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Objective:To investigate the effect of electroporation-mediated local gene therapy on the expression of Wnt3a and β-catenin in callus of distraction gap during mandibular distraction osteogenesis of rabbits.Methods:The experiments were conducted in the laboratory of the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from September 2019 to December 2019. Forty eight New-Zealand rabbits were randomly divided into control group (group A), gene therapy group (group B) and normal saline group (group C), with 16 rabbits in each group. After bilateral mandible osteotomy and distractors were implanted, the distractors were activated at a speed of 0.8 mm/d on 4th day, postoperatively, and lasted for 7 days, followed by consolidation period. Group A distracted only, group B was subject to local injection of recombinant plasmid pIRES-hBMP2-hVEGF165 in the distraction gap and electroporation stimulation at the beginning of activation distractors; and group C local injection of the same dose of normal saline in the distraction gap and electroporation stimulation at the beginning of activation distractors. Four animals in each group were sacrificed on the day at the end of distraction, 7th, 14th, 28th days of consolidation period, respectively. The callus in the distraction gap was taken for immunohistochemical staining and RT-PCR to detect the expression of Wnt3a and β-catenin, and image analysis was performed. SPSS 22.0 statistical software was used for data analysis.Results:Immunohistochemical staining showed that Wnt3a and β-catenin were mainly located in the cytoplasm and nuclei of fibroblasts, chondrocytes and osteoblasts in callus tissue. Immunohistochemistry and RT-PCR showed that the expression of Wnt3a and β-catenin reached a peak at the end of distraction. With the disappearance of distraction tension, the expression of Wnt3a and β-catenin gradually decreased. After gene therapy intervention, the expression of Wnt3a and β-catenin was significantly increased, and the expression of Wnt3a and β-catenin in group B was the highest at each time point, with statistically significant difference compared with groups A and C ( F=96.3, P<0.01). Conclusions:Gene therapy promotes the expression of Wnt3a and β-catenin in the callus of distraction gap, regulating the balance of the bone reconstruction system and thus promoting the formation of new bone in the distraction gap.
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Objective:To develop a neural network model for the evaluation of glomerular filtration rate (GFR) based on multilayer perceptual neural network, and to compare with the improved Chinese based creatinine GFR evaluation formula (C-GFR cr) and the evaluation formula (EPI-GFR cr) of the American Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) for the clinical applicability of multilayer perceptual neural network model in evaluating GFR. Methods:A total of 684 chronic kidney disease (CKD) patients used for developing a modified version of China′s based creatinine GFR evaluation formula were taken as the research object. The data of 454 patients were randomly selected as the development group and the data of the other 230 patients were as the verification group. The multilayer perceptual neural network GFR evaluation model (M-GFR cr) was established. With the double plasma GFR as the reference value (rGFR), the correlation, mean difference, mean absolute difference, precision and accuracy of C-GFR cr, EPI-GFR cr and M-GFR cr were compared. Results:Among the 684 CKD patients, there were 352 males and 332 females, with age of (49.9±15.8) years. The correlation between M-GFR cr and rGFR was the highest (Pearson correlation =0.93, P<0.001). The mean difference of M-GFR cr was lower than that of C-GFR cr ( Z=9.929, P<0.001) and EPI-GFR cr ( Z=10.573, P<0.001). The mean absolute difference of M-GFR cr was also lower than that of C-GFR cr ( Z=3.953, P<0.001) and EPI-GFR cr ( Z=4.210, P<0.001). The accuracy of ±15% of M-GFR cr was higher than that of C-GFR cr ( χ2=26.068, P<0.001) and EPI-GFR cr ( χ2=23.154, P<0.001). The accuracy of ±30% of M-GFR cr was also higher than that of C-GFR cr ( χ2=8.264, P=0.001) and EPI-GFR cr ( χ2=11.963, P=0.001). The results of different stages of CKD showed that in the early stage of CKD (CKD 1-2), the mean difference of M-GFR cr was lower than that of C-GFR cr ( Z=7.401, P<0.001) and EPI-GFR cr ( Z=8.096, P<0.001); the mean absolute difference of M-GFR cr was also lower than that of C-GFR cr ( Z=4.723, P<0.001) and EPI-GFR cr ( Z=4.946, P<0.001); the accuracy of ±15% of M-GFR cr was higher than that of C-GFR cr ( χ2=23.547, P<0.001) and EPI-GFR cr ( χ2=26.421, P<0.001); the accuracy of ±30% of M-GFR cr was also higher than that of C-GFR cr ( χ2=12.089, P=0.001) and EPI-GFR cr ( χ2=16.168, P<0.001). But there was no significant difference in the applicability among C-GFR cr, EPI-GFR cr and M-GFR cr in the advanced stages of CKD (CKD 3-5). Conclusion:Compared with the improved Chinese based creatinine GFR evaluation formula C-GFR cr and CKD-EPI evaluation formula EPI-GFR cr, the accuracy of multilayer perceptual neural network model to evaluate GFR in CKD patients has been significantly improved, especially in CKD 1-2 stage.
