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OBJECTIVE@#To develop and validate a mechanical power (MP)-oriented nomogram prediction model of weaning failure in mechanically ventilated patients.@*METHODS@#Patients who underwent invasive mechanical ventilation (IMV) for more than 24 hours and were weaned using a T-tube ventilation strategy were collected from the Medical Information Mart for Intensive Care-IV v1.0 (MIMIC-IV v1.0) database. Demographic information and comorbidities, respiratory mechanics parameters 4 hours before the first spontaneous breathing trial (SBT), laboratory parameters preceding the SBT, vital signs and blood gas analysis during SBT, length of intensive care unit (ICU) stay and IMV duration were collected and all eligible patients were enrolled into the model group. Lasso method was used to screen the risk factors affecting weaning outcomes, which were included in the multivariate Logistic regression analysis. R software was used to construct the nomogram prediction model and build the dynamic web page nomogram. The discrimination and accuracy of the nomogram were assessed by receiver operator characteristic curve (ROC curve) and calibration curves, and the clinical validity was assessed by decision curve analysis (DCA). The data of patients undergoing mechanical ventilation hospitalized in ICU of the First People's Hospital of Lianyungang City and the Second People's Hospital of Lianyungang City from November 2021 to October 2022 were prospectively collected to externally validate the model.@*RESULTS@#A total of 3 695 mechanically ventilated patients were included in the model group, and the weaning failure rate was 38.5% (1 421/3 695). Lasso regression analysis finally screened out six variables, including positive end-expiratory pressure (PEEP), MP, dynamic lung compliance (Cdyn), inspired oxygen concentration (FiO2), length of ICU stay and IMV duration, with coefficients of 0.144, 0.047, -0.032, 0.027, 0.090 and 0.098, respectively. Logistic regression analysis showed that the six variables were all independent risk factors for predicting weaning failure risk [odds ratio (OR) and 95% confidence interval (95%CI) were 1.155 (1.111-1.200), 1.048 (1.031-1.066), 0.968 (0.963-0.974), 1.028 (1.017-1.038), 1.095 (1.076-1.113), and 1.103 (1.070-1.137), all P < 0.01]. The MP-oriented nomogram prediction model of weaning failure in mechanically ventilated patients showed accurate discrimination both in the model group and external validation group, with area under the ROC curve (AUC) and 95%CI of 0.832 (0.819-0.845) and 0.879 (0.833-0.925), respectively. Furthermore, its predictive accuracy was significantly higher than that of individual indicators such as MP, Cdyn, and PEEP. Calibration curves showed good correlation between predicted and observed outcomes. DCA indicated that the nomogram model had high net benefits, and was clinically beneficial.@*CONCLUSIONS@#The MP-oriented nomogram prediction model of weaning failure accurately predicts the risk of weaning failure in mechanical ventilation patients and provides valuable information for clinicians making decisions on weaning.
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Humans , Respiration, Artificial/methods , Ventilator Weaning/methods , Nomograms , Lung , Risk FactorsABSTRACT
Objective:To analyze the operative outcomes and postoperative pathological features of retroperitoneal leiomyosarcoma(RPLMS) undergoing surgeries.Methods:Medical records of RPLMS patients admitted to Peking University International Hospital from Jan 2015 through Dec 2020 were retrospectively reviewed.Results:Ninety-seven patients undergoing resectional surgeries were included in the study. Of whom, 49 cases were primary RPLMS. Others were recurrent sarcomas or sarcomas with incomplete resection in the first surgical intentions. The most frequent symptoms were abdominal pain and distention (30 cases) as well as lower back pain (23 cases). All patients underwent resectional surgeries with a R 0/R 1 rate of 84.5%. Sixty-four cases received extended surgeries with combined organs resection. External iliac artery resection with reconstruction were performed on 2 cases. And 19 patients underwent partial IVC resection in combination of sarcoma resection. The general postoperative morbidity was 26.8%, including 4 intestinal fistulas, 1 pancreatic fistula, 1 vesicovaginal fistula, 1 urinary fistula, 1 biliary fistula, 2 abdominal major bleeding, 7 IVC thrombosis, 3 gastroplegiaetc. One patient deceased within post-operative 30 d due to massive bleeding.Pathology found that spindle and pleomorphic cell types were most common subtypes of RPLMS. Conclusions:Surgery remains the mainstay in the treatment of RPLMS which often presents with atypical symptoms. Extended surgeries combining with multiple organ and major vascular resections could be only suggested in experienced sarcoma centers due to high risk of severe postoperative complications.
