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Objective: To investigate the prognostic value of preoperative inflammatory and nutritional condition detection in the postoperative survival, and establish a prognostic model for predicting the survival of patients with gastric cancer. Methods: The clinicopathological data of 1123 patients with gastric cancer who had undergone radical gastrectomy in Tianjin Medical University Cancer Institute & Hospital from January 2005 to December 2014 were retrospectively analyzed. Patients with history of other malignancy, with history of gastrectomy, who had received preoperative treatment, who died during the initial hospital stay or first postoperative month, and missing clinical and pathological information were excluded. Cox univariate and multivariate analyses were used to identify independent clinicopathological factors associated with the survival of these gastric cancer patients. Cox univariate analysis was used to identify preoperative inflammatory and nutritional indexes related to the survival of patients with gastric cancer after radical gastrectomy. Moreover, the Cox proportional regression model for multivariate survival analysis (forward stepwise regression method based on maximum likelihood estimation) was used. The independent clinicopathological factors that affect survival were incorporated into the following three new prognostic models: (1) an inflammatory model: significant preoperative inflammatory indexes identified through clinical and univariate analysis; (2) a nutritional model: significant preoperative nutritional indexes identified through clinical and univariate analysis; and (3) combined inflammatory/nutritional model: significant preoperative inflammatory and nutritional indexes identified through clinical and univariate analysis. A model that comprised only pT and pN stages in tumor TNM staging was used as a control model. The integrated area under the receiver operating characteristic curve (iAUC) and C-index were used to evaluate the discrimination of the model. Model fitting was evaluated by Akaike information criterion analysis. Calibration curves were used to assess agreement between the predicted probabilities and actual probabilities at 3-year or 5-year overall survival (OS). Results: The study cohort comprised 1 123 patients with gastric cancer. The mean age was 58.9±11.6 years, and 783 were males. According to univariate analysis, age, surgical procedure, extent of lymph node dissection, tumor location, maximum tumor size, number of examined lymph nodes, pT stage, pN stage, and nerve invasion were associated with 5-year OS after radical gastrectomy for gastric cancer (all P<0.050). Multivariate analysis further identified age (HR: 1.18, 95%CI: 1.03-1.36, P=0.019), maximum tumor size (HR: 1.19, 95%CI: 1.03-1.38, P=0.022), number of examined lymph nodes (HR: 0.79, 95%CI: 0.68-0.92, P=0.003), pT stage (HR: 1.40, 95%CI: 1.26-1.55, P<0.001) and pN stage (HR: 1.28, 95%CI: 1.21-1.35, P<0.001) as independent prognostic factors for OS of gastric cancer patients. Additionally, according to univariate survival analysis, the preoperative inflammatory markers of neutrophil count, percentage of neutrophils, neutrophil/lymphocyte ratio, platelet/neutrophil ratio and preoperative nutritional indicators of serum albumin and body mass index were potential prognostic factors for gastric cancer (all P<0.05). On the basis of the above results, three models for prediction of prognosis were constructed. Variables included in the three models are as follows. (1) Inflammatory model: age, maximum tumor size, number of examined lymph nodes, pT stage, pN stage, percentage of neutrophils, and neutrophil-lymphocyte ratio; (2) nutritional model: age, maximum tumor size, number of examined lymph nodes, pT stage, pN stage, and serum albumin; and (3) combined inflammatory/nutritional model: age, maximum tumor size, number of examined lymph nodes, pT stage, pN stage, percentage of neutrophils, neutrophil-lymphocyte ratio, and serum albumin. We found that the predictive accuracy of the combined inflammatory/nutritional model, which incorporates both inflammatory indicators and nutrition indicators (iAUC: 0.676, 95% CI: 0.650-0.719, C-index: 0.698),was superior to that of the inflammation model (iAUC: 0.662, 95% CI: 0.673-0.706;C-index: 0.675), nutritional model (iAUC: 0.666, 95% CI: 0.642-0.698, C-index: 0.672), and TNM staging control model (iAUC: 0.676, 95% CI: 0.650-0.719, C-index: 0.658). Furthermore, the combined inflammatory/nutritional model had better fitting performance (AIC: 10 762) than the inflammatory model (AIC: 10 834), nutritional model (AIC: 10 810), and TNM staging control model (AIC: 10 974). Conclusions: Preoperative percentage of neutrophils, NLR, and BMI have predictive value for the prognosis of gastric cancer patients. The inflammatory / nutritional model can be used to predict the survival and prognosis of gastric cancer patients on an individualized basis.
