ABSTRACT
Objective To investigate the expression of myeloid-derived suppressor cells (MDSC), regulatory T cells (Treg), IL-17-producing CD4 + T cells (Th17), and CD8 + T cells (Tc17) in hepatitis B virus-related acute-on-chronic pre-liver failure (pre-ACHBLF), and to provide ideas for the early treatment of acute-on-chronic hepatitis B liver failure (ACHBLF). Methods A total of patients with pre-ACHBLF and 15 patients with ACHBLF who were hospitalized in Shijiazhuang Fifth Hospital, from August 2018 to May 2019 were enrolled as subjects, and 15 patients with chronic hepatitis B (CHB) and 15 healthy controls (HC) who underwent physical examination were enrolled as controls. Flow cytometry was used to measure the expression levels of MDSC and Th17, Treg, and Tc17 cells in peripheral blood; a blood analyzer was used to measure routine blood parameters and calculate neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index(SIRS) to evaluate the degree of inflammation, and the correlation between the expression of immune cells and the degree of inflammation was analyzed. An analysis of variance for independent samples was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Nemenyi test was used for further comparison between two groups. A Pearson linear correlation analysis or Spearman's rank correlation analysis was used to investigate the correlation between variables. Results Compared with the CHB group, the ACHBLF and pre-ACHBLF groups had significant increases in the expression levels of Th17, Treg, and Tc17 cells, and the pre-ACHBLF group also had a significant increase in the expression level of MDSC (all P < 0.05). The correlation analysis showed that in pre-ACHBLF patients, MDSC were positively correlated with leukocyte count, neutrophil count, NLR, MLR, and SII ( r =0.775, 0.727, 0.571, 0.786, and 0.846, all P < 0.05), and Treg cells were only positively correlated with leukocyte count ( r =0.618, P =0.043); Th17/Treg ratio and Tc17 cells were negatively correlated with the number of lymphocytes ( r =-0.790 and -0.795, both P < 0.05). Conclusion Cellular immune dysfunction is observed in patients with pre-ACHBLF, and the expression of MDSC is closely associated with the degree of inflammation and should be taken seriously in the early stage.
ABSTRACT
ObjectiveTo investigate the value of serum complement C3 level in determining the stage of liver fibrosis in primary biliary cholangitis （PBC）. MethodsClinical data were collected from 108 patients with PBC who attended Tianjin Second People’s Hospital and underwent liver biopsy from January 2012 to October 2022. The degree of liver fibrosis （S0-4） was assessed according to the Scheuer scoring system， with ≥S2 defined as significant liver fibrosis， ≥S3 defined as progressive liver fibrosis， and S4 defined as liver cirrhosis. The independent samples t-test was used for comparison of normally distributed continuous data between two groups， and a one-way analysis of variance was used for comparison between multiple groups； the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The area under the ROC curve （AUC） was used to evaluate the efficacy of complement C3 in the diagnosis of liver fibrosis in patients with PBC. The Spearman correlation analysis was used to investigate the correlation between complement C3 and liver fibrosis stage. ResultsAmong the 108 patients with PBC， there were 87 （80.6%） female patients and 102 patients （94.4%） with positive autoantibody. As for the stage of liver fibrosis， there were 5 patients （4.6%） in S0 stage， 41 （38.0%） in S1 stage， 23 （21.3%） in S2 stage， 25 （23.1%） in S3 stage， and 14 （13.0%） in S4 stage. There was a significant difference in the level of complement C3 between the patients with different liver fibrosis stages （H=42.891， P<0.001）. The level of complement