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Objective:To investigate the relationship between serum 25(OH)D and SIRT4 levels and glycolipid metabolism in children with different levels of obesity.Methods:A total of 124 children with different levels of obesity who received treatment in Shaoxing Women's and Children's Health Care Hospital from February 2016 to February 2021 were included in this study. These children were divided into mild/moderate obesity group ( n = 76) and severe obesity group ( n = 48) according to body mass index. An additional 62 healthy children who concurrently received a physical examination were selected for controls. The general data of all children were collected. The relationship between the factors that affect obesity in children and serum 25(OH)D and SIRT4 levels and glycolipid metabolism was analyzed. Results:In the control, mild/moderate obesity, and severe obesity groups, body mass was (26.68 ± 4.98) kg, (33.24 ± 5.48) kg, (37.18 ± 5.88) kg, respectively; waist circumference was (56.12 ± 4.62) cm, (68.45 ± 5.20) cm, (79.34 ± 5.65) cm, respectively; hip circumference was (68.42 ± 5.08) cm, (72.45 ± 6.45) cm, (80.56 ± 6.95) cm, respectively; body mass index (BMI) was (15.90 ± 2.04) kg/m 2, (23.58 ± 2.45) kg/m 2, (25.89 ± 2.35) kg/m 2], respectively; fasting insulin (FINS) level was (26.65 ± 3.68) pmol/L, (34.82 ± 4.15) pmol/L, (48.56 ± 5.49) pmol/l, respectively; homeostasis model assessment of insulin resistance (HOMA-IR) was (1.06 ± 0.24), (2.12 ± 0.35), (3.84 ± 0.52), respectively; total cholesterol (TC) level was (2.21 ± 0.45) mmol/L, (4.14 ± 0.58) mmol/L, (5.96 ± 0.64) mmol/L, respectively; triacylglycerol (TG) level was (0.68 ± 0.16) mmol/L, (1.12 ± 0.24) mmol/L, (1.56 ± 0.35) mmol/L, respectively; low density lipoprotein cholesterol (LDL-C) was (2.68 ± 0.42) mmol/L, (2.10 ± 0.32) mmol/L, (1.41 ± 0.25) mmol/L, respectively; high density lipoprotein cholesterol (HDL-C) was (1.98 ± 0.42) mmol/L, (3.12 ± 0.51) mmol/L, (4.10 ± 0.56) mmol/L, respectively. There were significant differences in body mass, waist circumference, hip circumference, BMI, FINS, HOMA-IR, TC, TG, HDL-C, and LDL-C among the three groups ( F = 53.62, 280.42, 53.33, 303.44, 338.48, 755.71, 618.75, 165.81, 186.89, 251.42, all P < 0.001). Body mass, waist circumference, hip circumference, BMI, FINS, HOMA-IR, TC level, TG level, HDL-C level, and LDL-C level were lower in the control group than in the mild/moderate obesity group ( t = -7.28, -14.56, -4.00, -19.72, -6.49, -21.45, -12.36, 9.20, -14.12, all P < 0.05). Body mass, waist circumference, hip circumference, BMI, FINS, HOMA-IR, TC, TG, HDL-C and LDL-C were lower in the mild/moderate obesity group than in the severe obesity group ( t = -3.79, -10.98, -6.61, -5.19, -15.81, -22.02, -16.34, -8.30, 12.68, -10.03, all P < 0.05). Serum 25(OH)D [(60.52 ± 8.95) nmol/L vs. (49.88 ± 8.12) nmol /L, t = 7.31, P < 0.05] and SIRT4 [(1.98 ± 0.38) mmol/L vs. (1.06 ± 0.30) mmol/L, t = 15.89, P < 0.05] levels were significantly greater in the control group than in the mild/moderate obesity group. Serum 25(OH)D [(49.88 ± 8.12) nmol/L vs. (41.62 ± 7.50) nmol /L, t = 5.68, P < 0.05] and SIRT4 [(1.06 ± 0.30) mmol/L vs. (0.52 ± 0.15) mmol/L, t = 11.57, P < 0.05] levels were significantly greater in the mild/moderate obesity group than in the severe obesity group. Multiple linear regression analysis showed that body mass, waist circumference, hip circumference, FINS, HOMA-IR, TC, TG, and LDL were the positive influential factors of childhood obesity ( B = 0.170, 0.310, 0.403, 1.000, 3.464, 2.080, 2.656, 4.324); HDL, serum 25(OH)D and SIRT4 were the negative influential factors of childhood obesity ( B = -2.096, -0.156, -6.615). Pearson correlation analysis showed that serum 25(OH)D was significantly negatively correlated with FINS, HOMA-IR, TC, TG and LDL ( r = -0.20, -0.46, -0.30, -0.36, all P < 0.01), and significantly positively correlated with FPG and HDL ( r = 0.43, 0.77, both P < 0.01). Serum SIRT4 was negatively correlated with FINS, TC, TG, and LDL ( r = -0.48, -0.74, -0.61, -0.64, all P < 0.01), and positively correlated with FPG and HDL ( r = 0.21, 0.84, both P < 0.01). Conclusion:Serum 25(OH)D and SIRT4 levels decrease with the aggravation of obesity in children and are closely related to glycolipid metabolism. Therefore, early detection of obesity can reflect the degree of obesity and glycolipid metabolism in children.
