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At present, many treatment options for colorectal cancer, including chemotherapy, targeted therapy and immunotherapy, have poor efficacy due to resistance variation and patient individualization. It is urgent to find new precise and effective treatment measures at this stage. Studies have shown that the pathogenesis and progression of colorectal cancer involve multiple processes such as inflammation, immunity, and cholesterol metabolism, and there are many types of potential interactive reactions. Clarifying the regulatory mechanism of various factors is helpful to provide new ideas for colorectal cancer treatment.
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Objective@#To explore the effects of vascular risk factors on cognitive function among the elderly in community.@*Methods@#A cross-sectional study was conducted in 1 269 elderly people (aged 65 and over) who were randomly selected from three communities.Through face-to-face interview, cognitive function was assessed by mini-mental state examination(MMSE), and blood samples were collected for laboratory examination.Logistic regression analysis was used to analyze the vascular risk factors affecting cognitive function.@*Results@#Age ((73.1±6.6), (71.3±4.9), t=4.603, P<0.05), education level (χ2=12.727, P<0.05), hypertension (χ2=9.106, P<0.05) and LDL-C (χ2=5.157, P<0.05) were significantly different in the elderly with or without mild cognitive impairment(MCI). After controlling age, gender and education, the logistic regression analysis showed that hypertension(β=0.378, P=0.006, OR(95%CI)=1.44(1.10-1.91)), systolic blood pressure ≥140 mmHg(β=0.350, P=0.011, OR(95%CI)=1.42(1.08-1.86), 1 mmHg=0.133 kPa), and high LDL-C(β=0.355, P=0.014, OR(95%CI)=1.43(1.08-1.89)) were the risk factors of MCI in the elderly in the community.Hypertension alone or high LDL-C (β=0.365, P=0.029, OR(95%CI)=1.44(1.04-2.00)) alone was risk factor for mild cognitive impairment in the elderly in the community.The risk of mild cognitive impairment in the elderly with hypertension and high LDL-C was 2.00 times higher than that in the healthy elderly (β=0.696, P<0.05, OR(95%CI)=2.00(1.36-2.97)).@*Conclusion@#Mild cognitive impairment in the elderly is closely related to hypertension and elevated LDL-C levels.Multiple vascular risk factors can further increase the risk of cognitive impairment.
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Objective To explore the effects of vascular risk factors on cognitive function among the elderly in community. Methods A cross-sectional study was conducted in 1 269 elderly people ( aged 65 and over) who were randomly selected from three communities. Through face-to-face interview, cognitive function was assessed by mini-mental state examination(MMSE),and blood samples were collected for labo-ratory examination. Logistic regression analysis was used to analyze the vascular risk factors affecting cogni-tive function. Results Age (( 73. 1 ± 6. 6), ( 71. 3 ± 4. 9),t=4. 603,P<0. 05),education level ( χ2=12. 727,P<0. 05),hypertension (χ2=9. 106,P<0. 05) and LDL-C (χ2=5. 157,P<0. 05) were significantly different in the elderly with or without mild cognitive impairment(MCI). After controlling age,gender and ed-ucation,the logistic regression analysis showed that hypertension(β=0. 378,P=0. 006,OR(95%CI)=1. 44 (1. 10-1. 91)),systolic blood pressure ≥140 mmHg( β=0. 350,P=0. 011,OR( 95% CI)= 1. 42( 1. 08-1. 86),1 mmHg=0. 133 kPa),and high LDL-C( β=0. 355,P=0. 014,OR(95%CI)=1. 43( 1. 08-1. 89)) were the risk factors of MCI in the elderly in the community. Hypertension alone or high LDL-C (β=0. 365, P=0. 029,OR(95%CI)=1. 44(1. 04-2. 00)) alone was risk factor for mild cognitive impairment in the eld-erly in the community. The risk of mild cognitive impairment in the elderly with hypertension and high LDL- C was 2. 00 times higher than that in the healthy elderly ( β=0. 696,P<0. 05,OR( 95%CI)= 2. 00( 1. 36-2. 97)). Conclusion Mild cognitive impairment in the elderly is closely related to hypertension and elevat-ed LDL-C levels. Multiple vascular risk factors can further increase the risk of cognitive impairment.
