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Objective:To detect the expression of long non-coding RNA (LncRNA) ARAP1-AS1 in pancreatic cancer, and to preliminarily explore its effects on the biological behaviors of proliferation, apoptosis, migration and invasion of pancreatic cancer cell.Methods:The pancreatic cancer tissue specimens and corresponding paracancerous tissue specimens of 25 patients were collected, and the expression of ARAP1-AS1 was detected by qPCR. Human pancreatic cancer cell line PANC-1 was cultured in vitro and divided into control group, siRNA-control group (transfected with siRNA control sequence), knockout group (transfected with ARAP1-AS1 siRNA), pcDNA3.1-control group (transfected with pcDNA3.1) and overexpression group (transfected with pcDNA3.1-ARAP1-AS1), qPCR method was used to detect the transfection efficiency, CCK-8 method was used to detect the cell proliferation ability, flow cytometry was used to detect the cell apoptosis, scratch test was used to detect the cell migration ability, Transwell method was used to detect the cell invasion ability, Western blot (WB) method was used to detect the expression of proliferating cell nuclear antigen (PCNA), B lymphoma-2 protein (Bcl-2), Bcl-2 related X protein (Bax), matrix metalloproteinase-9 (MMP-9) proteins.Results:The expression level of ARAP1-AS1 in pancreatic cancer tissues was significantly higher than that in adjacent tissues (2.26±0.13 vs 1.00±0.00) ( P<0.05). Compared with the siRNA-control group, the ARAP1-AS1 level (1.01±0.02 vs 0.29±0.03), PCNA, Bcl-2, MMP-9 protein levels, cell OD value (0.57±0.05 vs 0.23±0.03), scratch healing rate (78.53±7.02 vs 48.60±5.26), and number of invasions (229.63±22.59 vs 104.25±15.04) in PANC-1 cells of the knockout group were significantly reduced ( P<0.05), the Bax protein level and the apoptosis rate (4.52±0.42 vs 32.40±1.84) were significantly increased ( P<0.05). Compared with the pcDNA3.1-control group, the ARAP1-AS1 level (1.02±0.03 vs 2.06±0.08), PCNA, Bcl-2, MMP-9 protein levels, cell OD value (0.57±0.05 vs 0.90±0.08), scratch healing rate (77.65±6.67 vs 91.22±7.34), and number of invasions (225.34±19.65 vs 327.50±25.40) in PANC-1 cells of the overexpression group were significantly increased ( P<0.05), the Bax protein level and the apoptosis rate (4.58±0.48 vs 2.29±0.24) were significantly reduced ( P<0.05) . Conclusion:LncRNA ARAP1-AS1 is highly expressed in pancreatic cancer, which can promote the proliferation, migration and invasion of pancreatic cancer cells PANC-1, and reduce cell apoptosis.
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Objective:To investigate the performance of optical surface imaging (OSI) in the postmastectomy radiotherapy setup and to assess the effects of 3D printed silicone bolus on OSI detection precision.Methods:A retrospective analysis was conducted for 16 patients treated with left-sided postmastectomy radiotherapy (PMRT) in West China Hopital, Sichuan University from January to April, 2021. The setup errors of 16 patients without bolus detected using OSI (OSI no-bolus, OSI n) were obtained before error correction was conducted using cone-beam CT (CBCT). The correlation between OSI n and CBCT was analyzed, and then the diagnostic efficacy of OSI was assessed using the receiver operating characteristic (ROC) curves. The setup errors of six patients with 3D printed silicone bolus detected using OSI (OSI bolus, OSI b) were obtained through off-line image registration, and then the detection precision of OSI n and OSI b in the translational directions was compared. Results:The setup errors in the case of OSI n were highly correlated with CBCT in the translational direction ( r ≥ 0.80), but were weakly correlated in the rotation direction ( r < 0.40). In the ROC analysis, the area under the curve (AUC) in the y direction was the lowest and was in the order of AUC 5 mm ≥AUC 3 mm > 0.75 for any translational direction. The difference in the detection precision between OSI n and OSI b was not statistically significant in the x and z directions ( P > 0.05), but was statistically significant in the y direction ( Z = -2.56, P = 0.01). In the y direction, the systematic error of detection precision in the case of OSI b was 3.11 mm higher than that in the case of OSI n, and the random error of detection precision in the case of OSI b was 1.9 mm higher than that in the case of OSI n. Conclusions:OSI cannot yet substitute CBCT in the postmastectomy radiotherapy setup, but its detection error is still within the clinically acceptable range. The performance of OSI-assisted setup is expected to be further improved by mitigating the interference of factors such as bolus in the imaging path through operational training.