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Objective:To evaluate the prognostic effects of two comprehensive geriatric assessment (CGA) methods in elderly patients with acute myeloid leukemia (AML).Methods:Ninety-seven patients with newly diagnosed AML at Beijing Hospital from August 2008 to December 2019 were included (≥60 years old). All patients were evaluated by two methods of CGA. One was IACA index proposed by Beijing Hospital, including instrumental activities of daily living (IADL), age, Charlson comorbidity index (CCI), albumin; the other was proposed by Italian FIL study group (FIL-CGA), including activities of daily living (ADL), IADL, age, and modified cumulative illness rating score for geriatrics (MCIRS-G).Results:Among 97 patients, 54 patients received standard chemotherapy, 16 with decitabine, 2 with targeted therapy and 25 with the best supportive therapy. The overall response rate (ORR) in 72 treated patients were 67.7%, 33.3% and 0 respectively in fit, unfit and frail groups according to IACA index ( P=0.001). Based on FIL-CGA, the ORRs of fit, unfit and frail groups were 52.5%, 41.7% and 35.0% respectively ( P=0.418). The 1-year OS rates of fit, unfit and frail groups regarding IACA method were 78.7%, 27.7% and 0 respectively ( P<0.01). The 1-year OS rates of fit, unfit and frail groups regarding FIL-CGA method were 67.8%, 28.2% and 13.9% respectively ( P<0.01), while no significant difference was seen between unfit group and frail group ( P=0.111). The early death rates of fit, unfit and frail groups by IACA were 0, 6.0% and 28.6% respectively ( P=0.006), while those by FIL-CGA were 2.3%, 5.9%, 13.9% respectively ( P=0.123). Conclusion:Compared with FIL-CGA method, IACA predicts more effectively the treatment response, survival and early mortality in elderly patients with AML.
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FLASH radiotherapy (FLASH-RT) is a treatment modality that delivers ultra-high dose rate and ultra-fast radiation for cancer treatment. Compared to conventional dose rate radiotherapy, FLASH-RT can yield similar efficacy for tumors and achieve normal tissue protection, translating to an increased therapeutic window. Due to this unique feature, FLASH-RT is attracting increasing attention from the radiotherapy community, both academia and industry. Due to its unique Bragg peak as well as intrinsic high dose rate, application of FLASH has more value and profound significance in proton therapy while achieving highly conformal dose deposition simultaneously. This article reviews research progress on FLASH-RT, relevant cell and animal studies, experimental conditions and results. Moreover, this article also investigates the potential biological mechanisms, technical challenges for implementation and potential clinical applications of FLASH-RT.
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Objective To establish a LC-MS/MS method for the determination of salidroside in the capsule. Methods An electrospray ionization and multiple reaction detection were used to detect negative ion. Theophylline was used as standard. The detection ions of salidroside and theophylline used for quantitative analysis were m/z 299.0→119.0, and m/z 178.8→164.0, respectively. The Shim-pack XR-ODS (3.0 mm×75 mm, 2.0 μm) column was used for separation. The mobile phase was acetonitrile: 5 mmol/L ammonium acetate solution (90∶10, V/V). The flow rate was 0.40 ml/min. The column temperature was 25 ℃. Results The content of salidroside was analyzed within 3 minutes. The linear range was 10–2 000 ng/ml, and the minimum detection limit was 10 ng/ml. Conclusion The method has good repeatability, high sensitivity, fast analysis speed and simple operation. It can be used as a method for the determination of salidroside in the capsule. It is suitable for the quality inspection of drugs and convenient for safe use.