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Objective:To explore the diagnostic value of mechanical power (MP) in patients with moderate to severe acute respiratory distress syndrome (ARDS) based on the Medical Information Mart for Intensive Care-Ⅲv1.4 (MIMIC-Ⅲ v1.4).Methods:The information of ARDS patients undergoing invasive mechanical ventilation for no less than 48 hours who were hospitalized at Beth Israel Deaconess Medical Center in Boston, Massachusetts from June 2001 to October 2012 in the MIMIC-Ⅲ v1.4 were collected. The demographics of patients, disease severity scores, ARDS etiology, prognostic indicators, pre-ventilation arterial blood gas analysis and respiratory parameters within 48 hours of ventilation were extracted. According to the lowest oxygenation index (PaO 2/FiO 2) before ventilation, the patients were divided into mild to moderate ARDS group (> 150 mmHg, 1 mmHg≈0.133 kPa) and moderate to severe ARDS group (≤ 150 mmHg), and the differences in baseline characteristics between the two groups were compared. The independent predictors associated with the severity of ARDS were analyzed using Logistic regression. The receiver operator characteristic curve (ROC curve) was plotted. The area under ROC curve (AUC) was calculated to evaluate the diagnostic value of MP for moderate to severe ARDS. The Youden index was used to determine the diagnostic threshold of MP for moderate to severe ARDS. According to the cut-off value of MP based on Youden index, all ARDS patients were divided into high and low MP groups. Kaplan-Meier survival curve was used to analyze the 28-day survival status of patients. Results:A total of 403 ARDS patients were enrolled in the study, including 107 subjects with mild to moderate ARDS and 296 with moderate to severe ARDS. There were significant differences in age, sequential organ failure assessment (SOFA) score, the lowest PaO 2/FiO 2 before ventilation, the last PaO 2/FiO 2 before ventilation, 28-day mortality, the length of intensive care unit (ICU) stay, duration of mechanical ventilation, lung dynamic compliance (Cdyn) in the second 24 hours of ventilation and positive end-expiratory pressure (PEEP), plateau pressure (Pplat), driving pressure (ΔP), respiratory rate (RR), lung static compliance (Cst), MP, inspired fraction of oxygen (FiO 2) within 48 hours of ventilation between the two groups. After adjusting variables such as age, SOFA score, the last PaO 2/FiO 2 before ventilation, and related respiratory mechanics parameters, multivariate Logistic regression analysis showed that higher ΔP, PEEP and MP, and lower last PaO 2/FiO 2 before ventilation were independently associated with moderate to severe ARDS [odds ratio ( OR) and 95% confidence interval (95% CI) was 1.137 (1.032-1.252), 1.333 (1.139-1.561), 1.102 (1.030-1.179), and 0.996 (0.993-0.998), respectively, all P < 0.01]. The ROC curve analysis showed that the best cut-off value of MP for the diagnosis of moderate to severe ARDS was 18.1 J/min with sensitivity of 81.42% and specificity of 60.75%, and the AUC was 0.745 (95% CI was 0.690-0.799). According to the cut-off value of MP obtained by ROC curve, all ARDS patients were divided into high MP group (> 18.1 J/min) and low MP group (≤ 18.1 J/min). The Kaplan-Meier survival curve showed that the 28-day cumulative survival rate in the high MP group was significantly lower than that in the low MP group (73.8% vs. 85.1%; Log-Rank test: χ2 = 5.660, P = 0.017). Conclusion:MP is an independent predictor of the severity of ARDS, and it can be used to diagnose moderate to severe ARDS.