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Male , Humans , Middle Aged , Aged , Female , Prognosis , Retrospective Studies , Stomach Neoplasms/pathology , Neoplasm Staging , Gastrectomy , Serum AlbuminABSTRACT
With the development of social economy and improvement of people's health condition， life expectancy continues to extend and people are more concerned about the quality of life. Nowadays people's attention has shifted from living longer lives to living healthier lives. Life expectancy can only reflect the length of life， but not the health condition and quality of life. Meanwhile， healthy life expectancy contains death and disability information， which comprehensively reflects the length and quality of life and evaluates the health status of the population comprehensively. Through literature search and review， the article summarized the research on healthy life expectancy in recent years， including the concept proposal， index development， calculation， and application progress of health life expectancy. The research methods of healthy life expectancy are summarized in order to provide academic reference for further research.
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Objective:To develop a questionnaire for compliance with the management standard of nosocomial infection control in hemodialysis rooms (centers), and to evaluate the reliability and validity.Methods:Based on the Knowledge, Attitude/Belief, Practice (KAP) survey model, the initial questionnaire was formed by using literature review, the brainstorming and expert consultation. And the final questionnaire was developed by preliminary investigation and the formal investigation, and the reliability and validity test was carried out.Results:The questionnaire consisted of 3 subscales of knowledge, attitude and practice, totaling 40 items. The S-CVI was 0.953, 0.979, 0.943 respectively and that of each item was above 0.867. In the exploratory factor analysis, 3, 1 and 3 common factors were extracted and the cumulative contribution rate was 47.178%, 68.313% and 62.271% respectively. The Cronbach α coefficient was 0.906 for the total questionnaire and 0.641, 0.958 and 0.864 for 3 subscales. The retest reliability was 0.954 for the total questionnaire and 0.694, 0.893 and 0.708 for 3 subscales.Conclusions:The questionnaire had high reliability and validity, which can be used as an effective evaluation tool for the standard to investigate the compliance of medical staffs in hemodialysis rooms.
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Objective:To identify the risk factors of catheter-related bloodstream infection in hemodialysis patients using Meta-analysis.Methods:We searched PubMed, Web of Science, Cochrane Library, Embase, CBM, CNKI and Wangfang Data to collect literature about risk factors of catheter-related bloodstream infection in hemodialysis patients. Data were analyzed by RevMan 5.3 after literature screening, data extraction, and quality appraisal according to criteria by two researchers independently.Results:Ten literatures were recruited,including 3 143 cases and 7 risk factors.According to Meta analysis, catheter indwelling time ( OR value was 2.59, 95% CI 1.18-5.68), times of intubation ( OR value was 10.02, 95% CI 5.93-16.92), femoral vein catheterization ( OR value was 1.73, 95% CI 1.32-2.25), age ( OR value was 1.94, 95% CI 1.50-2.51), diabetes mellitus ( OR value was 2.58, 95% CI 2.03-3.29) and hemoglobin level ( OR value was 1.61, 95% CI 1.18-2.18), were significantly different in each group (all P<0.05). Conclusions:The main of risk factors for catheter-related bloodstream infection in hemodialysis patients are catheter indwelling time, times of intubation, femoral vein catheterization, age, diabetes mellitus and hemoglobin level. However, the relationship between catheter-related bloodstream infection and albumin level needs to be confirmed by more studies.