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Objective@#To evaluate the prognostic significance of comprehensive geriatric assessment (CGA) in Chinese elderly acute myeloid leukemia (AML) patients.@*Methods@#73 AML patients over the age of 60 were enrolled. CGA stratification included the following 3 instrument assessment: activity of daily living (ADL) ; instrumental activity of daily living (IADL) ; comorbidity score according to the Modified cumulative illness rating score for geriatrics (MCIRS-G) . According to CGA and age, the enrolled patients were grouped into 'fit’, 'unfit’ and 'frail’ categories.@*Results@#The median age of 73 elderly AML patients were 75 years old. According to CGA, 37 (50.1%) patients were classified as 'fit’, 14 (19.2%) as 'unfit’, and 22 (30.7%) as 'frail’. 33 (89.2%) patients in fit group received induction chemotherapy, or demethylation treatment, as 8 (57.9%) in unfit, 10 (45.5%) in frail. The overall response rate was 68.7%、62.5%, 75.0% in fit, unfit, and frail group, respectively (χ2=0.615, P=0.769) .The early mortality (8 weeks) in three groups were different: 5.4%, 7.1%, 27.3%, respectively (P<0.05) . The 1-year overall survival in the 'fit’, 'unfit’ and 'frail’ groups was 64.9%, 28.6% and 22.7%, respectively (P<0.05) . The CGA score, age, ECOG score, WHO classification (2016) were the prognostic factors of AML patients.@*Conclusion@#CGA can be used to determine the prognosis of elderly AML patients.
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Objective@#To explore the role of β-catenin in distraction osteogenesis of new bone formation, the expression of β-catenin in the distraction gap callus was detected during rabbit mandibular distraction osteogenesis.@*Methods@#26 New-Zealand rabbits were randomly divided into 3 groups. Group A is a normal control group with 2 rabbits, group B is the mandibular defect control group, and group C is the distraction group. Group B and C with 12 rabbits, respectively. The two rabbits in group A without surgery, their mandibles are normal control. In group B, vertical osteotomy was performed between the first molar and the mental foramen on the mandibles bilaterally, followed by rigid internal fixation with titanium plates and screw with 5 mm gap immediately. In group C, after the same osteotomy was performed, the fragments of mandibles were reduced and fixed with mandibular distractors bilaterally. On the fourth day postoperatively, the distraction started at a rate of 0.8 mm/d and lasted for 7 days, followed by consolidation period. Two rabbits of group B and C were sacrificed at 6th, 10th, 17th, 24th, 31st, 38th day postoperatively, respectively. The newly formed callus in the distraction gap of mandibles was harvested for Western blotting and immunohistochemistry examination to detect the distribution and expression of β-catenin. The experimental data were analyzed by SPSS 22.0 statistical software using Spearman function.@*Results@#The result of Western blotting showed that the expression of β-catenin gradually increased at distraction period(6-10 days after surgery) and reached the peak at the end of the distraction period(10th day postoperatively), it gradually decreased during the consolidation period. However, the expression of β-catenin in group C was higher than that of group B. Immunohistochemistry stain showed that the expression of β-catenin mainly located in inflammatory cells(eg. monocyte), fibroblast of the granulation tissue, the osteoblasts, osteocyte on the surface of new formed trabecular, and the connective tissues surrounding the new bone in the new formed callus. Cytoplasmic and nuclear staining were positive. In group C, the expression of β-catenin was strong (3.245 8±0.132 3) after distraction (6th day postoperatively), and reached a peak (4.602 8±0.021 9) on the 10th day postoperatively. With the disappearance of the distraction stress, the expression of β-catenin gradually decreased since17th day postoperatively(3.639 8±0.125 5), but the staining was still positive. In group B, the strong positive staining of β-catenin on the 6th day after surgery (2.734 0±0.134 7), the strongest staining on the 10th day after surgery (3.101 3±0.104 8), and the expression of β-catenin on the 17th day after surgery (2.542 8±0.211 1) was weaker than that on the 10th day after surgery. At each time point, the expression of β-catenin in group C was significantly higher than that in group B, and the difference was statistically significant (r=0.943, P=0.005 6).@*Conclusions@#During mandibular distraction osteogenesis, the distraction stress activates the Wnt signal pathway to enhance the expression of β-catenin, it suggests that β-catenin plays an important role in the transformation of the mechanical signal to chemical signals during the process of distraction osteogenesis, and participates in the regulation of new bone formation during distraction osteogenesis.
