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【Objective】 To investigate the transfusion ratio of plasma to RBC suspension during DIC caused by sever postpartum hemorrhage, so as to improve the clinical blood transfusion protocol. 【Methods】 A total of 82 parturients, who gave birth in our obstetrics department from January 2008 to December 2019 and treated successfully for DIC due to sever postpartum hemorrhage, were selected for the study. According to the plasma/RBC suspension ratio range (from 0.4 to 2.0) during DIC rescue, the included population was divided into four groups according to the ratio interval of 0.4: Group 1: 0.4~0.8 (13 people, median 0.7), Group 2 : 0.8~1.2(30 people, median 1.0), Group 3: 1.2~1.6(30 people, median 1.3), and Group 4: 1.6~2.0 (9 people, median 1.8). The general conditions, way of delivery, number of uterine artery perfusion embolization and surgical operations performed in the 4 groups were recorded. Once spontaneous postpartum hemorrhage occurred, blood cell analysis and coagulation function examinations were carried out every 1 to 2 hours until the condition was stable. The 24-hour blood loss, transfusion units of RBC suspension, fresh frozen plasma(FFP), platelet apheresis and fibrinogen during DIC and throughout the rescue of 4 groups were recorded and compared. Locally Weighted Regression (Lowess) method was applied to analyze the nonlinear association between the plasma/RBC suspension ratio and the duration of DIC, according to the duration of DIC in 4 groups. 【Results】 1) The shortest duration of DIC (326.15 min) was observed in DIC patients transfused with a plasma/ red blood cell suspension ratio=1.8. The duration of DIC (min) in the four groups were 505.21±259.53, 435.67±307.18, 420.93±259.43, and 247.86±215.77, respectively (P<0.05). 2) The coagulation indexes PT(s), INR, APTT(s) and Fib(g/L) gradually recovered between 2.9~13.9 h after transfusion in all four groups, especially in group 4 (median plasma/RBC suspension ratio of 1.8), whose changes were most pronounced in PT, INR, and Fib at 4.3 h, 2.9 h, and 5 h, respectively (P<0.05). 【Conclusion】 Fresh frozen plasma should be given as early as possible during blood transfusion treatment of DIC rescue. The increase of the ratio of plasma/RBC suspension is beneficial to the early recovery of DIC, and the optimal ratio of plasma to RBC suspension is 1.8.
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BACKGROUND@#The neoadjuvant chemotherapy is increasingly used in advanced gastric cancer, but the effects on safety and survival are still controversial. The objective of this meta-analysis was to compare the overall survival and short-term surgical outcomes between neoadjuvant chemotherapy followed by surgery (NACS) and surgery alone (SA) for locally advanced gastric cancer.@*METHODS@#Databases (PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar) were explored for relative studies from January 2000 to January 2021. The quality of randomized controlled trials and cohort studies was evaluated using the modified Jadad scoring system and the Newcastle-Ottawa scale, respectively. The Review Manager software (version 5.3) was used to perform this meta-analysis. The overall survival was evaluated as the primary outcome, while perioperative indicators and post-operative complications were evaluated as the secondary outcomes.@*RESULTS@#Twenty studies, including 1420 NACS cases and 1942 SA cases, were enrolled. The results showed that there were no significant differences in overall survival (P = 0.240), harvested lymph nodes (P = 0.200), total complications (P = 0.080), and 30-day post-operative mortality (P = 0.490) between the NACS and SA groups. However, the NACS group was associated with a longer operation time (P < 0.0001), a higher R0 resection rate (P = 0.003), less reoperation (P = 0.030), and less anastomotic leakage (P = 0.007) compared with SA group.@*CONCLUSIONS@#Compared with SA, NACS was considered safe and feasible for improved R0 resection rate as well as decreased reoperation and anastomotic leakage. While unbenefited overall survival indicated a less important effect of NACS on long-term oncological outcomes.
