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Objective To investigate the incidence of intraoperative hypothermia in elderly patients,and to analyze and discuss related influencing factors and targeted management strategies.Methods From February 2017 to February 2019,220 elderly patients admitted into our hospital for surgery were selected.According to whether or not they had intraoperative hypothermia,patients were divided into the hypothermia group and the non-hypothermia group.General information and surgical data were compared between the two groups.Measures for the prevention of intraoperative hypothermia were discussed.Results Of the 220 patients,103 had intraoperative hypothermia,and the incidence rate was 46.8％.The proportion of patients aged ≥70 years or with BMI ＜24 kg/m2 was higher in the hypothermia group than in the non-hypothermia group (all P ＜ 0.05).The proportion of patients with the anesthesia time ≥60 min or total intraoperative fluid intake ≥2000 ml was higher in the hypothermia group than in the non-hypothermia group(all P＜0.05).BMI ＜24 kg/m2 and total intraoperative fluid intake ≥ 2000 ml were the key risk factors for intraoperative hypothermia in elderly patients(all P＜0.05).Conclusions Intraoperative hypothermia is a common complication for elderly patients undergoing surgery.Intraoperative fluid intake and body mass are the key risk factors for intraoperative hypothermia.Targeted treatment measures based on the above related factors should be considered for elderly patients receiving surgery.
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Objective To evaluate the efficacy and safety of transcatheter hepatic arterial chemoembolization (TACE) combined with CT guided radiofrequency ablation (RFA) for primary liver cancer in the caudate lobe.Methods Sixteen patients with primary liver cancer in the caudate lobe were treated with combination therapy of TACE and RFA.Complet ablation rate,overall and recurrence-free survival,and complications were evaluated.Results A total of 15 cases achieved complet ablation,complet ablation rate was 93.75％ (15/16).Recurrence-free survival time was 19.35 months,overall survival time was 44.62 months.Overall survival rates were 88.23％,66.65％ and 33.18％ at 1,3,5 years after therapy,respectively.Conclusion TACE combined with RFA is a safe and useful therapeutic option for treatment of primary liver cancer in the caudate lobe.
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Objective To investigate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with CT-guided thermal ablation (radiofrequency ablation or microwave ablation) in treating intrahepatic cholangiocarcinoma.Methods The clinical data of 14 patients with pathologicallyproved intrahepatic cholangiocarcinoma,who were admitted to authors' hospital during the period from September 2009 to July 2013 to receive TACE with subsequent radiofrequency ablation (RFA) or microwave ablation (MWA),were retrospectively analyzed.A total of 18 lesions were detected in the 14 patients.The maximal diameter of the lesion (or the sum of maximal diameters if there were multiple lesions) ranged from 2.2 cm to 7.2 cm (mean 4.2±1.4 cm).After TACE,the lesion's complete ablation rate,surgical complications,tumor-free survival time and overall survival time were evaluated.Results Complete ablation was obtained in 15 lesions (83.3％,15/18).The incidence of moderate complications was 6.2％,and no severe complications or death occurred.After the treatment,the patients were followed up for 6-14 months,with a mean of (16.0±10.3) months.At the end of follow-up,6 patients (42.9％,6/14) died.The median tumor-free survival time in patients whose lesions obtained complete ablation was 17 months.The median survival time of all patients was 20 months.The 1-,2-and 3-year overall survival rates were 82.5％,41.3％ and 20.6％ respectively.Conclusion TACE combined with thermal ablation can be regarded as one of the treatment options for intrahepatic cholangiocarcinoma.
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Objective To compare laparoscopic Keyhole parastomal hernia repair with re-ostomy technique or without re-ostomy in the treatment of stoma hernia,then analyze the advantages of reconstruction ostomy,and summarize the key technical points of the reconstruction operation.Methods From Jan 2010 to Dec 2016,68 stoma hernia patients underwent laparoscopic Keyhole parastomal hernia repair with reostomy technique,52 patients underwent laparoscopic Keyhole parastomal hernia repair without re-ostomy technique.The preoperative,intraoperative and postoperative parameters were analyzed.Results Compared to without re-ostomy group,the re-ostomy reconstruction group had low incidence rate of intestinal fistula (x2 =5.411,P =0.033),patch infection (x2 =6.823,P =0.014),the incidence of postoperative serous swelling and serum swelling (x2 =14.266,P ＜0.001),postoperative recurrence (x2 =8.688,P =0.005) and postoperative appearance dissatisfaction (x2 =9.479,P =0.004).Conclusion Laparoscopic parastomal hernia repair and re-ostomy technique reduces the incidence rate of intestinal fistula,patch infection and serous swelling and serum swelling,decreases the postoperative recurrence rate and appearance dissatisfaction.
