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Purpose@#Invasive ductal carcinoma (IDC) accounts for 90% of triple-negative breast cancer (TNBC). IDC is mainly derived from the breast ductal epithelium which is innervated by the 4th to 6th thoracic sympathetic nerves. However, little is known about the contribution of the interactions between sympathetic nerves and breast cancer cells to the malignant progression of TNBC. @*Methods@#The expression levels of the β2 -adrenergic receptor (β2 -AR, encoded by ADRB2 gene), nerve growth factor (NGF), and tropomyosin receptor kinase A (TrkA) were determined using immunohistochemistry (IHC). NGF expression levels in the serum were compared by enzyme-linked immunosorbent assay (ELISA). Cell proliferation was assessed using the Cell Counting Kit-8 assay. The β2 -AR, NGF, p-ERK, and p-CERB expression levels were determined using western blotting. TNBC cells and neuronal cells of the dorsal root ganglion (DRG) in 2-day-old Sprague Dawley rats were co-cultured. Using norepinephrine (NE), NGF, and β2 -AR, NGF/TrkA blocker pretreatments, the axon growth of each group of DRG neuron cells was detected by immunofluorescence analysis. @*Results@#The sympathetic adrenergic neurotransmitter NE activated the ERK signaling pathway in TNBC cells. NE/β2 -AR signaling promotes NGF secretion. NGF further facilitates the malignant progression of TNBC by increasing sympathetic neurogenesis. In the coculture assay, the sympathetic adrenergic NE/β2 -AR signal pathway also enhanced NGF secretion. NGF binds TrkA in DRG neurons and promotes axonal growth. @*Conclusion@#These results suggest that NE/β2 -AR pathway promotes cell proliferation and NGF production in triple-negative breast cancer.
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To investigate the computed tomography (CT) characteristics and differential diagnosis of high altitude pulmonary edema (HAPE) and COVID-19, CT findings of 52 cases of HAPE confirmed in Medical Station of Sanshili Barracks, PLA 950 Hospital from May 1, 2020 to May 30, 2020 were collected retrospectively. The size, number, location, distribution, density and morphology of the pulmonary lesions of these CT data were analyzed and compared with some already existed COVID-19 CT images which come from two files, "Radiological diagnosis of COVID-19: expert recommendation from the Chinese Society of Radiology (First edition)" and "A rapid advice guideline for the diagnosis and treatment of 2019 novel corona-virus (2019-nCoV) infected pneumonia (standard version)". The simple or multiple ground-glass opacity (GGO) lesions are located both in the HAPE and COVID-19 at the early stage, but only the thickening of interlobular septa, called "crazy paving pattern" belongs to COVID-19. At the next period, some increased cloudy shadows are located in HAPE, while lesions of COVID-19 are more likely to develop parallel to the direction of the pleura, and some of the lesions show the bronchial inflation. At the most serious stage, both the shadows in HAPE and COVID-19 become white, but the lesions of HAPE in the right lung are more serious than that of left lung. In summary, some cloudy shadows are the feature of HAPE CT image, and "crazy paving pattern" and "pleural parallel sign" belong to the COVID-19 CT, which can be used for differential diagnosis.