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Objective To investigate the clinical characteristics of diffuse large B-cell lymphoma (DLBCL) and to evaluated the predictive value of comprehensive geriatric assessment (CGA)in advanced-aged DLBCL patients.Methods A total of 24 patients aged 80 years and over diagnosed with DLBCL in our hospital from March 2010 to July 2017 were enrolled in this study.CGA included three parts:age,activities of daily living(ADL)/instrumental activities of daily living(IADL)and comorbidity evaluated by the cumulative illness rating score for geriatrics(CIRS-G).According to CGA scores,all patients were classified into either the not-applicable group or the frail group.Results There were 10 and 14 patients in the not-applicable group and the frail group,respectively.Twenty-two patients received chemotherapy,and the incidences of toxicity after chemotherapy were comparable between the two groups.Nine patients achieved complete remission (CR),five patients partial remission(PR),and the overall response rate(ORR) was 63.6 ％.The not-applicable group seemed to have a higher complete remission rate than the frail group(60.0 ％ vs.25.0 ％,x2=2.764,P =0.192).However,the overall response rates were comparable between the two groups.Treatment-related deaths occurred in 2 and 3 patients(20.0 ％ vs.25.0 ％,x2 =0.078,P =1.000)in the not-applicable and frail groups,respectively.Relapse/progression-related deaths occurred in 3 and 5 patients in the not-applicable and frail groups(30.0％ vs.41.7％,x2 =0.321,P =0.675),respectively.The 2-year overall survival rates and progression-free survival rates were 56.3 ％ versus 35.2 ％ (x2 =0.635,P =0.426)and 42.2 ％ versus 16.7 ％ (x2 =2.156,P =0.142) in the not-applicable and frail groups,respectively.Conclusions Advanced-aged patients with DLBCL have a poor prognosis,which can be predicted by CGA to a certain extent.Further improvement in the current CGA scoring system is still needed to accurately predict the prognosis of DLBCL in advanced-aged patients and to guide treatment.
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Objective To evaluate the performance on comprehensive geriatric assessment (CGA) in elderly patients with acute myeloid leukemia (AML)and to investigate the differences between Eastern Cooperative Oncology Group (ECOG) performance status (PS) and CGA scoring.Methods Patients aged 60 years or over diagnosed with AML at Beijing Hospital from September 2008 to April 2018 were enrolled in this study.CGA was performed during staging procedures through application of age,activities of daily living(ADL)/instrumental activities of daily living(IADL)and the comorbidity score based on the cumulative illness rating scale for geriatrics(CIRS-G).According to CGA scores,patients were classified into a not-applicable group,an applicable group and a frail group.The difference between ECOG-PS and CGA scoring was compared.Results A total of 73 patients were enrolled in this study.There were 37 (50.7 ％),14 (19.2 ％) and 22 (30.1％) patients in the applicable,not-applicable and frail groups,respectively.Comorbidities were observed in the majority of patients,with cardiovascular disease,diabetes mellitus and hypertension among the most common disorders.In patients aged 60 to 64 years,16.7％ (1/6) were considered as frail,and the percentage of frail patients increased to 36.4％ (8/22)in patients aged 80 years and over.Moreover,functional impairment evaluated by CGA was observed in 36.5 ％ (19/52)of patients with ECOG-PS ≤ 1.Conclusions According to CGA scoring,approximately half of AML patients aged 60 years or over have functional impairment.Functional impairment is observed in some patients with ECOG-PS ≤1,indicating that ECOG-PS may underestimate functional impairment in elderly AML patients.