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Objective To evaluate the clinical efficacy of adult kidney transplantation from unilateral pediatric donor kidney. Methods Clinical data of pediatric donors (n=10) and adult recipients (n=19) undergoing kidney transplantation were retrospectively analyzed. The changes of renal function, liver function and the maximal diameters of the kidney allografts were compared at 1, 7, 14, 28, 60 d after operation. The short-term survival and incidence of postoperative complications of the recipients were analyzed. Results Ten donors included 6 males and 4 females, aged (7±3) years old, with a body mass index (BMI) of (16.3±3.8) kg/m2. All donors were donation after brain death followed by cardiac death. Among 19 recipients, 12 were males and 7 were females, aged (34±12) years old, with a BMI of (20.3±1.3) kg/m2.An oblique incision was created in the lower right abdomen of the recipients. The arteries and veins of donor kidney were anastomosed with the external iliac arteries and veins of the recipients. The ureter of donor kidney was anastomosed with the bladder of the recipients. After anastomosis, the kidney was placed and fixed in the right iliac fossa. The serum creatinine and blood urea nitrogen levels of the recipients were decreased at 1 week after kidney transplantation, and restored to normal range at postoperative 2 weeks. All parameters related to liver function were normal after operation. At postoperative 1 month, the maximal diameters of the kidney allografts were (9.5±0.3) cm on average, which basically reached those of normal adults. The 1-year survival rate of 19 recipients was 95%. One recipient died from pulmonary infection after ineffective treatment. Two recipients developed rejection, and 1 recipient experienced urinary system infection, who were healed after corresponding treatment. Conclusions Adult kidney transplantation from unilateral pediatric donor kidney is safe, feasible and effective, which can be utilized to enlarge the source of donor kidneys.
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【Objective】 To investigate the effects of atosiban combined with ritodrine hydrochloride on clinical efficacy， serological indicators and maternal and infant outcomes of patients with threatened premature delivery. 【Methods】 A total of 138 patients with threatened preterm delivery in the Department of Obstetrics and Gynecology of The First Affiliated Hospital of Air Force Military Medical University from June 2018 to June 2020 were collected and divided into two groups according to random number table method， with 69 patients in the control group treated with ritodrine hydrochloride and 69 patients in the study group treated with atosiban on the basis of the control group. Clinical efficacy， changes in serological indicators， maternal and child outcomes， and drug safety were compared between the two groups. 【Results】 There were 65 effective cases in the study group （94.20%） and 56 effective cases in the control group （81.16%）. There were statistically significant differences between the two groups （P0.05）. After treatment， timp-1， il-8， il-6， NO and PGE2 levels in the study group were significantly lower than those in the control group （P<0.05）. The success rate of fetal preservation， gestational age， neonatal weight and Apgar score were significantly higher in the study group than in the control group， while the rate of premature delivery was significantly lower than that in the control group （P<0.05）. The incidence of drug-induced adverse reactions （5.80%） was significantly lower in the study group than in the control group （26.09%） （P<0.05）. 【Conclusion】 Atosiban combined with ritodrine hydrochloride can effectively prolong pregnancy， reduce the level of serological indicators， improve maternal and infant outcomes， with fast effect， safe and significant efficacy. Therefore， it is worthy of application and promotion in the treatment of patients with threatened premature delivery.