C3 gradually decreased with the aggravation of liver fibrosis， with a negative correlation between them （r=-0.565， P<0.001）. Liver stiffness measurement （LSM）， aspartate aminotransferase/alanine aminotransferase ratio， aspartate aminotransferase-to-platelet ratio index， and fibrosis-4 were negatively correlated with complement C3， with a correlation coefficient of -0.439 （P<0.001）， -0.323 （P=0.001）， -0.206 （P=0.033）， and -0.291 （P=0.002）， respectively. The multivariate logistic regression analysis showed that complement C3 level was an independent predictive factor for significant liver fibrosis， progressive liver fibrosis， and liver cirrhosis， while LSM was an independent predictive factor for significant liver fibrosis and progressive liver fibrosis. The ROC curve analysis showed that complement C3 had an AUC of 0.731， 0.832， and 0.968， respectively， in the diagnosis of significant liver fibrosis， progressive liver fibrosis， and liver cirrhosis， with a corresponding cut-off value of 1.445， 1.235， and 1.005， respectively， and complement C3 combined with LSM had an AUC of 0.811， 0.941， and 0.976， respectively， in the diagnosis of significant liver fibrosis， progressive liver fibrosis， and liver cirrhosis. There was a significant difference in AUC between complement C3 combined with LSM and complement C3 alone in the diagnosis of significant liver fibrosis （Z=2.604， P=0.009）， and there was also a significant difference in AUC between complement C3 combined with LSM and complement C3 alone in the diagnosis of progressive liver fibrosis （Z=3.033， P=0.002）； there was no significant difference in AUC between complement C3 combined with LSM and complement C3 alone in the diagnosis of liver cirrhosis （Z=1.050， P=0.294）， while There was a significant difference in AUC between complement C3 combined with LSM and LSM alone in the diagnosis of liver cirrhosis （Z=2.326， P=0.020）. ConclusionSerum complement C3 level has a certain clinical value in assessing the degree of liver fibrosis in patients with PBC， and complement C3 combined with LSM can further improve the efficacy of complement C3 or LSM in the diagnosis of liver fibrosis in PBC.
ABSTRACT
Objective: To investigate the effect of TGF-β1 on the migration and invasion of gastric cancer cells, by regulating fatty acid synthetase. Methods: From January 2016 to December 2018, 54 paraffin samples were collected from Shunde Hospital of Southern Medical University. Immunohistochemistry was used to detect the expression of transforming growth factor β1 (TGF-β1) and fatty acid synthetase (FASN) in human gastric cancer tissues, and the correlation between them was analyzed. Transient transfection of TGF-β1 and TGF-β1 siRNA was used to construct gastric cancer cell lines. Real-time PCR was used to detect FASN mRNA level, and Western blot was performed to examine FASN protein level. Transient transfection of FASN siRNA was used to construct gastric cancer cell lines. Wound healing assays and Transwell assays were performed to observe the effect of migration and invasion ability of gastric cancer cells. Results: Immunohistochemical results indicated that the expression of TGF-β1 and FASN in gastric cancer tissue was significantly positively correlated. TGF-β1 overexpression plasmid transfection significantly up-regulated the expression level of FASN mRNA and protein, whereas TGF-β1 siRNA significantly inhibited the expression of FASN. After co-transfection with FASN siRNA, TGF-β 1-induced N-cadherin protein expression was reduced and E-cadherin protein expression was enhenced. Scratch and Transwell experiments showed that the increased cell migration and invasion by TGF-β1 were significantly decreased. Conclusions: FASN plays an important role in the migration and invasion of gastric cancer cells regulated by TGF-β1.