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Humans , Neoadjuvant Therapy , Stomach Neoplasms/surgery , Treatment OutcomeABSTRACT
Objective:To investigate the protective effect of cimetidine on mice with fractionated X-ray irradiation through right thorax.Methods:Thirty male C57BL/6 mice were randomly divided into control group, irradiation group and irradiation + cimetidine group (100 mg/kg), 10 mice in each group. Mice right thorax was locally irradiated with X-rays at a dose rate of 0.883 Gy/min to a cumulative dose of 24 Gy, 8 Gy per day in 3 d. After irradiation, the irradiation + cimetidine group was given cimetidine (100 mg·kg -1·d -1) for 7 d consecutively, and Ctrl and IR groups were given saline. Seven days after irradiation, the mice weight, spleen index and its T lymphocytes, B lymphocytes and NK cells were measured. Spleen tissue was stained with HE for pathological observation. Results:The fractionated irradiation lightly suppressed mice growth but obviously induced abscopal damage on spleen so that the spleen index were decreased. The irradiation group (0.369±0.011) had statistically significant difference compared with the control group(0.396±0.022)( t=2.978, P<0.05), the spleen pathological structure became disorder, and the percentages of CD3+ , CD4+ , CD3+ CD4+ , CD3+ CD8+ lymphocytes in spleen were decreased significantly( t=5.754, 3.570, 4.442, 5.281, 4.570, P<0.05). Cimetidine could partially restore the weight of irradiated mice, relieved spleen structure damage and effectively restored lymphocyte subsets, and partly recovered the levels of CD3+ , CD3+ CD4+ , CD3+ CD8+ lymphocytes in the spleen ( t=3.523, 2.706, 2.520, P<0.05). Conclusions:Cimetidine, as a potential radiation protection drug, could effectively reduce the mouse spleen injury induced by X-ray fractionated irradiation by improving mouse immune function.
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Objective To investigate the effect of fractionated radiotherapy on the immune system of mice with subcutaneously transplanted hepatocellular carcinoma.Methods Logarithmic growth of mouse hepatocellular carcinoma cells Hepa 1-6 were inoculated subcutaneously on the right side of C57BL/6 J mice (1×107 cells/mice).The tumor-bearing mice were randomly divided into control group (Ctrl) and irradiation group (IR),20 mice in each group.Additionally,10 healthy mice were set as normal control group.Local fractionated X-ray irradiation of 8 Gy×3 fraction was given to the subcutaneous tumors,and the dose rate was 0.883 Gy/min.At 7 and 14 d after irradiation,the tumor organ index,spleen organ index,spleen pathological changes,and splenic T lymphocyte subsets,B lymphocyte subsets,and NK cells were detected.Results Compared with Ctrl,at 7 and 14 d after irradiation,the tumor organ index decreased (t =4.649,26.34,P＜0.05),and the percentage of NK cells increased significantly (t =3.952,3.633,P＜0.05).The percentages of CD3+,CD4+,CD3+CD4+ lymphocytes and the ratio of CD4+/CD8+ lymphocyte decreased at 7 d after irradiation (t=3.193,3.656,3.219,2.641,P＜0.05),and the percentage of CD3+lymphocyte decreased at 14 d after irradiation (t =3.031,P＜0.05).But after irradiation,there were no significant changes in spleen organ index,B lymphocyte,CD3 + CD4+ lymphocyte and CD8 + lymphocyte.Conclusions Local hepatoma radiotherapy causes imbalance of lymphocytes in distal spleen of mice and hence reduces immunity,which provides a novel mechanism of radiological immunity damage.
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Objective@#To investigate the effect of fractionated radiotherapy on the immune system of mice with subcutaneously transplanted hepatocellular carcinoma.@*Methods@#Logarithmic growth of mouse hepatocellular carcinoma cells Hepa 1-6 were inoculated subcutaneously on the right side of C57BL/6 J mice (1×107 cells /mice). The tumor-bearing mice were randomly divided into control group (Ctrl) and irradiation group (IR), 20 mice in each group. Additionally, 10 healthy mice were set as normal control group. Local fractionated X-ray irradiation of 8 Gy×3 fraction was given to the subcutaneous tumors, and the dose rate was 0.883 Gy/min. At 7 and 14 d after irradiation, the tumor organ index, spleen organ index, spleen pathological changes, and splenic T lymphocyte subsets, B lymphocyte subsets, and NK cells were detected.@*Results@#Compared with Ctrl, at 7 and 14 d after irradiation, the tumor organ index decreased (t=4.649, 26.34, P<0.05), and the percentage of NK cells increased significantly (t=3.952, 3.633, P<0.05). The percentages of CD3+ , CD4+ , CD3+ CD4+ lymphocytes and the ratio of CD4+ /CD8+ lymphocyte decreased at 7 d after irradiation (t=3.193, 3.656, 3.219, 2.641, P<0.05), and the percentage of CD3+ lymphocyte decreased at 14 d after irradiation (t=3.031, P<0.05). But after irradiation, there were no significant changes in spleen organ index, B lymphocyte, CD3+ CD4+ lymphocyte and CD8+ lymphocyte.@*Conclusions@#Local hepatoma radiotherapy causes imbalance of lymphocytes in distal spleen of mice and hence reduces immunity, which provides a novel mechanism of radiological immunity damage.