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Objective:To discuss the clinical efficacy of modified Wendantang combined with Xueyaping recipe in the middle aged and young people with hypertension and syndrome of phlegm dampness accumulation， and investigate its effect on metabolism. Method:One hundred and twenty patients were divided into control group and observation group averagely. Patients in both groups got lifestyle intervention and bisoprolol maleate tablets， 5-10 mg/time， 1 time/day. Patients in observation group additionally took modified Wendantang combined with Xueyaping recipe， 1 dose/day. Patients in control group addiiotnally got placebo granules Banxia Tianma Wan， 6 g/time， 2 times/day. The treatment was continued for 12 weeks in both groups. Blood pressure was measured at home to measure the compliance rate of blood pressure during the treatment and after the treatment. Before and after treatment， 24 h mean systolic blood pressure （24 h SBP）， 24 h mean pulse pressure （24 h PP）， 24 h mean diastolic blood pressure （24 h DBP）， blood pressure variability （BPV） ［24 h systolic blood pressure standard deviation （24 h SSD）， 24 h diastolic blood pressure standard deviation （24 h DSD）， systolic blood pressure variation coefficient （nSCV）， and diastolic blood pressure variation coefficient （nDCV） were recorded，compare night coefficients］. Scores of syndrome of phlegm dampness accumulation， body mass index （BMI） and waist hip ratio （WHR） were evaluated. Levels of uric acid （UA）， total cholesterol （TC）， triglyceride （TG）， high-density lipoprotein cholesterin （HDL-C）， low-density lipoprotein cholesterin （LDL-C）， fasting blood glucose （FBG） and fasting insulin （FINS）， insulin resistance index （HOMA-IR）， homocysteine （Hcy）， Cystatin C （CysC）， angiotensin Ⅱ （Ang Ⅱ） and nuclear factor kappa B （NF-<italic>κ</italic>B） were measured. In addition， the safety was evaluated. Result:Compliance rate of blood pressure in observation group was 94.74%（54/57）， higher than 80.70% （46/57） in control group （<italic>χ</italic><sup>2</sup>=5.211， <italic>P</italic><0.05）. Levels of 4 h SBP， 24 h DBP， 24 h PP， 24 h SSD， 24 h DSD， nSCV， nDCV， Hcy， CysC， AngⅡ， and NF-<italic>κ</italic>B in observation group were all lower than those detected from control group （<italic>P</italic><0.01）. Score of syndrome of phlegm dampness accumulation was lower than that in control group （<italic>P</italic><0.01）. Levels of UA， TC， TG， LDL-C and HOMA-IR were lower than those in control group （<italic>P</italic><0.05）， while level of HDL-C was higher than that detected from control group （<italic>P</italic><0.05）. Conclusion:Based on lifestyle and western medicine intervention， Wendantang combined with Xueyaping recipe can further control the blood pressure level， reduce the symptoms of phlegm dampness retention syndrome， improve blood pressure variability， improve the compliance rate of blood pressure， improve the metabolism of patients and reduce the risk factors of ASCVD in middle aged and young people with hypertension.
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Purpose@#The purpose of this study was to compare the survival and toxicities in cervical esophageal squamous cell carcinoma (CESCC) treated by concurrent chemoradiothrapy with either three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) techniques. @*Materials and Methods@#A total of 112 consecutive CESCC patients were retrospectively reviewed. 3D-CRT and IMRT groups had been analyzed by propensity score matching method, with sex, age, Karnofsky performance status, induction chemotherapy, and tumor stage well matched. The Kaplan-Meier method and Cox proportional hazards model were used for overall survival (OS) and progression-free survival (PFS). Toxicities were compared between two groups by Fisher exact test. @*Results@#With a median follow-up time of 34.9 months, the 3-year OS (p=0.927) and PFS (p=0.859) rate was 49.6% and 45.8% in 3D-CRT group, compared with 54.4% and 42.8% in IMRT group. The rates of grade ≥ 3 esophagitis, grade ≥ 2 pneumonitis, esophageal stricture, and hemorrhage were comparable between two groups, while the rate of tracheostomy dependence was much higher in IMRT group than 3D-CRT group (14.3% vs.1.8%, p=0.032). Radiotherapy technique (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.01 to 0.79) and pretreatment hoarseness (HR, 0.12; 95% CI 0.02 to 0.70) were independently prognostic of tracheostomy dependence. @*Conclusion@#No survival benefits had been observed while comparing IMRT versus 3D-CRT in CESCC patients. IMRT with fraction dose escalation and pretreatment hoarseness were considered to be associated with a higher risk for tracheostomy dependence. Radiation dose escalation beyond 60 Gy should be taken into account carefully when using IMRT with hypofractionated regimen.
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Objective:Through the analysis of the characteristics and main chemical components of Ginseng Radix et Rhizoma,the correlation between the characteristics and components of Ginseng Radix et Rhizoma was explored,and a new evaluation standard of Ginseng Radix et Rhizoma grade was established to provide a more comprehensive and scientific basis for the quality evaluation of Ginseng Radix et Rhizoma. Method:The appearance characteristics of 48 batches of Ginseng Radix et Rhizoma samples were quantitatively measured. The contents of 9 kinds of Ginseng Radix et Rhizoma were determined. The results of correlation analysis,principal component analysis and cluster analysis were used to classify ginseng medicinal materials according to the analysis results,and the grade evaluation criteria were constructed. Result:First-class ginseng medicinal materials:diameter of main root>1.72 cm,length of reed head>2.61 cm,weight of single branch>14.15 g,content of ginsenoside Rb1>0.612 1%,content of ginsenoside Re>0.385 8%,content of ginsenoside Rg1>0.320 8%,no scar,impurities,moth,mildew. Second-class ginseng medicinal materials:the diameter of main root is 1.55-1.72 cm,the length of reed head is 1.74-2.61 cm,the weight of single branch is 10.24-14.15 g,the content of ginsenoside Rb1 is 0.496 8%-0.612 1%,the content of ginsenoside Re is 0.323 3%-0.385 8%,the content of ginsenoside Rg1 is 0.263 6%-0.320 8%,and there are no scars,impurities,worms and mildew. Third-class ginseng medicinal materials:main root diameter 1.29-1.55 cm,reed head length 1.34-1.74 cm,single branch weight 6.90-10.24 g,ginsenoside Rb1 content 0.389 5%-0.496 8%,ginsenoside Re content 0.235 2%-0.323 3%,ginsenoside Rg1 content 0.217 1%-0.263 6%,no impurities,worms,mildew. Fourth-class ginseng medicinal materials:diameter of main root11Conclusion:The appearance indexes of ginseng medicinal materials were divided according to the standards of taproot diameter,reed head length and single ginseng weight,and the content of ginsenoside Rg1,Re,Rb1 was used as the internal quality evaluation index. Ginseng commercial specifications were divided into four grades,which integrated the appearance and internal indicators,and had more scientific and comprehensive characteristics,which could be used as the basis for the classification of Ginseng Radix et Rhizoma medicinal materials.
