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Objective:To study the effect of permissive hypercapnia on pulmonary infection in patients underwent thoracoscopic combined with laparoscopic radical esophagectomy.Methods:From 2018 to 2020, 90 who patients underwent thoracoscopic laparoscopy combined with radical esophagectomy were divided into 3 groups by random who number table method, including 30 patients in experimental group 1, 30 patients in experimental group 2, and 30 patients in control group.PaCO 2 was maintained in the range of 56 mmHg-65 mmHg in experimental group 1, 46 mmHg-55 mmHg in experimental group 2 and 35 mmHg-45 mmHg in control group. The peak airway pressure (Ppeak) , lung dynamic compliance (Cdyn) and oxygenation index (OI) were observed and compared among the three groups after endotracheal intubation (T1) , 30 min after right artificial pneumothorax (T2) and 30 min after right lung recruitment (T3) ;The clinical pulmonary infection score (CPIS) , serum procalcitonin (PCT) on the 1st, 4th and 7th day after operation were analyzed and compared. Results:At T2, observation group A had the highest dynamic lung compliance (25.13 ± 5.70 vs 22.28 ± 4.26 vs 19.99 ± 4.36), the fastest heart rate (102.04 ± 10.91 vs 96.46 ± 9.91 vs 92.28 ± 8.08) and the lowest airway pressure (17.62 ± 1.79 vs 18.96 ± 1.90 vs 20.39 ± 1.71) ( P < 0.05). Observation group A had the lowest CPIS on the 1st, 4th and 7th day after operation compared with observation group B and control group (1.12±0.77 vs 1.71±0.90 vs 2.64±1.07) (6.08±1.20 vs 7.43±1.10 vs 8.31±1.55) (1.69±1.12 vs 2.32±0.98 vs 3.44±1.25) ( P<0.05) . Conclusion:Permissive hypercapnia can reduce airway resistance, improve lung compliance and reduce the risk of postoperative pulmonary infection.
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OBJECTIVE： To compare the efficacy and safety of domestic vancomycin and imported vancomycin in the treatment of methicillin-resistant Staphylococcus aureus （MRSA） caused lung infection after neurosurgery. METHODS： The patients after neurosurgery with MRSA pulmonary infection diagnosed in our hospital from Jan. 2014 to Jun. 2015 and using domestic vancomycin were included in domestic vancomycin group， while those who used imported vancomycin from Jul. 2015 to Dec. 2018 were included in imported vancomycin group. The baseline data of the two groups were matched by 1 ∶ 1 according to propensity score matching method. The 30-day all-cause mortality， 90-day all-cause mortality of severe patients， 7 d effective bacterial clearance rate and the incidence of ADR were compared between 2 groups. RESULTS： There were 108 cases in domestic vancomycin group and 279 cases in imported vancomycin group. After propensity score matching， 108 cases in domestic and 108 cases in imported vancomycin group were finally included. The 30-day mortality rates of domestic group and imported group were 10.19％（11/108） and 7.41％（8/108） respectively， and the 90-day all-cause mortality of 22 pairs of severe patients were 63.64％. The 7 d effective bacterial clearance rates were 75.00％（48/64） and 81.94％（59/72）， and there was no statistical significance （P＞0.05）. The incidences of creatinine increase ＞1 fold were 25.93％（28/108） and 12.04％（13/108）， the total incidences of ADR were 29.63％（32/108） and 15.74％（17/108）， respectively， with statistical significance （P＜0.05）. CONCLUSIONS： The therapeutic efficacy of imported vancomycin is similar to that of domestic vancomycin in the treatment of postoperative pulmonary infection with MRSA after neurosurgery， but the safety needs to pay close attation， especially the rise of serum creatinime.