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@#A Mn-clusters-porphyrin metal-organic framework nanosheet(nMn-MOF)was synthesized by coordination chelation to enhance photodynamic therapy. The nanosheet was characterized by dynamic light scattering, transmission electron microscopy and X-ray photoelectron spectroscopy. Oxygen sensor and ICG were used to investigate the production of oxygen and the singlet oxygen(1O2)generation. The cytotoxicity of the nanosheet against tumor cells were detected by CCK-8 assay, and the anti-hypoxia and oxygen-generation ability of nanosheets were investigated by fluorescence staining assay. The results indicated that this nanosheet could catalyze the intracellular H2O2 into O2, which overcame the tumor hypoxia. Furthermore, the generated oxygen was converted to cytotoxic 1O2 under the near infrared light irradiation, thereby enhancing photodynamic therapy.
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Objective@#To explore the clinical application effects of autologous platelet-rich plasma gel in the repair of various chronic wounds.@*Methods@#From January 2015 to January 2018, 76 patients with chronic wounds were admitted to our unit, with 39 men and 37 women, aged 28 to 75 (52±6) years. Before the operation, areas of wounds ranged from 2.0 cm×0.5 cm to 17.0 cm×5.0 cm, depths of wounds ranged from 1 to 6 cm, areas of wounds substrate ranged from 3 cm×3 cm to 17 cm×8 cm, and volumes of deep cavities ranged from 7 to 55 mL. All patients received operation 2 to 7 days after admission. Autologous platelet of 220-250 mL was collected from each patient by single extraction to make platelet-rich plasma of 10-50 mL. The cavity was filled completely by injection of platelet-rich plasma gel for 1-3 times. Wounds were sutured directly or covered by local flaps or other materials according to the conditions of wounds, and the unclosed wounds in primary stage were treated by continuous vacuum sealing drainage (VSD). Ultrasound, CT, or magnetic resonance imaging was performed to detect the healing of cavity after the operation. The healing of wound and repair of cavity after the operation and during follow-up were observed.@*Results@#Wounds in 39 patients were closed directly after primary operation. Among them, wounds of 36 patients were healed completely, and wounds of the other 3 patients were healed completely after second debridement and topical filling of platelet-rich plasma gel. The cavities in 35 patients were filled with granulation tissue after treatment of platelet-rich plasma gel for 1-3 times combined with VSD, and the wounds were healed after skin grafting or flap transplantation. The treatment of wounds discontinued in the other 2 patients after treatment of platelet-rich plasma gel for once. Postoperative follow-up was lost in 7 patients. During follow-up of 2 and/or 4 months after the primary operation, wounds were healed well with no recurrence, and cavities were filled with fibrous tissue.@*Conclusions@#Autologous platelet-rich plasma gel has advantages in treating chronic wounds, including a large amount by single extraction, flexible use mode, ability to fully fill the complex cavity, high surgical safety, and mild secondary injury. It′s a new choice for repair of chronic wounds in clinic.