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Objective:To explore the correlation between the characters and chemical constituents of Glycyrrhizae Radix et Rhizoma through the analysis of characters and main chemical constituents of Glycyrrhizae Radix et Rhizoma,and establish the grade evaluation criteria of Glycyrrhizae Radix et Rhizoma, so as to provide reference for the quality evaluation and quality control of Glycyrrhizae Radix et Rhizoma. Method:Correlation analysis,principal component analysis and cluster analysis were carried out for appearance and intrinsic indexes of Glycyrrhizae Radix et Rhizoma. Result:Class Ⅰ of Glycyrrhizae Radix et Rhizoma:the diameter of big end was more than 1.60 cm,middle circumference was more than 3.76 cm,inner core chromaticity b* was more than13.88,outer skin chromaticity a* was more than 37.61,glycyrrhizin content was more than 1.13%,with no worm,rot and impurity. Class Ⅱ of Glycyrrhizae Radix et Rhizoma:the diameter of big end was 1.39-1.60 cm,the middle circumference was 3.09-3.76 cm,the inner core chromaticity b* was 10.22-13.88,the skin chromaticity a* was 35.57-37.61,glycyrrhizin content was 0.69%-1.13%,with no worm,rot and impurity. Class Ⅲ of Glycyrrhizae Radix et Rhizoma:the diameter of the big end was 1.08-1.39 cm,the middle circumference was 2.41-3.09 cm,the inner core chromaticity b* was 5.16-10.22,the skin chromaticity a* was 29.19-35.57,glycyrrhizin content was 0.55%-0.69%,with no worm and rot. Substandard Glycyrrhizae Radix et Rhizoma:the diameter of the big end was lower than 1.08 cm,the central circumference was lower than 2.41 cm,the inner core color b* was lower than 5.16,the outer skin color a* was lower than 29.19, and glycyrrhizin content was lower than 0.55%. Conclusion:The grade evaluation standards established in this paper include appearance and intrinsic indexes, with scientific,comprehensive and practical characteristics. It can be used for the grade evaluation of Glycyrrhizae Radix et Rhizoma medicinal materials.
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Objective: On the basis of traditional experience identification,and appearance characteristics and intrinsic index components of Glycyrrhizae Radix et Rhizoma pieces,a comprehensive evaluation was carried out to explore the method of grading Glycyrrhizae Radix et Rhizoma pieces and establish grading standards. Method: Based on the investigation of 44 batches of Glycyrrhizae Radix et Rhizoma pieces,including their properties,glycyrrhizin content and ammonium glycyrrhizinate content,Glycyrrhizae Radix et Rhizoma pieces were classified according to the market grading to establish the grading standards. Result: Based on the above data,the Glycyrrhizae Radix et Rhizoma pieces were classified into four grades. First-class:average diameter>1.66 mm,average weight>0.54 g,glycyrrhizin content>1.10%,glycyrrhizic acid content>2.12%. Second-class:the average diameter is between 1.40-1.66 mm,the average weight is between 0.42-0.54 g,the content of glycyrrhizin is between 0.74%-1.10%,and the content of glycyrrhizic acid is between 1.95%-2.12%. Third-class:the average diameter is between 1.07-1.40 mm,the average weight is between 0.29-0.42 g,the content of glycyrrhizin is between 0.65%-0.74%,and the content of glycyrrhizic acid is between 1.88%-1.95%. Substandard:the average diameterConclusion: This experiment combines the traditional experience and modern analysis method,in order to develop a scientific,reasonable and accurate classification method.