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Humans , Altitude , COVID-19/diagnostic imaging , China , Diagnosis, Differential , Lung/diagnostic imaging , Pulmonary Edema/diagnostic imaging , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Objective:To investigate the effect of terlipressin on prognosis of adult septic shock patients.Methods:All randomized controlled clinical trials (RCT) of terlipressin in the treatment of adult septic shock patients from January 1980 to December 2019 were retrieved from CNKI, Wanfang, SinoMed, PubMed, Embase, Springer Link, Cochrane Library, Google Scholar, and etc. Patients in the treatment group received terlipressin while patients in the control group received norepinephrine or other vasopressors. Main outcome indicator was mortality. Secondary outcome indicators included the incidence of severe adverse events, limb peripheral ischemic events and renal complications. Literature screening, data extraction and quality evaluation were conducted by two researchers respectively. Meta-analysis was performed with RevMan 5.3 software. Funnel plot was used to analyze the publication bias.Results:A total of 507 related literatures were retrieved. According to the inclusion and exclusion criteria, 8 RCT studies were finally included, with a total of 811 patients. One study was considered to have a lower risk of bias, 6 studies had uncertain risk of bias, and 1 study had a higher risk of bias. The Meta-analysis showed that terlipressin did not significantly improve the mortality of septic shock patients compared with the control group [odds ratio ( OR) = 0.89, 95% confidence interval (95% CI) was 0.67-1.19, P = 0.45]; increased the incidence of severe adverse events ( OR = 2.98, 95% CI was 1.99-4.45, P < 0.000 01); there was a tendency to increase the incidence of limb peripheral ischemic events, but without statistical difference ( OR = 10.81, 95% CI was 0.88-133.19, P = 0.06); and reduced the incidence of renal complications ( OR = 0.30, 95% CI was 0.09-0.96, P = 0.04). Funnel plot analysis indicated that there might be publication bias in a study on case fatality and incidence of serious adverse events in the included literature. No significant publication bias was found in studies on the incidence of limb peripheral ischemic events and the incidence of kidney-related complications. Conclusions:The available evidence suggests that terlipressin could not significantly improve mortality in adult's septic shock patients, but it may reduce the incidence of renal complications. A tendency to increase the incidence of limb peripheral ischemic events in the terlipressin-treated group needs to be emphasized.
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Critical patients in the intensive care unit (ICU) are often accompanied with acute pain,which may lead to a series of physiological responses that affect the prognosis of patients.With the continuous advancement of modem medicine,the pain management strategies and analgesics have also greatly developed,and the concept has been continuously updated.In the individualized diagnosis and treatment mode,the pain management is an indispensable component of ICU comprehensive treatment.Multimodal analgesia (MMA) strategies have also shown to be effective in optimizing analgesia in critical patients.However,there are still many shortcomings and differences in pain evaluation and its management.The characteristics and methodologies of related analgesics need to be further summarized and discussed.The current literature about the evaluation of pain,pharmacology and non-pharmacological techniques were reviewed to provide references for the scientific and reasonable implementation of analgesia treatment in ICU.
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Exosomes are vesicle-like structures generated and secreted actively by all kinds of cells.They contain proteins, nucleic acids and also lipids from the original cells, functioning in interactions between cells by shuttling cellular cargoes, and regulation of immune response in the microenvironment.Besides, they play important roles in the oncogenesis and progression of lung neoplasms.Considerable studies have demonstrated great potentials of exosomal proteins and microRNAs as biomarkers for diagnosis, prognosis prediction and treatment of lung cancers, including immunotherapy and targeted delivering of anti-tumor drugs based on exosomes.