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Objective@#To investigate the effects of platelet-rich plasma (PRP) combined with polylactic acid/polycaprolactone (PLA/PCL) on healing of mininature pig deep soft tissue defect caused by fragment injury.@*Methods@#Two male Bama miniature pigs with 11 to 12 months (the same below) were selected by lottery to prepare PRP. The other twenty-seven male Bama miniature pigs were used to reproduce deep soft tissue defect caused by high-explosive ammunition fragment injury on bilateral posterior femoral region. According to the random number table, 27 pigs were divided into control group, material group, and PRP+material group, with 9 pigs in each group. After debridement, wounds of pigs in material group and PRP+material group were filled with PLA/PCL and PLA/PCL+2 mL activated PRP, respectively. Pigs in each group received suture of full-thickness skin to close the wounds. The operative duration was recorded. The length and volume of wounds of pigs in the above groups were measured immediately after surgery. In 1, 2, and 4 weeks after surgery, 3 pigs in each group were sacrificed to collect femoral wounds tissue on two sides, and PLA/PCL were collected from wounds of pigs in material group and PRP+material group for general observation of wounds tissue and degradation of the material. In 2 and 4 weeks after surgery, wounds tissue was obtained to observe the histological changes by hematoxylin-eosin staining, and expressions of transforming growth factor β (TGF-β) and vascular endothelial growth factor (VEGF), and angiogenesis were determined by immunohistochemical method. In 1, 2, and 4 weeks after surgery, wounds tissue was collected to determine mRNA expressions of TGF-β and VEGF by real-time quantitative reverse transcription polymerase chain reaction. Data were processed with analysis of variance of factorial design, one-way analysis of variance, and least significant difference-t test.@*Results@#(1) There were no significantly statistical differences in length and volume of the wounds of pigs among the three groups (F=0.336, 0.282, P>0.05). The operative duration in control group [(30.9±2.1)min] was significantly shorter than that of material group [(39.7±2.2)min] and PRP+material group[(40.0±2.6)min], t=-11.45, -11.88, P<0.01. (2) There were respectively 10, 7, and 5 wounds tissue with infection in pigs of control group, material group, and PRP+material group. In 1, 2, 4 weeks after surgery, all of the wounds tissue of pigs was infected in control group, while none of wounds tissue of pigs was infected in material group and PRP+material group. In pigs of material group and PRP+material group, materials and tissue were easily separated in 1 week after surgery; some materials were integrated with tissue and showed a tendency of degradation in 2 weeks after surgery; materials were completely embedded with tissue in 4 weeks after surgery. (3) In pigs of control group, erythrocytes and inflammatory cells infiltration in wounds tissue were observed in 2 weeks after surgery, and necrotic tissue and inflammatory cells infiltration in wounds tissue were still observed in 4 weeks after surgery. In pigs of material group and PRP+material group, a large number of erythrocytes and inflammatory cells infiltration were observed in 2 weeks after surgery. Compared with that of material group, wounds tissue of pigs in PRP+material group had no inflammatory cells infiltration in 4 weeks after surgery. (4) Protein expressions of TGF-β in fibroblasts and multinuclear macrophagocytes, VEGF in fibroblasts and vascular endothelial cells, and blood vessel formation in wounds tissue of pigs in PRP+material group were significantly more than those of pigs in control group and material group in 2 and 4 weeks after surgery. (5) The mRNA expression of TGF-β in wounds tissue of pigs in material group was significantly higher than that in control group in 4 weeks after surgery (t=-3.93, P<0.01). Compared with those of pigs in control group and material group, the mRNA expression of TGF-β in wounds tissue of pigs in PRP+material group was significantly increased at each time point (t=9.23, 13.81, 11.73, -7.51, -12.04, -7.80, P<0.01). The mRNA expression of VEGF in wounds tissue of pigs increased significantly in material group compared with that of pigs in control group in 4 weeks after surgery (t=-3.94, P<0.01). Compared with those of pigs in control group and material group, the mRNA expression of VEGF in wounds tissue increased significantly in wound tissue of pigs in PRP+material group at each time point (t=12.33, 3.95, 7.97, -11.36, -2.97, -4.04, P<0.01).@*Conclusions@#PRP combined with PLA/PCL can accelerate wound healing of deep soft tissue defect of mininature pigs caused by fragment injury by providing physical scaffold for newborn tissue growth, promoting mRNA and protein expressions of TGF-β and VEGF.
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Background@#Extralevator abdominoperineal excision (ELAPE) has become a popular procedure for low rectal cancer as compared with abdominoperineal excision (APE). No definitive answer has been achieved whether one is superior to the other. This study aimed to evaluate the safety and efficacy of ELAPE for low rectal cancer with meta-analysis.@*Methods@#The Web of Science, Cochrane Library, Embase, and PubMed databases before September 2019 were comprehensively searched to retrieve comparative trials of ELAPE and APE for low rectal cancer. Pooled analyses of the perioperative variables, surgical complications, and oncological variables were performed. Odds ratio (OR) and mean differences (MD) from each trial were pooled using random or fixed effects model depending on the heterogeneity of the included studies. A subgroup analysis or a sensitivity analysis was conducted to explore the potential source of heterogeneity when necessary.@*Results@#This meta-analysis included 17 studies with 4049 patients, of whom 2248 (55.5%) underwent ELAPE and 1801 (44.5%) underwent APE. There were no statistical differences regarding the circumferential resection margin positivity (13.0% vs. 16.2%, OR = 0.69, 95% CI = 0.42-1.14, P = 0.15) and post-operative perineal wound complication rate (28.9% vs. 24.1%, OR = 1.21, 95% CI = 0.75-1.94, P= 0.43). The ELAPE was associated with lower rate of intraoperative perforation (6.6% vs. 11.3%, OR = 0.50, 95% CI = 0.39-0.64, P < 0.001) and local recurrence (8.8% vs. 20.5%, OR = 0.29, 95% CI = 0.21-0.41, P < 0.001) when compared with APE.@*Conclusions@#The ELAPE was associated with a reduction in the rate of intra-operative perforation and local recurrence, without any increase in the circumferential resection margin positivity and post-operative perineal wound complication rate when compared with APE in the surgical treatment of low rectal cancer.