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Objective@#To investigate the effect of brucea javanica oil emulsion (BJOE) on the proliferation, collagen synthesis and ERK1/2 MAPK singaling pathway of hypertrophic scar fibroblasts (HSFs).@*Methods@#The human hypertrophic scar tissues were collected, and HSFs were isolated, cultured and identified in vitro. Cells were treated with BJOE under the concentration of 0.5, 1, 5, 10, 20 and 50 mg/ml for 24 h respectively; the half inhibitory concentration(IC50)of 24 h was calculated. The experimental groups were treated for 24, 48, 72 h by BJOE at the IC50, the control group was conventionally cultured without BJOE. Cell proliferation was detected by CCK-8 assay and cell cycle was determined by flow cytometry (FCM). The morphological changes of cells treated with BJOE at a concentration of IC50 for 24 h were observed. The protein expression levels of collagen Ⅰ, vimentin, ERK1/2 and p-ERK1/2 were measured by Western blot.@*Results@#The IC50 of BJOE was 1.176 mg/ml, so the concentration of 1 mg/ml was selected for the subsequent experiment. After 24, 48, 72 h treated with BJOE at a concentration of 1 mg/ml, the inhibition rates of BJOE on HSFs were (53.13±2.40)%, (75.07±2.67)%and (88.65±0.32)%, respectively. The difference was significant (P<0.05). Under the effect of BJOE, the number of HSFs significantly decreased, the interval between cells widened, cell protrusions were significantly shortened or even disappeared, and the cells became round. The percentage of cells decreased in S phase. Expression of type Ⅰ collagen, vimentin and p-ERK1/2 in HSF was significantly inhibited (P<0.05), while there was no significant difference in the expression of ERK1/2(P>0.05).@*Conclusions@#BJOE inhibites the proliferation of HSF and the synthesis of type Ⅰ collagen, and its mechanism is related to the inhibition of ERK1/2 phosphorylation and vimentin expression.
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Objective@#To validate comprehensive geriatric assessment (CGA) system in Chinese elderly diffuse large B cell lymphoma (DLBCL) patients.@*Methods@#Patients ≥ 65 years of age who had been diagnosed with de novo DLBCL were screened for eligibility (n=99). CGA was performed during staging procedures through application of the following instruments: age, comorbidity score according to the Cumulative Illness Rating Score for Geriatrics(CIRS-G), activities of daily living (ADL), and instrumental activities of daily living (IADL).@*Results@#All patients were classified as "ft" , "unfit" , and "frail" . Forty-nine (49.5%), 14 (14.1%), and 34 (36.4%) patients were categorized into the fit, unfit, and frail groups, respectively. The overall response rate was 91.8%, 64.3%, and 69.5% in fit, unfit, and frail group, respectively (χ2=9.311, P=0.007). Eleven (22.4%), 7 (50.0%), and 16(44.4%) patients showed disease relapse/progression in fit, unfit, and frail group, respectively (χ2=6.309, P=0.040). The 2-year probability of overall survival was 90.6%, 43.0%, and 58.5% in fit, unfit, and frail group, respectively (χ2=14.774, P=0.001). The 2-year probability of progression-free survival was 72.9%, 32.5%, and 37.3% in fit, unfit, and frail group, respectively (χ2=11.038, P=0.004).@*Conclusion@#The CGA index can predict the clinical outcomes of elderly DLBCL patients in China.
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Objective To measure the comprehensive geriatric assessment (CGA) in elder non-Hodgkin's Lymphoma (NHL) patients in a cross-sectional study;to compare the differences between Eastern Cooperative Oncology Group (ECOG)-performance status (PS) and CGA.Methods CGA stratification included the following 3 instrument assessments:activity of daily living (ADL);instrumental activity of daily living (IADL);comorbidity score according to the modified cumulative illness rating score for geriatrics (MCIRS-G).According to CGA and age,NHL patients,aged ≥60 years,were classified as "fit","unfit" and "frail" groups.ECOG-PS was evaluated and compared with CGA.Results According to CGA,51.6％ senior NHL patients (33 cases) were classified as "fit",12.5％(8 cases) as " unfit" and 35.9％ (23 cases) as "frail".Several comorbidities were observed in majority patients,such as cardiovascular disease,diabetes nellitus and hypertension.In the "younger aged" patients between 60 to 64ys,25％(3/12) was considered as "frail".However,this proportion increased to 42.9％ (6/14) in patients older than 80ys.Moreover,impaired CGA was observed in 38.9％(21/54) of ECOG-PS ≤1 patient.Conclusions Impaired CGA is as common as approximately half in elderly NHL patients and more than one third even in ECOG-PS ≤ 1 patients.ECOG-PS may underestimate the impaired fitness function in elder NHL patients.
