ABSTRACT
Objective:To investigate the clinical efficacy and safety of intravenous thrombolysis with different doses of alteplase in the treatment of acute cerebral infarction in older adult patients.Methods:A total of 65 older adult patients with acute cerebral infarction (onset within 4.5 hours, age ≥ 75 years) who underwent intravenous thrombolysis in Wenzhou Central Hospital from February 2021 to February 2022 were included in this study. They were randomly assigned to undergo intravenous thrombolysis with either low dose alteplase (0.6 mg/kg, low dose group, n = 32) or standard dose alteplase (0.9 mg/kg, standard dose group, n = 33). The National Institutes of Health Neurological Stroke Scale score before and 24 and 48 hours after treatment, modified Rankin scale score before and 7, 14 and 90 days after treatment, serum C-reactive protein (CRP), neuron-specific enolase (NSE) and tumor necrosis factor-α (TNF-α) levels before and 24 hours after treatment, 24-hour incidence of intracranial hemorrhage, 24-hour incidence of symptomatic intracranial hemorrhage, and 90-day mortality were compared between the two groups. Results:Compared with before treatment, the National Institutes of Health Neurological Stroke Scale scores in each group were significantly decreased at 24 and 48 hours after treatment (low dose group, t24 h = 6.78, t48 h = 7.86; standard dose group: t24 h = 8.09, t48 h = 10.13, all P < 0.001). Compared with before treatment, the modified Rankin scale score in each group was significantly decreased at 7, 14 and 90 days after treatment (low-dose group: t7 d = 5.19, t14 d = 8.47, t90 d = 9.85; standard dose group: t7 d = 6.83, t14 d = 7.74, t90 d = 13.66, all P < 0.001). At 24 hours after treatment, serum levels of CRP, NSE, TNF-α in each group were significantly decreased (low-dose group: tCRP = 5.13 , tNSE = 4.22, tTNF-α = 34.29; standard dose group: tCRP = 4.87, tNSE = 5.53, tTNF-α = 31.98, all P < 0.001). At each time point after treatment, there were no significant differences in these indices between the two groups (all P > 0.05). The 24-hour incidence of intracranial hemorrhage in the low dose group was significantly lower than that in the standard dose group ( χ2 = 4.58, P = 0.032). There were no significant differences in incidence of symptomatic intracranial hemorrhage and 90-day mortality between the two groups (all P > 0.05). Conclusion:Intravenous thrombolysis with low dose alteplase (0.6 mg/kg) for the treatment of acute cerebral infarction in older adult patients exhibits equivalent clinical efficacy to that with standard dose alteplase (0.9 mg/kg), and the former is much safer than the latter.
ABSTRACT
Objective To investigate the effect of minimally invasive surgery in patients with midge-upper advanced gastric cancer (AGC). Methods 167 patients with middle-upper AGC underwent total gastrectomy+D2 lymph node dissection from January 2009 to December 2013 were enrolled in the study and divided into laparoscopic assisted total gastrectomy (LATG) group (n = 57) and open total gastrectomy (OTG) group (n = 110). Baseline data, operative, postoperative data and follow-up result were compared between the two groups. Results There were no significant differences in baseline data between the two groups (P > 0.05); The intraoperative blood loss and incision length in LATG group were significantly lower than that in OTG group (P 0.05); Postoperative first aerofluxus time, ecovery liquid diet time, postoperative hospitalization days and VAS score of pain in 3 d after operation in LATG group were significantly lower than that in OTG group (P 0.05); There was no patient dying within 30 d after surgery.The median follow-up time was 38.2 months (1~58 months). Postoperative 1, 3 year overall survival rates in LATG group and OTG group were 87.7% and 83.6%, 71.9% and 64.5%, and there were no significant differences between the two groups (P > 0.05). Conclusion For patients with middle-upper AGC, LATG+D2 lymph node dissection has lots of advantages including less intraoperative blood loss, shorter incision, faster postoperative recovery, shorter hospital stay and so on, which is safe and effective, and their short-and long-term results are satisfactory.
ABSTRACT
Objective To investigate the inhibitory effects of oridonin combined with gemcitabine on pancreatic cancer SW1990 cells in vitro, and the potential mechanisms thereof. Methods The pancreatic cancer SW1990 cells were treated with vehicle alone and various concentrations (10,20,40,80 and160μmol/L) of oridonin, followed by 24, 48 and 72 h cell culture. Effects of oridonin on cell proliferation were determined by using a CCK-8 kit. SW1990 cells were treated with oridonin (40μmol/L) and gemcitabine (20μmol/L) alone or together for 48 h, and the untreated cells were used as the con-trol. The cell survival rate was detected by CCK-8 assay. Apoptosis induction was assessed by using Annexin V-FITC kit. Semi-quantitative RT-PCR was used to examine the changes of NF-κB mRNA and XIAP mRNA expressions. Results Oridonin inhibited the growth of pancreatic cancer SW1990 cells in a dose-and time-dependent manner. Compared with the other groups, the cell survival rate was significantly lower in the combination group (P<0.05). Oridonin combined with gemcitabine induced a higher percentage of apoptosis in pancreatic cancer cells than that of oridonin or gemcitabine alone (P<0.05). Moreover, the expressions of NF-κB and XIAP mRNA in pancreatic carcinoma cells were obviously down-regu-lated in combination group (P<0.05). Conclusion Oridonin can enhance the antitumor effect of gemcitabine on pancreatic cancer in vitro, which may be related to through the down-regulation of NF-κB and its downstream of XIAP, and then induc-ing cell apoptosis in pancreatic cancer.
ABSTRACT
It makes review on the application of CD-DST on clinical treatment and sci-research of the carcinoma of large intestine from its technological principle and characteristics.It views that as an advanced test technology of medical allergy in vitro, there’s successful report in clinical treatment and concerned scientific study of tumor, however, it’s mainly used in lung cancer and gynecological tumor, the application in the carcinoma of large intestine waits for promotion.