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Objective To investigate the value of dynamic contrast-enhanced(DCE)-MRI and DWI for the early assessment of curative effects in NSCLC. Methods Forty patients from September 2012 to September 2014 with NSCLC proven by pathology were examined with DCE-MRI and DWI, at one week before the first chemotherapy and one month after treatment. DCE parameters (MER, slope, WR) and ADC values of the tumors were calculated on the workstation. According to the changes of the tumor-size after treatment, all patients were divided into two groups: good response group and poor response group. Pretreatment parameters were compared between the two groups with independent-samples t test, and parameter changes before and after treatment were compared with paired-samples t Test. ROC curve of tumor response characteristic was analyzed. Pearson correlation coefficient was used to study the correlation between post-treatment parameter changes and tumor size reduction. Results Pretreatment ADC, MER and slope value were (1.15 ± 0.09) × 10-3 mm2/s, 1.13 ± 0.28, (3.76 ± 1.27)% in the good response group(15 patients), and were (1.34±0.33)×10-3mm2/s, 0.78±0.16, (2.63±0.58)%in poor response group(25 patients), respectively. There was significant difference between tumors in two groups(t=2.329, 3.152, 4.556,P=0.027, 0.032, 0.009), the lower ADC value and the higher MER/slope value was observed in the good response group. The change rates of ADC after one month treatment in the two groups were (20.43±6.40)%, (2.98±1.65)%(t=3.485,P=0.009), and slope change were (-61.80±19.21)%, (-30.80±11.16)%(t=3.280, P=0.020). Both the rising rate of ADC and decreasing rate of slope value were significant higher in good response group than the poor response group. The ROC curve was used to analyze the change rate of ADC and slope after tumors treatment, the area under the ROC curve in ADC was largest(Az=0.790), the diagnosis efficiency was highest. We found significant positive correlation between ADC, MER, slope change rate and tumor maximum diameter reduction rate after chemotherapy(r=0.637, 0.396, 0.532,P<0.05). Conclusions DCE parameters and ADC values possess important clinical value to evaluate the early effect of chemotherapy in NSCLC. ADC value is more sensitive to early lung cancer response.
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Objective To investigate the effects of Epimedium ,Astragalus ,Radix Puerariae on DMT1 expression in the cere‐bral cortex of APPswe/PS1ΔE9 double transgenic mice model of AD .Methods A total of 60 specific‐pathogen‐free male APPswe/PS1ΔE9 double transgenic mice aged 6 months were equally and randomly assigned to model ,Epimedium ,Astragalus ,Radix puerari‐ae ,compound and DFO groups .An additional 10 6‐month‐old C57BL/6J mice served as negative control group .Using immunohisto‐chemistry and molecular biology methods to investigate the effects of a compound combining the effective components of Epimedi‐um ,Astragalus ,Radix puerariae on DMT1 expression in the cerebral cortex of APPswe/PS1ΔE9 double transgenic mice model of AD . Results Immunohistochemical staining results revealed that DM T 1 positive cell did not show in negative control group .DM T1 ex‐pression was higher in model group compared with the negative control group .DMT1 expression was lower in the compound and deferoxamine groups than in the model group .No significant difference was detected in DM T 1 expression between deferoxamine and compound groups .RT‐PCR ,Western blot and immunohistochemical staining results showed no significant difference .Conclusion These compounds can downregulate DMT1 expression and inhibit iron overload in the cerebral cortex of mice with Alzheimer′s dis‐ease ,reduce iron overload induced impairment of the central nervous system .
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OBJECTIVE:To optimize the clarification and purification technology of Perillae folium extract. METHODS:The effects of 3 clarification and purification methods as chitosan flocculation clarification,ZTC 1+1-Ⅱflocculation clarification,water precipitation on retention rate of total flavonoids and removal rate of solid of Perillae folium extract were compared to screen suit-able clarification and purification technology. With the retention rate of total flavonoids and removal rate of solid as comprehensive evaluation index,single factor and orthogonal test were designed to investigate the optimal value of concentration proportion,the amount of the flocculant,flocculation temperature and whisking speed in optimal clarification and purification method. RESULTS:Among 3 methods,the chitosan flocculation clarification was the best with concentration proportion of 1∶4,chitosan of 1.0 g/L, flocculation temperature at 60 ℃,whisking speed of 100 r/min,whisking time of 4 min,standing time of 12 h. Under the condi-tion of optimal processing,the retention rate of total flavonoids was (85.1 ± 0.75)%,and the removal rate of solid was (24.6 ± 1.33)%(n=5). CONCLUSIONS:Chitosan flocculation can be used to effectively remove the impurity of Perillae folium extract, and optimized clarification and purification technology is stable and feasible.
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Objective To investigate the effect of bisdemethoxycurcumin on the proliferation and apoptosis of melanoma B16-F10 cells. Methods The B16-F10 cells were incubated with bisdemethoxycurcumin for 24 h, and MTT assay was used to detect the proliferation of B16-F10 cell. Flow cytometry was used to detect cell cycle and cell apoptosis. A C57BL/6 mouse melanoma model was established to investigate the effect of bisdemethoxycurcumin on the proliferation of melanoma. Expression of BCL-1 in B16-F10 cells and tissues was detected by western blotting assay. Results bisdemethoxycurcumin could significantly inhibit B16-F10 cell proliferation, induce B16-F10 cell apoptosis and block the cell cycle at S phase. The intravenous dosing of bisdemethoxycurcumin could inhibit the growth of melanoma. Bisdemethoxycurcumin could inhibit the expression of BCL-1. Conclusion Bisdemethoxycurcumin can inhibit the proliferation of B16-F10 cell, resulting from its role in promoting cell apoptosis.
