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Prevention and treatment of complications after liver transplantation play a significant role in maintaining liver graft function and improving clinical prognosis of the recipients. Neutrophil extracellular trap (NET) are fibrous net-like structures composed of DNA as the skeleton and histones and granular proteins released by activated neutrophils. Studies have shown that the activation of neutrophils and the release of NET in donor liver after liver transplantation are involved in the incidence of multiple liver transplantation-related complications including ischemia-reperfusion injury, acute rejection, acute liver failure and recurrence of hepatocellular carcinoma, etc. In this article, the effect of NET on the complications after liver transplantation was mainly assessed, and research progress on NET as a potential target for the prevention and treatment of complications after liver transplantation was reviewed, aiming to provide reference for the prevention and treatment of complications after liver transplantation, enhance clinical efficacy of liver transplantation and improve clinical prognosis of the recipients.
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Objective:To investigate the effects of different chemotherapy dose intensity on the short-term efficacy and adverse reactions of patients with advanced colon cancer.Methods:A real-world database of patients with advanced colon cancer in Wangjing Hospital of China Academy of Chinese Medical Sciences and China-Japan Friendship Hospital from January 2017 to December 2020 was established, including 105 patients treated with the same chemotherapy regimen for two consecutive cycles. The patients were grouped according to the average relative dose intensity (ARDI) of chemotherapy, and the population differences, treatment regimens, short-term efficacy and adverse reactions of different chemotherapy dose intensities were evaluated. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of ARDI for short-term efficacy.Results:There were 31 patients in the high dose intensity group (ARDI≥80%) , 34 patients in the medium dose intensity group (80%<ARDI<60%) , and 40 patients in the low dose intensity group (ARDI≤60%) . There were statistically significant differences in age ( χ2=13.20, P=0.010) and Karnofsky functional status (KPS) score ( χ2=7.99, P=0.008) among the high dose intensity group, medium dose intensity group and low dose intensity group. Compared with the low dose intensity group, the proportion of young and middle-aged patients in the high dose intensity group was higher, and the proportion of elderly patients was lower ( χ2=12.63, P=0.002) . Compared with the medium dose intensity group, the proportion of patients with KPS score ≥60 was lower and the proportion of patients with KPS score <60 was higher in the low dose intensity group ( P=0.013) . There was a statistically significant difference in the application of chemotherapy regimen among the three groups ( χ2=22.88, P=0.027) , and there was a statistically significant difference in the application of chemotherapy regimen between the high dose intensity group and low dose intensity group ( χ2=16.25, P=0.009) . The proportions of the high, medium and low dose intensity groups receiving combined chemotherapy were 96.77% (30/31) , 82.35% (28/34) and 80.00% (32/40) respectively. The incidences of chemotherapy drug reduction in the high, medium and low dose intensity groups were 93.55% (29/31) , 100% (34/34) and 100% (40/40) respectively, and the incidences of chemotherapy delay were 41.94% (13/31) , 79.41% (27/34) and 87.50% (35/40) respectively. The objective response rates of the high, medium and low dose intensity groups were 22.58% (7/31) , 14.71% (5/34) and 2.50% (1/40) respectively, with a statistically significant difference ( χ2=7.11, P=0.027) . The disease control rates of the high, medium and low dose intensity groups were 93.55% (29/31) , 91.18% (31/34) and 87.50% (35/40) respectively, with no statistically significant difference ( χ2=0.75, P=0.714) . The differences of carcinoembryonic antigen before and after treatment in the high, medium and low dose intensity groups were 2.09, 0.47 and -0.72 ng/ml respectively, with a statistically significant difference ( χ2=10.09, P=0.006) . Compared with the low dose intensity group, the difference of carcinoembryonic antigen before and after treatment in the high dose intensity group was greater ( χ2=23.12, P=0.005) . The differences of carbohydrate antigen 199 before and after treatment in the high, medium and low dose intensity groups were 2.30, 0.00 and -0.21 U/ml respectively, with a statistically significant different ( χ2=8.85, P=0.012) . Compared with the low dose intensity group, the difference of carbohydrate antigen 199 before and after treatment in the high dose intensity group was greater ( χ2=21.40, P=0.010) . No adverse reactions above grade 3 occurred in the three groups, and the safety was good. The most common adverse reactions were anemia (61.90%, 65/105) , leucopenia (39.05%, 41/105) , neutropenia (29.52%, 31/105) and nausea (36.19%, 38/105) . There were no statistically significant differences in the incidences of adverse reactions among the high, medium and low dose intensity groups (all P>0.05) . ROC curve analysis found that the area under the curve predicting objective response was 0.70, the sensitivity was 92.30%, and the specificity was 52.10% when the chemotherapy ARDI threshold was 64%. Conclusion:In the real world, colon cancer patients receiving high dose intensive chemotherapy have better objective response rate, and tumor markers decreased significantly. The baseline status of colon cancer patients receiving low dose intensive chemotherapy is poor, but there is no statistically significant difference in disease control rate between patients receiving low dose intensive chemotherapy and patients receiving high dose intensive chemotherapy, and the adverse reactions are controllable.
