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Methods:A total of 1 152 amniotic fluid samples were collected from pregnant women who underwent prenatal diagnosis in the Nanjing Maternity and Child Health Care Hospital, Women′s Hospital School of Medicine Zhejiang University, West China Second University Hospital, Sichuan University/West China Women′s and Children′s Hospital, and Xiamen Maternal and Child Health Hospital from September 2014 to August 2016. These samples were examined with SD-HRM and karyotyping simultaneously. Clinical sensitivity and specificity of SD-HRM were calculated, and Kappa values were measured to evaluate the consistency of detection results of the two methods.Results:A total of 161 cases of trisomy 21, 60 cases of trisomy 18, and 5 cases of trisomy 13 were detected by SD-HRM in 1 152 prenatal samples, sensitivity and specificity were both up to 100%, and Kappa values is equal to 1 which were consistent with the results of karyotype analysis.Conclusion:SD-HRM is validated to be highly accurate for the prenatal diagnosis of common trisomies, which is promising in the clinical practice.
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Objective To investigate the efficacy and safety of posterior pedicle screw internal fixation as add-on to transpedicular bone grafting in the treatment of thoracolumbar fractures in elderly patients.Methods The 86 elderly patients with thoracolumbar fracture admitted to our hospital were enrolled in the retrospective study.All patients were divided into a control group(n=40)receiving posterior short-segment pedicle fixation,and a study group(n=46)undergoing transpedicular bone grafting as add-on to posterior short-segment pedicle fixation.The recovery of lumbar function and neurological function were compared between the two groups.Results The Cobb angle of the injured vertebrae was significantly decreased in two groups at one week after operation,and then increased slightly with time-lapse(Ftime =86.34,P＜0.05).The whole Cobb angle of injured vertebrae was lower in the study group than in the control group(F =7.68,P＜0.05).The Cobb angle reduction of injured vertebrae was more in the study group than in the control group (Ftime× groups =4.19,P ＜0.05).The height of the anterior and posterior edges of injured vertebrae was significantly increased in two groups at 1 week after operation,and then decreased slightly with time-lapse(Ftime =75.87 and 66.92,P ＜0.05).The overall level of anterior and posterior edges height of injured vertebrae was higher in the study group than in the control group(Fgroup =9.75 and 6.76,P＜0.05).The increased height of anterior and posterior edges of injured vertebrae was higher in the study group than in the control group(Ftime× groups =7.59 and 5.21,P＜0.05).The bone fusion rate was higher in the study group than in control group (97.8 ％ vs.82.5 ％,P ＜ 0.05).The failure rate of internal fixation was lower in the study group than in the control group (2.2 ％ vs.17.5％,x2 =5.96,P ＜ 0.05).The recovery of neurological function was better in the study group than in the control group(Z =2.12,P ＜0.05).The Oswestry disability index(ODI)in two groups was decreased with time-lapse(Ftime =85.49,P＜0.05).The overall ODI level was lower in the study group than in the control group(Fgroup =47.28,P＜0.05).The decrement of ODI index was larger in the study group than in the control group(Ftime× groups =8.97,P ＜ 0.05).Conclusions Posterior pedicle screw internal fixation in combination with transpedicular bone grafting are safe and effective in the treatment of thoracolumbar fractures in the elderly,which can improve the stability of vertebral compression,and promote the recovery of neurological function and lumbar function.
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Objective: To investigate the characteristics and clinical value of lymph node metastasis according to the clinical data of re-gional lymph node resection in pancreatic head carcinoma. Methods: We summarized and statistically analyzed the lymph node num-bers in lymph node dissection specimens of 160 cases of pancreatic duct adenocarcinoma from February 2010 to October 2013 in Fu-dan University, Shanghai Cancer Center retrospectively and explored the relationship between various clinical factors and lymph node metastasis; and summarized the clinical data in group 16 lymph node metastasis of the patients and investigated the clinical signifi-cance of lymph node dissection in these patients. Results: After the pathological diagnosis of pancreatic adenocarcinoma, 72.5% of all the 160 patients had lymph node metastasis (116 cases of 656 lymph node metastases). Among them, 26 patients had group 16 lymph node metastasis. Lymph node metastasis was not related to gender, age, tumor size, or differentiation, but related to tumor clinical staging. In this study, we found that the lymph node metastasis in group 16 was in subgroup 16b1. patients without lymph nodes me-tastasis, patients with lymph nodes metastasis while without group 16 lymph nodes metastasis and patients with both lymph nodes metastasis and group 16 lymph nodes metastasis, the postoperative median survival time was 25.6 months, 17.25 months and 10.95 months, respectively (P<0.001). Patients with lymph node metastasis in subgroup 16b1 and cancer antigen 19-9>370 U/mL had a shorter survival period. Conclusions: Proper subgroup 16b1 lymph node resection is necessary for radical pancreaticoduodenectomy.