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Objective:To explore the characteristics of immunological reconstitution of T-cell subsets and the role of Cornus,a Chinese medicinal herb on T lymphocytes in mice after irradiation (IR). Methods:Irradiated model mice were exposed to a single dose of X-ray radiation (2. 6 Gy) with or without Cornus treatments. Bloodroutine was examined before or after irradiation. CD3+,CD4+, CD8+ T cells and Th1, Tc1, Th2, Th17, Treg from spleen or peripheral blood were determined by flow cytometry. Results: Total lymphocytes and CD3+T cells including CD4+T and CD8+T cells,were significantly reduced 3 days after irradiation (P<0. 05). The re-constitution of CD3+ T cells ( especially CD8+T cells ) started from 5 days post irradiation, CD4+T cells increased 8 days after irradiation. However,the production of IFN-γ by Th1 or Tc1 cells were evidently decreased compared with control group even 8 days post irradiation (P<0. 05). In contrast to Th1,Th2/Th17/Treg were observably increased in irradiation group (P<0. 05). But the percentage of Th1 was obviously increased, and Th2, Th17, Treg were markedly decreased in cornus treated mice compared with irradiated mice (P<0. 05). Conclusion: The immunological reconstitution of T lymphocytes started from 5 days after total irradiation with rapid recovery of CD8+ T cells but not CD4+T cells. Cornus effectively improved the imbalance of T cell subsets by promoting the proliferation of Th1 and suppressing Th17 and Treg.
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Gas chromatography with mass spectrum detector ( GC-MSD) coupled with purge-and-trap system was set up to analyze the concentration of isoprene in natural waters. The best experimental conditions were established, including purge gas flow rate ( 50 mL/min ) , purge time ( 15 min ) , the optimum capillary column ( Rt-Alumina BOND/KCl) and the appropriate condition of temperature programming. When analyzing isoprene in natural waters, the precision was <4% (n=6), the detection limit was 0. 5 pmol/L and the recovery was 91%-102%. The preservative experiment showed that there was no obvious variation in sample concentrations of isoprene within 60 days. The concentrations of isoprene measured with the method ranged from 60 . 8 to 278 . 7 pmol/L in the Jiaozhou Bay and its adjacent river estuaries and from 44 . 7 to 77 . 2 pmol/L in Yellow River estuary, which was in good accord with those results reported in literatures in other coastal waters. In conclusion, the analytical method could meet the requirements of the analysis of concentration of isoprene in natural waters.
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BACKGROUND:Fluorouracil is a basic chemotherapy drug for gastric cancer, and its drug resistance is commonly seen in clinic. Cancer stem cels have low sensitivity to chemotherapy drugs, which may be an important cause of tumor recurrence and progression folowing chemotherpay. OBJECTIVE: To explore the sensitivity of gastric cancer stem cels to 5-fluorouracil and related biology mechanism underlying multidrug resistance. METHODS: Stem cel marker CD44 and multidrug resistance protein thymidylate synthase in 69 cases of gastric cancer tissues were tested by immunohistochemical staining. The selection strategy was based on the clonal morphology, and gastric cancer stem cels were isolated from human gastric cancer cel line AGS to detect the expression of CD44 and thymidylate synthase and the self renewing ability. Inhibitory concentration 50 (IC50) of 5-fluorouracil in different AGS cel clone was detected using cel counting kit-8. RESULTS AND CONCLUSION:In 69 cases of gastric cancer tissues, the positive expression rates of thymidylate synthase and CD44 were 57% (39/69) and 61% (42/69), respectively, and there was a positive correlation between the expression of CD44 and thymidylate synthase (Kappa=0.41,χ2=11.59,P < 0.05). Cloning efficiency of the AGS cel line was 39% (29/69), wherein, vice cloning, secondary cloning, and ful clone proportions were 17% (5/29), 69% (20/29), 14% (4/29), respectively. After sub-cloning, the clone was digested using trysin folowed by low-density passage; vice clones were unable to passage, secondary clones could only passage a few, and ful clones could serialy passage. After treatment with different concentrations of 5-fluorouracil, the ful clone growth inhibition rate was significantly lower than that of secondary clones and AGS cels (P < 0.05). These findings show that gastric cancer stem cels are less sensitive to 5-fluorouracil, indicating the cels have a resistance to chemotherapy drugs, which may be one of the chemotherapy resistance mechanisms in the clinical treatment of gastric cancer.