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Objective To investigate the expression of Wnt/β-catenin signal antagonist DKK1 protein in callus of distraction gap during mandibular distraction osteogenesis (MDO).Methods Twenty four healthy New Zealand rabbits were randomly divided into distraction group,fracture control group,with twelve rabbits each,respectively.In distraction group,bilateral mandibular distraction models were established.In control group,after bilateral mandibular osteotomy,the two bone fragments were fixed by titanium plate and screws with a 5 mm gap.The expression of DKK1 in the distracted calluses was analyzed by cell digital imaging software.Results Expression of DKK1 was colocalized in the nucleus and cytoplasm of osteoblasts,fibroblasts,cartilageand newly embedded osteocytes.The expression of DKK1 increased following distraction activated after surgery,peaked at 10 days after surgery,the population of cells that stained for DKK1 decreased gradually.At 31 to 38 days postoperatively,DKK1 expression reduced gradually,mainly located in the osteocyte,and both nucleus and cytoplasm were positive staining.At each time point,the expression of DKK1 in distraction group was higher than that in the control group and the difference was statistically significant (P＜0.05).Conclusions During MDO,the Wnt/β-catenin pathway is activated due to the distraction and mechanical strain on the bone.With the increased expression of Wnt-related factors,the endogenous negative feedback is enhanced to induce DKK1 expression and to regulate the activated Wnt/β-catenin pathway.This would be beneficial to the new bone formation and remodeling in the distraction gap.
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Objective To investigate the clinical efficacy of large spot modulated Q 1064 nm laser combined with Xiaoyao pills in the treatment of chloasma.Methods 90 patients with chloasma were treated in the hospital.The patients were randomly divided into 3 groups:treatment group were treated with Q 1064 nm laser combined with large spot Xiao Yao pill;the control group 1 was treated with large spot Q 1064 nm laser only,and control group 2 was treated with Xiaoyao Pill only.Results After 8 weeks of treatment,the effective rate was higher in the treatment group than the control group 2 (P＜0.05);after 16 weeks of treatment,the efficacy was better in the treatment group than the control group 1 and control group 2 (P＜0.05).The combination of the two methods can improve the curative effect and inhibit the recurrence.Conclusions The treatment of chloasma with large speckle modulated Q 1064 nm laser combined with Xiaoyao pills is effective and worthy of clinical promotion.
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Objective Intradialytic hypotension (IDH) is one of the common complications during hemodialysis,however its diagnostic criteria are highly controversial at present.In order to fully understand the prevalence of IDH in our center and figure out which diagnostic criteria is better for Chinese maintenance hemodialysis (MHD) patients,we choose several IDH definitions by reviewing published literatures and analyze their association with mortality.Methods The patients were recruited from Blood Purification Center of Ruijin Hospital undergoing hemodialysis during July 2012.Pre-,intra-and post-dialysis blood pressure were recorded.Patients' clinical characteristics,laboratory results and cardiac ultrasound results were collected.Based on several IDH definitions,we investigated the prevalence rate of IDH and its frequency among MHD patients.SPSS 23.0 was used to analyze data and conduct survival analysis.Results Totally 219 MHD patients underwent 16084 hemodialysis in 6 months.The prevalence rate,overall and individual frequency of IDH fluctuated between 45.21％-100.00％,4.64％-37.60％ and 0.00％-33.00％ respectively.For every IDH criteria,the patients were recruited into the group IDH(+) if they ever met the corresponding definition,otherwise the group IDH(-).Survival analysis found that IDH (the criteria of an absolute systolic blood pressure (SBP) ＜ 90 mmHg or with a decrease of SBP≥ 20 mmHg) could decrease the risk of patients' cardiovascular mortality but was not relevant to all-cause mortality.Further analysis showed these patients had better cardiac functions mainly reflecting in lower Pro-BNP (2880 ng/L vs 6909 ng/L),lower prevalence rate of left ventricular hypertrophy (52％ vs 83％) and higher left ventricular ejection fraction (65.0％ vs 62.5％) than IDH(-) patients.No correlation was found between other IDH criteria and mortality.Conclusions The prevalence rate,overall and individual IDH frequency of IDH are of high variability when diagnosed by different IDH criteria.All IDH episodes defined by our selected definitions are of no association with all-cause mortality.An absolute SBP ＜ 90 mmHg or with a decrease of SBP≥20 mmHg can decrease the risk of cardiovascular mortality due to their better cardiac function.Large scale researches should be conducted to find optimal IDH definition and explore the association of IDH and mortality.