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Objective To investigate the significant of peripheral CD4+CD69+T lymphocytes in patients with autoimmune hemolytic anemia (AIHA)/Evans syndrome (ES).Methods In this study peripheral blood samples from 32 patients with AIHA/ES (15 hemolytic episode patients,17 remission patients) and 13 healthy controls were collected.Patients with AIHA/ES were recruited in Tianjin Medical University General Hospital from October 2015 to May 2016.The percentages of CD69+ T lymphocytes were analyzed by flow cytometry.The expression of CD69 mRNA in CD4+T lymphocytes which was sorted from peripheral blood by magnetic activated cell sorting (MACS) was detected using real-time PCR.Soluable CD69 was measured by ELISA.Results In hemolytic episode patients,the ratio of CD3+CD69+/CD3+T lymphocytes [(3.08 ± 1.48)％] was significantly higher than that in healthy controls [(1.28 ± 0.83)％,P＜0.01] and in remission group[(1.96± 1.33)％,P＜0.05].The absolute count of CD3+CD69+T lymphocytes in hemolytic episode group [(2.94± 1.81)× 107/L] was higher than that in healthy controls [(1.48± 1.42)× 107/L,P＜0.05].The ratio of CD3+CD4+CD69+/CD3+CD4+T cells in hemolytic episode group [(2.16± 1.56)％] was significantly higher than that in remission group [(1.16±0.62)％,P＜0.05] and healthy controls[(0.94±0.78)％,P＜0.05].The quantity of CD3+CD4+CD69+T lymphocytes in hemolytic episode group[(1.04±0.98)× 107/L] was higher than in healthy controls [(0.44± 0.38) × 107 / L,P＜0.05].The ratio of CD3+CD8+CD69+/CD3+ CD8+T lymphocyte in hemolytic episode group [(4.87±2.56)％] was significantly higher than that in healthy controls[(1.83± 1.27)％,P＜0.01].The quantity of CD3+CDs+CD69+T lymphocytes in three groups did not show significant difference.The ratio of CD3+CD4+CD69+/CD3+CD4+T lymphocytes in hemolytic episode group was negatively correlated with hemoglobin (Hb) (P＜0.01),positively correlated with the percentage of reticulocytes (Ret％)(P=0.01)total bilirubin(TBil),indirect bilirubin(IBil) (P＜0.01) and not correlated with absolute reticulocytes count,lactic dehydrogenase (LDH),complement 3(C3),complement 4 (C4).The ratio of CD3+CD4+CD69+/CD3+CD4+T lymphocytes in remission group was negatively correlated with Hb (P＜0.05).In hemolytic episode patients CD69 mRNA (32.26±35.11) was significantly higher than that in remission group(6.05±5.87)(P＜0.05)and healthy controls (1.76± 1.85)(P＜0.01).CD69 mRNA in remission group was significantly higher than healthy controls (P＜0.05).Serum CD69 in hemolytic episode patients [(494.21 ± 16.06) ng/L] was significantly higher than that in healthy controls [(441.39± 104.6) ng/L,P＜0.05].Conclusion Our findings suggest that the proportion of CD4+CD69+ T lymphocytes increase in AIHA/ES patients,which is correlated with the severity of disease.
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Pancreatic cancer is a highly malignant,fast progressive digestive system neoplasm with poor prognosis,and the incidence has increased significantly in recent years.With deepening of the molecular mechanism of pancreatic cancer,researchers indeed have a clearer understanding of the disease,which provides clues for translation of basic research into clinical practice.The 2017 annual meeting of the Chinese Society of Clinical Oncology (CSCO) was held in Xiamen on September 26th to 30th.In this paper,authors selected and reviewed advances in pancreatic cancer research on surgical treatment,chemotherapy,radiotherapy,targeted therapy and immnunotherapy on pancreatic cancer from 2017 CSCO,in order to provide new clues for optimization of diagnosis and treatment of pancreatic cancer.