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Aim To investigate the protective effect of cinnamic aldehyde ( CA ) on hormone-induced osteo-clasts proliferation and bone resorption in vitro and its molecular mechanisms. Methods RAW264. 7 cells induced into osteoclast were treated with RANKL and M-CSF and then were divided into control group, dexa-methasone ( DEX ) group and different doses of CA (11. 6, 23. 2, 46. 4 μg·L-1 ) groups. OCs were ob-served after tartrate resistant acid phosphatase( TRAP) staining. The cell proliferation was determined by MTT assay at different time points. The expression levels of TRACP5 b in cell cultured supernatants were measured by ELISA. RT-PCR technique was applied to examine the transcriptional levels of RANK and NFATc1 . Re-sults In MTT assay, the proliferation of osteoclasts stimulated by dexamethasone was promoted seriously compared with negative control group ( P < 0. 05 ) . Meanwhile, DEX could strengthen the content of TRACP5 b and up-regulate the expressions of RANK and NFATc1 mRNA. After administration of CA, the proliferation was inhibited, while the enhanced expres-sion of TRAP5b was reversed,and the over-expressions of RANK and NFATc1 mRNA were obviously down-regulated in a time-and-dose-dependent manner ( P <0. 05 ) . Conclusion The results suggest that CA in-hibits proliferation and bone resorption of osteoclast in-duced by DEX, which may be mediated by down-regu-lation of RANK and NFATc1 mRNA.
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Since initial identification of astrocyte elevated gene -1 ( AEG-1 ) as a HIV-1-inducible novel oncogene in 2002 ,it has emerged as an important oncogene providing a valuable prognostic marker in pa-tients with various cancers.The present review discusses AEG -1 structure,function and localization.Further-more,we summarize the potential role of AEG -1 in the progression of hepatocellular carcinoma (HCC).This re-view can help us better understand the molecular mechanism in hepatocarcinogenesis .
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Objective:To investigate the role of Th1/Th2 shift in unexplained recurrent spontaneous abortion (URSA) and to study the effect and molecular mechanism of Bushen Guchong decoction on URSA treatment by regulating Th 1/Th2 paradigm.Methods:30 cases of URSA patients were given Bushen Guchong decoction administration ; meanwhile,30 cases of normal pregnancy women were taken as control group.Th1/Th2 paradigm in peripheral blood monocytes of URSA patients before and after Bushen Guchong decoction administration was detected by flow cytometry.Moreover,the mRNA expression of the specific transcription factors for Th1 and Th2 subsets -T-bet and GATA-3 were detected by RT-PCR assay.Furthermore,the relationship between the Th1/Th2 paradigm and the uterine bleeding time after Bushen Guchong decoction administration was analyzed by Pearson correlation and re -gression tests.Results: Compared with normal pregnancy women , the proportion of Th1 subset of URSA patients was increased significantly (P<0.05),while the proportion of Th2 subset was decreased markedly (P<0.05).Additionally,the ration of Th1/Th2 subsets was increased in URSA women (P<0.05).After Bushen Guchong decoction treatment ,the proportion of Th1 subsets in URSA patients and T-bet mRNA expression were up-regulated significantly ( P<0.05 ) , whereas the Th2 proportion and GATA-3 mRNA expression were down-regulated obviously (P<0.05).Moreover,the ratio of Th1/Th2 was decreased significantly (P<0.05).Correlation analysis showed that the uterine bleeding time was positively related to both the proportion of Th 1 and the ratio of Th1/Th2, while negatively related to the proportion of Th 2 subsets.Conclusion:Th1/Th2 shift was involved in URSA.Bushen Guchong decoction up-regulated the transcription level of GATA-3 and down-regulated the transcription level of T-bet.Thereby, Bushen Guchong decoction exerted the curative effect on URSA by revising Th 1/Th2 shift.