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Patient-specific volumetric modulated arc therapy (VMAT) quality assurance (QA) process is an important component of the implementation process of clinical radiotherapy. The tolerance limit and action limit of discrepancies between the calculated dose and the delivered radiation dose are the key parts of the VMAT QA processes as recognized by the AAPM TG-218 report, however, there is no unified standard for these two values among radiotherapy centers. In this study, based on the operational recommendations given in the AAPM TG-218 report, treatment site-specific tolerance limits and action limits of gamma pass rate in VMAT QA processes when using ArcCHECK for dose verification were established by statistical process control (SPC) methodology. The tolerance limit and action limit were calculated based on the first 25 in-control VMAT QA for each site. The individual control charts were drawn to continuously monitor the VMAT QA process with 287 VMAT plans and analyze the causes of VMAT QA out of control. The tolerance limits for brain, head and neck, abdomen and pelvic VMAT QA processes were 94.56%, 94.68%, 94.34%, and 92.97%, respectively, and the action limits were 93.82%, 92.54%, 93.23%, and 90.29%, respectively. Except for pelvic, the tolerance limits for the brain, head and neck, and abdomen were close to the universal tolerance limit of TG-218 (95%), and the action limits for all sites were higher than the universal action limit of TG-218 (90%). The out-of-control VMAT QAs were detected by the individual control chart, including one case of head and neck, two of the abdomen and two of the pelvic site. Four of them were affected by the setup error, and one was affected by the calibration of ArcCHECK. The results show that the SPC methodology can effectively monitor the IMRT/VMAT QA processes. Setting treatment site-specific tolerance limits is helpful to investigate the cause of out-of-control VMAT QA.
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Humans , Calibration , Quality Assurance, Health Care , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted , Radiotherapy, Intensity-ModulatedABSTRACT
Objective:To explore the causes and precaution procedures of olfactory dysfunction after transsphenoidal surgery for pituitary lesions.Methods:The clinical data of 72 patients underwent transsphenoidal surgery for pituitary lesions in our hospital from November 2016 to May 2018 were summarized. Resection under microscope was performed in 27 patients and resection under endoscope in 45 patients. The olfactory function of patients with postoperative olfactory disorders was evaluated one and 6 months after surgery. Bilateral nasal passages were examined by nasal endoscopy 3-6 months after surgery. Whether intraoperative operations were related to olfactory impairment was analyzed.Results:There were seven hyposmic/anosmic patients; three patients (6.7%) were operated via endoscopic approach and four patients (14.8%) were operated via microscopic transsphenoidal approach; incidence of olfactory dysfunction between the two groups showed no statistical difference ( P>0.05). One month after operation, two patients had a slight decrease in olfactory function, 4 had a severe decrease in olfactory function and one had anosmia. Six months after the operation, two patients with severe hypoxia got improvment, but failed to return to normal level; and the rest of the patients showed no significant improvement. Three-6 months after operation, nasal endoscopic examination found that all patients had healed nasal wound, two patients had large volume of nasal mucus secretion, and 3 patients had postoperative nasal mucosa adhesion. In these 72 patients,cauterization of the mucosa around the sphenoid ostium was performed in 6 patients, placement of the speculum above the sphenoid ostium was performed in 2 patients, and olfactory damage was noted in all the 8 patients. Conclusions:Olfactory dysfunction after transsphenoidal surgery for pituitary lesions is common, and attention should be paid.Placement of the speculum above the sphenoid ostium and cauterization of the mucosa around the sphenoid ostium might be the main reasons for olfactory damage.
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OBJECTIVE： To study the effects of bezafibrate （BEZ） and fenofibrate （FEN） on the proliferation of lung adenocarcinoma PC-9 cells and the expression of c-myc. METHODS： The effects of BEZ and FEN （12.5， 25， 50， 100， 200 μmol/L） on the survival rate of PC-9 cells were detected by CCK8 method. PC-9 cells were divided into administration group and control group. Administration group was given low， medium and high concentration （25， 50， 100 μmol/L） of BEZ and FEN； control group was treated with dimethyl sulfoxide for 48 h. Cell cycle distribution and apoptosis were detected by flow cytometry. qRT-PCR was used to detect mRNA relative expression of c-myc in cells. The protein relative expression of c-myc in cells were detected by Western blot assay. RESULTS： The survival rates of PC-9 cells were （80.76±3.2）％， （74.35±5.06）％， （62.8±1.23）％， （59.03±1.55）％， （39.8±1.01）％ under the action of above concentration of BEZ； and the survival rates of PC-9 cells were （74.46±1.30）％， （61.91±4.77）％， （48.95±2.8）％， （37.05±1.55）％， （32.49±1.36）％ under the action of FEN. Compared with control group， G1 phase cell ratio increased significantly in medium and high concentration groups of BEZ and FEN； the apoptotic rate of PC-9 cells was increased significantly in low， medium and high concentration groups of BEZ and FEN； mRNA and protein relative expression of c-myc were decreased significantly， with statistical significance （P＜0.05）. CONCLUSIONS： BEZ and FEN can inhibit the proliferation of PC-9 cells， and down-regulate c-myc expression.