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Objective:To summarize the experience of surgical treatment of pelvic retroperitoneal neoplasms.Methods:A total of 107 patients with pelvic retroperitoneal neoplasms underwent surgical treatment from Apr 2015 to Sep 2020. According to the neoplasm location, size, and the relationship with the surrounding tissues, individualize the surgical plan, analyze the patient's basic condition, bleeding volume, tumor size, whether it is the first operation,or combined organ resection, etc.to find out the relevant factors affecting the surgical complications.Results:The surgical route included anterior approach in 67 cases , sacrococcygeal approach in 21 cases, combined abdominal-sacral approach in 13 cases, and laparoscopy in 5 cases. Twenty-nine patients underwent combined organ resection, postoperative complications occurred in 27 patients including colorectal anastomotic leakage in 6 cases, urinary fistula in 6 cases, delayed pelvic floor healing in 6 cases, rectovaginal fistula in 3 cases, and postoperative bleeding in 2 cases. The statistical analysis show whether or not first operation is related to the occurrence of complications ( χ2=4.79, P<0.05) Conclusion:Pelvic retroperitoneal neoplasms need to be fully prepared before surgery and individualized design. Intraoperative combined bleeding control measures and combined organ resection can effectively increase the resection rate and ensure the safety of surgery.
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Gastric cancer is one of the most common malignant tumors worldwide, and the 5-year survival rate of patients is extremely low. In spite of several advances have been made in surgery and chemoradiotherapy, the survival rate of gastric cancer patients has slightly improved. In recent years, significant progress has been made in antiangiogenic therapy for gastric cancer. This article reviews the research progress of antiangiogenic therapy for gastric cancer in recent years, so as to provide a certain reference for clinical practice.
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Objective:To evaluate primary retroperitoneal liposarcoma surgeries in combination with involved bowel resection .Methods:Clinical data of primary retroperitoneal liposarcoma patients admitted for surgery at Peking University International Hospital from Jan 2015 to July 2019 were retrospectively reviewed.Results:Twenty-four patients undergoing resectional surgeries combining with bowel resection were included for the study, of which 6 cases underwent right hemicolectomy, 8 did left hemicolectomy, 6 did sigmoidectomy, 2 did proctectomy and 8 did small bowel resection. The post operative morbidity was 38%. 2 of 24 had anastomotic fistula. There was no mortality. Final pathology disclosed well differentiated liposarcoma in 13 and dedifferentiated liposarcoma in 11 cases. 18 cases were confirmed with bowel infiltration pathologically. All patients were followed up after the surgery. After a median of 25 months following up, 8 cases developed recurrences and 3 deceased. Two-year overall survival and progression free survival probability were 91% and 71% respectively. Dedifferentiated liposarcoma as a pathological type was found as the only risk factor associated to poor progression free survival ( Z=2.02, P=0.042). Conclusion:Combining resection of primary retroperitoneal liposarcoma with involved bowel was relatively safe, with low morbidity, increasing tumor clearance. Dedifferentiated liposarcoma is associated wth poor prognosis.
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Objective:To investigate the pathogeny, diagnosis and treatment of solitary fibrous tumors of the abdomen and pelvis.Methods:Retrospective analysis was made on the clinical data of 12 SFT patients undergoing surgical resection in Peking University International Hospital from Jul 2015 to Jul 2019.Results:All patients underwent radical resection. After operation, complications in clued pelvic hemorrhage in 1 case and ureteral fistula in 1 case, all improved after conservative treatment.According to pathological and immunohistochemical results, 7 cases were MSFT and 5 cases were SFT. All patients were followed up for 2-53 months. 5 cases were recurrent, among which 1 case died of intestinal obstruction caused by tumor compression.Conclusion:The clinical manifestations of solitary fibrous tumors are mostly nonspecific.Imaging examination and puncture pathology are of great significance for preoperative diagnosis. Radical resection is an important means to improve the prognosis of patients.
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Objective:To explore the occurrence of symptoms in postoperative patients with oral cancer, and to explore the types and number of symptom groups.Methods:The Anderson symptom assessment scale for head and neck cancer was used to conduct a questionnaire survey on 345 patients after oral cancer surgery. The results of two exploratory factor analysis methods were compared, and the cluster analysis and Spearman rank correlation analysis were combined to determine the symptom group of patients after oral cancer surgery.Results:There were 4 symptom groups in patients with oral cancer, including oral and pharynx symptoms group, dietary and digestive symptoms group, gastrointestinal and emotional symptoms group, and rest activity symptoms group.Conclusions:There are many symptom groups that affect the life of patients with oral cancer in the rehabilitation process after surgery, so the medical staff should carry out targeted intervention mode to achieve better intervention effect.