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Objective To investigate the application value of Braun anastomosis in pancreaticoduodenectomy.Methods The retrospective cohort study was conducted.The clinicopathological data of 389patients who underwent pancreaticoduodenectomy in the Fudan University Shanghai Cancer Center from March 2012 to July 2014 were collected.Of 389 patients,235 receiving Braun anastomosis and 154 receiving non-Braun anastomosis were respectively allocated into Braun anastomosis group and non-Braun anastomosis group.All the patients underwent pancreaticoduodenectomy with digestive tract reconstruction using Child method.Patients in the Braun anastomosis group received 5-10 cm Braun anastomosis between input and output end of jejunum,and patients in the non-Braun anastomosis group didn't receive jejunum-jejunum Braun anastomosis after gastrojejunostomy.Observation indicators included:(1) intraoperative situations;(2) postoperative recovery;(3) follow-up.Patients were followed up using outpatient examination and telephone interview up to May 2015.Follow-up included monthly routine blood retest,hepatorenal function retest and urine and stool routine retest,and enhanced CT scan in the epigastric region for every three months to detect recovery of digestive tract function.Measurement data with normal distribution were represented as x±s.Comparison between groups was analyzed using t test,and count data were analyzed using chi-square test.Results (1) Intraoperative situations:389 patients underwent successful pancreaticoduodenectomy.Standard pancreaticoduodenectomy and pyloric-preserving pancreaticoduodenectomy were respectively applied to 205 and 30 patients in the Braun anastomosis group and 137 and 17 patients in the non-Braun anastomosis group,with no statistically significant difference (x2=0.259,P＞0.05).Anastomosis and reconstruction of pancreatic stump:anastomosis of main pancreatic duct and jejunal mucosa,embedded anastomosis of papillary main pancreatic duct and pancreas-stomach anastomosis were detected in 138,89,8 patients in the Braun anastomosis group and 85,60,9 patients in the non-Braun anastomosis group,respectively,with no statistically significant difference (x2 =1.535,P＞ 0.05).Total operation time,pancreasjejunum anastomosis time and volume of intraoperative blood loss were (398.9 ± 61.9) minutes,(20.6 ±3.5) minutes,(401 ± 59) mL in the Braun anastomosis group and (401.3± 59.2) minutes,(20.7± 2.1) minutes,(407± 159)mL in the non-Braun anastomosis group,respectively,with no statistically significant difference (t =-0.380,-0.562,-0.319,P＞0.05).(2) Postoperative recovery:time to initial anal exsufflation,time for fluid diet intake and time of drainage tube removal were (103 ± 28) hours,(77± 25) hours,(12 ± 5) days in the Braun anastomosis group and (102 ± 31) hours,(79 ± 30) hours,(13 ± 6) days in the non-Braun anastomosis group,respectively,with no statistically significant difference (t =0.330,-0.712,-1.783,P＞0.05).Delayed gastric emptying,gastrointestinal hemorrhage,obstruction of afferent loop and pancreatic fistula were detected in 25,3,0,30 patients in the Braun anastomosis group and 27,4,2,23 patients in the non-Braun anastomosis group,respectively,with no statistically significant difference (x2=3.818,0.918,3.068,0.695,P＞0.05).Seventeen patients were combined with delayed gastric emptying and pancreatic fistula,including 8 in the Braun anastomosis group and 9 in the non-Braun anastomosis group,with no statistically significant difference between the 2 groups (x2=1.363,P＞0.05).Patients with postoperative complications were improved by symptomatic and supporting treatment.Duration of hospital stay and treatment expenses were (14±7) days,(73 205±4 538)yuan in the Braun anastomosis group and (22± 11) days,(83 219±5 738) yuan in the non-Braun anastomosis group,with statistically significant differences between the 2 groups (t=-8.767,-19.139,P＜0.05).(3) Follow-up:389 patients were followed up for 6 months,without death.Six and 9 patients in the Braun anastomosis group and non-Braun anastomosis group had regurgitation cholangitis.There was no readmission due to gastrointestinal hemorrhage and digestive tract obstruction,and no signs of hyperglycaemia and intractable diarrhea occurred.Conclusion Braun anastomosis can reduce duration of postoperative hospital stay and treatment expenses.