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Objective@#To understand the microbial pollution of indoor air in colleges and universities, and to provide a reference for controlling microbial pollution and improving indoor air quality.@*Methods@#In November 2018, the air microorganisms in different functional areas and at different times were sampled and cultured in a university in Beijing by Anderson’s six-level sampler.@*Results@#During the test, there were differences in microbial aerosol concentrations in different functional areas and at different times(F=3.99，7.77, P<0.05), the concentration of bacteria in toilets was relatively high, the average concentration was 659 CFU/m3 and the concentration of fungi in the campus was relatively high, the average concentration was 660 CFU/m3; the concentration of bacteria and fungi in the air at 12 o’clock noon was relatively low, the average concentration was 320 CFU/m3 and 322 CFU/m3. The particle size distribution of microorganisms in the air presents roughly the same law, and the peak concentration of microbial concentrations occurs at the Ⅳ and Ⅴ levels (1.1-3.3 μm), in which the highest concentration of bacteria (253 CFU/m3) appears at the Ⅴ level, and the highest concentration of fungi (249 CFU/m3) appears at the Ⅳ level.@*Conclusion@#The microbial concentration in the air of colleges and universities was mainly concentrated in the size of 1.1-3.3 μm, and it was necessary to take targeted comprehensive control measures to effectively improve air quality.
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Objective To compare the early clinical efficacy of renal transplantation between extended criteria donor (ECD) and standard criteria donor (SCD). Methods Clinical data of 85 recipients undergoing renal transplantation from donation after cardiac death (DCD) were retrospectively analyzed. According to the types of donors, all recipients were divided into the ECD group (n=31) and SCD group (n=54). The level of serum creatinine (Scr), incidence of early complications and clinical prognosis within 3 months after renal transplantation were compared between 2 groups. Results No statistical significance was observed in the levels of Scr within 1 month after renal transplantation between the ECD group and SCD group (all P>0.05). At postoperative 60 and 90 d, the level of Scr in the ECD group was (189±97) and (175± 69) μmol/L respectively, significantly higher than (142±49) and (135±41) μmol/L in the SCD group (P=0.005 and 0.002). In the ECD group and SCD group, the incidence of acute rejection (AR) was 6% and 15%, the incidence of delayed graft function (DGF) was 23% and 19%, the incidence of pulmonary infection was 10% and 6%, the incidence of other early complications was 32% and 15%, respectively, no statistical significance was identified (all P>0.05). In the ECD group and SCD group, the survival rate of the recipient was 97% and 94%, the survival rate of the renal was 84% and 91%, no statistical significance was identified (all P>0.05). Conclusions Compared with the SCD, renal transplantation from ECD can achieve equivalent early clinical efficacy. In the present condition of serious deficiency of donor kidney, the application of ECD can enlarge the supply of the donor kidney.
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Objective To summarize the experience of endovascular embolization for the treatment of posterior circulation aneurysms. Methods The clinical and follow-up data of 65 patients with posterior circulation aneurysm treated with endovascular embolization in Jiangmen Central Hospital, Guangdong Province were analyzed retrospectively. Results A total of 65 patients with posterior circulation aneurysm received endovascular embolization in Jiangmen Central Hospital, including 30 females (46.2％) and 35 males (53.8％). Their age ranged from 37 to 76 years old(mean 57.3 ± 10.25).Ruptured aneurysms were found in 57 cases (87.7％) and unruptured aneurysms were found in 8 cases (12.3％). Parent arteries:22 (33.8％) in vertebral artery,23 (35.4％) in basilar artery,3 (9.2％) in posterior cerebral artery,2 (3.1％) in superior cerebellar artery, 2 (3.1％) in anterior inferior cerebellar artery, and 10 (15.4％) in posterior inferior cerebellar artery. Hunt-Hess grade:gradeⅠin 15 cases,gradeⅡin 29 cases,gradeⅢin 11 cases, grade Ⅳ in 6 cases, and grade Ⅴ in 4 cases. Twenty-one patients (32.3％) were treated with coil embolization alone,29 (44.6％) were treated with stent-assisted coil embolization, 6 (9.2％) were treated with stenting alone, and 9 (13.8％) were treated with parent artery embolization. Immediate angiography after surgery revealed that 54 patients (83.1％) were completely embolized, and 11 (16.9％) were not embolized completely. Three patients (4.6％) complicated with cerebral infarction, 2 (3.1％) had intraoperative rupture,2 had respiratory disturbance(3.1％),1 (1.5％) had hoarseness, and 1 had vitreous hemorrhage (1.5％).At discharge,the modified Glasgow outcome scale assessment showed that 53 patients (81.5％) had excellent outcome,5 (7.7％) had good outcome, and 7 (10.8％) had poor outcome. Of the patients with poor outcome, 2 (3.1％) died. Thirty-four patients (52.3％) were followed up by angiography, of whom 6 (17.6％) recurred, and 1 died of complicated cerebral infarction. Conclusion Although endovascular treatment of posterior circulation aneurysms is difficult, flexible selection of endovascular treatment may achieve good therapeutic effect.