ABSTRACT
Objective:To investigate the influencing factors of significant liver fibrosis in patients with chronic hepatitis B (CHB) concurrent with non-alcoholic fatty liver disease (NAFLD).Methods:Those who underwent liver pathological examination and confirmed diagnosis of CHB and NAFLD in Tianjin Second People′s Hospital from August 2014 to September 2017 were enrolled. Data regarding their demographic information, laboratory tests results, and liver pathology results were analyzed. The latter results were used to categorize the patients either in non-significant liver fibrosis group (Metavir stage<F2) or in significant liver fibrosis group (Metavir stage≥F2). The measurement data were compared using t test or Mann-Whitney U test, and the count data using chi-square test.The factors influencing the onset of significant liver fibrosis were subsequently explored with binary logistic regressions. Results:Out of 273 patients screened, 160 and 113 patients respectively belonged to the non-significant fibrosis group and the significant fibrosis group. Age, histologic activity, NAFLD type, liver stiffness measurement, hepatitis B e antigen (HBeAg) status (positive/negative), hepatitis B virus (HBV) DNA, aspartate aminotransferase, γ-glutamyl transpeptidase, total bilirubin, high blood glucose (with/without) and platelet count between the two groups were statistically significant( t=2.232, χ2=44.276, χ2=4.808, t=2.096, χ2=5.299, t=3.191, U=7 041.500, U=6 873.500, t=2.989, χ2=5.588, t=3.429, all P<0.05). Logistic regression showed that non-alcoholic steatohepatitis (NASH), histologicactivity, HBV DNA and platelet count were the independent influencing factors for significant liver fibrosis (odds ratio ( OR)=2.809, 6.730, 0.843, 0.995, respectively, all P<0.05). Patients were divided into two subgroups according to their HBeAg status, the results showed that for patients with negative HBeAg, NASH, histologic activity, HBV DNA and platelet count were the independent influencing factors for significant liver fibrosis ( OR=8.629, 3.626, 0.740, 0.992, respectively, all P<0.05). For patients with positive HBeAg, histologic activity and high blood glucose were the independent risk factors for significant liver fibrosis ( OR=12.738, 4.223, respectively, both P<0.01). Conclusion:Liver inflammation, NASH and high blood glucose are the serious risk factors during the onset and progression of significant liver fibrosis in patients with CHB and NAFLD, while HBV DNA and platelet count levels are negatively correlated with significant liver fibrosis.
ABSTRACT
Objective:To observe the effects of salvianolic acid B on migration and tube formation of the retinal vascular endothelial cell (RVEC) in high glucose, and explore its mechanism with network pharmacology.Methods:The cells were divided into normal group, model group and 1.0, 0.5, 0.1 μg/ml salvianolic acid B group according to the random number table method. The cells of each group were added with 5.5 mmol/L glucose for intervention, and the salvianolic acid B group was added with 1.0, 0.5, and 0.1 μg/ml salvianolic acid B for intervention. After 72 h, the cell viability of each group was detected by the CCK-8 method. The cells were divided into normal group, model group and low-, medium-, and high-dose salvianolic acid B group according to the random number table method. Then the cells of the normal group were added with 5.5 mmol/L glucose; the model group was added with 25 mmol/L glucose; the low-, medium-, and high-dose salvianolic acid B group was added with 25 mmol/L glucose and 0.062 5, 0.1250, 0.250 0 μg/ml salvianolic acid B. Then by taking Transwell test to detect the number of cell migration, and Matrigel test to analyze the total length of cells tubes. The active targets of Salvianolic acid B were screened by SuperTarget and Swiss TargetPrediction. Then, the targets of diabetic retinopathy were obtained by searching the GAD database, pharmGkb database, TTD database, DiGSeE database and OMIM database. The effective targets of drug-disease interaction were screened, and the component-target-disease interaction network was constructed by Cytoscape. Finally, the effective targets were analyzed by DAVID for GO analysis and KEGG pathway enrichment analysis. Molecular docking was performed by using Accelrys Discovery Studio Client 2.5 software.Results:The CCK-8 method showed that the cell absorbance values of 0.5 and 0.1 μg/ml salvianolic acid B group were not significantly different from those of the normal group ( P>0.05). The results of Transwell experiment and Matrigel experiment showed that compared with the model group, the relative number of migrating cells and the total length of tubule formation in each dose group of salvianolic acid B decreased ( P<0.05 or P<0.01). The interaction network revealed that salvianolic acid B acted on 46 targets and 8 signaling pathways. Conclusions:Salvianolic acid B could inhibit the migrating and tube forming ability of RVEC cultivated by high glucose. The results suggest that salvianolic acid B may play roles in preventing diabetic retinopathy.