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Objective To discuss the clinical application value of omeprazole and rabeprazole quadruple therapy on Helicobacter pylori associated peptic ulcer.Methods 360 patients with Helicobacter pylori associated peptic ulcer were selected.They were divided into two groups randomly.The rabeprazole group (180 cases) was treated with rabeprazole with quadruple therapy based,omeprazole group (180 cases) was treated with omeprazole quadruple therapy of short acting as the foundation,to observe and record the two groups of patients with clinical curative effect,the healing rate of ulcer,Helicobacter pylori eradication rate,histopathology and treatment of gastric mucosa during adverse reaction condition.Results The cure rate of rabeprazole group was significantly higher than that of omeprazole group (P ＜ 0.05).Compared the two groups before treatment,upper abdominal pain,abdominal discomfort,belching symptoms,no significant difference,the two groups after treatment in patients with upper abdominal pain,abdominal discomfort and belching percentage of patients decreased,and Rebela was the proportion of patients with lower group (P ＜ 0.05).After treatment,the rabeprazole group of ulcer healing rate 90.5％ (163/180),Helicobacter pylori eradication rate was 87.8％ (158/180),omeprazole group of ulcer healing rate was 70.5％ (127/180),Helicobacter pylori eradication rate was 72.2％ (130/180).The rabeprazole group of the healing rate of ulcer and Helicobacter pylori eradication rate were higher (P ＜ 0.05).Before treatment,there was no significant difference on gastric mucosal histopathological score between two groups.After treatment,two groups of gastric mucosa pathological score were decreased (P ＜ 0.05),no difference between the two groups.During the treatment,there was no significant difference on adverse reactions between two groups.Conclusion Rabeprazole with short acting quadruple therapy can significantly treat Helicobacter pylori causes,promote gastric mucosa repair,improve the clinical symptoms of peptic ulcer,the medication is safe,it is worthy of clinical use.
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Objective To establish the theoretical basis of the probiotic application among very low birth weight(VLBW) infants,the efficacy of probiotics on the gut microbiota of VLBW infants on the 14th postnatal day was studied.Method The VLBW infants admitted to BaoAn Maternal and Child Care Hospital from January 2015 to December 2015 were randomly assigned into probiotics group and placebo group.From the first feeding to corrected gestational age of 36 weeks,probiotics group was treated with a combination of Bifidobacterium and Lactobacillus while placebo group with placebo.Fecal samples were collected on the 1st and 14th postnatal day.Total bacterial DNA was extracted and sequenced using high-throughput 16S rRNA gene sequencing on MiSeq sequencing platform.Result A total of 21 VLBW infants were enrolled,9 in probiotics group and other 12 placebo group.No significant differences of clinical data existed between the two group (P ＞ 0.05),The abundance and diversity of microflora (P ＞ 0.05) on the first day between the two group were similar.Compared with placebo group,the relative abundance of Bifidobacterium and Lactobacillales in stool samples on the 14th day was significantly increased,while the Halomonas was significantly decreased.The relative abundance of the Shannon-index was increased,but without significant difference (P =0.16).Conclusion Enteral supplementation of probiotics in VLBW infants may increase probiotic bacterium and microflora diversity.
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Diabetes is a common disease,the complications caused by hyperglycemia have a serious impact on the quality of life of patients.The wound healing after skin injury in diabetic patient is affected by many factors.This article reviews various factors related to angiogenesis and wound healing in diabetes,including insulin,endogenous hydrogen sulfide,hypoxia inducible factor-1α and tumor necrosis factor-α.These findings may provide a new theoretical basis for the treatment of diabetic wound healing,foot ulcer and other complications.
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BACKGROUND:Animal models of osteoporosis play an important role in the research of the pathogenesis, occurrence and development of osteoporosis, as wel as in the clinical diagnosis, prevention and treatment of osteoporosis. OBJECTIVE: To summarize and discuss the establishment and research ideas of osteoporosis models, explore the current situation and advance of osteoporosis models, compare the advantages and disadvantages of various methods, and provide evidence for clinical investigation. METHODS: A computer-based online search was conducted in SinoMed, VIP, Wanfang and PubMed databases by using the key words of “animal model, osteoporosis” from January 1969 to October 2015. The language was limited to both Chinese and English. Relevant articles were screened according to inclusion and exclusion criteria. The documents about the methods of osteoporosis model preparation, method improvement as wel as their advantage and disadvantage were summarized. RESULTS AND CONCLUSION:A total of 576 articles were included. Among them, articles published earlier, duplicated, and similarly were excluded, and 53 articles were finaly included. Various animal models of osteoporosis may only focus on the certain causes, certain stage, some of the main symptoms and some pathophysiological changes of disease. Accordingly, appropriate modeling methods and experimental animals should be selected based on research objective. Rat undergoing castration is the most commonly used model in the modeling of osteoporosis. Among drug methods for constructing osteoporosis model, glucocorticoids is the most commonly used one. Disuse method and nutritional method have limitations, and always combined with castration and drug methods. The effects of gene transfer, gene mutation and brain-derived model deserve