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Objective:To demonstrate the relationship between the Th 1/Th2/Th17/Treg paradigm and the bone loss induced by estrogen deficiency and looking for potential target for clinical treatment.Methods:30 BALB/c mice were divided randomly into the normal control group , the sham operation group , and the ovariectomy group.The serum estradiol ( E2 ) was assessed by ELISA.Bone mineral density (BMD) of thigh bone was measured with dual energy X ray absorptiometry.Meanwhile,the T-cell subsets (Th1:CD4+TNFα+, Th2: CD4+IL-4+, Th17: CD4+IL-17 A+, Treg: CD4+CD25+Foxp3+) in spleen lymphocytes were analyzed by flow cytometry.Results:Compared with the normal group and the sham operation group , both E2 and BMD in the ovariectomy group decreased significantly ( P<0.05 ).The percentage of Th 1 and Th17 subset increased while the percentage of Th 2 and Treg decreased significantly in ovariectomy mice compared with sham operation mice.Correlation analysis showed that BMD was positively related to E 2 level and the percentage of Th 2 and Treg subset;however ,BMD was negatively related to the percentage of Th 1 and Th17 subset ( P<0.05 ).Conclusion: Conclusion: T-cell paradigm was involved in the bone loss induced by estrogen deficiency.Modifying T-cell paradigm may become a potential target for reducing bone loss induced by estrogen deficiency .
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Objective To evaluate the efficacy of neuronavigation-guided selective percutaneous radiofrequency aiming at the target point semilunar ganglion in the treatment of trigeminal neuralgia.Methods One hundred and forty-seven patients with primary trigeminal neuralgia of both sexes,aged 32-99 yr,with VAS score ≥ 8,were randomly divided into 2 groups:C-arm group (group C,n =72) and neuronavigation group (group N,n =72).Hartel anterior puncture was used and the C-arm guided puncture was performed at the target point foramen ovale in group C.In group N,three-dimensional reconstruction was made after the skull MRI images were transmired to the navigational system of StealthStation,and then the puncture path and point were designed after the target in the trigeminal ganglion was determined.The successful puncture and puncture-and radiofrequency-related complications were also recorded.The VAS scores were recorded at 1 and 7 days and 1,6,12 and 24 months after operation and the analgesic efficacy was evaluated.The therapeutic effect was evaluated by using Barrow Neurological Institute scoring system at 1 and 24 months after operation.Results No puncture-related side effects,damage to the oculomotor nerve or tinnitus developed in group N.The success rate of puncture at first attempt and the effective analgesia rate at different time points after operation were significantly higher,and the treatment effect was better in group N than in group C (P ＜ 0.05).There was no significant difference in the time for location of the nerve and incidence of facial numbness between the two groups (P ＞ 0.05).Conclusion Neuronavigation-guided selective percutaneous radiofrequency aiming at the target point semilunar ganglion in the treatment of trigeminal neuralgia provides a better efficacy,and a lower recurrence rate and a higher probability of successful puncture,with fewer complications.