ABSTRACT
Autophagy can regulate liver physiology and balance liver metabolism. Autophagy activation has a double-sided and complex effect on liver injury, and it is regulated by many factors and is associated with many protein pathways. This article summarizes the role of mTOR in the regulation of autophagy, which can inhibit or enhance autophagy through the PI3K/Akt upstream signaling pathway and participate in the physiological and pathological changes of related liver diseases. Therefore, this article reviews the research advances in the mTOR/PI3K/Akt autophagy pathway in liver injury, in order to provide new therapeutic targets for related liver diseases.
ABSTRACT
Histology teaching requires a combination of theory and experiment for a better understanding of microstructure and related functions of body.On the basis of the comparison and summary of the advantages and limitations of traditional light microscopy tissue slices and the emerging digital slicing,we combined them in the teaching of micromorphology experiments to achieve a better teaching results.Each experimental course (about 3 to 4 hours) was divided into four parts:teaching videos,observation of light microscopy tissue slices and digital slicing,discussion on course content and random quizzes.This teaching method contributed to the improvement of the students' interest and motivation in learning,the teachers' teaching efficiency and the overall teaching quality.
ABSTRACT
Objective To explore the effects of the interfacial debonding caused by water environment in the mouth and the interfacial defects between the crown and cement on stress distributions in all-ceramic crowns. Methods The three-dimensional solid model of lithium disilicate CAD/CAM crowns for the first mandibular molar was established. Seven debonding states between inferior surface of the crown and top surface of the cement (Stage 1-7) as well as two interfacial defects (Case I and II) were defined in finite element software ABAQUS. The bottom of nine models was completely constrained. For stress calculation, the 600 N vertical load was applied at occlusal surface via an analytical rigid hemisphere with the diameter of 5 mm. Results Under occlusal vertical load, the stress on interior of the crown and top surface of the cement was mainly distributed at the boundary of the debonding areas and margin of the defects. The first principle stress on interior of the crown did not exceed its ultimate tensile strength, but the maximum tensile stress of the cement exceeded its ultimate tensile strength, leading to cohesive failure in the cement. Conclusions The axial wall played a critical role in maintaining the principal tensile stress of the crown at a lower level. The defects at bonding interface between the crown and cement had a more significantly impact on load capacity of the crown than the increase in debonding areas. In order to improve load bearing capacities of all-ceramic crowns, attention should be paid to avoid defects in clinical prosthodontic practices.
ABSTRACT
Objective To explore the effects of the interfacial debonding caused by water environment in the mouth and the interfacial defects between the crown and cement on stress distributions in all-ceramic crowns. Methods The three-dimensional solid model of lithium disilicate CAD/CAM crowns for the first mandibular molar was established. Seven debonding states between inferior surface of the crown and top surface of the cement (Stage 1-7) as well as two interfacial defects (Case I and II) were defined in finite element software ABAQUS. The bottom of nine models was completely constrained. For stress calculation, the 600 N vertical load was applied at occlusal surface via an analytical rigid hemisphere with the diameter of 5 mm. Results Under occlusal vertical load, the stress on interior of the crown and top surface of the cement was mainly distributed at the boundary of the debonding areas and margin of the defects. The first principle stress on interior of the crown did not exceed its ultimate tensile strength, but the maximum tensile stress of the cement exceeded its ultimate tensile strength, leading to cohesive failure in the cement. Conclusions The axial wall played a critical role in maintaining the principal tensile stress of the crown at a lower level. The defects at bonding interface between the crown and cement had a more significantly impact on load capacity of the crown than the increase in debonding areas. In order to improve load bearing capacities of all-ceramic crowns, attention should be paid to avoid defects in clinical prosthodontic practices.
ABSTRACT
Objective To isolate and identify 3 flavonoids (taxifolin, orobol and quercetin) from Cudrania tricuspidata, and develop a method for determining 3 flavonoid constituents in Cudrania tricuspidata. Methods Three flavonoids was isolated from ethanol extract of Cudrania tricuspidata by chromatography, and its structure was identified by nuclear magnetic resonance. The analysis was conducted on an Aglient C18 column (4.6 mm ×250 mm, 5 μm) eluted with 1％ acetic acid and methanol as mobile phases in gradient mode. The flow rate was 1 ml/min and the detection wavelength was set at 310 nm. The column temperature was 25 ℃. Results Taxifolin, orobol and quercetin were isolated from ethanol extract of Cudrania tricuspidata by chromatography. The content of taxifolin, orobol and quercetin were 0.850 mg/g, 0.518 mg/g, 0.103 mg/g. Conclusion The method can be used for the quality control of Cudrania tricuspidata as a reference.