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23 cases were treated with immediate full denture.The second base-remodeling or re-prosthodontic treatment was given 3 months later based on the oral condition.Masticatory efficiency (ME)was measured at each stage.About 30% patients participated in the second base-remodeling procedure with ME of 52.63%.
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Objective:To evaluate color doppler ultrasound diagnosis value of cesarean scar pregnancy.Methods: Using color doppler ultrasound probe belly and vaginal probe, faceted searches in patients with suspected scar pregnancy, observe suspicious gestational sac or clutter echo of the location, size, shape, and presence of complications, and radiography, video records, follow-up.Results: The abdominal and vaginal color to exceed cesarean scar pregnancy can make a definite diagnosis.Conclusion: Color doppler flow imaging (CDFI) in cesarean scar pregnancy has a characteristic ultrasonographic performance, ultrasound can accurately make a clear diagnosis. It is the first choice for clinical diagnosis.
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Objective:To study the neuro-protective effects of Shenfu injection on Nrf 2 signaling pathway affected by cerebral ischemia reperfusion.Methods: A total of 68 adult male Sprague-Dawley rats were randomly divided into sham group , cerebral ischemia-reperfusion group,and(8 mg/kg)Shenfu injection treatment group.Shenfu injection was injected intraperitoneally in the rats after MCAO.Neurologic deficit was evaluated after 24 hours of reperfusion.All the rats were sacrificed after 24 h of ischemia-reoerfusion for biochemical analysis or Nissl staining.Results:Shenfu injection treatment significantly increased the expression of Nrf 2,HO-1 and NQO-1(P<0.05).Furthermore,Shenfu injection treatment significantly reduced the expression of cleaved -caspase-3 and attenuated neurological deficits after cerebral ischemia reperfusion ( P<0.05 ).Lastly, Shenfu injection could evidently alleviate the severity of neuronal degeneration ( P<0.05 ).Conclusion:Shenfu injection could confer neuroprotection after cerebral ischemia reperfusion through modulating the Nrf2 signaling pathway.
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Objective To investigate the effect of super-selective intracoronary administration on acute myocardial in farction patients.Methods A total of 240 patients with ST-segment elevation myocardial infarction who received emergency percutaneous coronary intervention in our department from March 2012 to January 2014 were selected and divided into the intravenous drug administration group (n=77),the conventional intracoronary drug administration group (n=81) and the super-selective intracoronary drug administration group (n=82).Parameters,including the Thrombolysis in Myocardial Infarction (TIMI) classification,ST segment resolution after operation,peak values of creatine kinase MB (CK-MB) and troponin-I (cTn-I),left ventricular ejection fraction,left ventricular end-diastolic diameter (LVEDD),major adverse cardiovascular events and bleeding events,were compared between the groups.Results There were no significant differences in TIMI flow grade between the three groups (x2 =0.14,P=0.529).The percentage of patients with complete ST segment resolution after operation was higher in the super-selective intracoronary drug administration group than in the intravenous drug administration and conventional intracoronary drug administration groups (74.4％ vs.62.3％,61.7％,x2 =8.24,P＜0.05).Peak values of CK-MB and cTn-I were lower in the super-selective intracoronary drug administration group than in the other groups (P＜0.05).There were no significant differences in left ventricular ejection fraction and LVEDD between the three groups after operation,but left ventricular ejection fraction and the incidence of angina pectoris significantly improved in the super-selective intracoronary drug administration group than in the other groups after a three month follow-up (P＜0.05).There were no significant differences in target lesion revascularization,nonfatal myocardial infarction and druginduced thrombocytopenia between the three groups (P ＞ 0.05).Conclusions Super-selective intracoronary drug administration can significantly enhance cardiac function and alleviate angina pectoris in patients with acute myocardial infarction,and should be a recommended method.
