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Objective:To analyze the prognostic factors of patients with Ⅰ B1-Ⅱ A cervical cancers after surgery and to assess the effects and adverse reactions of intensity-modulated radiotherapy(IMRT)combined with concurrent chemotherapy(CCRT). Methods:A retrospective analysis was performed based on the clinical and follow-up data of 362 patients with Ⅰ B1-Ⅱ A cervical cancers who were treated in Changzhou Second People′s Hospital from January 2009 to December 2019. Meanwhile, these patients suffered large primary tumors(LPT; tumors size: ≥4 cm), lymphatic vascular space invasion (LVSI), and deep stromal invasion(DSI; stromal infiltration depth: ≥1/2) after surgery and showed at least one intermediate-risk factor. Among these cases, 161 cases were treated with CCRT, 131 cases under-went single radiotherapy (RT), and 70 cases received unadjuvanted radiotherapy. The Kaplan-Meier method and the logrank test were adopted for univariate survival analysis, the binary logistic regression was used to analyze the recurrence risk, and Cox regression model was used for multivariate survival analysis. Results:The 3 and 5-year overall survival (OS) rates were 94.20% and 88.39%, respectively. The retrospective analysis showed that the risk factors of recurrence included tumor size ≥ 4 cm and poorly differentiated cancers( OR=3.287, 2.870, 95% CI: 1.366-7.905, 1.105-7.457, P<0.05). Compared with the treatment without adjuvant radiotherapy and RT, CCRT reduced the recurrence rate of tumors with tumor size of ≥ 4 cm, adenocarcinomas or adenosquamous carcinomas (pathological types), and poorly differentiated carcinomas( χ2=6.725-7.518, P<0.05). A multivariate analysis showed that the CCRT improved the recurrence-free survival ( HR=0.290, 95% CI: 0.128-0.659, P=0.003) and OS ( HR=0.370, 95% CI: 0.156-0.895, P=0.024). A subgroup analysis indicated that CCRT prolonged the OS of patients with tumor size ≥ 4 cm or poorly differentiated cancers compared to the patients receiving no radiotherapy or those treated with RT (χ 2=7.614, 5.964, P<0.05). Compared with the cases receiving single radiotherapy, those receiving CCRT did not suffer an increase in the incidence of hematology, radiation enteritis, and cystitis above grade 3 according to observation ( P>0.05). Conclusions:Among the intermediate-risk factors leading to the recurrence of postoperative cervical cancers, the factors of large primary tumors or poorly differentiated cancers affect the prognosis of patients.Compared with RT and the treatment without adjuvant radiotherapy, IMRT combined with concurrent chemotherapy can prolong the recurrence-free survival and overall survival of patients with large tumors or poorly differentiated cancers and adverse reactions induced are tolerable.
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Objective The three-dimensional (3D) solid model of medulla oblongata-upper cervical spinal cord based on specimen pathological section data was established, and the stress and strain levels of medulla oblongata-upper cervical spinal cord under dentate process compression were obtained by finite element analysis, so as to provide references for clinical research. Methods Mimics was used to process the slice data, so as to establish the point cloud model. SolidWorks was used to locate, edit and optimize the point cloud model, so as to establish the 3D solid model. HyperMesh was used to establish the finite element model and ANSYS was used for finite element analysis. Results The medulla oblongata-upper cervical spinal cord model with clear boundary between gray matter and white matter and white matter fiber bundle was established. The stress and strain levels and stress-strain curves of white matter and gray matter under different compression degrees were obtained. Conclusions Combined with pathological sections of specimens and reverse engineering, the 3D medulla oblongata-upper cervical spinal cord model with clear morphology and structure of gray/white matter can be established. When the medulla oblongata-upper cervical spinal cord is compressed, the stress level of gray matter is lower than that of white matter, and about 20% of compression is the critical state of white matter. When the disease develops beyond the critical state, the biomechanical properties of white matter may fail, resulting in gray matter damage.