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Objective To investigate the efficacy and safety of intravesical instillation with Sufuning (SFN) lotion for prevention of postoperative recurrence of bladder cancer. Methods A total of 240 bladder cancer patients who were diagnosed as bladder cancer and accepted trans-urethral resection of bladder tumor from January 2010 to June 2016 in Shanxi Provincial Cancer Hospital were randomly divided into the experimental group (120 cases) and the control group (120 cases) according to the envelope method. The patients in the experimental group were treated with SFN lotion for immediate intravesical instillation(250 mg for once), and the patients in the control group were treated with pirarubicin (THP) for immediate intravesical instillation (30 mg for once). The patients of two groups were treated with intravesical chemotherapy once a week for 8 times, and the chemotherapy was performed once a month for 1 year. The recurrence rate, progression-free survival (PFS) rate, overall survival (OS) rate and recent side effects were compared between the two groups. Results The patients were followed up for 6 to 60 months. The median follow-up time was 36.5 months.In the experimental group,6 patients were lost and 8 patients were lost in the control group.The experimental group, the total recurrence rate was 26.3 % (30/114). The control group, the overall recurrence rate was 25.0 % (28/112) (χ2= 0.142, P = 0.781). Five years of PFS rate in the experimental group and the control group was 73.7 % (84/114) and 75.0 % (84/112) respectively, and there was no significant difference between the two groups (χ2= 2.011, P= 0.615). Five years of OS rate in the experimental group and the control group was 95.6 % and 92.9 % respectively, and there was no significant difference between the two groups (χ 2= 1.611, P= 0.425). The major side effects included chemical cystitis and hematuria. The incidence of chemical cystitis and hematuria in the experimental group was significantly lower than that in the control group(χ2=5.991,P=0.018;χ2=4.925,P=0.036).There was a statistically significant difference of the hematological side effects (blood routine changes) between the two groups (χ 2= 4.891, P= 0.032). Conclusion It is safe and effective for intravesical instillation of SFN lotion to prevent the recurrence of bladder cancer.
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Objective To investigate the independent association of serum Fetuin-B with metabolic syndrome in obese Chinese adults.Methods Cross-sectional data on socio-demographic,lifestyle,clinical characteristics, and serum Fetuin-B were collected for 1 318 Chinese adults with central obesity.Associations of serum Fetuin-B with metabolic syndrome and insulin resistance were analyzed using multivariable Logistic regression analysis.Results A total of 820(62.2%)individuals were identified as metabolic syndrome.Subjects with metabolic syndrome showed significantly increased levels of serum Fetuin-B than those with non-metabolic syndrome[(4.18 ±1.39 vs 4.02 ± 1.35)μg/ml,P=0.043].Increased serum Fetuin-B were significantly associated with increased fasting plasma glucose and insulin levels, as well as prevalences of non-alcoholic fatty liver disease(NAFLD)and insulin resistance.After adjustment for potential confounders, serum Fetuin-B was significantly associated with increased risks of metabolic syndrome and insulin resistance(OR=1.19,95%CI 1.06-1.34,P=0.004;OR=1.15,95%CI 1.01-1.30,P=0.031 respectively).Conclusion Serum Fetuin-B level was significantly associated with NAFLD;and elevated serum Fetuin-B was significantly associated with increased risk of metabolic syndrome.