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BACKGROUND@#Extralevator abdominoperineal excision (ELAPE) has become a popular procedure for low rectal cancer as compared with abdominoperineal excision (APE). No definitive answer has been achieved whether one is superior to the other. This study aimed to evaluate the safety and efficacy of ELAPE for low rectal cancer with meta-analysis.@*METHODS@#The Web of Science, Cochrane Library, Embase, and PubMed databases before September 2019 were comprehensively searched to retrieve comparative trials of ELAPE and APE for low rectal cancer. Pooled analyses of the perioperative variables, surgical complications, and oncological variables were performed. Odds ratio (OR) and mean differences (MD) from each trial were pooled using random or fixed effects model depending on the heterogeneity of the included studies. A subgroup analysis or a sensitivity analysis was conducted to explore the potential source of heterogeneity when necessary.@*RESULTS@#This meta-analysis included 17 studies with 4049 patients, of whom 2248 (55.5%) underwent ELAPE and 1801 (44.5%) underwent APE. There were no statistical differences regarding the circumferential resection margin positivity (13.0% vs. 16.2%, OR = 0.69, 95% CI = 0.42-1.14, P = 0.15) and post-operative perineal wound complication rate (28.9% vs. 24.1%, OR = 1.21, 95% CI = 0.75-1.94, P = 0.43). The ELAPE was associated with lower rate of intraoperative perforation (6.6% vs. 11.3%, OR = 0.50, 95% CI = 0.39-0.64, P < 0.001) and local recurrence (8.8% vs. 20.5%, OR = 0.29, 95% CI = 0.21-0.41, P < 0.001) when compared with APE.@*CONCLUSIONS@#The ELAPE was associated with a reduction in the rate of intra-operative perforation and local recurrence, without any increase in the circumferential resection margin positivity and post-operative perineal wound complication rate when compared with APE in the surgical treatment of low rectal cancer.
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@#AIM: To study the expressions of TGFBI and microtubule-associated protein 1 light chain 3 alpha(LC3)in granular corneal dystrophy, and the influences of lithium chloride(LiCl)on corneal stromal fibroblast cell proliferation by TGFBI. <p>METHODS: Immunohistochemistry and Western-blot assays were used to detect the expression levels of TGFBI and LC3 in corneal dystrophy and normal corneal tissues. TGFBI overexpression vector was transfected into corneal stromal fibroblasts, and then the cells were treated with 5, 10, 20, 40mmol/L LiCl for different times(0, 1, 6, 12h), and Western-blot assay was performed to evaluate the expression levels of TGFBI and LC3, and CCK-8 assay was carried out to assess cell proliferation activity.<p>RESULTS: TGFBI and LC3 were highly expressed in corneal tissues of patients with corneal dystrophy. TGFBI overexpression inhibited the proliferation ability of corneal stromal fibroblasts(<i>P</i><0.05). LiCl inhibited the expression levels of TGFBI and LC3, and enhanced the cell proliferation activity in corneal stromal fibroblasts transfected with mutant TGFBI(<i>P</i><0.05).<p>CONCLUSION: LiCl promoted the proliferation and autophagy of corneal stromal fibroblasts, and its mechanism may be related to down regulated expressions of TGFBI and LC3.