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Objective@#To explore the method of relieving intestinal obstruction in patients with recurrent cervical cancer accompanied with intestinal obstruction after radical radiotherapy.@*Methods@#The data of 10 recurrent cervical cancer patients accompanied with high risk weak constitution and intestinal obstruction after radical radiotherapy from May 2012 to May 2018 were retrospectively analyzed, including preoperative radiotherapy dose, physique and obstruction status, operation time, operation blood loss, postoperative digestive tract patency and diet. All of the 10 patients with cervical cancer recurrence accompanied with intestinal obstruction and disturbance of independent walking after radical radiotherapy.@*Results@#The median fasting time of the 10 patients was 21 days, the median weight was 35.5 kg, the median body mass index (BMI) was 13.3 kg/m2, the median value of hemoglobin was 67 g/L, and the median value of platelet was 44×109 /L. All of the patients underwent enterostomy. the median operation time was 6.0 min and the median amount of bleeding was 5.0 ml. All of the patients defecated after operation, fed on the first day after operation, and were able to walk on their own 5 days after operation.@*Conclusions@#Although the cervical cancer patients with recurrent intestinal obstruction after radical radiotherapy are extremely weak, some patients still have the opportunity to relieve intestinal obstruction if the treatment strategy and surgical method are appropriate.
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The membrane protein claudin-3 (CLDN3) is critical for the formation and maintenance of tight junction and its high expression has been implicated in dictating malignant progression in various cancers. However, the post-translational modification of CLDN3 and its biological function remains poorly understood. Here, we report that CLDN3 is positively correlated with ovarian cancer progression both and Of interest, CLDN3 undergoes -palmitoylation on three juxtamembrane cysteine residues, which contribute to the accurate plasma membrane localization and protein stability of CLDN3 Moreover, the deprivation of -palmitoylation in CLDN3 significantly abolishes its tumorigenic promotion effect in ovarian cancer cells. By utilizing the co-immunoprecipitation assay, we further identify ZDHHC12 as a CLDN3-targating palmitoyltransferase from 23 ZDHHC family proteins. Furthermore, the knockdown of ZDHHC12 also significantly inhibits CLDN3 accurate membrane localization, protein stability and ovarian cancer cells tumorigenesis Thus, our work reveals -palmitoylation as a novel regulatory mechanism that modulates CLDN3 function, which implies that targeting ZDHHC12-mediated CLDN3 -palmitoylation might be a potential strategy for ovarian cancer therapy.
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Objective@#To explore the basic conditions and postoperative quality of life in patients undergoing oral vestibular thyroid surgery.@*Methods@#A total of 128 patients undergoing oral vestibular thyroid surgery were enrolled in the Department of Head and Neck Surgery from March 2015 to April 2018. On the basis of routine thyroid tumor care, we used telephone, WeChat public platform, WeChat group, QQ, and Email. Questionnaires such as information technology and clinic review. Correlation analysis was performed using SPSS 22.0.@*Results@#According to the analysis of SPSS statistical software, the postoperative recovery of the patients is good, and more than 95% of the patients have the feeling of "no" or "a little" for symptoms, and 91.8% (102/111) and 93.6% (104/111) of the patients have the perception of the general health status and life quality of the patients in the past 1 week respectively. Analysis of variance of postoperative life quality of patients, postoperative regression post was significantly correlated with postoperative social cognition, insomnia and economic difficulties of patients. The education level, occupation, marital status and family income of the patients all had significant influences on the postoperative economic status of the patients, and the differences were statistically significant (t=2.66-4.74, P<0.05). In the regression analysis of patients′ life quality, emotional function and physical function were independent risk factors affecting patients′ life quality, with statistical significance (t=-2.072, -5.564, P < 0.05).@*Conclusion@#Endoscopic thyroidectomy via oral vestibule has the advantages of good effect, beautiful appearance and high quality of life, which is worth popularizing and applying.