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@#AIM:To evaluate the effect of monocular rectus surgery for adult sensory exotropia. <p>METHODS: Totally 76 cases of adult sensory exotropia of degree -15<sup>△</sup> to -160<sup>△</sup>(-68.36<sup>△</sup>±30.77<sup>△</sup>)examined through Krimsky method were included into this study. A total of 16 cases, 37 cases and 23 cases with different degrees of strabismus were treated separately with routine amount monocular lateral rectus recession, routine amount monocular medial rectus resection plus lateral rectus recession, and exceed constant amount monocular medial rectus resection plus lateral rectus recession. Follow-up was performed at 1d, 1wk, 1, 3 and 6mo after operation. The eye position, monocular movement, intraocular pressure(IOP), slit lamp, and fundus of these patients were examined. <p>RESULTS:After surgery, 67 cases(88%)were positive and 9 cases(12%)were undercorrection. The postoperative intraocular pressure of operative eye at 1wk was equal to preoperative(<i>P</i>=0.090), and IOP decreased to a valley value at 1mo(<i>P</i><0.01), there was no significant difference in intraocular pressure between 3mo and 1mo(<i>P</i>=0.092), and no significant difference in intraocular pressure between 6mo and 3mo(<i>P</i>=0.123). And 2 cases(3%)had inflammatory reaction induced by anterior segment ischemia at 1d and 1wk postoperative visits, and they recovered at 1mo follow-up visit; 4 cases(5%)experienced an external dysfunction at the 1, 3 and 6mo follow-up. <p>CONCLUSION:Monocular rectus surgery has a good therapeutic effect on adult patients with sensory exotropia; the decrease in intraocular pressure secondary to the detached rectus is worth the attention of the surgeon; the incidence of complications after detaching monocular of two rectus muscles is comparable low. Exceed constant amount rectus strabismus surgery for sensory exotropia may result in limited function of postoperative ocular hyperextension.
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We analyzed epidemiological and clinical characteristics of the case of human infected with avian influenza (H5N6) in Anhui Province and provided evidences for drawing up the prevention and control measures.We did an epidemiolog ical investigation on the case,close contacts and infection source of the infected case;relevant specimens were collected and tested in laboratories.The data gathered were analyzed with descriptive epidemiology method.The first case of human infected with avian influenza (H5N6) in Anhui was a single case and did not showed signs of human-to-human transmission.The early clinical manifestations and signs was lack of specificity.This case had definite contact with sick/dead poultry one week before the onset of the disease.Two environmental specimen of live poultry market which was the source of sick/dead poultry had been detected and the results were H5N6 positive.This case was a local infection case and contacting with sick/dead poultry was the source of infection,while there was no evidence of human to human transmission.
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<p><b>OBJECTIVE</b>To explore the effect of BCR-ABL gene transcripts on Leukemia-free survival (LFS) and prognosis of patients with Philadelphia chromosome positive acute lymphoblastic leukemia (PhALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).</p><p><b>METHODS</b>The clinical data of 107 cases of PhB-ALL patients received allo-HSCT from July 2006 to November 2014 in the First Affiliated Hospital of Soochow University were collected and the relationship between the clinical characteristics and LFS after transplantation was analyzed.</p><p><b>RESULTS</b>Out of 107 PhALL patients (64 males and 43 females) with a median age of 30(7 to 54)years old, 35.5% (38/107) cases relapsed after transplantation within a median time of 6.9 (1.5 to 40.7) months. A total of 39 (36.4%) cases died within a median time of 19.8 (3.6 to 83.7) months after HSCT, of which 51.3% (20/39) due to disease relapse and 25.6% (10/39) due to infection. BCR-ABL gene transcripts of 49 cases turn into negative before transplantation, of which the expected 5-year cumulative incidence of relapse (CIR), non-relapse mortality (NRM) and overall survival (OS) were 26.5%, 29.5% and 41.6%, respectively. Another 49 cases still had a positive BCR-ABL gene transcripts before transplantation, of which the life expectancy of 5 year CIR, NRM and OS were 64.4%,8.9% and 48.9%, respectively. Compared with BCR-ABL positive patients, BCR-ABL negative patients showed a lower CIR (P<0.001), a higher NRM (P=0.030) and a similar OS (41.6% versus 48.9%, P=0.497). Multivariate analysis showed that BCR-ABL positive (P=0.016) and a disease statusphase ≥CR2 (P<0.001) before HSCT were independent risk factors for LFS, while the age underwent HSCT was the principal element affecting prognosis (P<0.001).</p><p><b>CONCLUSION</b>Both the relapse and infection are the main causes of death in the patients after transplantation. A disease status ≥CR2 and the BCR-ABL positive before transplantation are 2 independent risk factors of LFS in the patients with PhALL after allo-HSCT.</p>