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Objective To systematically investigate the prognostic value of preoperative platelet-to-lymphocyte ratio (PLR) in patients with hepatocellular carcinoma (HCC).Methods Medline,EMBASE,Cochrane Library,CNKI,CBM,VIP,and Wanfang Data were searched for studies assessing the association between preoperative PLR and prognosis of HCC published up to January 2017.Two reviewers independently screened the articles according to the inclusion and exclusion criteria,extracted data,and assessed methodological quality,and then a meta-analysis was performed using RevMan 5.3 software.The chi-square test was used for the analysis of heterogeneity between studies.Results A total of 18 articles with 4193 patients were included.The meta-analysis showed that compared with those with low PLR,patients with high PLR had significantly lower overall survival (OS) rate (hazard ratio [HR] =1.74,95％ confidence interval [CI] 1.42-2.14,P ＜ 0.001) and disease-free survival rate or relapse-free survival rate (HR =1.76,95％ CI:1.56-1.98,P ＜0.001).The subgroup analysis revealed that patients with high PLR had significantly shorter OS than those with low PLR,regardless of race (Asian or Caucasian),treatment method (surgery,chemotherapy,or multimodality therapy),sample size (≥200 or ＜ 200),cut-off value of PLR (≥ 150 or ＜ 150),and NOS score (≥7 or ＜ 7) (all P ＜ 0.05).Conclusion High preoperative PLR is closely associated with poor prognosis of HCC patients,suggesting that PLR might be a prognostic factor in HCC patients.
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Objective To systematically investigate the prognostic value of preoperative platelet-to-lymphocyte ratio (PLR) in patients with hepatocellular carcinoma (HCC).Methods Medline,EMBASE,Cochrane Library,CNKI,CBM,VIP,and Wanfang Data were searched for studies assessing the association between preoperative PLR and prognosis of HCC published up to January 2017.Two reviewers independently screened the articles according to the inclusion and exclusion criteria,extracted data,and assessed methodological quality,and then a meta-analysis was performed using RevMan 5.3 software.The chi-square test was used for the analysis of heterogeneity between studies.Results A total of 18 articles with 4193 patients were included.The meta-analysis showed that compared with those with low PLR,patients with high PLR had significantly lower overall survival (OS) rate (hazard ratio [HR] =1.74,95％ confidence interval [CI] 1.42-2.14,P ＜ 0.001) and disease-free survival rate or relapse-free survival rate (HR =1.76,95％ CI:1.56-1.98,P ＜0.001).The subgroup analysis revealed that patients with high PLR had significantly shorter OS than those with low PLR,regardless of race (Asian or Caucasian),treatment method (surgery,chemotherapy,or multimodality therapy),sample size (≥200 or ＜ 200),cut-off value of PLR (≥ 150 or ＜ 150),and NOS score (≥7 or ＜ 7) (all P ＜ 0.05).Conclusion High preoperative PLR is closely associated with poor prognosis of HCC patients,suggesting that PLR might be a prognostic factor in HCC patients.
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Objective To investigate the efficacy of 125I radioactive particle implantation combined with surgery and chemotherapy in the treatment of locally advanced urinary tract urothelial carcinoma (UTUC).Methods The clinical data of 128 patients of locally advanced (T3,T4) UTUC treated with surgery with radioactive particle implantation plus postoperative GC chemotherapy (experimental group) and surgery plus postoperative GC chemotherapy (control group) were retrospectively analyzed.All the patients underwent complete resection of the tumor.The postoperative pathology was urinary tract epithelium cancer.In the experimental group,there were 45 (69.2％) males and 20 (30.8％) females,with median age 56.5 years.There were 39 (60.0％) patients diagnosed with renal pelvic cancer,including 13 (33.3 ％) patients with local lymph node metastasis;26 patients (40.0％) with ureteral cancer,11 patients (42.3％) with local lymph node metastasis.In the control group,there were 46 males (73.0％) and 17 females (27.0％),with median age 57.1 years.There were 40 (63.5％) patients with renal pelvic cancer,including 12 (30％) cases of local lymph node metastasis;23 patients with ureteral carcinoma (36.5％),including 10 patients (43.4％) with local lymph node metastasis.There was no significant difference in basehne data between the two groups (P ＞ 0.05).The recurrence and distant metastasis,recurrence-free survival,distant disease free survival(DDFS),disease-specific survival(DSS),overall survival (OS) and comphcations of two groups were compared.Results The follow-up time was 50.5 months (ranged 5 to 62 months).In experimental group,there were 2 cases,5 cases,11 cases,16 cases and 21 cases