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With the development and maturity of liver transplant techniques, liver transplantation has become one of the vital treatment options for hepatocellular carcinoma (HCC). Postoperative recurrence and metastasis of HCC after liver transplantation is one of critical factors that affect the long-term survival of recipients. Exploring the prevention and therapeutic strategies for HCC recurrence and metastasis after liver transplantation plays a pivotal role in improving the clinical efficacy of liver transplantation for HCC recipients. Intimate monitoring, active prevention, early diagnosis, comprehensive surgical treatment and local treatment, especially targeted immunotherapy, and individualized prevention and therapeutic strategies are of significance for the prevention and treatment of HCC recurrence and metastasis after liver transplantation. In this article, the monitoring, diagnosis, prevention and treatment of tumor recurrence and metastasis after liver transplantation for HCC were reviewed, aiming to provide reference for the prevention and treatment of tumor recurrence and metastasis after liver transplantation, enhancing clinical efficacy of liver transplantation and prolonging the survival of recipients.
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Objective:To analyze the correlation between serum claudin-1(Cla-1) level and the risk of papillary thyroid carcinoma(PTC) in patients with thyroid nodules.Methods:The clinical data of 345 patients with thyroid nodules were retrospectively analyzed. According to the pathological results, they were divided into PTC group and benign thyroid nodule(BTN) group. The difference of serum Cla-1 level between 2 groups and its correlation with the risk of PTC were analyzed.Results:In groups of PTC( n=225) and BTN( n=120), the median value of serum Cla-1 level was 14.03(10.30, 20.40) ng/mL. The differences in the median value[17.90(14.00, 22.93)ng/mL vs 9.40(8.15, 11.20) ng/mL] of serum Cla-1 level in the PTC and BTN were statistically significant by Wilcoxon signed-rank test. The prevalence of PTC in thyroid nodules increased gradually with increasing of serum Cla-1 level. Receiver operated characteristic curve analysis showed that the best diagnostic cut-off value of the PTC was 13.02 ng/ml of which the sensitivity was 81.8%, the specificity was 89.2%, and the area under curve(AUC) was the largest(AUC=0.944, P<0.01, 95% CI 0.922-0.965). Logistic regression analysis showed that elevated serum Cla-1 level increased the risk of PTC, and it was statistically significant( OR=4.334, 95% CI 1.662-11.303, P=0.003). There was a significant correlation among the serum Cla-1 level and gender, age, location of involvement, number and diameter of cancer nodules, extracapsular invasion of thyroid, lymph node metastasis, tumor stage and combined with Hashimoto′s thyroiditis( P<0.01). Conclusion:The serum level of Cla-1 may be one of risk factors to predict PTC, and it is related to the total amount of PTC tumor cells in vivo, but it was not related to the aggressive behavior of tumor.
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Objective: To explore clinical effect of transformation of dressing change process on reducing temporary catheter?related infection in hemodialysis patients. Methods: A total of 60 patients underwent temporary hemodialysis from Apr 2013 to Apr 2014 were randomly divided into intervention group and control group, 30 cases in each. The patients in the control group received conven?tional treatment, the patients in the intervention group received dressing change according to the process, infection rate was compared and analyzed. Results: The indwelling time in the intervention group was (46?35±6?24) days, the total infection rate was 3?33%. The indwelling time in the control group was (39?24±4?64) days, the total infection rate was 13?33% (P<0?05). And there was significant difference in the number of dressing changes, treatment time ( P<0?05) . Conclusion: The scientific, effective dressing process playes an inhibitory effect in temporary catheter?related infection in hemodialysis patients and can prolong the service life of catheter, promote the rehabilitation of patients.