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Objective@#To observe the expressions of periostin (Postn) in colon cancer tissues and cells, and to investigate its biological effect and mechanism in colon cancer cells.@*Methods@#Real-time quantitative polymerase chain reaction (RT-qPCR) and western blot were used to detect the expressions of Postn, let-7a and miR-98 in 20 pairs of colon cancer tissues and adjacent normal tissues, colon cancer cell lines including SW480, HT-29, HCT-116 and human normal colon epithelial cell NCM460. Small interfering RNAs (siRNAs) of Postn, pcDNA3.1-Postn plasmids, let-7a mimic and its negative control let-7a mimic-NC, miR-98 mimic and its negative control miR-98 mimic-NC were transfected into HCT-116 cells. 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-2H tetrazolium bromide (MTT) was used to detect cell viability. Flow cytometry was used to detect cell apoptosis. Luciferase reporter gene assay was used to determine the targeting relationship between miRNAs and Postn.@*Results@#Compared with adjacent normal tissues, Postn expression was up-regulated (P<0.05) while let-7a/miR-98 expression was down-regulated (P<0.05) in colon cancer tissues. Compared with NCM460 cells, Postn expression was up-regulated (P<0.05) while let-7a/miR-98 expression was down-regulated (P<0.05) in SW480, HT-29 and HCT-116 cells. In colon cancer tissues, the expression of Postn was negatively correlated with the expressions of let-7a and miR-98 (r=-0.69, P<0.001; r=-0.80, P<0.001). Inhibition of Postn in vitro reduced the viability of HCT-116 cells [(53.73±7.63)%, P<0.05], increased the apoptotic rate [(22.88±3.40)%, P<0.05], enhanced the expression of epithelial-mesenchymal transition (EMT) marker E-cadherin (2.44±0.39, P<0.05), while down-regulated the expressions of N-cadherin and Vimentin (0.44±0.07 and 0.38±0.06, P<0.05). Overexpression of Postn in vitro enhanced the cell viability of HCT-116 cells [(134.41±8.82) %, P<0.05], decreased the expression of E-cadherin (0.55±0.09, P<0.05), increased the expressions of N-cadherin and Vimentin (2.93±0.42 and 2.24±0.34, P<0.05), but had no effect on the apoptotic rate (P>0.05). Overexpression of let-7a or miR-98 partially reversed the biological effects of Postn overexpression in colon cancer cells, which implicated that Postn was a target gene of let-7a/miR-98.@*Conclusions@#Postn is a cancer-promoting molecule of colon cancer, and inhibition of Postn expression can increase the apoptotic rate of colon cancer cells and repress EMT. Postn expression and function is regulated by let-7a/miR-98.
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Objective To investigate the effhect of ultrasound-guided nerve block on the prognosis of patients undergoing laparoscopic cholecystectomy.Methods A total of 150 cases undergoing elective laparoscopic cholecystectomy in our hospital was used as the research object,and randomly divided into control (n =75) and observation (n =75) groups.The control group used punctured local infiltration analgesia,and observation group used the transversus abdominis plane block (TAP) combined with local infiltration analgesia hole.The postoperative awake time,hemodynamic changes,pain score,and analgesic use were compared between two groups.Results The recovery time was significantly reduced in the observation group (9.7 ± 2) minutes compared to the control group (23.9 ± 2.4) minutes.The additional total dose of analgesics and average additional times were significantly lower in the observation group compared to the control group (P ＜0.05).The pain score were 0.99 ±0.22 after waking,1.05 ±0.14 at the postoperative 6 h,1.13 ±0.23 at the postoperative 24 h,and 1.40 ±0.38 at the postoperative 48 h in the observation group,which was significantly lower than the corresponding 3.99 ± 0.36,3.67 ± 0.43,3.39 ± 0.38,and 3.93 ± 0.20 in the control group (P ＜ 0.05).With the postoperative time,postoperative 48 h in two groups of visual pain scores were significantly higher than that of 24 h after the operation (P ＜ 0.05).The incidence of adverse reactions was no significant difference between observation group (36％) and control group (32％) (P ＞ 0.05).Conclusions Ultrasound-guided nerve block can obviously reduce postoperative pain,reduce drug use frequency and dosage,significantly improve postoperative outcomes,and does not increase the incidence of adverse drug reactions.It is worthy of clinical reference.