ABSTRACT
Objective@#To optimize the preparation process for Haoqin-Huaban granules so as to provide experimental basis for the development and utilization of the compound.@*Methods@#Taking the extraction rate of gentiopicroside from Gentiana macrophylla Pall as the observation index, L9(34)orthogonal test was used to investigate the amount of water, extraction time, and extraction frequency for optimizing the water extracting technology of the Haoqin-Huaban granules. Then the dry paste was used for the raw material, the ratio of the diluent (dextrin) and the concentration and dosage of the binder (ethanol) were investigated by single factor, and the particles were prepared.@*Results@#The optimum water extraction process was A2B2C3, which indicated that the prescribed medicinal materials with 8 times water were extracted 1 h for 3 times. The extract was concentrated into paste, vacuum drying, pulverizing, mixing according to the ratio of 5:1, with ethanol, made of soft material, pelletizing, drying at 60 ℃ for granulation, in order to make Haoqin-Huaban granules.@*Conclusions@#The preparation process is reasonable and feasible, which provides experimental basis for the industrial production of Haoqin-Huaban granules.
ABSTRACT
Objective To analyze the alkaloids in the different parts of Aconitum wulingense by HPLC-ESI-Trap-MS. Methods The Agilent XDB-C18(250 mm×4.6 mm, 5 μm) column with gradient elution of 0.1% solvent (A)-acetonitrile(B), at a flow rate of 1 ml/min was used. The column temperature was set at 30 ℃. The MS analysis was based on positive ions mode. Results In the roots, a total of 61 diterpenoid alkaloids were discovered, among which 46 were identified. In the stems, 38 alkaloids have been found, among which 33 alkaloids were identified and 27 were the same with the roots. In the leaves, 18 alkaloids have been detected and 8 were the same with the roots. Conclusions The method is accurate, reliable and efficient, and is suitable for rapid identification of ingredients in Aconitum wulingense, which provides a reference for the development and utilization of Aconitum wulingense and clarify its efficacy and material basis.
ABSTRACT
Objective To analyze the change of intrahepatic regulatory T cells (Treg )/helper thymphorytes (Th)17 balance in patients with different phases of chronic hepatitis B virus (HBV ) infection ,and to explore the role of Treg/Th17 balance in maintaining immune tolerance and inducing immune clearance ,and its influence on disease progression .Methods Sixty-eight patients with chronic HBV infection who underwent liver biopsy in Tianjin Second People′s Hospital were included .The 68 patients included 20 cases in immune tolerant (IT) phase ,36 cases in immune clearance (IC) phase and 12 cases in inactive phase .Eight healthy liver transplant donors were collected as healthy controls .The intrahepatic Treg/Th17 levels were detected by immuno-histochemical method . The changes of Treg/Th17 balance in patients with different phases of chronic HBV infection ,and the relationship between Treg/Th17 balance and the decreases of hepatitis B surface antigen (HBsAg ) , hepatitis B antigen (HBeAg) and HBV DNA levels in the peripheral blood were analyzed in patients with IC phase at two weeks of admission .Results The intrahepatic Treg and Th17 levels in IC phase group were the highest , then and they were higher in inactive phase group were higher than those in IT phase group ,And they were the lowest in control group .The Treg level in IC phase group increased significantly compared with the other three groups (all P< 0 .01) ,and there were no significant differences among the other three groups (all P> 0 .05) .The Th17 level between IT phase group and inactive phase group was not significantly different (P> 0 .05) ,while the differences were not significant in other groups (all P>0 .05) .Treg/Th17 ratio of IT phase group was the highest ,then the ratio of control group was higher than that of inactive phase group ,and IC phase group was the lowest ratio .The differences between IC phase group ,control group