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Objective: To evaluate the relationship between the brain glucose metabolism and left ventricular function parameters, and to explore the cerebral glucose metabolism reduction regions in patients with ischemic heart disease (IHD). Methods: A total of 110 consecutive IHD patients who underwent gated (99)Tc(m)-sestamibi (MIBI) SPECT/CT myocardial perfusion imaging, gated (18)F-fluorodeoxyglucose (FDG) PET/CT myocardial and brain glucose metabolic imaging within three days in Beijing Anzhen Hospital from April 2016 to October 2017, were enrolled in this study. Left ventricular functional parameters of SPECT/CT and PET/CT including end-diastolic volume (EDV), end-systolic volume (ESV) and left ventricular ejection fraction (LVEF) were analyzed by QGS software. Viable myocardium and myocardial infarction region were determined by 17-segment and 5 score system, and the ratio of viable myocardium and scar myocardium was calculated. According to the range of viable myocardium, the patients were divided into viable myocardium<10% group (n=44), viable myocardium 10%-<20% group (n=36) and viable myocardium≥20% group (n=30). Pearson correlation analysis was used to analyze the correlation between the range of viable myocardium and scar myocardium and the level of cerebral glucose metabolism. Brain glucose metabolism determined by the mean of standardized uptake value (SUV(mean)) was analyzed by SPM. The ratio of SUV(mean) in whole brain and SUV(mean) in cerebellum were calculated, namely taget/background ratio (TBR). Differences in cerebral glucose metabolism among various groups were analyzed by SPM. Results: There were 101 males, and age was (57±10) years in this cohort. The extent of viable myocardium and the extent of scar, LVEF evaluated by SPECT/CT and PET/CT were significantly correlated with TBR (r=0.280, r=-0.329, r=0.188, r=0.215 respectively,all P<0.05). TBR value was significantly lower in viable myocardium<10% group, compared with viable myocardium 10%-<20% group (1.25±0.97 vs. 1.32±0.17, P<0.05) and viable myocardium≥20% group (1.25±0.97 vs. 1.34±0.16, P<0.05). Furthermore, in comparison with viable myocardium≥20% group, the hypo-metabolic regions of viable myocardium<10% group were located in the precuneus, frontal lobe, postcentral gyrus, parietal lobe, temporal lobe, and so on. Conclusions: There is a correlation between impaired left ventricular function and brain glucose metabolism in IHD patients. In IHD patients with low myocardial viability, the level of glucose metabolism in the whole brain is decreased, especially in the brain functional areas related to cognitive function.
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Aged , Humans , Male , Middle Aged , Brain , Fluorodeoxyglucose F18 , Glucose , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Stroke Volume , Tomography, Emission-Computed, Single-Photon , Ventricular Function, LeftABSTRACT
Objective@#To investigate the adverse events and efficacy in cervical cancer patients receiving intensity modulated radiationtherapy (IMRT) plusbrachytherapy with or without chemotherapy, and to indentify the factors that may affect the prognosis.@*Methods@#In this retrospective analysis, we analyzed the clinical and follow-up data of the 422 cervical cancer patients, who received IMRT plus brachytherapy with or without chemotherapy.Among these patients, 353 cases received concurrent chemoradiotherapy and the other 69 cases received radiotherapy alone. Kaplan-Meier method was utilized to calculate the overall survival (OS) rates. Log-rank-test and Cox regression were performed to executing the univariate and multivariate analysis of the OS, respectively.@*Results@#The rate of complete response (CR) in the patients receiving concurrent chemoradiotherapy was significantly higher than that of the patients who received single radiotherapy (77.6% vs. 65.2%, χ2=4.812, P<0.05). The 1-, 3-, and 5-year OS rates were 93.4%, 79.4%, and 65.0%, respectively. Univariate analysis showed that age, Federation International of Gynecology and Obstetr(FIGO)2009 staging, lymph node metastasis, pathological type, chemotherapy experiences concurrent with radiotherapy, short-term efficiency, and sequential chemotherapy could affect the OS (χ2=6.375-613.123, P<0.05). Multivariate analysis showed that FIGO staging, lymph node metastasis, pathological type, chemotherapy experiences concurrent with radiotherapy, and the short-term efficacy were the independent determinants for the prognosis (χ2=3.930-42.994, P<0.05). For patients with positive pelvic lymph node, there were no statistical differences in the para-aortic lymph node (PALN) metastasis whether undergoing prophylactic extended field irradiation of the PALN or not(PALN metastasis rates: 6.1% vs. 16.8%, P>0.05). The OS for the patients receiving prophylactic extended field irradiation of the PALN was higher than that of patients without prophylactic radiation (χ2=3.953, P<0.05).@*Conclusions@#Cervical cancer patients receiving IMRT plus brachytherapy with or without chemotherapy had achieved promising prognosis. Prophylactic extended field irradiation of the PALN contributed to the improved OS in the patients with pelvic lymph node metastasis. FIGO staging, pathology type, lymph node metastasis, radiotherapy concurrent with chemotherapy or not, and short-term efficiency were independent factors for the prognosis.