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Objective To investigate the regulating effect of fire needling on Wnt andβ-catenin genes of Wnt/β-catenin pathway in neural stem cells in spinal cord injury.Methods Sixty female SD rats were randomly allocated, including 5 rats to a blank group, 5 rats to a sham operation group, 25 rats to a model group and 25 rats to a fire needling group. The model and fire needling groups of rats were again separately divided into 1 d, 3 d, 7 d, 10 d and 14 d groups. A model was made using modified Allen's method in the model and fire needling groups. The BBB score was recorded and the expressions of Wnt andβ-catenin genes were determined in every group.Results In the model and fire needling groups, the BBB scores were significantly higher at 7 and 10 days than at the previous time point and there was a statistically significant difference (P<0.05). The BBB score at every time point after treatment was significantly higher in the fire needling group than in the model group and there was a statistically significant difference (P<0.05). Wnt3a gene expressions increased in the model and fire needling groups at 7 and 10 days compare with the previous time point (P<0.05). At 7 and 10 days, Wnt3a gene expression was higher in the fire needling group than in the model group and there was a statistically significant difference (P<0.05). The changing tendency ofβ-catenin gene expression levels was basically the same as that of Wnt3a's.Conclusion Fire needling can modulate the expressions of Wnt3a andβ-catenin genes in neural stem cells in spinal cord injury.
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Objective To investigate the regulating effect of fire needling on Wnt andβ-catenin genes of Wnt/β-catenin pathway in neural stem cells in spinal cord injury.Methods Sixty female SD rats were randomly allocated, including 5 rats to a blank group, 5 rats to a sham operation group, 25 rats to a model group and 25 rats to a fire needling group. The model and fire needling groups of rats were again separately divided into 1 d, 3 d, 7 d, 10 d and 14 d groups. A model was made using modified Allen's method in the model and fire needling groups. The BBB score was recorded and the expressions of Wnt andβ-catenin genes were determined in every group.Results In the model and fire needling groups, the BBB scores were significantly higher at 7 and 10 days than at the previous time point and there was a statistically significant difference (P<0.05). The BBB score at every time point after treatment was significantly higher in the fire needling group than in the model group and there was a statistically significant difference (P<0.05). Wnt3a gene expressions increased in the model and fire needling groups at 7 and 10 days compare with the previous time point (P<0.05). At 7 and 10 days, Wnt3a gene expression was higher in the fire needling group than in the model group and there was a statistically significant difference (P<0.05). The changing tendency ofβ-catenin gene expression levels was basically the same as that of Wnt3a's.Conclusion Fire needling can modulate the expressions of Wnt3a andβ-catenin genes in neural stem cells in spinal cord injury.
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Resistin is a new adipokine found in vivo in recent years. Recent studies have indicated that resistin contributes to the development of insulin resistance and type 2 diabetes mellitus (T2DM) and mediates inflammatory reaction via different signal pathways. As a signal factor between inflammation and metabolism, resistin is expected to provide new insights for the treatment of insulin resistance and T2DM. However, because specific receptor of resistin has not been identified in the body so far, the molecular mechanism of resistin actions is still unclear. In this article, we review the latest progresses of resistin study, especially the role of resistin in insulin resistance and its signaling mechanism.