and IT phase group were significant (all P< 0 .05) ,and the difference between inactive phase group and IT phase group was also significant (all P<0 .05);and there was no significant difference among other groups (all P>0 .05) .The decreases of HBsAg ,HBeAg and HBV DNA levels in the peripheral blood at two weeks admission were negatively correlated with the intrahepatic Treg cell level in patients in IC phase of chronic HBV infection ( r= -0 .941 ,-0 .869 ,and -0 .883 ,respectively ,both P<0 .01) .The Treg ,Th17 levels and their ratio in IC phase group with different degree of inflammation and fibrosis had significant differences :G4 group > G3 group > G2 group ,S3 group > S2 group > S1 group (all P<0 .05) .Conclusions There is no change of the Treg/Th17 balance in IT phase ,and Treg has no influence on maintaining immune tolerance in chronic HBV infection .T he imbalance of Treg/Th17 is observed in IC phase .Th17 may actively participate in the immune-mediated liver injury and the development of hepatic fibrosis in CHB patients .Treg may inhibit inflammation and reduce liver injury via the negative feedback regulation mechanism ,and may impede the eradication of HBV simultaneously .
ABSTRACT
Objective:To compare the efficacy of morphine with intravenous injection and subcutaneous injection in the treatment of advanced cancer,and explore the indications of different drug delivery methods for high-dose morphine. Methods: A prospective study was performed,and 46 cases of patients with advanced cancer pain were collected and divided into intravenous group and subcutaneous group according to the administration route. Pain was assessed during the administration,and the analgesic efficiency and the incidence of adverse reactions were observed to compare the efficacy and safety of two different ways to give high-dose morphine. Results:No statisti-cally significant differences were found in the number of outbreaks needed to be rescued,the frequency of morphine-induced drug deliver-y,the efficiency of analgesia after opioid transfer,and the incidence of opioid-related side effects between the groups (P>0.05). The dose of morphine in the subcutaneous group was higher than that of the intravenous group(P<0.05). Conclusion:The continuous ad-ministration of morphine with intravenous injection and subcutaneous injection can quickly,safely and effectively relieve pain. With the same analgesic efficacy,patients can choose appropriate administration route according to the dose of morphine, the influence degree of primary diseases and the individual will.
ABSTRACT
Objective To compare the effect of enteral nutrition liquid with different dietary fiber content on serum protein in patients with stress hyperglycemia.Methods A total of 90 patients with stress hyperglycemia were randomly divided into three groups:enteral nutritional suspension (SP) group (Peptisorb),enteral nutritional suspension (TPF-FOS) group (Jevety) and enteral nutritional suspension (TPF-D) group (Glucerna),each group consisting of 30 patients.In the three groups,prealbumi (PA),serum albumin (ALB),retinol binding protein (RBP),transfer-rin (TRF) and hemoglobin (Hb) were continuously measured on the 1st,2nd,3rd,4th,5th,6th and 7th day.Data were analyzed by SPSS 15.0.Variances on time and group were analyzed by repeated measures of general linear model.Results The PA,ALB,RBP,TRF and Hb were significantly different among Peptisorb group,Jevety group and Glucerna group (P＜ 0.05).The PA,ALB and Hb which were determined in different time,were not significantly impacted by Peptisorb,Jevety or Glucerna,and not significantly changed with time.The RBP and TRF which were determined at different time,were not impacted by Peptisorb,Jevety or Glucema,but time× group from RBP and TRF which were determined in different time,were significantly impacted in Peptisorb group,Jevety group and Glucerna group (P＜ 0.01).Conclusion The content from different dietary fiber significantly affects serum protein in patients with stress hyperglycemia,and TPF-D has the most significant effect on serum protein.