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Objective@#To explore the effect of high quality nursing on the salivary fistula of the patients after parotid tumor operation.@*Methods@#August 2015-2017 June, 60 cases of parotid tumor were selected in our hospital for parotid tumor surgery. According to the nursing intervention methods, the observation group and the control group were divided into the observation group and the control group (n=30). The control group (n=30) was given the routine nursing. The nursing satisfaction of the two groups and the incidence of depression and anxiety before and after nursing. as well as the incidence of postoperative salivary fistula were observed.@*Results@#The total satisfaction degree of nursing in the observation group was 96.67% (29/30), the control group was 76.67% (23/30). The total satisfaction degree of nursing in the observation group was significantly higher than that of the control group, and the difference was statistically significant (χ2=17.311 4, P<0.01). After nursing, the Self-rating Depression Scale (SDS) score and the Self-rating Anxiety Scale (SAS) score of the observation group were 10.35±1.65, 13.56±1.44, which were significantly lower than 21.51±2.49, 30.42±3.58 in the control group, and the difference was statistically significant (t=20.463 5, 23.931 6, P<0.01). After nursing, physical function, cognitive function, emotional function, social function and role function score of observation group were 75.2±6.8, 70.2±7.0, 75.6±5.0, 76.8±7.3, 76.4±7.0, which were significantly higher than 60.7±6.7, 51.6±7.3, 60.8±6.2, 61.3±7.4, 61.1±7.4 of control group, the difference was statistically significant (t=8.167 3-10.177 5, P<0.0). The incidence of salivary fistula in the observation group was 10.00% (3/30) which was significantly lower than 43.33 (13/30) of the control group, and the difference was statistically significant (χ2=28.404 5, P<0.05).@*Conclusion@#The application of high quality nursing in postoperative salivary fistula of parotid tumor patients is significant. It can effectively improve the patients′ unhealthy psychological emotion, improve their quality of life and reduce the incidence of complications, which is worthy of clinical promotion.
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Objective@#To observe the pathological response in tumor tissues and the vascular endothelial growth factor (VEGF) changes in serum of patients with esophageal carcinoma receiving radiotherapy or concurrent chemoradiotherapy, and to investigate the relationship between these two factors and the prognosis of these patients.@*Methods@#A total of eighty-nine patients with esophageal carcinoma treating with radiotherapy or concurrent chemo-radiotherapy were prospective included. Gastroscopy and biopsy were performed at 4 week of radiotherapy to assess pathologicalresponse. VEGF serum levels were measured by double antibody sandwich avidin-biotin ELISA prior to, at 4 week of, and 1 week after radiotherapy. The relationship between pathological response in tumor tissues and VEGF serum changes and the prognosis of the patients were analyzed. The survival curve and survival rate were respectively drawn and calculated by the Kaplan-Meier method, and the Log-rank test was used for survival analysis. Multivariate Cox proportional hazard model was used to analyze the prognostic factors.@*Results@#Pathological responses were classified into two degrees: Non-CR responses (22 cases), and CR responses (67 cases). The 1-, 3- and 5-year OS rates in CR group and non-CR group were 77.6%, 46.3%, 35.2% (median OS: 30.0 months, 95%CI 14.3-45.6 months) and 50.0%, 0.0%, 0.0% (median OS: 11.4 months, 95%CI 4.2-18.6 months), respectively, showing that the OS in CR group were significantly higher than that in non-CR group (P<0.001). Meanwhile, the 1-, 3- and 5-year PFS rates in CR group and non-group were 69.7%, 40.9%, 34.3% (median PFS: 21.7 months, 95%CI 13.1-30.3 months) and 36.4%, 0.0%, 0.0% (median PFS: 7.4 months, 95%CI 2.1-12.4 months), respectively, showing that the PFS in CR group was significantly higher than that in non-CR group (P<0.001). VEGF serum changes were classified into three degrees: increased group (16 cases), stable group (43 cases) and decreased group (30 cases). The 1-, 3- and 5-year OS rates in VEGF increased group were 50.0%, 18.8%, 12.5% (median OS: 9.2 months, 