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ObjectiveTo investigate the relation ship of obesity with high blood pressure and type 2 diabetes and to find characteristics of the prevalence. MethodsFrom different BMI groups,2,090 cases aged 60-86 years were randomly collected according to the medical and health information.Hypertension and diabetes were diagnosed by WHO international diagnostic criteria.ResultsIn hypertension group (976 cases), average body mass index (BMI), pulse pressure ( PP), total cholesterol (TC), triglyceride (TG), fasting blood glucose (FBG) showed significant difference compared with non-hypertention group (1114 cases) (all P＜0.01)[(26.32±3.66)kg/m2 , (16.28±13.21 )mm Hg, (4.78±1.23) mmol/L, (1.79±1.36) mmol/L, (5.61±1.37) mmol/L vs. (25.28± 3.36) kg/m2, ( 11.37 ± 9.39) mm Hg, (4.54 ± 1.23 ) mmol/L, ( 1.52 ± 1.12) mmol/L, ( 4.28 ±2.12)mmol/L].In diabetes group (272 cases), average BMI, PP, TC, TG and FBG showed significant difference as compared with non-diabetes group (1818 cases)(all P＜0.01)[(26. 29±3.24)kg/m2 , (82.43± 10.22) mm Hg, (18.77±10.11) mm Hg, (4.85±2.05) mmol/L, (1.76± 1.76)mmol/L vs. (24.13±3.42) kg/m2 , (80.38±6.87) mm Hg, (12.26±9.56) mm Hg, (4.36± 1.21)mmol/L, (1.52± 1.21) mmol/L]. In normal blood lipids group, BMI, PP, and FBG were found significant differences compared with high TC or TG group (all P＜0.05).ConclusionsThe increase of body mass index in the elderly has a close relationship with hypertension and type 2 diabetes. It is important to prevent obesity in the prevention and control of hypertension and diabetes.
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Malignant transformation is closely related to gene mutations.The tumor suppressor gene p53 codes for a transcription factor,P53 protein,plays a critical regulation role in oncogene expression,DNA synthesis and repair systems,and cell apoptosis.It has been demonstrated that p53 mutation occurs in more than 50% of cancer cells,which is thought to play a crucial role in malignant transformation.p53-based gene therapeutical approaches in vitro and in vivo aiming at a direct correction of the specific molecular defect in p53-mutated malignant cells,showed notable efficacy in numerous cancer types.In this review,we discussed the current advances in this field,focusing on adenovirus-mediated wild-type p53 gene therapy.
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Tumor angiogenesis, resulting from the imbalance of angiogenic cytokines and angiogenesis inhibitors, is crucial for tumor growth and metastasis. As a new field of cancer therapy, tumor anti-angiogenesis therapy with regard to abrogation of tumor vasculature has become an important anti-tumor strategy. Gene therapies have the potential to provide antiangiogenic mediators specifically targeted to organs containing tumors and make a great improvement in this therapy. This article reviews the current understanding of tumor angiogenesis, with a focus on gene therapy in this field.
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Objective: To evaluate the contents of ? aminobutyric acid(GABA) and glutamate(Glu) in gastric cancer tissue and normal tissue surrounding the cancer. Methods: 30 patients of gastric cancer underwent surgical treatment were examined. A high performance liquid chromatographic method(HPLC) was applied for the analysis and quantification of GABA and Glu in gastric cancer tissues and normal tissues surrounding the lesion after precolumn derivatization with phenylisothyocyanate (PITC). GABA and Glu were determined with UV detector. The differences in GABA and Glu contents in gastric cancer tissues were regarded to have close link of lymph node metastasis and histological type. Results: GABA and Glu contents were high significantly in gastric cancer tissue comparing with those of surrounding normal tissue( P 0.05). Conclusion: GABA and Glu are involved in the factors of gastric carcinogenesis. The results suggest GABA Glu system detection should be included into the diagnosis and therapy consideration in gastric cancer.
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Alteration in gastric emptying may play a role in the pathogenesis of many diseases.And various methods to measure gastric emptying have been developed.Nine procedures for the assessment of gastric emptying were reviewed in this paper including intubation test,radiology method,absorption test,real time ultrasound,breath test,radionuclide technique et al .Among all of these methods,radionuclide technique is considered as the good standard method.
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Objective To study the clinical and endoscopic features of Gastric mucosa－ associated lymphoid tissue(MALT) lymphoma. Methods Clinical and endoscopic data of thirty two patients with gastric MALT lymphoma diagnosed pathologically after opration were analyzed. Results Patients with gastric MALT lymphoma had a median age of 51.3years with male predominance and a bimodal age distribution pattern, aged 30～ 39 and 60～ 69 years respectively. The symptoms were not characteristic.The tumor originated from antrum in 12 cases,corpus in 8 and multifocal lesions were found in 12 instances. The tumor appeared infilitrative in 12, ulcerative in 16 and nodular in 6 patients endoscopically. Lymphatic metastasis was detected in infiltrative type, before the serosa was involved. Immunohistochemistry showed B－ cell lymphoma in all the 32 cases.And Helicobacter pylori(H.pylori) infection was found in 27 cases(84.4％ ).Nocorrelation was found between endoscopic types and manifestations.Metastasis to local lymph nodes was found early in infiltrative tumor.Conclusions It is suggested that H.pylori infection may play a role in the pathogenesis of gastric MALT lymphoma.