ABSTRACT
OBJECTIVE:To investigate therapeutic efficacy and safety of clarithromycin intensive therapy on patients with chronic rhinosinusitis and its effects on serum inflammatory cytokines.METHODS:A total of 186 patients with chronic rhinosinusitis were randomly divided into control group 1 (62 cases),control group 2 (62 cases) and observation group (62 cases).Control group 1 was given Amoxicillin and clavulanate potassium tablet (7∶ 1) 0.457 g,3 times a day.Control group 2 was given Clarithromycin dispersible tablet 0.25 g orally,once a day.Observation group was given Clarithromycin dispersible tablet 0.5 g orally on the first week,twice a day,0.25 g at the second week,twice a day.Both groups were treated for 2 weeks.Clinical efficacies of 3 groups were observed.Clinical symptom score,TNF-α,IL-6 and hs-CRP before and after treatment as well as the occurrence of ADR were observed.RESULTS:Total response rate was in descending order:observation group (93.55％) ＞control group 2 (80.65％) ＞control group 1 (65.51％),with statistical significance (P＜0.05).Before treatment,there was no statistical significance in clinical symptom score,the levels of TNF-α,IL-6 and hs-CRP among 3 groups (P＞0.05).After treatment,clinical symptom score,the levels of TNF-αt,IL-6 and hs-CRP were significantly lower than before treatment;those indexes of 3 groups were in ascending order:observation group＜control group 2＜control group 1,with statistical significance (P＜0.05).The incidence of ADR in observation group and control groups were significantly lower than control group 1,with statistical significance (P＜0.05).There was no statistical significance between observation group and control group 2 (P＞0.05).CONCLUSIONS:Clarithromycin intensive therapy shows significant therapeutic efficacy for chronic rhinosinusitis,improves clinical symptoms of patients and reduces the level of serum inflammatory factor without increasing the occurrence of ADR.
ABSTRACT
Objective: To discuss the conversion coefficient of morphine injection with continuous intravenous pump delivery or subcutaneous injection for the patients with advanced cancer pain demanding high dose of opioids.Methods: Using a retrospective survey, the patients with advanced cancer pain demanding high dose of opioids with poor efficacy were divided into 3∶1 group and 2.5∶1 group, and the conversion coefficient of 3∶1 or 2.5∶1 was used for the opioids equivalently conversed to intravenous or subcutaneous injection of morphine.After the conversion, the degree of pain relief, the analgesic efficiency in the conversion process, titration time, daily oral morphine equivalent amount at stable pain, morphine related adverse reactions and the other indicators were studied to evaluate the analgesic effect of morphine injection with different conversion coefficient.Results: There was no statistical significant difference between the two groups in the degree of pain relief, the effective rate of analgesia and the daily oral akministration amount of morphine at sable pain(P>0.05).The adjustment times for morphine in the two groups was (1.57±0.93) and (1.0±0.00), respectively, and the difference was statistically significant (P0.05).Conclusion: Giving morphine injection to the patients with terminal cancer pain demanding high dose of opioids with poor effect, the use of PCA pump through intravenous or subcutaneous injection can effectively relieve pain.Using the conversion coefficient of 2.5:1 can quickly complete the titration process, and safely achieve the effective analgesia.
ABSTRACT
BACKGROUND:Cancer stem cel s have self-renewal ability and can differentiate into new tumors. Cancer stem cel s are the source of tumor formation and recurrence, and they can make tumors insensitive to radiotherapy and chemotherapy. OBJECTIVE:To explore the effect of paclitaxel plus cisplatin on the proliferation and apoptosis of nasopharyngeal cancer stem cel s (NPCSCs) and involved signal pathways. METHODS:NPCSCs were sorted by immunomagneticbeads and were treated with paclitaxel, cisplatin or their combination. The expression of caspase-3, activated caspase-3 and Bcl-2, which are related to apoptosis, was determined by western blot. The expression ofβ-catenin and its downstream proto-oncogene, c-myc, was also determined by western blot. The activity of the Wnt/β-catenin pathway was inhibited by knocking downβ-catenin expression orβ-catenin inhibitor XAV939. Proliferation and apoptosis of NPCSCs were detected by MTT and flow cytometry, respectively. RESULTS AND CONCLUSION:Either paclitaxel or cisplatin could inhibit proliferation and induce apoptosis of NPCSCs. The expression of apoptosis marker, activated caspase-3, was increased and the expression of the inhibitor of apoptosis, Bcl-2, was declined. Combined use of paclitaxel and cisplatin had synergistic effect when used together. Either paclitaxel or cisplatin could inhibit the expression ofβ-catenin and c-myc, suppressed the proliferation and induced the apoptosis of NPCSCs by inhibiting the activity of Wnt/β-catenin pathway. These results indicate that the combined use of paclitaxel and cisplatin may inhibit the proliferation of NPCSCs and promote apoptosis via the Wnt/β-catenin pathway.