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Objective To investigate the application value of Braun anastomosis in pancreaticoduodenectomy.Methods The retrospective cohort study was conducted.The clinicopathological data of 389patients who underwent pancreaticoduodenectomy in the Fudan University Shanghai Cancer Center from March 2012 to July 2014 were collected.Of 389 patients,235 receiving Braun anastomosis and 154 receiving non-Braun anastomosis were respectively allocated into Braun anastomosis group and non-Braun anastomosis group.All the patients underwent pancreaticoduodenectomy with digestive tract reconstruction using Child method.Patients in the Braun anastomosis group received 5-10 cm Braun anastomosis between input and output end of jejunum,and patients in the non-Braun anastomosis group didn't receive jejunum-jejunum Braun anastomosis after gastrojejunostomy.Observation indicators included:(1) intraoperative situations;(2) postoperative recovery;(3) follow-up.Patients were followed up using outpatient examination and telephone interview up to May 2015.Follow-up included monthly routine blood retest,hepatorenal function retest and urine and stool routine retest,and enhanced CT scan in the epigastric region for every three months to detect recovery of digestive tract function.Measurement data with normal distribution were represented as x±s.Comparison between groups was analyzed using t test,and count data were analyzed using chi-square test.Results (1) Intraoperative situations:389 patients underwent successful pancreaticoduodenectomy.Standard pancreaticoduodenectomy and pyloric-preserving pancreaticoduodenectomy were respectively applied to 205 and 30 patients in the Braun anastomosis group and 137 and 17 patients in the non-Braun anastomosis group,with no statistically significant difference (x2=0.259,P＞0.05).Anastomosis and reconstruction of pancreatic stump:anastomosis of main pancreatic duct and jejunal mucosa,embedded anastomosis of papillary main pancreatic duct and pancreas-stomach anastomosis were detected in 138,89,8 patients in the Braun anastomosis group and 85,60,9 patients in the non-Braun anastomosis group,respectively,with no statistically significant difference (x2 =1.535,P＞ 0.05).Total operation time,pancreasjejunum anastomosis time and volume of intraoperative blood loss were (398.9 ± 61.9) minutes,(20.6 ±3.5) minutes,(401 ± 59) mL in the Braun anastomosis group and (401.3± 59.2) minutes,(20.7± 2.1) minutes,(407± 159)mL in the non-Braun anastomosis group,respectively,with no statistically significant difference (t =-0.380,-0.562,-0.319,P＞0.05).(2) Postoperative recovery:time to initial anal exsufflation,time for fluid diet intake and time of drainage tube removal were (103 ± 28) hours,(77± 25) hours,(12 ± 5) days in the Braun anastomosis group and (102 ± 31) hours,(79 ± 30) hours,(13 ± 6) days in the non-Braun anastomosis group,respectively,with no statistically significant difference (t =0.330,-0.712,-1.783,P＞0.05).Delayed gastric emptying,gastrointestinal hemorrhage,obstruction of afferent loop and pancreatic fistula were detected in 25,3,0,30 patients in the Braun anastomosis group and 27,4,2,23 patients in the non-Braun anastomosis group,respectively,with no statistically significant difference (x2=3.818,0.918,3.068,0.695,P＞0.05).Seventeen patients were combined with delayed gastric emptying and pancreatic fistula,including 8 in the Braun anastomosis group and 9 in the non-Braun anastomosis group,with no statistically significant difference between the 2 groups (x2=1.363,P＞0.05).Patients with postoperative complications were improved by symptomatic and supporting treatment.Duration of hospital stay and treatment expenses were (14±7) days,(73 205±4 538)yuan in the Braun anastomosis group and (22± 11) days,(83 219±5 738) yuan in the non-Braun anastomosis group,with statistically significant differences between the 2 groups (t=-8.767,-19.139,P＜0.05).(3) Follow-up:389 patients were followed up for 6 months,without death.Six and 9 patients in the Braun anastomosis group and non-Braun anastomosis group had regurgitation cholangitis.There was no readmission due to gastrointestinal hemorrhage and digestive tract obstruction,and no signs of hyperglycaemia and intractable diarrhea occurred.Conclusion Braun anastomosis can reduce duration of postoperative hospital stay and treatment expenses.