95%CI 2.2-17.9 months), respectively, while the 1-, 3- and 5-year OS rates in VEGF stable group were 67.4%, 30.2%, 19.9% (median OS: 19.9 months, 95%CI 14.9-24.9 months), respectively, and the 1-, 3- and 5-year OS rates in VEGF-decreased group were 86.7%, 50.0%, 42.9% (median OS: 28.7 months, 95%CI 5.4-51.2 months), respectively, showing that the OS in VEGF-decreased group was significantly the highest among the three groups (P<0.05). The 1-, 3- and 5-year PFS rates in VEGF-increased group were 43.8%, 12.5%, 0 (median PFS: 8.0 months, 95%CI 2.5-15.9 months), respectively, while the 1-, 3- and 5-year PFS rates in VEGF stable group were 57.1%, 26.2%, 20.8% (median PFS: 15.5 months, 95%CI 10.7-20.4 months), respectively, and the 1-, 3- and 5-year PFS rates in VEGF decreased group were 76.7%, 46.7%, 39.7% (median PFS: 20.1 months, 95%CI 2.4-40.1 months), respectively, showing that the PFS in VEGF decreased group was significantly the highest among the three groups (P=0.013).@*Conclusions@#Pathological response and VEGF changing trend during radiotherapy were both closely related to prognosis of patients with esophageal carcinoma.@*Trial registration@#This clinical trial was registered in the United States Trial, ID: NCT01551641
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Objective To investigate the mechanism that receptor activator of NF-κB ligand (RANKL) promotes arterial calcification.Methods Firstly,RANKL was added into the culture media,in which the monocyte precursor cells alone were cultured.Morphological observation and tartrate resistant acid phosphatase(TRAP)stain were used to assess whether RANKL could induce the monocyte precursor cells to differentiate into osteoclast-like cells.During arterial calcification,both in vivo and in vitro expressions of RANKL and osteoprotegerin (OPG,as RANKL inhibitor)were measured via real-time PCR.The extent of osteoclast-like cell differentiation was also assessed.Results It was found that RANKL could induce osteoclast-like cell differentiation.There were no both in vivo and in vitro expressions of osteoclast-like cells in the early stage of calcification.At that time,the ratio of RANKL to OPG was very low.In the late stage of calcification,a small amount of osteoclast-like cell expression coincided with a relatively high ratio of RANKL to OPG.According to the results,the ratio of RANKL to OPG was very low during most of the arterial calcification period.This made it possible for OPG to completely inhibit RANKL-induced osteoclast-like cell differentiation.The ratio of RANKL to OPG was (0.36 ± 0.08) (F =36) and (1.68 ± 0.08) (F =36) respectively in the early and late subgroup of calcification group in the animal model,but was zero in the control group(both P＜0.05).The ratio of RANKL to OPG was(0.42±0.09) (F=16)and(1.50 ± 0.10)(F=16)respectively in the early and late subgroup of calcification group in the cell model,but was zero in the control group(both P＜0.05).Conclusions Our result likely explains why RANKL has the ability to induce osteoclast-like cell differentiation,but acts as a promoter of calcification.
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Objective To observe the effect of yang-supplementing moxibustion in improving the muscular spasm, motor function, and activities of daily living (ADL) of patients with post-stroke hemiplegia.Method Totally 120 patients with post-stroke limb spasm due to qi deficiency and blood stagnation were randomized into group A, B, and C, 40 cases in each group. Group C was intervened by conventional treatment, group A was by yang-supplementing moxibustion in addition to the conventional treatment, and group B was by fire therapy in addition to the conventional treatment. The modified Ashworth Scale (MAS), Fugl-Meyer Scale (FMS), and Barthel Index (BI) were observed before and after intervention.Result Respectively after 1-month and 2-month treatment, the MAS, FMS, and BI scores were significantly different from that before intervention in the 3 groups (P<0.01). After 1-month and 2-month treatment, the MAS, FMS, and BI scores in group A were significantly different from that in group B and group C (P<0.05), and the scores in group B were significantly different from that in group C (P<0.05).Conclusion Yang-supplementing moxibustion can effectively improve the post-stroke limb spasm, and can promote the recovery of motor function.