ABSTRACT
Objective To investigate the effectiveness and safety of minimal invasive surgery combined with ventriculoscope for the treatment of basal ganglia hemorrhage.Methods From June 2014 to June 2015 there were 57 patients with basal ganglia hemorrhage were selected into this study.These patients were signed into the minimal invasive surgery combined with ventriculoscope group and the craniotomy group according to the methods of surgery they received.And the clinical outcomes of the two groups were compared.Results Compared with the craniotomy group,patients in the minimal invasive surgery combined with ventriculoscope group got a significantly lower Glasgow coma scale at 7 days,14 days and 28 days after the operation (P =0.02,0.04,0.04);the hospital stays were significantly reduced in the minimal invasive surgery combined with ventriculoscope group [(21.45 ±5.67)d vs.(25.67 ±7.45)d,P =0.02];and the operation time were significantly reduced as well [(134.45 ±21.11)min vs.(178.65 ±45.32)min,P =0.000)].There was no significant difference in intra-cranial pressure,rate of hematoma clearance,rate of organ functional failure,rate of re-bleeding and mortality 28 days after operation (P >0.05).Conclusion The minimal invasive surgery combined with ventriculoscope is effective and safe for the treatment of basal ganglia hemorrhage,which is worthy of popularization.
ABSTRACT
Objective To explore the appropriate frequency of ventilator tube replacement by researching the influence of different ventilator circuit change frequency on ventilator-associated pneumonia (VAP).Methods A prospective randomized sampling study was conducted.The patients undergoing invasive mechanical ventilation over or equal to 3 days admitted to emergency intensive care unit (EICU) of the First Affiliated Hospital of Kunming Medical University from December 2012 to December 2015 were enrolled.The patients were divided into 3,7 and 10 days group according to the frequency of ventilator tube replacement.Bacteriology of ventilator tube and the incidence of VAP were compared among the groups.Results Ninety-eight patients were enrolled,mainly with the artificial airway of endotracheal intubation or tracheotomy,with 56 male and 42 female,aging 8 to 86 years with mean of (51.97 ± 17.56) years.There were no statistical differences in gender,age,Glasgow coma scale (GCS) score,cough function and application of glucocorticoid,enteral nutrition,atomization and sedative therapy among three groups,indicating that the risk factors among three groups were consistent.The bacteria detection rates of extension tube,breathe out tube,breathe in tube,and hydrops collection cup were 36.7％,36.7％,33.3％,and 33.3％ respectively in 3 days group,and they were 73.0％,67.6％,62.2％,and 62.2％ in 7 days group respectively,and were all 90.3％ in 10 days group.It was showed that the bacteria detection rate in different pipe parts was almost the same with the same change frequency,and the rate was higher with the longer usage of ventilator tube (x2 values were 20.599,19.879,21.975,21.975,all P =0.000).The longer of the tube used time,the higher incidence of VAP.The incidence of VAP in 3,7,10 days groups were 26.7％,59.5％ and 77.4％,respectively,but there was statistically significant difference among all groups (x2 =30.486,P ＜ 0.001).Based on the value of 3 days group,the incidence of VAP in the 7 days group was 15.950 folds of 3 days group,and the incidence of VAP in the 10 days group was 18.333 folds of the 3 days group (both P ＜ 0.001).Conclusion This study suggests that the longer of pipeline using time,the more serious degree of bacterial contamination of pipeline,the higher incidence of VAP.