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Objective To compare the effects of sevoflurane and propofol anesthesia on endothelial glycocalyx degradation in the patients undergoing abdominal surgery.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 25-75 yr,weigbing 45-80 kg,scheduled for elective open colon or rectal surgery,were divided into 2 groups (n =30 each) using a random number table method:sevoflurane anesthesia group (group S) and propofol anesthesia group (group P).In group S,1.5％-2.5％ sevoflurane was inhaled for maintenance of anesthesia.In group P,propofol was intravenously infused at 50-150 μg · kg-1 · m-1 to maintain the bispectral index value at 40-60.The concentrations of heparan sulfate (HS),syndecan-1 and vascular cell adhesion molecule-1 (VCAM-1) in serum were determined after tracheal intubation (T0),at 1 h after skin incision (T1),at 2 h after skin incision (T2),at the end of operation (T3) and at 24 h after operation (T4).Blood gas analysis and blood biochemical test were performed at T0 and T4,and strong ion gap (SIG) was calculated.Results Compared with the baseline at T0,the concentrations of serum HS at T2-4 and syndecan-1 at T3-4 and SIG at T4 were significantly increased,and the concentrations of serum ALB at T4 were decreased in S and P groups (P＜0.05).Compared with group P,the concentrations of serum HS at T3,4 and syndecan-1 at T4 and SIG at T4 were significantly decreased,the concentrations of serum ALB at T4 were increased (P＜0.05),and no significant change was found in the serum concentrations of VACM-1 and lactate in group S (P＞0.05).Conclusion Compared with propofol anesthesia,sevoflurane anesthesia is more helpful in decreasing endothelial glycocalyx degradation and in reducing vascular endothelial damage in the patients undergoing abdominal surgery.
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Objective:To explore the diagnostic value of ultrasound-guided fine needle aspiration biopsy(US-FNAB)for thyroid nod-ules.Methods:The clinical characteristics and cytopathological diagnosis of patients with thyroid nodules in Tianjin Medical University General Hospital were analyzed retrospectively;the results of the cytopathological and pathological diagnoses were compared and an-alyzed.Results:Of the 1,241 US-FNAB samples,the ratio of men to women with thyroid nodules was 1:3.83(257/984).The incidence of thyroid nodules gradually increased from the age of 20 years and declined after the age of 60 years.The nodules,which were less than or equal to 1.0 cm in size,accounted for 51.57%(640 cases),and Thyroid Imaging Reporting And Data System(TIRADS)classifica-tion 4 accounted for 86.38%(1 072 cases).Of cyto-pathological diagnoses,22.00%(273 cases)were non-diagnostic,9.75%(121 cases) were benign,30.62%(380 cases)were atypia with undetermined significance,32.15%(399 cases)were suspicious for malignancy,and 5.48%(68 cases)were malignant.In the 302 patients who underwent surgery,the number of cases of clear diagnoses,unavailable di-agnoses,and atypia of undetermined significance were 203,21,and 78,respectively.In the 203 cases of clear diagnoses,the sensitivi-ty,specificity,positive predictive value,negative predictive value,precision,and misdiagnoses following US-FNAB of thyroid nodules were 100.00%(201/201),50.00%(1/2),99.50%(201/202),100.00%(1/1),99.51%(202/203),and 0.49%(1/203),respectively.In the 78 cases that were atypia of undetermined significance,the malignancy rate was 70.51%.Whether the atypia of undetermined signifi-cance was malignant or not was related to the TIRADS classification(P<0.05),and not related to the age,sex,tumor size,or location of the nodules(P>0.05).Conclusions:US-FNAB has high diagnostic value for thyroid nodules and is worthy of being popularized widely.If it replaced some intra-operative frozen sectioning procedures,it may reduce intra-operative waiting time and financial burden of pa-tients.
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Objective@#To investigate the risk factors of poor graft function (PGF) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for severe aplastic anemia (SAA) .@*Methods@#Clinical data from 111 SAA patients who received allo-HSCT were analyzed retrospectively. Factors including age, gender, interval to transplantation, the level of serum ferritin before transplantation were analyzed by Cox multivariate regression analysis.@*Results@#Among the 111 patients who underwent allo-HSCT, 16 developed PGF (14.4%) . Multivariate analysis showed donor type (HR=2.656, 95%CI 1.204-5.858, P= 0.016) and the level of serum ferritin before tansplantation (HR=3.170, 95%CI 1.400-7.180, P=0.006) were significant risk factors for PGF.@*Conclusion@#Unrelated donor transplantation and the high level of serum ferritin before transplantation are risk factors for PGF.