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Objective To explore extracellular signal-regulated kinase ( ERK1/2 ) expression in the role of curcumin inhibited staurosporine (STS)-mediated neurons toxic injury through added PD098059, and to clarify ERK1/2 mediated inhibitory role of curcumin on STS-induced neurons toxic injury.Methods The neurons toxic injury model of primary cultured hippocampal neurons was established by STS.The experiment was divided into six groups:normal control group, STS model group, PD098059 +STS model group, curcumin +STS pretreatment group, curcumin+PD098059+STS treatment group and curcumin treatment group.The cell viability were determined by MTT method, lactate dehydrogenase (LDH) release rate, cell toxicity were detected, nuclear shape were observed by DAPI staining, and ERK1/2 expression were detected by Western blot method.Results The cell viability of curcumin +STS pretreatment group was significantly higher than STS model group ( P <0.001 ); the cell viability had no significant difference between PD098059 +STS model group and curcumin +PD098059 +STS treatment group;compared with curcumin +STS model group , the cell viability of curcumin +PD098059 +STS treatment group was significantly decreased ( P<0.001 ).LDH results showed that the nerve cell toxicity of curcumin +STS pretreatment group was obviously less than STS model group (P<0.001).The cell nuclear shape showed typical apoptosis morphological characteristics in STS model group, and curcumin inhibited the effect of STS mediated-neuronal apoptosis.ERK1/2 protein expression in curcumin +STS pretreatment group significantly increased compared with STS model group ( P <0.001 ) .Conclusion Curcumin inhibited STS-mediated neurons toxicity injury by up-regulating ERK1/2 expression.After PD098059 blocking the nerve cells ERK1/2 synthesis, the inhibitory action of curcumin failed to implemented, which illustrated that ERK1/2 mediated curcumin to inhibit STS-induced neuronal toxic injury.
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Objective To explore the effect of heat shock protein 70(HSP70)expression in the role of Curcumin inhibited staurosporine(STS)-mediated neurons toxic injury.Methods The primary cultured hippocampal neurons was cultured in vitro and the stress damage model of STS-induced nerve cell toxicity was established.The experiment were divided into six groups according to the added drugs:normal control group,the STS model group (final concentration was 20μmol/L),Quercetin+STS model group(final concentration were 10 μmol/L and 20 μmol/L,respectively),Curcumin+STS pretreatment group(for 20μmol/L final concentration),Curcumin+Quercetin+STS treatment group(final concentration were 20μmol/L,10μmol/L and 20μmol/L,respectively)and Curcumin treatment group(final concentration was 20μmol/L).The cell viability were determined by thiazole blue (MTT)method,cell toxicity were measured by lactate dehydrogenase(LDH)release rate and HPS70 expression were detected by Western Blot. Results MTT results showed that the cell viability of Curcumin+STS pretreatment group was significantly higher than STS model group(P<0.001).Compared with Quercetin+STS model group,the cell viability of Curcumin+Quercetin+STS treatment group had little change.LDH results show that the nerve cell toxicity of Curcumin+STS pretreatment group was obviously less than that of STS model group(P<0.001).Western Blot results show that compared with STS model group,HSP70 protein expression in Curcumin+STS pretreatment group was significantly increased(P<0.001).Conclusion Curcumin can inhibit STS-mediated neurons toxicity stress damage though increasing HSP70 expression,when added Quercetin to block HSP70 expression in nerve cells,the inhibiting effect of Curcumin on STS-mediated neuron toxic stress injury is counteract.
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AIM: To study apoptosis and bcl-2 mRNA gene expression of cardiomyocytes in donor hearts of immature rabbits underwent prolonged protection by 11, 12-epoxyeicosatrienoic acid (11, 12-EET), and further probe into the possible mechanisms. METHODS: 24 isolated immature rabbit hearts were performed to the model in a Langendorff perfusion apparatus and randomly assigned to normal control group,ST control group and EET group. The isolated rabbit hearts in ST control group and EET group were stored for 24 hours with 4 ℃ hypothermia, and underwent 30 minutes of reperfusion (37 ℃). TUNEL and in situ hybridization (ISH) methods were applied in the present study and apoptotic cells and bcl-2 mRNA gene expression were observed. RESULTS: The numbers of apoptotic cardiomyocytes in ST group and EET group were higher than that in normal control group, and the numbers of apoptotic cardiomyocytes were significantly decreased in EET group and bcl-2 mRNA positive expression were higher than that in ST control group, respectively. CONCLUSIONS: There were apoptosis during the prolonged protection of donor heart in our study, and we proved that: ①11,12-EET could decrease cardiomyocyte apoptosis significantly. ②Up-regulation of the bcl-2 mRNA expression in cardiomyocytes may be one of the mechanism responsible for inhibition of cardiomyocyte apoptosis by 11, 12-EET.