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Objective To evaluate the effect of education on the family function of breast reconstruction after breast cancer. Methods Totally 130 cases of breast reconstruction after breast cancer were selected from January 2015 to August 2017, and 65 cases were divided into observation group and control group by random number table method. The control group received routine education; The observation group and the spouse received synchronous education. In the preoperative and postoperative 3 months, 6 months after the Female Sexual Function Index (FSFI) to assess patients sexual function, the Family Intimacy and Adaptability Scale to assess the patient's family intimacy and adaptability, comparing the indicators of two groups of patients. Results After 6 months of operation, the two groups were compared, and the intervention group was (24.82 ± 3.75) points, and the control group was (22.32±4.75), with statistically significant difference(t=- 3.35, P < 0.05). Comparison of familial closeness and adaptability score of the two groups, the intervention group was (76.80 ± 8.14) points, (59.98 ± 3.56) points; The control group was (68.48 ± 11.46) points, (52.27 ± 9.49) points,with statistically significant difference(t=-4.81,-6.18, P<0.05). Conclusion The simultaneous education can improve the sexual function and familial intimacy and adaptability of breast reconstruction after breast cancer.
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In recent years, anti-angiogenic drugs influencing vascular endothelial growth factor receptor (VEGFR) and vascular endothelial growth factor (VEGF) signaling have been widely used in the treatment of malignant tumors. Apatinib is an orally bioavailable small molecule antiangiogenic agent. The CSCO Guide to Gastro-Oncology,published in 2017, lists apatinib as the only targeted drug targeted for third-line treatment of gastric cancer. This review summarizes the recent advances in the structure, mechanisms of action, reversing drug resistance, clinical efficacy, adverse reactions, and biomarkers in various types of malignancies.
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Objective To assess the value of serum carcinoembryonic antigen (CEA)and carbohydrate antigen 19-9 (CA19-9) levels in the diagnosis of gastric cancer in elderly patients.Methods This prospective study included 104 elderly patients with gastric cancer at our hospital from March 2015 to December 2016 to serve as an experimental group.Moreover,104 elderly patients with benign gastric lesions were enrolled to serve as a control group.Serum CEA and CA19-9 levels were compared between the two groups.The diagnostic specificity,sensitivity,and validity for gastric cancer were calculated by using CEA or CA19-9 alone or the two in combination.Results Serum CEA and CA19-9 levels in the experimental group were significantly higher than in the control group(t =3.001 and 5.110,P =0.039 and 0.016,respectively);The specificity,sensitivity,and validity of CEA and CA19-9 in combination were significantly higher than when each of the measures was used alone(x2 =2.101 and 2.109,P =0.031 and 0.019,respectively).Serum CEA levels showed good predictive power for both lymph node metastasis of gastric cancer(Z =5.109,P =0.002) and liver metastasis of gastric cancer(Z =3.910,P =0.026);Serum CA19-9 levels could predict lymph node metastasis of gastric cancer (Z =4.189,P =0.003) Conclusions Serum CEA and CA19-9 in combination have high sensitivity and validity for gastric cancer detection;Elevated CEA can predict gastric cancer metastasis and elevated CA19-9 may predict lymph node metastasis.