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Objective To observe the clinical efficacy of yang-supplementing fire moxibustion in treating chronic obstructive pulmonary disease (COPD) in stable stage. Method Totally 120 COPD patients of yang deficiency type in stable stage were divided into 3 groups by the random number table, a yang-supplementing fire moxibustion group (yang-supplementing group), a dry mild moxibustion group (mild moxibustion group), and a regular Western medication group (regular group), 40 cases in each group, and 30-day treatment was taken as a course. They were treated and observed for a course, followed by a 3-month follow-up study. The pulmonary function indexes, yang-deficiency signs, quality of life, and comprehensive therapeutic efficacy were observed in the three groups. Result After treatment, the pulmonary function indexes, yang deficiency signs, quality of life, and comprehensive therapeutic efficacy were significantly improved in the three groups (P<0.01); the percent of predicted forced expiratory volume in one second (FEV1%) and yang deficiency signs were significantly improved after intervention in the mild moxibustion group (P<0.05); meanwhile, the quality of life was also significantly improved after intervention in the mild moxibustion group and regular group (P<0.01); the therapeutic efficacy of the yang-supplementing group was better than that of the mild moxibustion group and regular group, and the efficacy of the mild moxibustion group was better than that of the regular group. Conclusion Yang-supplementing fire moxibustion can improve the pulmonary function, postpone the progressive decrease of pulmonary function, significantly improve the yang deficiency constitution, enhance the quality of life and comprehensive therapeutic efficacy in treating yang-deficient COPD patients in stable stage.
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Osteoclast-like cells are known to inhibit arterial calcification. Receptor activator of NF-κB ligand (RANKL) is likely to act as an inducer of osteoclast-like cell differentiation. However, several studies have shown that RANKL promotes arterial calcification rather than inhibiting arterial calcification. The present study was conducted in order to investigate and elucidate this paradox. Firstly, RANKL was added into the media, and the monocyte precursor cells were cultured. Morphological observation and Tartrate resistant acid phosphatase (TRAP) staining were used to assess whether RANKL could induce the monocyte precursor cells to differentiate into osteoclast-like cells. During arterial calcification, in vivo and in vitro expression of RANKL and its inhibitor, osteoprotegerin (OPG), was detected by real-time PCR. The extent of osteoclast-like cell differentiation was also assessed. It was found RANKL could induce osteoclast-like cell differentiation. There was no in vivo or in vitro expression of osteoclast-like cells in the early stage of calcification. At that time, the ratio of RANKL to OPG was very low. In the late stage of calcification, a small amount of osteoclast-like cell expression coincided with a relatively high ratio of RANKL to OPG. According to the results, the ratio of RANKL to OPG was very low during most of the arterial calcification period. This made it possible for OPG to completely inhibit RANKL-induced osteoclast-like cell differentiation. This likely explains why RANKL had the ability to induce osteoclast-like cell differentiation but acted as a promoter of calcification instead.
Subject(s)
Animals , Male , Rats , Acid Phosphatase , Genetics , Metabolism , Aorta , Metabolism , Pathology , Cell Differentiation , Coculture Techniques , Gene Expression Regulation , Isoenzymes , Genetics , Metabolism , Monocytes , Cell Biology , Metabolism , Myocytes, Smooth Muscle , Metabolism , Pathology , Osteoclasts , Metabolism , Pathology , Osteoprotegerin , Genetics , Metabolism , RANK Ligand , Genetics , Metabolism , Pharmacology , Rats, Sprague-Dawley , Signal Transduction , Tartrate-Resistant Acid Phosphatase , Vascular Calcification , Genetics , Metabolism , PathologyABSTRACT
Objective To optimize the method for radiotherapy target delineation after breast cancer surgery, and to observe its advantage in raising work efficiency. Methods Ten physicians in our department were selected, and 20 patients who received breast?conserving surgery were randomly selected. The 10 physicians delineated the targets for these patients with the method in the control group and the method in the study group, and the time required for each delineation was recorded. The method in the control group was commonly used in daily practice and the method in the study group was optimized. The independent?samples t test was applied to compare the differences between the two groups. Results With the optimized method, the average time of delineation in the study group was less than that in the control group ( 51 min vs. 65 min, P=0. 029) . The time curves for delineation in the control group were relatively flat;the time curves for delineation in the study group were high at first, then decreased gradually, and finally became flat. The time for each physician to finish delineation skillfully was relatively stable, while in the study group, the time started to decrease after delineation for the first few patients, with an apparent learning process. Conclusions The optimized method for target delineation in breast cancer is feasible, reliable, and easy to master, and can increase work efficiency, which is more obvious in physicians with rich experience in delineation.