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Objective@#To analyze the morbidity, clinical characteristics, therapeutic outcomes and prognosis of cardiac lymphoma.@*Methods@#Individual patient data were obtained from pathology defined 10 cases of cardiac lymphoma from Jan 2000 to Jun 2016. The patient’s general information, clinical manifestation, pathological diagnosis, laboratory examination, cardiac involvement feature, cardiac complications, treatment, therapeutic effect and prognosis were analyzed.@*Results@#Of 3 918 cases of lymphoma patients, 10 cases of cardiac involvement were identified, including primary cardiac lymphoma (PCL) in 1 case, secondary cardiac lymphoma (SCL) in 9 cases. Of the 10 patients in our analysis, the male-to-female ratio was 3∶2, with a median age of 55 (19-88) years old. The most presenting complaints were dyspnea in 7 cases, followed by chest pain in 5 cases, fatigue in 2 patients and edema in 2 cases. Pathological types included diffuse large B cell lymphoma (DLBCL) in 7 cases, T cell lymphoma (T-LBL) in 1 case, Hodgkin’s lymphoma (HL) in 1 case, and Burkitt lymphoma (BL) in 1 case. The sites of the heart affected by lymphoma in the PCL patient were right and left atriums with multiple nodules; and for SCL, the sites were mainly pericardium associated with a pericardial effusion in 5 cases, a pericardial mass in 2 cases. Congestive heart failure affects 7 patients and cardiac arrhythmias were identified in 4 cases mainly sinus tachycardia, atrial fibrillation and atrioventricular block. Except one untreated because of old age and poor performance, the rest of 9 patients were treated by either chemotherapy in 4 cases or chemotherapy combined radiotherapy (including the extracardiac sites) in 5 patients. With the median follow-up of 9 months, the one PCL patient achieved partial response (PR) , progress free survival (PFS) for 6 months and the overall survival (OS) for 21 months; in the cohort of 6 SCL patients cardiac involved at diagnosis, complete response (CR) was achieved in 1 case (16.7%) , PR in 3 cases, progressing disease (PD) in 2 cases, with the median PFS for 5 months and the median OS for 19 months; and for the other 3 SCL patients cardiac involved at progression, PR was achieved in 2 case and death in 1 case, with the median PFS for 4 months and the median OS unavailable because of censored data.@*Conclusion@#Cardiac lymphoma represents a rare subset of lymphoma, the most common type is DLBCL, and the main clinical manifestations are dyspnea and chest pain, always combined by arrhythmia and congestive heart failure. The main therapeutic regimen for cardiac lymphoma includes combined chemotherapy and the prognosis for patients with either PCL or SCL is usually poor.
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The aim of this research was to explore the most optimal method of DNA extraction from formalin-fixed, paraffin-embedded (FFPE) tissues, and to improve the amplification of long fragments with the method. Three methods, one step method, phenol-chloroform extraction method, and genomic DNA purification kit method, were employed to extract DNA from twenty normal thyroid tissues which were fixed with formalin and embedded with paraffin. The highest proportionality of OD260/OD280 in the examples was obtained by phenol-chloroform extraction method, 1.703 +/- 0.086, compared to the results of the other two methods. As for the long DNA segments amplification, the achievement ratio of one step method, phenol-chloroform extraction method and genomic DNA purification kit method were 0%, 5% and 10%, respectively, by traditional PCR method, but 0%, 95% and 85% respectively by the nest PCR. We have found that the best process of extracting DNA from FFPE is digesting by proteinase K and purifying by phenol-chloroform, and it is effective to amplify long DNA segments from FFPE by nest PCR.
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Humans , Base Sequence , DNA , Formaldehyde , Molecular Sequence Data , Paraffin Embedding , Pathology, Molecular , Methods , Polymerase Chain Reaction , Methods , Sensitivity and Specificity , Thyroid Gland , Pathology , Tissue FixationABSTRACT
CD+4 CD+25 regulatory T cell ( CD+4 CD+25 Treg) is a unique T-cell subsets with immune regulation function. Natural CD+4 CD+25 Treg originates from the thymus and acquired CD+4 CD+25 Treg can beinduced from CD+4 CD-25 T cells in peripheral blood. A specific transcription inhibitory factor-Foxp3 can be expressed, besides, it also can express other membrane molecules, such as CD4, CD25, CTLA-4 (CD152), GITR,etc. Its main function is immunosuppression and immune anergy. Recent research finds that it over-expresses in some non-Hodgkin lymphoma, and the number of CD+4 CD+25 Treg increases as tumor progression. The increased CD+4 CD+25 Treg can accelerate tumor growth and recurrence, and inhibit effector T cells (CD+4 T cells or CD+8 T cells), which makes it probably play a role in tumor immune escape mechanisms. In this article, the recent research results of CD+4 CD+25 Treg in T cell non-Hodgkin lymphoma (mainly cutaneous T-cell lymphoma and adult T-cell lymphoma) were reviewed.
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Objective: To study the expressions of mitochondrial protein (MAB1273), Bcl-2, and Bax in renal cell carcinoma and to investigate their role in the tumorigenesis. Methods: The expressions of mitochondrial protein, Bcl-2 and Bax were detected by immunohistochemistry SP method in 9 tissue samples of renal on-cocytoma, 6 samples of chromophobe carcinoma, 23 samples of clear cell carcinoma and 12 samples of normal renal tissue. Results: The expression of MAB1273 in renal oncocytoma, chromophobe carcinoma and clear cell carcinoma was much higher than that in normal renal tissue (P=0.006). No significant difference was found in MAB1273 expression among the three types of renal carcinoma. The expression of Bcl-2 was higher in the renal carcinoma groups than in the normal renal tissue group, with a significant difference (P=0.008). The expression of Bax was not different among all of the groups (P=0.057). Rank correlation analysis showed a positive correlation between MAB1273 and Bcl-2 expression (r=0.341, P=0.015). The expression of Bcl-2 was negatively correlated with Bax expression (r= -0.287, P=0.043). Conclusion: Overexpression of mitochondrial protein and Bcl-2 and underexpression of Bax may play a part in the genesis of renal oncocytoma, chromophobe carcinoma and the clear cell carcinoma, indicating that overexpression of MAB1273 may be correlated with apoptosis of renal cell carcinoma cells.