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OBJECTIVE@#To analyze the expression characteristics of leukemia stem cell (LSC) antigen in acute myeloid leukemia (AML) and to explore the correation of LSC-specific antigens with the subtypes, cytogenetics and clinical efficacy of AML.@*METHODS@#A total of 61 newly diagnosed patients with AML (except M3) hospltalized in Department of Hematology of our hopital were selected from January 2013 to March 2016. The immun phenotypes and expression of Tim-3, CD96 and CD123 on leucamia cells were detected by direct immunofluorescenct flow cytometry. 61 patients were divided into positive expression and megative expression groups according to expression of Tim-3, CD96 and CD123; the correlation of LSC antigen expression level with high WBC count, chromosome and therapeutic efficacy was analyzed.@*RESULTS@#Among 61 newly diagnosed patients with AML (except M3), the expression rate of Tim-3, CD96 and CD123 was 52.45%, 44.26% and 55.73% respectively. The expression rates of Tim-3, CD96 and CD123 between the AML subtypes and total patients was not stetistically different (P>0.05). The high WBC count occurred more easily in AML (except MS) patients with positive expression of Tim-3, CD96 and CD123, but compared with AML patients with negative espression, the difference was not statstically significant (P>0.05). The proportion of chromosone karyotype with poor prognosis detected in patients with positive expression of Tim-3 and CD96 was higher than that in patients with negative expreesion (P0.05). After 2 courses of chemotherapy, the complete remission (CR) rate in patients with positive expression of Tim-3, CD96 and CD123 was significantly lower than that in patients with negative expression of Tim-3, CD96 and CD123 (P0.05), while the difference of OS time in patients with positive and negative expression of CD123 was not significant (P>0.05).@*CONCLUSION@#The expression levels of Tim-3, CD96 and CD123 in newly diagnosed AML (except M3) sybtype patients are not significantly different form those in total patients. The high WBC count ocours more easily in patients with positive expression of Tim-3, CD96 and CD123. After 2 course of chemotherapy, the CR rate in patients with positive expression of Tim-3, CD96 and CD123 was significantly lower than that in patients with negative expression. The proportion of chromsome karyotype with poor prognosis detected in patients with positive expression of Tim-3 and CD96 is high, moreover, OS time in patients with positive expression of Tim-3 and CD96 is shorter than that in patients with negative expression.
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Humans , Antigens, CD , Flow Cytometry , Interleukin-3 Receptor alpha Subunit , Leukemia, Myeloid, Acute , Prognosis , Stem CellsABSTRACT
ABSTRACT In order to establish an optimal soybean embryonic tip regeneration system that can serve as soybean genetic transformation receptor, and be used for the study of genetic function verification, the influences of single factor on the adventitious bud of embryonic tip induction, elongation and rooting stage, are researched and compared.The single factors includes seeds soaking time, different kinds of hormones, different concentration of hormone and different concentration of sucrose. By one-way ANOVA and LSD ad hoc test , the results show that, for the embryonic tip adventitious bud induction stage, 12h is the optimal seeds soaking time, 2.0mg·L-1 is the optimal concentration of 6-Benzyl Aminopurine(6-BA), for the embryonic tip adventitious bud elongation stage, 0.2mg·L-1 indole-3-butyric acid (IBA) is optimal and 2.0mg·L-1Gibberellic acid (GA3) is optimal, and for the adventitious bud of embryonic tip rooting stage, 2.0mg·L-1 IBA is optimal,the average rooting rate is 93.34%. An Optimal embryonic tip regeneration system is established, and optimum mediums in different stages are found.
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Objective To evaluate transoral Orvil EEA stapler (OrVil) procedure in laparoscopic total gastrectomy for cardiac carcinoma compared with conventional anvil head method (purse-string suture).Methods From May 2014 to December 2014 20 cases were included into OrVil group,and 25 cases into purse-string suture group.Results The two groups had similar mean numbers of dissected lymph nodes [(25 ± 3) vs.(24 ± 4),t =1.067,P =0.292],the mean time of operation,intraoperative blood loss,and postoperative complications (5 vs.6,P =0.938).The length of incision was significantly shorter [(5 ±1) cm vs.(11 ± 2) cm,t =-10.724,P ＜ 0.0l] and the esophagojejunostomy time was significantly less [(28 ± 4) min vs.(39 ± 5) min,t =-7.996,P ＜ 0.01] with the use of OrVil.The time to first flatus and postoperative hospital stay were (3.7 ± 0.9) d vs.(4.4 ± 1.0) d,t =-2.485,P =0.017 and (13 ± 5) d vs.(16 ±4) d,t =-2.184,P =0.035.Conclusions OrVil is a technically safe and feasible surgical procedure for esophagojejunostomy in laparoscopy assisted total gastrectomy in the treatment of cardiac carcinoma.