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Objective To observe the clinical efficacy of yang-supplementing moxibustion in treating cancer-induced fatigue of yang-deficiency type. Method Seventy-five patients with cancer-induced fatigue of yang-deficiency type were randomized into 3 groups by using random number table: yang-supplementing fire moxibustion group, fire therapy group, and a conventional control group, 25 patients in each group. The improvements of fatigue, quality of life and traditional Chinese medicine (TCM) syndrome were observed. Result The three treatment protocols were all effective in improving fatigue, quality of life and TCM syndrome, and the effects of yang-supplementing fire moxibustion were more significant than the other two treatments, and that of fire therapy group was superior to that of the conventional control group. Conclusion Yang-supplementing fire moxibustion can effectively improve fatigue, yang-deficiency symptoms, and the quality of life in cancer-induced fatigue of yang-deficiency type.
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Objective:Combining the reality of school, to explore the method of training on the implementation of the outstanding doctor education.Methods: Deepening the reform of teaching, curriculum integration, constructing reasonable curriculum system, strengthen the innovation ability and practice ability, build a outstanding doctor training system, revision of the talent training scheme, the implementation of outstanding physician education program.Results:in our school outstanding doctor the actual situation of the education training, and further analysis and research, explore the method of training on the implementation of the outstanding doctor education.Conclusion: by deepening the reform of teaching, constructing curriculum system, strengthen the innovation ability and practice ability, build a outstanding doctor training system, revision of the talent training scheme, the implementation of outstanding physician training plan, so the method of training on the implementation of the outstanding doctor education is feasible.
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Objective To establish the chip technology‐based real‐time PCR (RT‐PCR) platform and to apply it in the viral loads detection of HIV‐1 and HCV .Methods Based on the primers designed to aim at the conversed regions of HIV‐1 and HCV , The gene chip tube was prepared ,and the RT‐PCR reaction system was established for the simultaneous determination of viral loads .And the melting curves were used to distinguish viral species .The sensitivity and specificity of the method were estimated , and performance of the method was verified by using clinical samples .Results The specificity of the method was good .The lowest detectable limit of the detection method of HCV and HIV‐1 was 1 × 103 copy/mL .The clinical samples with viral loads around 1 × 103 -1 × 106 copy/mL could be detected accurately .Conclusion The method provides a new idea for the detection of HCV and HIV‐1 .
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Objective To study the radioseusitization effect of gold nanoparticles modified by sodium glycididazole.Methods The sodium glycididazole was connected to gold nanoparticle,in dimension of about 18 nm,that had been modified with polyethylene glycol.The nanoparticle-swallowing efficiency of lung adenocarcinoma A549 cells was observed by a scanning electron microscope.Cells were divided into four groups:sodium glycididazole group,gold nanoparticles group,sodium glycididazole-gold nanoparticles group,and no drug control group.The radiosensitivity was detected by MTT and colony formation assays.Results Sodium glycididazole-gold nanoparticles could enter the cell cytoplasm and nucleus.The concentration of 0.003 mg/ml gold nanoparticles and sodium glycididazole-gold nanoparticles had no obvious cytotoxic effect.After irradiation of 2,4,6,8 Gy,the cell survival of the sodium glycididazole-gold nanoparticle group was significantly lower than that of the other three groups (F =4.8,14.5,5.7,7.6,P ＜0.05) and the D0 and Dq values of the sodium glycididazole-gold nanoparticle group were significantly lower than those of other three groups.Conclusion Sodium glycididazole-gold nanoparticles can enhance the radiosensitivity of lung adenocarcinoma cells.