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ObjectiveTo systematically evaluate the efficacy and safety of octreotide in the treatment of hepatocellular carcinoma (HCC). MethodsOnline databases including PubMed, Cochrane Library, Embase, China National Knowledge Internet, Wanfang Data, and China Science and Technology Journal Database were comprehensively searched for relevant randomized controlled trials (RCTs) of octreotide in the treatment of HCC. The quality of included studies was assessed using the method recommended by the Cochrane handbook for systematic review. A meta-analysis was performed by using RevMan 5.3.4 software. ResultsEleven RCTs were included, which involved 909 cases (treatment group, 452 cases; control group, 457 cases). As for clinical efficacy, octreotide significantly increased the response rate (RR=2.30, 95% CI: 1.25~4.22, P=0.007) and decreased the progression rate (RR=0.78, 95% CI: 0.59~1.04, P=0.09), but there was no significant difference in disease control rate and progression rate between the two groups (P＞0.05). The overall survival rate and 6-month, 1-year, and 2-year survival rates in the treatment group were not significantly higher than those of the control group (all P＞0.05). As regards to safety, severe adverse events in the treatment group were significantly reduced (RR=0.72, 95% CI: 0.54~0.98, P=0.03), but there were no significant differences in diarrhea, nausea/vomiting, liver function abnormality, and blood glucose fluctuation between the two groups (all P＞0.05). ConclusionFor HCC patients, octreotide can significantly increase the clinical response rate incidence of grade 3/4 adverse events, but it does not lead to significant improvement in disease progression and survival rate.
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<p><b>OBJECTIVE</b>To examine the incidence of hepatitis B virus (HBV) S gene mutation in recipients with recurrent HBV infection after liver transplantation (LT) and to evaluate the clinical significance of these mutants.</p><p><b>METHODS</b>Two-hundred-and-ninety-nine patients who received LT for HBV-related liver diseases in single centre were enrolled in the study and followed up. Serum HBV DNA was amplified by fluorescence quantitative polymerase chain reaction, and HBV-S gene mutation was detected by Sanger's enzymatic method.</p><p><b>RESULTS</b>Twelve of the 299 patients developed recurrent HBV after LT, and 2 of these 12 carried a mutant of the HBV-S gene (incidence rate of 16.67%). One of the patients had T126I and G145A mutations, and the other had a M 133L mutation. Cox regression modelling identified the risk factors of HBV recurrence after LT as HBV-YMDD mutants (P =0.01), HBV-S mutants (P =0.03) and compliance decrease (P =0.03).</p><p><b>CONCLUSION</b>HBV-S mutants may contribute to recurrence of HBV after LT, and the mechanism should be addressed in future studies.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , DNA, Viral , Genetics , Genetic Variation , Hepatitis B , Virology , Hepatitis B virus , Genetics , Liver Transplantation , Mutation , Postoperative Period , Recurrence , Viral Envelope Proteins , GeneticsABSTRACT
Objective To analyze and study the implication of dynamic changes in plasma CD62P among patients with obstructive jaundice and cholecystolithiasis.Methods A total of 58 patients diagnosed with choledocholithiasis and jaundice were included in the obstructive jaundice group,and 50 patients were in the cholecystolithiasis group.Peripheral venous blood was collected on preoperative day 3,on opera-tive day,and on postoperative days 3,6,9,12,15,18,and 21 in two groups,and the concentrations of plasma CD62P were measured by ELISA.Comparison of continuous data between the two groups was made by t test.Results The concentrations of plasma CD62P from preop-erative day 3 to postoperative day 18 were significantly higher in the obstructive jaundice group than in the cholecystolithiasis group (P<0.01 across all time points).In the cholecystolithiasis group,the concentrations of plasma CD62P significantly increased on operative day, and the increase continued and reached the peak on postoperative day 3,then followed by a decrease down to the preoperative level on post-operative day 9.In the obstructive jaundice group,the concentrations of plasma CD62P reached the peak on postoperative day 9,followed by a gradual decrease down to the preoperative level on postoperative day 18 and to an even lower level (preoperative level of patients with cho-lecystolithiasis)on postoperative day 21.Conclusion Extrahepatic biliary obstruction may lead to endothelial cell injury and platelet acti-vation,the condition of which is improved with the relief of obstruction.The surgery for obstructive jaundice may lead to much more endothe-lial cell injury and higher platelet activation than that for cholecystolithiasis.