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Background and purpose:Lower expression of E-cadherin is associated with metastasis of cancer cells, however, the correlation between E-cadherin and glucose metabolism has seldom been reported. This article studied the correlation between E-cadherin and glycolysis effect in PANC-1 cells.Methods:Through treatment of transforming growth factor β (TGF-β) in PANC-1 cells to decrease E-cadherin expression, knock-down the gene of E-cadherin interaction protein β-catenin, and overexpressing of E-cadherin, the effects of E-cadherin on the glucose uptake and lactate production ability and on the expression of key glycolytic genes were assessed.Results:E-cadherin negatively regulated the glycolytic effect of PANC-1 cells by inhibiting glucose uptake and lactate production (P<0.05). Moreover, E-cadherin interacting partner β-catenin signiifcantly promoted glucose metabolism transformation in PANC-1 cells (P<0.05). Moreover, key glycolysis regulator sirtuin 3 (SIRT3) could lower E-cadherin expression.Conclusion:Lower expression of E-cadherin induced the transformation of glucose metabolism transformation in PANC-1 cells and manipulation of E-cadherin expression level could change the glycolysis effect. Moreover, through maneuver glycolysis process could inhibit high metastatic potential of pancreatic cancer cells.
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Background and purpose: Lysine specific demethylase 1(LSD1) is an important chromatin modifier. It epigenetically regulates gene expression pattern through chromatin modification and participates in maintenance of tumor malignant properties, such as oncogenesis, development, invasion, migration and metabolic transformation. SIRT3 (sirtuin 3) is a mitochondria localized tumor suppressor and regulates tumor metabolic transformation and oxidative stress. The correlation between LSD1 and SIRT3 has never been reported before. This study aimed to elucidate the correlation between LSD1 and SIRT3 with gene transcriptional regulation methods. Methods: RNA interference technique, co-immunoprecipitation assay(CoIP), chromatin immune-precipitation assay(ChIP) and ifrelfy luciferase activity assay were employed to elucidate the correlation between LSD1 and SIRT3 in pancreatic cancer. Results:mRNA and protein levels of SIRT3 were signiifcantly elevated in LSD1 knock-down PANC-1 cells. LSD1 interacts with PGC-1α, an important regulator of SIRT3 gene expression. LSD1 and PGC-1αoccupied the same region in SIRT3 promoter region through ChIP analysis. Luciferase activity assay validated LSD1 as a negative regulator of PGC-1αin SIRT3 gene transcriptional regulation. Conclusion:LSD1, as an important tumor promoter, negatively regulates the expression of tumor suppressor gene SIRT3, these results provide important clues for the role that LSD1 plays in aberrant metabolism and oxidative stress.
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Natural cyclopeptides are hot spots in chemical and pharmaceutical fields because of the wide spreading bio-resources, complex molecular structures and various bioactivities. Bio-producers of cyclopeptides distribute over almost every kingdom from bacteria to plants and animals. Many cyclopeptides contain non-coded amino acids and non-pepditic bonds. Most exciting characteristic of cyclopeptides is a range of interesting bioactivities such as antibiotics gramicidin-S (2), vancomycin (3) and daptomycin (4), immunosuppressive cyclosporin-A (1) and astin-C (8), and anti-tumor aplidine (5), RA-V (6) and RA-VII (7). Compounds 1-4 are being used in clinics; compounds 5-8 are in the stages of clinical trial or as a candidate for drug research. In this review, the progress in chemical and bioactive studies on these important natural bioactive cyclopeptides 1-8 are introduced, mainly including discovery, bioactivity, mechanism, QSAR and synthesis.