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Objective To investigate the clinical efficacy of methylene blue in the treatment of refractory hypotension caused by vascular paralysis during the course of vasodilatory shock. Methods The related articles were searched by retrieving the terms using methylene blue, vascular paralysis, hemodynamics, hypotension, vasodilatory shock in CNKI, China Biomedical Literature database, Wanfang database, PubMed, Springer Link, and BIOSIS Previews database. The retrieval time was from January 1994 to June 2017. The randomized clinical trials (RCTs) which using methylene blue as the experimental group, normal saline or catecholamine as the control in the treatment of refractory hypotension caused by vascular paralysis during the course of vasodilatory shock were collected. The primary end points were mean arterial pressure (MAP) immediately or 1 hour after the methylene blue administration, and the mortality at the longest follow-up available; the secondary end point was serum lactic acid (Lac) 1 hour after the methylene blue administration. Literature screening, data extraction and quality evaluation were carried out by two researchers. Meta analysis was performed using RevMan 5.3 software. The sensitivity analysis was performed in two trials with low risk of bias. The funnel plot for MAP was performed in five relative trials to analyze the research and publication bias. Results Totally 269 relative articles were collected, according to the inclusion and exclusion criteria, finally 6 RCTs with 214 patients were enrolled, 108 in methylene blue group, and 106 in control group. Four of the studies were considered to have mild to moderate risk of bias, two studies of high risk of bias. The Meta-analysis demonstrated that compared with the control group, methylene blue could significantly improve MAP [mean difference (MD) = 4.87, 95% confidence interval (95%CI) = 2.61 to 7.13, P < 0.000 1], reduce the serum Lac levels (MD = -1.06, 95%CI = -1.98 to -0.14, P = 0.02), and the mortality was decreased without statistical difference [odds ratio (OR) = 0.58, 95%CI = 0.25 to 1.31, P = 0.19]. Sensitivity analysis was performed in two trials with low risk of bias, which demonstrated methylene blue could exactly increase MAP (MD = 8.93, 95%CI = 1.55 to 16.32, P = 0.02). Funnel plot for MAP was performed in five relative trials which found no obvious publication bias. Conclusions Methylene blue could significantly increase MAP in the patients with refractory hypotension caused by vascular paralysis during the course of vasodilatory shock, decrease the Lac levels, and does not increase the risk of death. Therefore, methylene blue should be a potential and safe vasoconstrictor.
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Objective To detect the levels of helper T cells (Th) 17 and Th9 cells in the peripheral blood of patients with pedi-atric bronchial asthma and the expression of interleukin 17 (IL-17) ,IL-9 and total IgE in serum ,and to discuss their effect and clini-cal significance in pathogenesis of pediatric asthma .Methods A total of 46 children with bronchial asthma ,including asthma attack group (n=26) and asthma remission group (n=20) were selected .Healthy children were selected as healthy control group (n=20) .Flow cytometry was used to detect the percentages of Th17 and Th9 cells in the peripheral blood .The levels of IL-17 and IL-9 in serum were measured by enzyme-linked immunosorbent assay (ELISA) .Serum total IgE levels were measured by the specific protein analyzer .Results The percentages of Th17 and Th9 cells in the peripheral blood were significantly higher in asthmatic group compared with remission group and healthy control group (P<0 .05) .The percentages of Th17 and Th9 cells in the periph-eral blood was significantly higher in remission group compared with healthy control group (P<0 .05) .The levels of IL-17 ,IL-9 and total IgE in serum were significantly higher in asthmatic group compared with remission group and healthy control group (P<0 .05) .The levels of IL-17 ,IL-9 and total IgE in serum were significantly higher in remission group compared with healthy control group (P<0 .05) .The levels of IL-17 and IL-9 in serum of asthmatic children were positively correlated with total IgE levels (P<0 .05) .The correlation analysis results showed that the levels of IL-17 ,IL-9 and total IgE in serum of patients with pediatric bron-chial asthma have a positive correlation .(r=0 .717 ,0 .491 ,0 .786 ,P<0 .05) .Conclusion Th17 ,Th9 cells and their cytokines in pe-ripheral blood of patients with pediatric bronchial asthma play important roles in the pathogenesis of asthma and are positively cor-related with the severity of asthma .