occurred recurrence and distant metastasis in 6 months,1 year,2 years,3 years and 5 years respectively,and the 5-year cumulative recurrence and distant rate was 32.3％ (21/65).In control group,there were 3 cases,5 cases,17 cases,21 cases and 32 cases,occurred recurrence and distant metastasis in 6 months,1 year,2year,3 year,5 year respectively,and the 5-year cumulative recurrence and distant rate was 50.8％(32/63).There was significant difference between the two groups (P =0.034).In the experimental group and the control group,the 5-year non-metastatic survival rates were 61.5％ (40/65)and 41.3％ (26/63),respectively.There was significant difference in 5-year non-metastatic survival rate between the two groups (P =0.033).The 5-year DSS rates were 69.2％ (45/65) and 50.8％ (32/63),respectively.The 5-year DSS rate of the two groups was significantly different (P =0.033).The 5-year OS rates were 53.8％ (35/65) and 36.5％ (23/63) respectively.There was significant difference in the 5-year OS rate between the two groups (P =0.049).Condusions Compared with surgery and chemotherapy,the use of 125I radioactive particle implantation combined with surgery and chemotherapy in the treatment of locally advanced stage (T3-T4) UTUC could achieve the total survival benefit,and less adverse reactions.
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Objective To analyze the follow-up results and clinical characteristics of one case of highly sensitized recipient after combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation.Methods This patient was diagnosed as having chronic renal insufficiency in the uremia period 10 years ago,subjected to kidney transplantation 9 years ago,and got renal allograft loss 8 years ago.The recipient was positive for PRA (for class Ⅰ,31％,and for class Ⅱ,63％).Under the general anesthesia,the patient was given combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation.The ATG was used for immune induction.Rituximab and plasma exchange were applied to prevent acute rejection.Regular follow-up was done after discharge.Results On the postoperative day (POD) one,ALT was 256 IU/L,AST was 342 IU/L and serum creatinine was 502 μmol/L.On the POD 6,ALT and AST levels were normal and serum creatinine was 141 μmol/L.Serum creatinine increased to 202 μmol/L and the volume of urine reduced on the POD 7.The ultrasound displayed graft size increased slightly,substantial echogenicity enhanced,artery blood flow RI increased to 0.8,suggesting the occurrence of acute rejection.A single dose of Rituximab,intravenous IG,and plasma exchange were given.On the POD 60,serum creatinine was reduced to 131 μmol/L.During a follow-up period of 28 months,imrnunosuppresants were given:Tac + MMF + Pred.FK506 valley concentration was maintained at 6-8 μg/L.The function of the transplanted kidney and liver was normal,and the general conditions were good.Conclusion Combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation is safe.Individualized medication and regular follow-up are the important factors for long-term survival of recipients.
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Objective To evaluate the effect of hypothermia status in the donors upon the renal graft function after renal transplantation from donation after citizen's death. Methods Thirty-six eligible donors were randomly divided into the normal temperature (body temperature 36.5-37.5 ℃ , n=19) and hypothermia groups (body temperature 34.0-35.0 ℃ , n=17). The matched recipients undergoing renal transplantation were also assigned into the normal temperature (n=38) and hypothermia groups (n=34). Perioperative conditions of the donors and recipients were compared between two groups. And postoperative renal graft function of the recipients were statistically compared between two groups, including the incidence of delayed graft function (DGF) and primary nonfunction (PNF). Results No statistical significance was identified in the perioperative amount of urine volume, serum creatinine (Scr), systolic blood pressure, saturation oxygen, warm ischemia time and cold ischemia time of the donors between two groups (all P>0.05). No statistical significance was noted in terms of the operation time, intraoperative mean blood glucose and intraoperative mean arterial pressure of the recipients between two groups (all P>0.05). Postoperative incidence of DGF of the recipients in the hypothermia group was 6%, significantly lower than that in the normal temperature group (24%) (χ2=4.393, P=0.036). Postoperative incidence of PNF of the recipients was 3% in both the hypothermia and normal temperature groups with no statistical significance (χ2=0.000, P=1). Conclusions The hypothermia status of the donors can significantly reduce the incidence of DGF, whereas exerts no evident effect upon the incidence of PNF in the recipients.