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Recent studies showed that activation of Wnt/β-catenin pathway promoted the differentiation of osteoblast-like cells in the arterial calcification, but its mechanism remains unknown. In this study, the hypothesis that Wnt/β-catenin pathway promotes the differentiation of osteoblast-like cells by upregulating the expression of receptor activator of NF-κB ligand (RANKL) was examined. LiCl was used to activate the Wnt/β-catenin pathway. The differentiation of osteoblast-like cells was observed by Von Kossa staining, calcium content assay, alkaline phosphatase (ALP) activity assay, and detection of osteocalcin expression. Real-time PCR was performed to detect the expression of RANKL and osteoprotegerin (OPG, the decoy receptor of RANKL) during the osteoblast-like cell differentiation. Different concentrations of OPG were added to the culture media respectively to inhibit the function of RANKL, and the change in the differentiation of osteoblast-like cells was evaluated. The results showed that when the Wnt/β-catenin pathway was activated by LiCl, the expression of RANKL was significantly increased, which coincided with the differentiation of osteoblast-like cells (P<0.05), and the OPG treatment could partly attenuate the promoting effect of Wnt/β-catenin pathway on the differentiation of osteoblast-like cells (P<0.05), but it failed to completely abolish such effect. It was concluded that activation of Wnt/β-catenin pathway promotes the differentiation of osteoblast-like cells by both RANKL-dependent and RANKL-independent mechanisms.
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Recent studies showed that activation of Wnt/β-catenin pathway promoted the differentiation of osteoblast-like cells in the arterial calcification, but its mechanism remains unknown. In this study, the hypothesis that Wnt/β-catenin pathway promotes the differentiation of osteoblast-like cells by upregulating the expression of receptor activator of NF-κB ligand (RANKL) was examined. LiCl was used to activate the Wnt/β-catenin pathway. The differentiation of osteoblast-like cells was observed by Von Kossa staining, calcium content assay, alkaline phosphatase (ALP) activity assay, and detection of osteocalcin expression. Real-time PCR was performed to detect the expression of RANKL and osteoprotegerin (OPG, the decoy receptor of RANKL) during the osteoblast-like cell differentiation. Different concentrations of OPG were added to the culture media respectively to inhibit the function of RANKL, and the change in the differentiation of osteoblast-like cells was evaluated. The results showed that when the Wnt/β-catenin pathway was activated by LiCl, the expression of RANKL was significantly increased, which coincided with the differentiation of osteoblast-like cells (P<0.05), and the OPG treatment could partly attenuate the promoting effect of Wnt/β-catenin pathway on the differentiation of osteoblast-like cells (P<0.05), but it failed to completely abolish such effect. It was concluded that activation of Wnt/β-catenin pathway promotes the differentiation of osteoblast-like cells by both RANKL-dependent and RANKL-independent mechanisms.
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Animals , Rats , Cell Differentiation , Cells, Cultured , Osteoblasts , Metabolism , Osteogenesis , RANK Ligand , Metabolism , Signal Transduction , Wnt Signaling Pathway , beta Catenin , MetabolismABSTRACT
<p><b>BACKGROUND</b>Contrast induced acute kidney injury (CIAKI) is an important complication in the use of iodinated contrast media (CM). Our study was to evaluate the neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C for early diagnosis of CIAKI.</p><p><b>METHODS</b>The patients with established or suspected coronary artery disease (CAD) with the estimated glomerular filtration rate (eGFR) was more than 30 ml × min(-1) × 1.73 m(-2) and nor more than 90 ml × min(-1)× 1.73 m(-2) were continuously enrolled. The blood samples of the first 50 patients were obtained before and at 2, 4, 8, 24 and 48 hours after procedure to identify the time points at which the biomarkers reached peaks and at which the blood samples of the rest of patients were obtained. The plasma NGAL and cystatin C measure used enzyme-linked immunosorbent assay (ELISA) kit. The diagnostic characteristics of absolute and relative increasing NGAL and cystatin C for CIAKI were evaluated.</p><p><b>RESULTS</b>Total 311 patients were enrolled, among whom 39 (12.5%) developed CIAKI. Plasma NGAL increased at 2 hours and reached peak at 4 hours after procedure, while plasma cystatin C increased at 2 hours and reached peak at 24 hours after procedure. Thus, we determine rational point of time at 4 hours for NGAL and at 24 hours after procedure for cystatin C, respectively. The plasma NGAL at 4 hours after CM exposure showed largest area under curve (AUC) of 0.662 (95% confidence interval (CI): 0.565 - 0.758, P = 0.002) with 51.5% sensitivity and 80.6% of specificity. The relative increasing 25% of NGAL showed the best sensitivity and specificity of 0.872 and 0.808, respectively, with maximum Youden index of 0.680, while cystatin C with relative increasing more than 25% had 76.9% of sensitivity and 81.2% of specificity. Combined two biomarkers might get more than 90% of specificity.