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Objective To investigate the factors affecting the recovery of immunological function after bilirubin decreasing interventional therapy in patients with obstructive jaundice.Methods 67 patients with malignant obstructive jaundice were investigated.The patients were randomly divided into the enteral nutrition (EN) group (n =34)and the parenteral nutrition (PN) group (n =33).TBIL,DBIL,TSP,ALB,PA,TF,CD3 +,CD4 +,CD8 +,CD4 +/CD8 + were determined before PTCD and at the 7th day after the procedure.Results Except for 20 patients,the levels of TBIL,DBIL,CD8 + significantly declined,and the levels of TSP,ALB,PA,TF,CD3+,CD4+,CD4+/CD8 + significantly increased in the 2 groups of patients.There was no significant difference in the recovery of liver function and immunological status between the PN and the EN groups.Conclusions The recovery of immunological function was significantly associated with reduction of serum bilirubin in patients with malignant obstructive jaundice.There was no relationship with the ways of nutrition support.
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Hydatid is a common pathogen found in human and animals,incidence of hepatic echinococcosis is high in the west China.In recent years,operation and chemotherapy are basic treatment.Faced with varieties of operational manner,a proper choice is very important.5 operational manners are compared in this article,furthermore,problems in the selection of operational manner is analysed.
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Some locally advanced tumors involving multiple abdominal organs without distal metastasis may cause digestive tract obstruction.Some of these patients can achieve long-term survival after Ro resection,others can obtain digestive tract obstruction relief,pain anesis and survival prolongation after R1 resection combined with postoperative comprehensive treatment.In this review,the efficacy of complex pancreaticoduodenectomy combined with organs resection was introduced based on reviewing the literatures.After the surgery,some patients achieved R0 resection and long-term survival,and the quality of life was significantly improved in some patients.
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Objective To compare the efficacies of early intensive and moderate insulin therapy on the prognosis of patients with severe acute pancreatitis (SAP).Methods The clinical data of 78 patients with SAP complicated by hyperglycemia who were admitted to the Second Hospital of Lanzhou University from January 2005 to December 2009 were retrospectively analyzed.All patients were divided into the intensive insulin therapy (IIT)group (31 patients) and moderate insulin therapy (MIT) group (47 patients).The target levels of blood glucose were 0.80-1.10 g/L(4.4-6.1 mmol/L) in the IIT group and 1.44-1.80 g/L(8.0-10.0 mmol/L) in the MIT group,respectively.The effects of the 2 therapies on the prognosis of the patients were compared.All data were analyzed by the t test or chi-square test.Results The daily intravenous insulin dosage,fasting glucose level and incidence of severe hypoglycemia were ( 35 ± 11 ) u,( 1.02 ± 0.13 ) g/L[ (5.7 ± 0.7 ) mmol/L] and 10％ (3/31 )in the IIT group,and ( 24 ± 15 ) u,( 1.58 ± 0.21 ) g/L[ ( 8.8 ± 1.2 ) mmol/L] and 2％ ( 1/47 ) in the MIT group.A significant difference was detected in the daily intravenous insulin dosage between the 2 groups( t =12.76,P ＜=0.05),but no significant difference was detected in the incidence of severe hypoglycemia between the 2 groups (x2 =0.91,P ＞ 0.05 ).The levels of albumin and prealbumin on the 14th day were ( 34 ± 6) g/L and (231 ± 31 ) mg/L in the IIT group,and (35 ± 5)g/L and (241 ± 29)mg/L in the MIT group,respectively,with no significant difference between the 2 groups( t =-1.94,-1.68,P ＞ 0.05).The incidences of abdominal infection,circulatory dysfunction,respiratory dysfunction and acquired kidney injury were 23％ (7/31),32％ (10/31),26％ (8/31)and 13％ (4/31) in the lIT group,and 26％ (12/47),36％ ( 17/47),30％ (14/47) and 23％ (11/47) in the MIT group,with no significant difference between the 2 groups(x2 =0.09,0.13,0.15,1.33,P ＞ 0.05).The scores of APPACHE Ⅱ on the 14th day were 9 ± 4 in the IIT group and 9 ± 3 in the MIT group,respectively,with no significant difference between the 2 groups ( t =- 0.60,P ＞ 0.05 ).There were 4 ( 13％ ) patients in the IIT group and 7( 15％ ) patients in the MIT group died of multi-organ dysfunction syndrome,including 2 patients in the IIT group and 6 patients in the MIT group complicated with sepsis.There was no significant difference in the mortality between the 2 groups ( x2 =0,P ＞ 0.05 ).Conclusions Compared with MIT,early IIT could not improve the prognosis of the patients with SAP.MIT is appropriate for SAP patients complicated with hyperglycemia.