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Humans , Diabetes Mellitus, Type 2 , Inflammation , Insulin Resistance , Resistin , Signal TransductionABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of Jianpi Liqi Yiliu Formula (JLYF) combined with cytokine-induced killer (CIK) cells for treating patients with advanced hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Between January 2011 and January 2014, 60 advanced HCC patients were enrolled in this study, who were assigned to the treatment group and the control group according to their willingness for taking JLYF, 30 cases in each group. All patients received CIK cell treatment: 1 x 10⁹-3 x 10⁹ each time, by intravenous dripping from the 1st day to the 3rd day, once per day. Besides, patients in the treatment group took JLYF decoction, while those in the control group took Chinese medical decoction by syndrome typing. All patients received treatment of at least two cycles. The time to progression (TTP) , overall survival (OS), disease control rate (DCR), performance status scale (PS), Child-Pugh scale, and adverse reactions were observed, and subgroup analyzed.</p><p><b>RESULTS</b>To May 31, 2014, all patients reached the clinical endpoint. TTP was 3.5 months (95% Cl: 3.30-4.10) in the treatment group, better than that (2.5 months, 95% CI: 2.32-2.68) of the control group (P < 0.05). DCR was 36.7% in the treatment group and 30.0% in the control group (P > 0.05). OS was 5.2 months (95% CI: 4.53-5.87) in the treatment group and 4.6 months (95% CI: 4.06-5.14) in the control group (P > 0.05). The PS scale was 1.60 ± 0.10 after treatment, lower than that (1.80 ± 0.09) before treatment in the treatment group (P < 0.05). When the PS scale was 0-2 or Child-Pugh scale was class A, TTP was longer in the treatment group than in the control group (P < 0.05). No adverse reaction occurred in the two groups during the treatment course.</p><p><b>CONCLUSIONS</b>The combination of JLYF with ClK cell treatment could prolong advanced HCC patients' TTP, improve PS scale, as compared with syndrome typed Chinese medical decoction treatment group. Besides, when the PS scale was 0-2 or Child-Pugh scale was class A, it was a better treatment program for advanced HCC patients.</p>
Subject(s)
Humans , Carcinoma, Hepatocellular , Therapeutics , Cell- and Tissue-Based Therapy , Cytokine-Induced Killer Cells , Cell Biology , Disease Progression , Drugs, Chinese Herbal , Therapeutic Uses , Liver Neoplasms , TherapeuticsABSTRACT
<p><b>OBJECTIVE</b>To assess brush sign (BS) on susceptibility-weighted imaging (SWI) in prediction of hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS) after intravenous thrombolysis(IVT).</p><p><b>METHODS</b>Patients with acute cerebral ischemic stroke, who had major cerebral artery occlusion (internal carotid artery, middle cerebral artery M1 and M2), treated with intravenous recombinant tissue plasminogen activator (rt-PA) from August 2009 to October 2014 in the Second Affiliated Hospital, Zhejiang University School of Medicine, were enrolled in the study. All patients underwent SWI scanning. The asymmetry index (AI) was defined as the difference of intensity between ischemic and normal hemispheres on the SWI phase map; according to AI values patients were divided into 3 groups: BS=0(n=9), BS=1 (n=39) and BS=2 (n=18). The relationships between BS and HT and the clinical outcome among the 3 groups were analyzed.</p><p><b>RESULTS</b>Sixty-six patients aged 68 ± 13 years were included in the study, including 44 males (67%) and 22 females (33%), and 44 (67%) with acute ischemic stroke. The mean pre-treatment National Institutes of Health Stroke Scale (NIHSS) score was 13 (6-17), and the onset to needle time was (252 ± 88) min. Twenty-six (39.4%) patients had HT, including 18 cases (27.3%) with HI and 8 cases (12.1%) with PH; BS was observed more frequently in HT group than non-HT group. Binary logistic regression analysis showed that BS was independently associated with HT of patients with acute ischemic stroke following IVT (OR=2.589, 95% CI: 1.080-6.210, P=0.033). In those without reperfusion after IVT, patients with higher BS grade had higher HT rate (P=0.023).</p><p><b>CONCLUSION</b>Brush sign on SWI can be used for predicting hemorrhagic transformation after intravenous thrombolysis in patients with acute ischemic stroke.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Administration, Intravenous , Brain Ischemia , Diagnosis , Drug Therapy , Carotid Artery, Internal , Pathology , Diagnostic Imaging , Recombinant Proteins , Therapeutic Uses , Stroke , Diagnosis , Drug Therapy , Thrombolytic Therapy , Tissue Plasminogen Activator , Therapeutic Uses , Treatment Outcome , United StatesABSTRACT