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<p><b>OBJECTIVE</b>To predict and identify the target gene of miR-145, and to explore the underlying mechanism of the inhibition of miR-145 on drug resistance to Oxaliplatin (L-OHP) in human colorectal cancer cells.</p><p><b>METHODS</b>L-OHP-resistant human colorectal cancer cell line (HCT116/L-OHP) was established in vitro by exposing to increased concentrations of L-OHP in cell culture medium. MiR-145-mimics and its negative control (NC-miRNA) were transfected into HCT116/L-OHP cells using liposome to establish HCT116/L-OHPover-expressing miR-145 and HCT116/L-OHP. The target genes of miR-145 were predicted by bioinformatic analysis, and validated by dual luciferase activity assay. After determination of G protein coupled receptor 98(GPR98) as target gene, corresponding plasmids were constructed and transfected to establish HCT116/L-OHPover-expressing GPR98 and HCT116/L-OHP. HCT116/L-OHP cells over-expressing both GPR98 and miR-145 (HCT116/L-OHP) were acquired through modification of the binding sites of GPR98 cDNA with miR-145. CCK-8 assay was used to assess the proliferation (A value) and sensitivity to L-OHP (the lower the IC50, the stronger the sensitivity) in HCT116/L-OHP cells. Real-time quantitative PCR was used to measure the mRNA expression of miR-145 and GPR98. Western blot was used to examine the protein expression of GPR98 and drug-resistant associated protein, such as P-glycoprotein (gp), multiple drug-resistance protein 1(MRP1), cancer-inhibition gene PTEN.</p><p><b>RESULTS</b>HCT116/L-OHP cell line was successfully established with ICof (42.34±1.05) mg/L and miR-145 mRNA expression of 0.27±0.04, which was higher than (9.81±0.95) mg/L (t=39.784, P=0.000) and lower than 1.00±0.09 (t=13.021, P=0.000) in HCT116 cells. Based on HCT116/L-OHP cells, HCT116/L-OHPcells were established successfully, with relative miR-145 expression of 10.01±1.05, which was higher than 1.06±0.14 in HCT116/L-OHPand 1.00±0.16 in HCT116/L-OHP (F=161.797, P=0.000). GPR98 was identified to be the target gene of miR-145. The relative mRNA and protein expressions of GPR98 in HCT116/L-OHPcells were 8.48±0.46 and 1.71±0.09, respectively, which were higher than those in HCT116/L-OHP(mRNA: 3.65±0.40, protein: 1.21±0.10) and HCT116/L-OHP (mRNA: 3.49±0.35, protein: 1.22±0.08; all P<0.05). The A value was 1.31±0.10, and the relative protein expressions of P-gp and MRP1 were 1.53±0.18 and 1.49±0.20 in HCT116/L-OHPcells, which were higher than those in HCT116/L-OHP (A value: 0.82±0.08, relative protein expression: 1.00±0.06 and 1.21±0.13, all P<0.05). The A value was 0.89±0.08, and the relative protein expressions of P-gp and MRP were 1.02±0.24 and 1.38±0.25 in HCT116/L-OHPcells, which were higher than those in HCT116/L-OHP(A value: 0.20±0.05, relative protein expression: 0.20±0.07, 0.55±0.10, all P<0.05). The relative protein expression of PTEN in HCT116/L-OHPcells was 0.12±0.03, which was lower than 1.25±0.14 in HCT116/L-OHP cells(P<0.05). In addition, relative protein expressions of P-gp and MRP1 were 1.02±0.24 and 1.38±0.25 in HCT116/L-OHPcells, which were higher than those in HCT116/L-OHPcells (0.20±0.07 and 0.55±0.10), while PTEN expression in HCT116/L-OHPcells was lower as compared to HCT116/L-OHPcells (1.41±0.16 vs. 1.98±0.13, P<0.05).</p><p><b>CONCLUSION</b>MiR-145 inhibits drug resistance to L-OHP of HCT116 cells through suppressing the expression of target gene GPR98.</p>
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Humans , ATP Binding Cassette Transporter, Subfamily B , ATP Binding Cassette Transporter, Subfamily B, Member 1 , Cell Line, Tumor , Physiology , Colorectal Neoplasms , Down-Regulation , Genetics , Drug Resistance, Neoplasm , Genetics , Physiology , HCT116 Cells , Physiology , In Vitro Techniques , MicroRNAs , Genetics , Pharmacology , Multidrug Resistance-Associated Proteins , Organoplatinum Compounds , Pharmacology , PTEN Phosphohydrolase , RNA, Messenger , Receptors, G-Protein-Coupled , GeneticsABSTRACT
Objective To evaluate a novel lymph node (LN) sorting method on surgical resected sample guided by nanometer carbon staining and principle following the supplying artery tributory in rightsided colon carcinoma.Methods From May 2015 to June 2016,51 patients were randomly divided into two groups adopting traditional LN sorting method and that of a combination of nanometer carbon and artery guided.The final LN status were compared between the 2 groups.Results The total LN number and the positive LN in novel method group were higher than control group (437 vs.349,70 vs.54).The dissection time used,the number of harvested positive LN that was ＜ 5 mm were significantly different [(13.1 ± 3.2) minvs.(17.8 ±3.8)min,t=4.75,P=0.000;1.0±l.0vs.0.2 ±0.6,t=3.51,P=0.000].The number of patients with harvested LN less than 12,the rate of positive lymph nodes,the rate of metastasis were not significantly different (all P ＞ 0.05) between the two groups.Conclusions Use of nanometer carbon development combined with artery approach facilitates LN sorting,yielding more positive LNs,and increating the accuracy of pathological staging in right-sided colon cancer.