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OBJECTIVE:To systematically review the efficacy and safety of insulin glargine versus insulin detemir in the treat-ment of type 2 diabetes,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EM-Base,Cochrane Library,CBM,CJFD,VIP and Wanfang database,randomized controlled trials (RCT) about the clinical efficacy and safety of insulin glargine versus insulin detemir in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality evaluation by Cochrane 5.1.0. RESULTS:A total of 18 RCTs,in-volving 3 638 patients were included. Results of Meta-analysis showed there was no significant difference in reducing glycosylated hemoglobin[MD=0.08,95%CI (-0.01,0.17),P=0.09];fasting blood glucose level in insulin glargine group was significantly lower thaninsulin detemir,the difference was statistically significant [MD=0.15,95%CI(0.03,0.27),P=0.02]. And there was no significant difference in the incidence of hypoglycemia [OR=0.97,95%CI(0.91,1.03),P=0.25];the degree of body mass gain ininsulin detemir was significantly lower than insulin glargine group [MD=-0.95,95%CI(-1.06,-0.85),P=0.003],but the in-cidence of injection site reactions was significantly higher than insulin glargine group [OR=2.28,95%CI(1.16,4.50),P=0.02],the differences were statistically significant. CONCLUSIONS:The insulin glargine has better efficacy,than insulin detemir with lower incidence of injection site reactions but higher degree of body mass gain than insulin detemir in the treatment of type 2 diabetes.
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Objective To investigate the rationality of prophylactic use of anti‐bacterial in 251 type Ⅰ incision opera‐tions .Methods The anti‐bacterial use of 251 type Ⅰ incision operations sampled randomly from May 2012 to May 2013 were retrospectively analyzed .Results The prophylactic antibiotics rate was 98 .41% in the 251 cases of the type Ⅰ incision;among the 247 cases used anti‐bacterial ,the utility rate of first generation cephalosporin antibiotic was 28 .57% after surgery and the rate of prophylactic antibiotic use within 0 .5‐2 h before operation was 61 .94% .14 .17% of antibiotic treatment was finished within 48 h after surgical operation .Conclusion There was the unreasonable situation in the prophylactic use of anti‐bacterial , w hich need to be improved .
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The aberrant epigenetic reprogramme is an important cause for abnormal development of nuclear transfer embryos. The objective of this study was to investigate the CpG island methylation profiles and relative expression levels of H19 gene in different tissues of cloned goat fetus. We detected liver, placenta, kidney, lung and heart in the dead cloned goat fetus and the age-matched normal goat fetus (control) by using bisulfite sequencing and real time PCR. Results indicated that methylation levels of the fifth CpG island of H19 gene in dead cloned goat fetus was significant high compared with that in the control in placenta (70% vs 49.41%, P < 0.05), and relative expression levels of H19 gene was significant low compared with that in the control (883.3 vs 1 264.5, P < 0.05). Reversely, the methylation levels was significant low compared with that in the control in lung (63.53% vs 88.24%, P < 0.05), and relative expression levels was significant high compared with that in the control (1 003.4 vs 515.5, P < 0.05). The differences of others groups were insignificant (P > 0.05). Results showed the abnormal DNA methylation proflies of H19 gene occurred in some tissues of cloned goat fetus, which affected normal expression levels of H19 gene, indicating that aberrant DNA methylation reprogramme may be one of the important factors for the death of cloned animals.
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Animals , Female , Cloning, Organism , CpG Islands , DNA Methylation , Epigenesis, Genetic , Fetus , Metabolism , Genomic Imprinting , Goats , Kidney , Embryology , Metabolism , Liver , Embryology , Metabolism , Lung , Embryology , Metabolism , Nuclear Transfer Techniques , RNA, Long Noncoding , RNA, Untranslated , Genetics , MetabolismABSTRACT
AIM: Investigated the relationship between NF-κB activation and cell apoptosis in mouse macrophages treated with 7-ketochesterol (7-KC). METHODS: Cell apoptosis was detected by MTT assay, DNA fragmentation assay and flow cytometric analysis. NF-κB activation was detected by western blot and immunohistochemistry. Inhibitory assay was used to show the effect of the activation of NF-κB on the apoptosis induced by 7-KC. RESULTS: 7-KC inhibited macrophages proliferation, and then induced apoptosis, which is associated with NF-κB activation. Moreover, cell apoptosis with NF-κB activation was inhibited by pyrrolidine dithiocarbamate (PDTC), an inhibitor of NF-κB. CONCLUSION: 7-KC induced the activation of NF-κB and following cell apoptosis.