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Abstract?AlM:To investigate effect and safety of the limbal stem cell transplantation combined with low concentrations of mitomycin C for pterygium patients with type 2 diabetes mellitus (T2DM).? METHODS: Eighty patients of 96 pterygium eyes admitted to hospital were divided into groups of high concentration, low concentration group and the control group, and 3 groups were given pterygium excision combined with limbal stem cell transplantation. The high concentration group, the low concentration groups were given prior to stem cell transplantation 0. 2, 0. 1mg/mL mitomycin C coverage. The cure rate and recurrence rate in three groups of patients, as well as visual acuity before and after treatment were compared.?RESULTS: Three groups patients' visual acuity were significantly improved after treatment (P0. 05);epithelial healing time of high concentration group was significantly higher than low concentration group and the control group (P0. 05); cure rates of low concentration group was higher than high dose group, the recurrence rate in low concentration group was lower than the high dose group.? CONCLUSlON: Pterygium excision combined with limbal stem cell transplantation has significant efficacy for pterygium, and mitomycin C can effectively reduce the relapse rate, but for the patients with T2DM concentration of mitomycin C should be reduced.
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<p><b>OBJECTIVE</b>To study the safety and feasibility of transorally inserted anvil (OrVil(TM)) in laparoscopic-assisted radical resection for Siewert type II adenocarcinoma of the esophagogastric junction (AEG).</p><p><b>METHODS</b>Clinical data (operative time, rate of thoracotomy, residual cancer in the proximal margin, and postoperative recovery) of 72 patients suffered from Siewert type II AEG were analyzed retrospectively, including 46 cases of applying OrVil(TM) in digestive tract reconstruction for laparoscopic-assisted radical resection and 26 cases of applying pouch clamp embedding anvil, between May 2009 and August 2012 in Department of Minimally Invasive Gastrointestinal Surgery at the Peking University Cancer Hospital and Institute.</p><p><b>RESULTS</b>The length between proximal margin and superior border of tumor was (2.5±1.5) cm in OrVil(TM) group, significantly longer than that in the traditional group [(1.6±1.1) cm, P<0.01]. Moreover, the intraoperative frozen pathological positive incidence of cancer remnant was 2.2% (1/46), and rate of thoracotomy was 0, both of which were significantly lower as compared to the traditional group [23.1% (6/26) and 15.4% (4/26) respectively, both P<0.01]. However, intraoperative blood loss and postoperative complications did not differ between the two groups (both P>0.05).</p><p><b>CONCLUSIONS</b>As for laparoscopic-assisted Siewert type II AEG radical resection, application of OrVil(TM) in digestive tract reconstruction is a safe surgical procedure, and can effectively reduce the rate of intra-operative thoracotomy, which is beneficial to postoperative recovery.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma , General Surgery , Esophageal Neoplasms , General Surgery , Esophagogastric Junction , Gastrectomy , Methods , Laparoscopy , Methods , Retrospective Studies , Stomach Neoplasms , General SurgeryABSTRACT
P13K/Akt signaling pathway is an classic anti-apoptotic,urge-survival signal transduction pathway.It plays important regulation and control roles in neurons apoptosis.PTEN ( phosphatase and tensin homolog deleted on chromosome 10) is a highly conservative tumor suppressor gene with a dual-specificity phosphatase activity.PTEN protein can specifically dephosphorylats the 3 position of phosphoinositides,antagonize the PI3K/Akt signaling pathway,as negativity regulation and control roles to cell survival and growth.This review summarizes the progresses of the composition,function in PI3 K/Akt and PTEN,and the relationship with developing brain after hypoxia-ischemia.