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Objective To clone human canstatin gene, construct its prokaryotic expression vector, express and purify its recombinant protein. Methods The total RNA was extracted from human placenta tissues. The canstatin gene fragment was synthesized and amplified from the total RNA by RT-PCR. The resulting product was cloned into pUCm-T vector and sequenced. Then the confirmed canstatin cDNA was cloned into plasmid pET-22b(+) and then transformed into E.coli BL21 where it was induced to express proteins by isopropyl-1-thio-b-Dgalactopyranoside (IPTG). The expression of protein was analyzed through SDS-PAGE. Cells after induced 3 hours by IPTG were harvested, sonicated briefly and the proteins were purified through affinity chromatography. Results (1)The extracted total RNA was separated into three clear bands indicating 28S, 18S, and 5S after electrophoresis and the concentration was 1.8 g/L. (2)The target sequences were specifically amplified through RT-PCR. (3)The purified RT-PCR product was cloned into pUCm-T vector and then sequenced, demonstrating to be the same as that of canstatin gene in GenBank. (4) the expression vector pET-22b(+) was constructed and verified by the method of BamH Ⅰ and Hind Ⅲ digestion. (5) After IPTG induction, there was a new protein band about Mr 24kD on SDS-PAGE. The percent expressed product over total bacterial proteins after 1, 2, 3, and 4 hours of induction was 18.2%, 18.8%, 23.0% and 23.4%, respectively, estimated by densitometry. (6)After affinity chromatography, SDS-PAGE showed only one clear band existed in 125 mmol/L or 250 mmol/L imidizone elution. Conclusion Human canstatin gene has been successfully cloned and its prokaryotic expression vector has also been successfully constructed. Further more, purified recombinant proteins are obtained through affinity chromatography, laying foundation for further study of its clinical application.
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Objectives This study was to evaluate GABA BR (including GABA BR1 and GABA BR2) expression in human gastric cancer. Methods Thirty randomly chosen patients with gastric cancer who underwent surgical treatment were entered into the current study. Immunohistochemistry was carried out to determine the expression of GABA BR. Results Immunohistochemistry analysis showed that the scores of GABA BR1 and GABA BR2 in human gastric cancer tissue increased apparently compared with the adjacent normal tissue(P
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Objective To express the recombinant human canstatin protein, and to examine its biological activity. Methods Canstatin cDNA was cut off from the plasmid pUCm-T/canstatin with restriction enzymes BamHⅠ and Hind Ⅲ. The cDNA fragment was then ligated into the correspondence sites of plasmid pET-22b(+) by T4 DNA ligation enzyme and transformed into E.coli BL21 which was induced to express proteins with isopropyl-1-thio-b-dgalactopyranoside (IPTG). The expressed proteins were analyzed by SDS-PAGE and purified through Ni-NTA column affinity chromatography. Chick chorioallantoic membrane (CAM) assay was performed to determine the activity of the recombinant protein. Results Canstatin cDNA from pUCm-T showed one clear objective DNA band with electrophoresis. Seven of positive colonies were selected and identified by restriction enzyme analysis with BamH Ⅰ and Hind Ⅲ. Electrophoresis revealed that all selected colonies had two specific bands,one near the location of primary plamid,the other near that of objective gene fragment. After IPTG induction, there was a new protein band about 24 000 on SDS-PAGE.The induced product over total bacterial proteins in 1,2, 3. and 4 hours after induction was 18. 2%, 18. 8%, 23.0% and 23.4%, respectively, by densitometry examination. CAM assay demonstrated that the recombinant canstatin protein significantly inhibited the embryonic neovascularization in a dose-dependent manner. Conclusion The prokaryotic expression vector of human canstatin gene has been successfully constructed, laying the foundation for further clinical study.
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Objective To explore the role of glutamate decarboxylase (GAD) in the pathogenesis of human gastric cancer. Methods Thirty patients with primary gastric cancers who were diagnosed and treated at our hospital were enrolled into the current study. Immunohistochemistry was carried out to check the ex-pression of GAD protein. Reverse transcription polymerase chain reaction ( RT-PCR) was performed to ex-amine the expression of GADmRNA. Then investigated the relationships among the sites of gastric cancer, depth of infiltration, and degree of differentiation, staging and lymphatic metastasis. Results Immunohisto-chemistry analysis showed that GAD expression decreased in gastric cancer tissues compared with that of ad-jacent normal tissue(P