencing identified 26 and 36 high frequency gene mutations in tumors derived from the PDX model and clinical sample from patients, including 21 common gene mutations.@*Conclusions@#The PDX model of MPM is established. The model is characterized by highly malignant tumor with rapid growth and high invasiveness.
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OBJECTIVE@#To evaluate the effect of tumor-stroma ratio (TSR) on disease progression and prognosis of pseudomyxoma peritonei (PMP) from the appendix.@*METHODS@#The study included 30 PMP patients with complete individual patient data, who underwent cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in Beijing Shijitan Hospital. Image-Pro Plus was used to quantitatively analyze the proportion of tumor and stromal areas in hematoxylin-eosin staining pathological images, from which TSR was derived. Correlation studies were conducted to evaluate the relationships between TSR and clinicopathological features, immunohistochemical characteristics, and prognosis of PMP.@*RESULTS@#Among 30 PMP patients, there were 16 males (53.3%) and 14 females (46.7%), with the mean age of (54.9±2.3) years. There were 15 cases (50.0%) of low-grade mucinous carcinoma peritonei (LMCP) and high-grade mucinous carcinoma peritonei (HMCP), respectively, with vascular tumor emboli occurring in 4 cases (13.3%), nerve invasion occurring in 3 cases (10.0%), and lymphatic metastasis occurring in 4 cases (13.3%). The median peritoneal cancer index (PCI) score was 36 (range: 3-39). The median TSR was 8% (range: 2%-24%), with TSR≤10% in 19 cases (63.3%) and TSR>10% in 11 cases (36.7%). Immunohistochemistry showed that 16 cases (53.3%) had Ki67 label index ≤ 50% and 14 cases (46.7%) > 50%. The mutation rate of p53 was 56.7% and the loss rate of MMR protein was 11.8%. In addition, the expression rates of MUC2, MUC5AC, CDX2, CK7, and CK20 were 66.7%, 100.0%, 82.6%, 56.0%, and 92.3%, respectively. There were significant correlations between TSR and histopathological types, nerve invasion, Ki67 label index, and p53 mutation (P<0.05 for all). At the end of the last follow-up, 21 patients (70.0%) died and 9 patients (30.0%) survived, including 6 patients survived with tumor. The median overall survival (OS) was 12.7 months (95%CI: 10.4-11.5 months), and the 1-, 2-, and 3-year survival rates were 60.5%, 32.3%, and 27.7%, respectively. The median OS was 19.4 months (95%CI: 3.0-35.9 months) in the TSR≤10% group, versus 12.6 months (95%CI: 0.7-24.5 months) in the TSR>10% group (χ2=3.996, P=0.046).@*CONCLUSION@#TSR is correlated with histopathological types, tumor proliferation, invasion behaviors and prognosis of PMP, thus could be a new prognostic indicator for PMP.
Subject(s)
Female , Humans , Male , Middle Aged , Appendix , Cytoreduction Surgical Procedures , Hyperthermia, Induced , Peritoneal Neoplasms , Prognosis , Pseudomyxoma Peritonei , Retrospective StudiesABSTRACT
To establish patient derived xenograft (PDX) model of malignant peritoneal mesothelioma (MPM), and to identify the key characteristics of tumor biology of the model, so as to provide an experiment platform for studying the pathologic mechanisms and new therapeutic strategies for MPM. Surgically excised MPM tumor tissues were inoculated subcutaneously in BALB/c-nu/nu mice for 3 stable passages. In the 4th passage, the subcutaneous tumors were harvested under aseptic conditions, cleaned and made into MPM tumor cell homogenate. Four nude mice (two males and two females) were selected and one male and one female nude mouse were inoculated in the abdominal cavity at the dose of 100 μL, others were inoculated at a dose of 200 μL. The PDX model of MPM was established. The changes of body mass in nude mice were measured regularly, the extent of abdominal and pelvic tumors was judged by experimental peritoneal cancer index (ePCI) score, and the pathologic characteristics of tumors were analyzed. The subcutaneous and abdominal animal models of MPM were successfully established. The subcutaneous tumor model grew into tumor on the 20th day, followed by a slow growth stage between the 20th and 29th day, then a rapid growth stage between the 30th and 57th day. According to the dose of tumor cells (100, 200 μL) and timing (14th and 69th days after grafting), the abdominal tumor model successfully simulated the early and late clinical stages of MPM. The HE staining results of the MPM nude mice model showed that the tumor was epithelial mesothelioma and invaded most of the organs, including liver, spleen, pancreas, mesentery. Immunohistochemical staining for calretinin, cytokeratin 5/6, WT1 and Ki-67 were positive. Whole-genome exon sequencing identified 26 and 36 high frequency gene mutations in tumors derived from the PDX model and clinical sample from patients, including 21 common gene mutations. The PDX model of MPM is established. The model is characterized by highly malignant tumor with rapid growth and high invasiveness.
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A highly sensitive and selective bioluminescent probe for hydrazine (BPH) was designed, synthesized and evaluated for detection of hydrazine in vitro and in vivo. BPH was designed to include a specific recognition group (acetyl) of hydrazine at an appropriate modification site of the optical reporter hydroxyluciferin (D-luciferin), which showed excellent performance both in selectivity and sensitivity to hydrazine. The results showed that the bioluminescent probe BPH developed in this study is an innovative and widely applicable tool for detecting hydrazine in complex natural environment or in animals.