<p><b>OBJECTIVE</b>To investigate the cerebral lesions of diffusion weighted imaging (DWI) hyperintensity in patients with subacute stroke with intravoxel incoherent motion (IVIM) technique.</p><p><b>METHODS</b>The clinical data of 20 patients with ischemic stroke (3 to 7 d after onset) who underwent DWI and IVIM scanning between June 2014 and July 2015, were retrospectively analyzed. The parameters from IVIM including slow diffusion coefficient (D), fast diffusion coefficient (D(*)) and perfusion fraction (f) were processed. DWI hyperintensity was segmented by its signal intensity greater than the mean+2 standard deviations of the value in the homologous contralateral region. Then, DWI hyperintensity was classified into two regions of interest (ROIs): infarction core and peri-core with the ADC threshold of 0.55 × 10⁻³ mm²/s. The mirrored ROIs of infarction core and peri-core were also obtained. Then, we measured the values of ADC and D, D(*) and f in these ROIs. The ratios of ADC (rADC), D (rD), D(*) (rD(*)) and f (rf) were also calculated (e.g., rADC=ADCinfarction core/ADCmirrored region).</p><p><b>RESULTS</b>Compared with mirrored region, ADC, D and f in the infarction core region decreased by 45% (P<0.001), 42% (P<0.001) and 32% (P<0.001), respectively; while ADC, D and f in the peri-core region decreased by 22% (P<0.001), 32% (P<0.001) and 8% (P=0.009), respectively. The values of rADC, rD, rD(*) and rf in the infarction core region were significantly lower than those in the peri-core region (all P<0.001). Pearson analysis showed that rADC was positively correlated with rf in the peri-core region (r=0.467, P=0.038).</p><p><b>CONCLUSION</b>During subacute stage of stroke, compared to the infarction core region within DWI hyperintensity, D and f increase in the peri-core region of DWI hyperintensity, reflecting the increased water diffusion in microstructure and perfusion volume in microvasculature. This result shows that the potential reason for the heterogeneous ADC signal is associated with the disappearance of cellular edema and microvascular compensatory with increased blood volume.</p>
Subject(s)
Humans , Diffusion Magnetic Resonance Imaging , Motion , Retrospective Studies , Stroke , Diagnosis , PathologyABSTRACT
<p><b>OBJECTIVE</b>To investigate factors related to hemorrhagic transformation and favorable outcomes in wake-up ischemic stroke (WUIS) patients undergoing intravenous thrombolytic therapy.</p><p><b>METHODS</b>Clinical data of 600 patients undergoing multimodal image-guided intravenous recombinant tissue plasminogen activator (rt-PA) therapy in Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine center from May 2009 to May 2015 were retrospectively analyzed. Among 600 patients, 68 were diagnosed as WUIS including 17 cases aged 80 or older. Hemorrhagic transformation within the first 24 h after thrombolysis was assessed according to ECASS II criteria. Favorable outcome was defined as three-month modified Rankin Scale (mRS) 0-3. Univariate and binary logistic regression were used to analyze the risk factors of hemorrhagic transformation and poor clinical outcomes in WUIS patients.</p><p><b>RESULTS</b>Univariate analysis showed that WUIS patients aged ≥ 80 years had a lower rate in males (41.2% vs 76.5%, P=0.007), smokers (11.8% vs 43.1%, P=0.019) and favorable outcome (52.9% vs 78.4%, P=0.043); and a higher rate of cardiac embolism (64.7% vs 35.3%, P=0.034) compared with those aged <80 years. Binary logistic regression showed that age was not an independent risk factor for favorable outcome (OR=0.524, 95% CI:0.141-1.953, P=0.336) or hemorrhagic transformation (OR=1.039, 95% CI: 0.972-1.111, P=0.262).</p><p><b>CONCLUSION</b>Older age is not related to the favorable outcome or hemorrhagic transformation in WUIS patients undergoing multimodal image-guided intravenous thrombolytic therapy.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Administration, Intravenous , Age Factors , Brain Ischemia , Diagnosis , Drug Therapy , Fibrinolytic Agents , Therapeutic Uses , Recombinant Proteins , Therapeutic Uses , Retrospective Studies , Risk Factors , Stroke , Diagnosis , Drug Therapy , Thrombolytic Therapy , Tissue Plasminogen Activator , Therapeutic Uses , Treatment OutcomeABSTRACT
OBJECTIVE@#To evaluate the effect of down-regulation of Nav1.7 on the activation of astrocytes and microglia in DRG of rats with cancer pain, and explore the transmission of the nociceptive information.@*METHODS@#Lentiviral vector harboring RNAi sequence targeting the Nav1.7 gene was constructed, and Walker 256 breast cancer cell and morphine was injected to build the bone cancer pain model and morphine tolerance model in rats. Lentiviral vector was injected. Rats in each model were divided into 4 groups: model group, PBS group, vehicle group and LV-Nav1.7 group. The expression levels of GFAP and OX42 in dorsal root ganglia (DRG) were measured.@*RESULTS@#After the animal model was built, the level of Nav1.7, GFAP and OX42 was improved obviously with the time prolonged, which was statistically significant (P<0.05). The expression level of GFAP and OX42 in the DRG in the LV-Nav1.7 group declined obviously compared to the model group, PBS group and vehicle group (P<0.05).@*CONCLUSIONS@#Intrathecal injection of Navl.7 shRNA lentiviral vector can reduce the expression of Nav1.7 and inhibit the activation of astrocytes and microglia in DRG. The effort is also effective in morphine tolerance bone cancer pain model rats.