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Chemotherapy is one of the main treatments for gastric cancer, but its drug resistance often limits the effectiveness of chemotherapy, leading to treatment failure. Drug resistance can be divided into primary drug resistance and secondary resistance. It has showed that several factors were involved in the multidrug resistance of gastric cancer, including the expression of drug resistance-related proteins, abnormalities of apoptosis-related genes, dysfunction of DNA damage repair, epithelial-mesenchymal transition and non-coding RNA. The solution to improve the efficacy of chemotherapy is to overcome drug resistance or delay drug resistance. This article will explore the progress in multi-drug resistance of gastric cancer.
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Objective To investigate the application of peripheral perfusion index (PPI) in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock. Methods A prospective single-blind randomized controlled trial (RCT) was conducted. Adult patients with sepsis admitted to emergency medical department and intensive care unit (ICU) of the First People's Hospital of Lianyungang City in Jiangsu Province from January 2013 to December 2016 were enrolled. The patients were randomly divided into two groups (n = 46). The PPI group was defined using PPI < 1.4 as diagnosis of septic shock standard, and PPI > 2 as treatment guide target. Control group was defined according to the traditional diagnostic criteria of shock which systolic blood pressure was less than 90 mmHg (1 mmHg = 0.133 kPa) or systolic blood pressure value decrease> 40 mmHg baseline and bundle treatment was performed. The volume of fluid resuscitation, organ dysfunction, the sequential organ failure score (SOFA), acute physiology and chronic health evaluationⅡ (APACHE Ⅱ) score,continuous renal replacement therapy (CRRT) time, mechanical ventilation (MV) time, the length of ICU stay and 28-day mortality were observed. Results There were 39 and 27 septic shock patients in PPI group and control group respectively. The diagnostic criteria of traditional septic shock with blood pressure as "gold standard", the sensitivity of PPI < 1.4 for septic shock was 94.3%, the specificity was 28.2%, the authenticity was 66.3%, the positive predictive value was 64.1%, the negative predictive value was 78.6%, the positive likelihood ratio was 1.31, the negative likelihood ratio was 0.18. The per capita fluid replacement within 24 hours in the PPI group was significantly higher than that in the control group (mL: 4 601±1 250 vs. 3 458±1 006, P < 0.01), but there was no significant difference in the per capita volume of the patients diagnosed as septic shock (mL: 4 596±1 320 vs. 4 205±1 058, P > 0.05). Compared with the control group, the PPI group treated patients within 48 hours with less vascular active drugs (cases: 6 vs. 15), APACHE Ⅱand SOFA score were lower (48 hours: APACHE Ⅱ was 10.2±2.1 vs. 12.0±3.2; 72 hours: SOFA was 5.1±1.8 vs. 6.0±2.1, APACHE Ⅱ was 8.9±1.8 vs. 9.8±2.2), the period of CRRT and the length of ICU stay were shorter [the period of CRRT (days): 3.0±0.9 vs. 3.6±1.4, the length of ICU stay (days): 5.2±2.1 vs. 6.3±2.9), the difference was statistically significant (all P < 0.05). There was no significant difference in the liver and kidney function index, arterial blood lactic acid (Lac), MV time (days: 3.3±1.4 vs. 3.5±1.2) and 28-day mortality (15.22% vs. 19.57%) between two groups (all P > 0.05). Conclusions The inadequacy of microcirculatory perfusion by oximetry-derived PPI is more sensitive to the diagnosis of septic shock than hypotension of systemic circulation. With PPI guiding the fluid resuscitation of septic shock patients, vasopressors can be withdrawn earlier and the duration of the CRRT and ICU can be decreased.