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The New Delhi metallo-β-lactamase-1 (NDM-1) was first reported in 2010, detected in a Klebsiella pneumoniae isolate from a Swedish patient of Indian origin. It has recently attracted extensive attention for its biological activities to catalyze the hydrolysis of almost all of β-lactam antibiotics. The gene for NDM-1 can spread from one strain of bacteria to another by horizontal gene transfer. The most troubling aspect is that there are currently no clinically available inhibitors to block the metallo-β-lactamase action. Therefore, there is urgent need to develop new NDM-1 inhibitors, which can protect β-lactam antibiotics from the hydrolysis effect of NDM-1. In this review, the current research, drug-assistant mechanism and potential NDM-1 inhibitors are summarized.
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Aim To evaluate the effects of salvianolic acid B ( Sal B ) on bone metabolism and its potential mechanism in high fat diet ( HFD) mice.Methods Thirty C57BL/6J male mice were divided into three groups with 10 mice each, namely normal , HFD and HFD+Sal B.HFD and HFD+Sal B mice were treated with HFD, and HFD+Sal B group mice were also with Sal B (125 mg· kg -1· d-1).After 12 weeks' treat-ment, femurs were harvested .The effects of Sal B on biomechanical strength were evaluated by biomechani-cal tests, and the effects of Sal B on bone microstruc-ture were evaluated by Safranin O/fast green staining and hematoxylin and eosin staining .The expression of nuclear factor-kappa B ( NF-κB)-p65 and NADPH ox-idase 4 ( Nox4 ) and cathepsin K in femurs was deter-mined by immunohistochemical staining . Results Maximum load and elastic load significantly decreased ,and the trabeculae became thinner and irregular in the femurs of HFD mice , while Sal B treatment could re-verse the descending biomechanical strength and the disorganized femurs bone micro-structures in HFD mice.In addition, the expressions of Nox4, NF-κB-p65 and cathepsin Kmarkedly increased in HFD mice , and Sal B possessed the ability to down-regulate the ex-pression of Nox4, NF-κB-p65, and cathepsin K in the femurs triggered by HFD .Conclusions Sal B treat-ment improves bone metabolism via regulating Nox 4/NF-κB/cathepsin K signaling pathway in HFD mice . The findings contribute to the understanding and exten-sion of the applications of Salvia miltiorrhiza and its constituents on osteoporosis .
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Objective To establish a data center to ensure hospital data reliability and safety in a wisdom hospital.Methods A remote active-active data center based on visualization was constructed with hospital infrastracture,modified overall architecture of hospital data center,visualization technology,disaster recovery technology,cloud computing technology and storage technology.Results A new mode for constructing hospital active-active data center was put forward with considerations on data storage,disaster recovery,application and backup as well as the integration of intranet and extranet,which enhanced the stability and continuity of hospital operation systems,high safety and reliability of operation data.Conclusion The active-active data center lays a foundation for the construction of the wisdom hospital.
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Objective To establish a data center to ensure hospital data reliability and safety in a wisdom hospital.Methods A remote active-active data center based on visualization was constructed with hospital infrastracture,modified overall architecture of hospital data center,visualization technology,disaster recovery technology,cloud computing technology and storage technology.Results A new mode for constructing hospital active-active data center was put forward with considerations on data storage,disaster recovery,application and backup as well as the integration of intranet and extranet,which enhanced the stability and continuity of hospital operation systems,high safety and reliability of operation data.Conclusion The active-active data center lays a foundation for the construction of the wisdom hospital.
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<p><b>OBJECTIVE</b>To analyze the imaging features of (18)F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography(PET)/computed tomography (CT) in acquired immune deficiency syndrome-related lymphoma (ARL) patients correlated with their clinical signs, symptoms, and treatments.</p><p><b>METHODS</b>Five ARL patients underwent ¹⁸F-FDG PET/CT at Peking Union Medical College Hospital from October 2008 to January 2013. Two patients received two additional follow-up studies 6 months later.</p><p><b>RESULTS</b>Among these 5 patients, ¹⁸FDG-PET/CT helped in diagnosis of two patient and changed therapeutic strategy in other two patients. In two patients underwent ¹⁸F-FDG PET/CT brain scans, low-metabolism lesion was newly found in cerebral cortex. Of 4 patients receiving highly active antiretroviral therapy, PET/CT also demonstrated diffusely elevated ¹⁸F-FDG uptake in subcutaneous adipose tissue in two patients.</p><p><b>CONCLUSION</b>¹⁸F-FDG PET/CT is a highly useful tool in the diagnosis and treatment of ARL patients, in particular in the identification of associated encephalopathy and lipodystrophy.</p>
Subject(s)
Humans , Acquired Immunodeficiency Syndrome , Fluorodeoxyglucose F18 , Lymphoma , Multimodal Imaging , Positron-Emission Tomography , Tomography, X-Ray ComputedABSTRACT
This article describes the experiences of professor CHEN Quan-xin, an old famous TCM doctor, in the treatment of insomnia. He believes that insomnia stems from incoordination between nutrient qi and defensive qi and deficient cultivation of cardiac spirit, and treatment of insomnia need to regulate spirit and quiet heart coherently. Painless acupuncture method of Chen's flying needling is adopted including to select Shenmen (HT 7), Sanyinjiao (SP 6) and Anmian (Extra) as the main points and take special needling technique and grading reinforcing and reducing manipulations. During treatment, he pays attention to understanding patients' psychological and mental status through "watching one's expressions and weighing his words carefully".