</p><p><b>CONCLUSIONS</b>Single measurement of NGAL or cystatin C had poor sensitivity and specificity; however, the relative increasing 25% of NGAL at 4 hours after CM exposure demonstrated higher diagnostic values for CIAKI. Combining relative increasing plasma NGAL with relative increasing plasma cystatin C might perform better for early diagnosis of CIAKI.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Acute Kidney Injury , Blood , Diagnosis , Acute-Phase Proteins , Angioplasty, Balloon, Coronary , Biomarkers , Blood , Contrast Media , Creatinine , Blood , Cystatin C , Blood , Lipocalin-2 , Lipocalins , Blood , Proto-Oncogene Proteins , Blood , Renal InsufficiencyABSTRACT
<p><b>BACKGROUND</b>The radial approach has been increasingly used as an alternative to femoral access. And more procedures using repeated transradial coronary intervention (r-TRI) are performed. However, few data about r-TRI has been obtained. Therefore, we investigated the safety and feasibility of r-TRI using the same route.</p><p><b>METHODS</b>A total of 423 consecutive eligible patients undergoing r-TRI were enrolled in the r-TRI group, and 846 patients with initial TRI (i-TRI) were assigned to the i-TRI group in a 2:1 matching ratio compared to r-TRI group. The primary endpoint included the success rate of the procedure and the incidence of vascular related complications.</p><p><b>RESULTS</b>The baseline clinical characteristics in the two groups were comparable. The success rate of procedures in the r-TRI and i-TRI was similar (96.0% vs. 97.5%, P = 0.130). In subgroup analysis (coronary angiography only or angiography with pecutaneous coronary intervention), similar results were also observed. The puncture numbers and incidence of radial artery spasm in the r-TRI group were significantly higher than in the i-TRI group (P = 0.024 and P < 0.001, respectively). The other procedural outcomes in the two groups were identical. With respect to the incidence of overall vascular related complication and independent events, there were no significant differences in spite of a higher incidence of radial artery occlusion (RAO) in the r-TRI group (RAO: 1.2% vs. 0.7%, P = 0.521). The patients in the i-TRI group had more comfortable feeling than patients in the r-TRI group (P = 0.001).</p><p><b>CONCLUSIONS</b>R-TRI produces a comparable procedure success rate and incidence of vascular complication when compared to i-TRI. It should be considered as an acceptable and safe procedure.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Angioplasty, Balloon, Coronary , Methods , Coronary AngiographyABSTRACT
Objective To establish a rabbit model of radiation-induced skeletal muscle injury in order to study the ultrastructural pathological changes and underlying mechanism.Methods 28 New Zealand rabbits were randomly divided into 2 groups with 16 rabbits in experimental group and 12 rabbits in control group.The experimental rabbits were irradiated on hip with a single dose of 80 Gy of 9 MeV electrons from a linear accelerator.1 month and 6 months after irradiation the pathological changes were respectively observed under light microscope and electron microscope.Results One month after irradiation,the morphologic changes including degeneration,necrosis of muscle cells,and hemorrhage between the muscle cells were observed under light microscope and the swelling of myofibrillae,blurring of light and shade band,vacuolar degeneration of mitochondria and amorphous areas of necrosis were observed under electron microscope.Six months after irradiation,the morphologic changes of nucleolus chips,fibrous connective tissue,thickening of vascular wall and vascular congestion between the muscle cells and the amorphous areas of necrosis in the experimental group were much more serious than those of 1 month after irradiation.In addition,the myofilaments were lost in degeneration areas and the sarcomere became shorten.Observation with electron microscope showed that the mitochondrial size and its morphological changes were varied and the amounts of collagen between myofibrillaes were increased 6 months after irradiation.Conclusions A rabbit model of high-dose irradiated skeleton muscle injury was successfully established with a single dose of 80 Gy of 9 MeV electrons from a linear accelerator.The degeneration and necrosis of muscle cells may be promoted by mitochondrial and vascular injury,degeneration of vessel and nerve fiber.