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Objective To investigate the combination effect of tramadol and low dose propofol on emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure. Methods Ninety patients receiving sevoflurane for adenotonsillectomy procedure were randomly divided into control group (administration of 0.1 mL/kg normal saline 30 min before the end of operation), tramadol group (administration of 1 mg/kg tramadol 30 min before the end of operation) and tramadol + propofol group (administration of 1 mg/kg tramadol 30 min before the end of operation and 1 mg/kg propofol at the end of operation). Time of extubation and time stayed in postanesthetic care unit (PACU) after operation were recorded, scores of Pediatric Anesthesia Emergence Delirium ( PAED) Scale, modified Aldrete scores and pain scores were obtained immediately after entrance into PACU, and the prevalences of post-operative nausea and vomiting were observed. Results There was no significant difference in time of extubation, time stayed in PACU and modified Aldrete Scores among groups (P >0.05). There were significant differences in scores of PAED Scale immediately after entrance into PACU, with control group > tramadol group > tramadol + propofol group (P < 0.05). The pain scores of tramadol group and tramadol + propofol group were significantly lower than that of control group (P < 0.05). The prevalence of nausea and vomiting was the highest in tramadol group, and the prevalence in tramadol + propofol group was significantly lower than that in tramadol group ( P < 0.05). Conclusion The combination use of tramadol and low dose propofol can decrease the severity of emergence agitation in children receiving sevoflurane for adenotonsillectomy procedure, and reduce the prevalence of nausea and vomiting.
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Regional arterial intra-chemotherapy (RAIC) was an effective method of combined therapy for pancreatic carcinoma, which could elevate the regional con-centration of anticancer agents for sufficient dosage in pan-creas, reduce the systemic adverse events, increase the toler-ation of chemotherapy.It could also increase the concentra-tion of anticancer agents in regional lymph node of pancreas, thus decrease the lymph node metastasis.The mechanism of RAIC for pancreatic cancer and the impact for lymph node metastasis needed to be further investigated.
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Objective To observe the clinical efficacy and safety of topical interferon alfa-1b cream in the treatment of herpes zoster. Methods A randomized, double-blind, parallel placebo-controlled clinical study was conducted. The test drug was topically used in herpes zoster patients, three times a day for 2 weeks. Patients whose skin lesions cleared completely were followed for 29 days to observe postherpetic neuralgia. Results One hundred and twenty-eight patients with herpes zoster were enrolled into this trial. Sixty-five patients were randomly selected to receive interferon alfa-1b cream and sixty-three patients received vehicle cream. After following up for 11, 14, 22, 29 days the cure rates were 69.2%, 81.5%, 90.8%, 95.4% respectively in the study group and were 57.1%, 71.4%, 84.1% and 84.1% respectively in the control group(P
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Objective To investigate the T cell clonality in patients with systemic lupus erythematosus (SLE) . Methods T cell clonality in peripheral blood lymphocytes from six patients with active SLE was analyzed using reverse transcriptase- polymerase chain reaction (RT- PCR) and GeneScan technique. Results T cell receptor (TCR) Vβ PCR products from two patients were derived from polyclonal T cells, however, TCR Vβ9, Vβ2, VβI, Vβ2 pioducts from the other four patients were derived from oligoclonal T cells respectively.ConclusionT cells from patients with SLE demonstrated a striking oligoclnality and their clonal expansion may be a specific response driven by autoantigens.
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Objective In order to evaluate the therapeutic effect, to screen effective drugs for AIDS, and to find out the changes of patient's condition, it is necessary to develop an objective method to quantitate the levels of viral load of the patients before and after treatment.Method Differential PCR(D PCR) was used to co amplify the target HIV 1 gag gene and reference template ? globin gene, so as to determine the level of HIV replication quantitatively. The levels of HIV DNA in the peripheral blood mononuclear cells of 8 patients with AIDS were determined quantitatively.Results The levels of the provirus of the 8 patients ranged from 0 508 2 210 copies/?g DNA, there were differences in the levels of replication and integration. Conclusion It is the authors′ opinion that this method is easy to control with an advantage of reliability, quickness and reproducibility, It is suitable to measure clinical specimens, and provides an objective evidence for the evaluation of responses to therapeutic intervention.
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To investigate the predisposing role of HLA-DR genes to systemic lupus erythematosus (SLE), We used polymerase chain reaction and sequence specific oligonucleotide (PCR/SSO) probe hybridization to type HLA-DR subregion in the patients with SLE of Han nationality from Jiangsu province and matched control subjects. The results indicated that DR2 gene frequency was significantly more frequent in patients than that in controls. Whereas DR4 significantly decreased in patients compared with controls. It suggests that DR2 or the other unidentified genes tightly linked to it might be the susceptible genes of SLE. Whereas DR4 might have a protective effect on SLE.