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This study was aimed to dynamically observe the expression level of lactate dehydrogenase (LDH) in MDS patients and to explore the significance of LDH level for prognostic judgement of MDS patients. The expression level of LDH in 163 confirmedly diagnosed patients from 2001 to 2009 years in our hospital, the changes of LDH level in follow-up patients and relation of the LDH changes to prognosis, survival time and MDS progression, as well as the relation of LDH level to blood cell count, ratio and karyotype of blast cells in bone marrow were analyzed retrospectively. The results showed that the median LDH level in 163 MDS patients at diagnosis was 214 U/L (range 102 - 865 U/L), the median survival time of patients with increased LDH (> 240 U/L) was 25.6 months which was significantly shorter than that of patients with normal LDH level (56.8 months)(p < 0.05). When MDS patients were classified according to IPSS, the increased LDH level in MDS patients was observed in high risk and intermediate II groups (337.20 ± 298.00 U/L and 234.07 ± 216.00 U/L, respectively) which was significantly higher than that in low risk group (154.94 ± 46.08 U/L) (p < 0.05). The LDH level in patients with MDS progression was obviously enhanced while LDH level in patients without progression was not enhanced, mainly maintained in stable level as compared with LDH level at diagnosis and before progression (p < 0.005). By multivariate analysis, the increase of LDH level was found to be an independent prognostic factor. It is concluded that the LDH level may be used as indicator for judging prognosis of MDS patients, which is helpful to early recognition of MDS progression and risk stratification of disease, as well as selection of rational therapy.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , L-Lactate Dehydrogenase , Blood , Myelodysplastic Syndromes , Blood , Diagnosis , Prognosis , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To study the effects of PI3K/Akt signaling pathway inhibitor wortmannin on long-term learning and memory abilities in neonatal rats with hypoxic-ischemic brain damage (HIBD).</p><p><b>METHODS</b>Forty-eight neonatal rats were randomly assigned to blank control (n=8), sham-operated (n=8), HIBD model (n=10), HIBD+DMSO (dimethyl sulfoxide, n=8) and HIBD+wortmannin groups (n=8). Wortmannin (2 μL) was injected to the left hippocampus 30 minutes before HIBD inducement in the HIBD+wortmannin group. The Morris water maze test was used to examine the long-term learning and memory abilities at the age of 28 days.</p><p><b>RESULTS</b>With the increased number of swimming, the escape latency was shortened in various groups. From the second day, the escape latency in the HIBD+wortmannin group was significantly longer than that in the sham-operated and the blank control groups (P<0.05), and the differences increased with the time. On the fourth day, there were significant differences in the escape latency between the HIBD+wortmannin group and the HIBD+DMSO group as well as the HIBD model group (P<0.05). On the eighth day (retention trial), there were the most obvious differences in the escape latency between the HIBD+wortmannin group with the other four groups. In the space exploration test, the number of times crossing the former platform location within 120 seconds after removing the platform in the HIBD+DMSO and the HIBD model group was lower than the sham-operated and the blank control groups (P<0.05). The HIBD+wortmannin group showed lower number of times crossing the former platform location compared with the HIBD+DMSO and the HIBD model groups (P<0.05), as well as the sham-operated and the blank control groups (P<0.01).</p><p><b>CONCLUSIONS</b>P13K/Akt signaling pathway inhibitor wortmannin can aggravate the cognitive impairments, thus affecting adversely long-term learning and memory abilities in neonatal rats with HIBD.</p>
Subject(s)
Animals , Rats , Androstadienes , Pharmacology , Animals, Newborn , Dimethyl Sulfoxide , Pharmacology , Hypoxia-Ischemia, Brain , Psychology , Learning , Maze Learning , Memory , Phosphatidylinositol 3-Kinases , Physiology , Proto-Oncogene Proteins c-akt , Physiology , Rats, Sprague-Dawley , Signal Transduction , PhysiologyABSTRACT
AIM: To investigate the biocolonization of poly 2-hydroxyethy methacrylate (PHEMA) sponge with cornea tissue and evaluate the therapeutic effects of modified porous poly 2-hydroxyethy methacrylate-Polymethyl met-hacrylate (PHEMA-PMMA) Keratoprostheses (KPro) on rabbit and monkey corneas. METHODS:The KPro were made using two-stage polymerization combined with mechanical cutting. The experiment was divided into two groups. In the control group, ten normal rabbit eyes received lamellar implanta-tion of PHEMA sponges. The sponges were obtained 2 weeks, 1,2,3 and 4 months after operation. The cell proliferation and neovascularization inside the sponges were observed using light and transmission electron microscopy (TEM) and immunohistochemistry. In the experimental group, the porous PHEMA-PMMA KPros were inserted into the lamellar pockets of eight rabbit corneas and two monkey corneas (stage I operation). The healing process was investigated by slit-lamp microscopy. The anterior lamellar cornea tissues were removed 3 months after surgery, exposing the under-neath transparent core (stage II operation). The operated eyes were then followed up for 3-6 months.light microscope, fibroblasts started to grow into the cornea 2 weeks after operation; lots of cells, accompanied with new blood vessels, invaded into the cornea 2-3 months after surgery. Invading cells of sponge, as well as keratocytes, were positive for vimentin. Under the electron microscope, the invading cells looked healthy and were surrounded by extracellular matrix and collagen. In 8 rabbit eyes which received KPro implantation, anterior lamellar cornea melting happened in two eyes after the stage II operation. The remaining 6 corneas retained their central cores during observation after the stage II operation.Two monkey operated eyes were found no complication thoughout the whole follow-up.cornea. The modified PHEMA-PMMA KPros have obtained a relatively stable results after implantation into animal corneas.