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Objective To investigate the clinical characteristics, prevention and treatment of multi-drug resistant organisms (MDROs) infection early after renal transplantation from donation after citizen's death. Methods Clinical data of 166 patients undergoing allogeneic renal transplantation and regular follow-up in Xijing Hospital from November 2011 to September 2016 were retrospectively analyzed. General conditions were statistically compared between the recipients undergoing renal transplantation from donation after cardiac death (DCD) and their counterparts receiving living related donor renal transplantation. The incidence of MDROs infection, onset time, course of diseases, complications, infection site and etiological type were observed. The therapeutic methods and clinical prognosis were summarized. Results The incidence of MDROs infection early after renal transplantation in the recipients undergoing DCD renal transplantation was 14%, significantly higher than 2% in those receiving living related donor renal transplantation, and 13% and 2% for the incidence of delayed graft function with statistical significance (both P<0.05). The incidence of renal graft loss was 8%and 2%, and 5% and 1% for the mortality rate without statistical significance between two groups (both P>0.05). MDROs infection occurred in 11 patients after DCD renal transplantation. The most common infection site was urinary system(n=6) and the most prevalent pathogenic bacterium was Escherichia coli (n=4). All patients infected with MDROs were treated with a sufficient dosage of effective antibiotics according to the outcomes of bacterial culture and drug sensitivity test. Eight patients obtained favorable clinical prognosis, one underwent nephrectomy and two died. Conclusions The incidence of MDROs infection early after DCD renal transplantation is higher than that after living related-donor renal transplantation. Strict donor screening, early detection, intimate monitoring and timely treatment can effectively reduce the risk of MDROs and enhance clinical prognosis.
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Objective Through analyzing benign and malignant pleural effusion samples by proteomic techniques, finding protein biomarkers to provide help and new clues for effusion differential diagnosis.Methods Two-dimensional electrophoresis(2-DE) and matrix-assisted laser desorption ionization-time of flight-mass spectrometry(MALDI-TOF-MS) were used to search and identify protein biomarkers, enzyme linked immunosorbent assay(ELISA) was to validate the biomarkers.Results By comparing malignant group with benign group, 43 significantly different protein spots(Up or down regulated≥2 times) were found.Including 9 up regulated spots and 34 down regulated spots.And 7 spots were identified(Up or down regulated≥3 times) by MALDI-TOF-MS and validated 2 spots immunoglobulin λ(Igλ) and haptoglobin(Hp) by ELISA.The results showed that Igλ showed no statistical significance between two groups, while Hp showed the statistical significance(P<0.05).The diagnostic sensitivity and specificity of Hp in malignant pleural effusion were 75.00% and 52.38% at diagnostic cut-off point of 389.02 μg/L.Conclusion The application of proteomics technology has a great help with protein biomarkers searching in pleural effusion.HP has a certain value for the differential diagnosis of benign and malignant pleural effusionand and worthy of further study.
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Objective To investigate the effect and potential mechanism of pigment epithelium derived factor(PEDF) acting upon SK-MES-1 cell and human umbilical vein endothelial cells(HUVECs).Methods CCK-8 was used to detect the effect of varying concentrations of PEDF upon HUVECs and SK-MES-1 cell, measuring the degree of cell proliferation and inhibition effect across varying times.The flow cytometry tests were carried out to invest gate the apoptosis of these two kinds of cells when exposed to varying concentration of PEDF.qRT-PCR were carried out to assess the vascular endothelial growth factor(VEGF) gene expression level in these two kinds of cells after treatment of PEDF.Results CCK-8 results revealed that PEDF had a concentration-dependent and time-dependent cell proliferation inhibition effect on SK-MES-1 cell and HUVECs(P<0.05);Flow cytometry showed that the apoptosis of the cells in the treatment group were higher than that of control group(P<0.05), and the apoptosis rate of high concentration group was higher than that of the low concentration group(P<0.05);qRT-PCR results showed that PEDF was able to inhibit expression of mRNA of VEGF in both HUVECs and SK-MES-1 cell compared with control samples(P<0.05).Conclusion The antitumor properties of PEDF is mainly related to the inhibition of tumor angiogenesis and direct effects on tumor cells, the effect of PEDF on HUVECs and SK-MES-1 cell maybe related to the effects of PEDF on downregulating expression of VEGF.