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Objective To investigate the central neurotoxicity induced by nucleoside analog reverse transcriptase inhibitors (NRTIs)-stavudine (D4T).Methods Mouse primary cortical neurons were cultured and treated with different concentrations of stavudine.Neuron apoptosis was analyzed by calcein/acetomethoxy/propidium iodide (AM/PI) staining. Morphological change of neuron was confirmed by immunofluorescence.Mitochondrial DNA copies which were usually evaluated through Cycloxygenase 2 (COX-2) and thymidine kinase2 (TK2) mRNA were determined by real-time quantitative polymerase chain reaction.Chi-square test,student t test and Wilcoxon nonparameter test were used to analyze the data.Results Neuronal apoptosis observed in 50 μmol/L D4T treatment group was more significant than that in 0μmol/L D4T treatment group and 25 μmol/L D4T treatment group (51.3％±12.4％ vs 24.9％±8.2％ and 26.5％±10.6％,respectively; x2 =7.25 and 6.93,respectively; both P＜0.01).The average neurite numbers of each neuron were 11.2±3.6 in 0μmol/L D4T treatment group,8.6±2.8 in 25 μmol/L D4T treatment group and 4.3±2.4 in 50 μmol/L D4T treatment group.The difference was statistically significant between 25 μmol/L D4T treatment group and 0 μmol/L D4T treatment group (t=4.06,P＜0.01) and between 50 μmol/L D4T treatment group and 25 μmol/L D4T treatment group (t =4.35,P＜ 0.01). Furthermore,the average lengths of neuritis were (319.9±100.2) μm in 0 μmol/L D4T treatment group,(298.3±83.9) μm in 25 μmol/L D4T treatment group and (258.4±82.2) μm in 50 μmol/L D4T treatment group.The difference was statistically significant between 25 μmol/L D4T treatment group and 0 μmol/L D4T treatment group (t=4.58,P＜0.01) and between 50 μmol/L D4T treatment group and 25 μmol/L D4T treatment group (t=4.65,P＜0.01).TK2 mRNA expression dramatically decreased along with the increasing D4T concentration.The fold changes were 0.34 in 25 μmol/L D4T treatment group and 0.08 in 50 μmol/L D4T treatment group. The difference was statistically significant between 25 μmol/L D4T treatment group and 0μmol/L D4T treatment group (Z=- 3.28,P＜0.01) and between 50 μmol/L D4T treatment group and 25 μmol/L D4T treatment group (Z=-4.25,P＜0.01).Compared with 0μmol/L D4T treatment group,the relative fold changes of COX-2 copies were 1.01 in 25 μmol/L D4T treatment group and 1.12 in 50 μmol/L D4T treatment group.The differences were not significant among the three groups (Z=0.98 and 1.24,respectively; both P＞0.05).Conclsion It suggests that short-term exposure to D4T may result in neuron apoptosis,neurite shrink and down-regulated expression of TK2,but the level of mitochondrial DNA copies keeps stable.
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Objective To reconstruct the initiative procedure of HIV-1 reverse transcription in vitro and establish a methodology of assessing activity of HIV-1 reverse transcriptase (RT) with real-time PCR Methods The tRNALys-3 gene was amplified from genome in healthy individuals through polymerase chain reaction (PCR), and then T7 transcription promoter was added in 5'-terminal of the tRNALys-3. The tRNA[Lys-3 cRNA product was obtained by applying T7 RNA polymerase through a transcription reaction. The 5'-LTR-PBS DNA was also obtained by transcription reaction from the HIV-1 infectious clone and inserted into pGEM-T easy vectors. 5'-LTR-PBS cRNA was obtained by applying SP6 RNA polymerase whose combining site was located in pGEM-T easy vectors. Then the two RNA samples was catalyzed by two kinds of standard reverse transcriptases (SuperScript Ⅲ and HIV-1 standard reverse transcriptase, respectively) and the cDNA was synthesised. The relative activity of RT was determined with the real-time PCR. Results The tRNALys-3 primer and the SP6-5'-LTR-PBS RNA were procured accurately, whose length were 93bp and 872 bp, respectively. After the following serial dilution of Super Script Ⅲ and HIV-1 standard reverse transeriptase:1 : 10, 1: 100, 1:1 000, 1:10 000, each step of reverse transcription process worked successfully. Real-time PCR results showed that Ct values of the two groups were 13.9, 18. 3, 20. 9, 24. 9 and 20. 4, 25. 5, 28. 7, 32. 5 respectively. Conclusion A novel real-time PCR method is developed to assay the RT activity directly through reconstructing the initiation of HIV reproduction, which may be helpful for clinical management, screening of new antiretroviral drugs, and drug resistance test.
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reproducible, and may cover the major circulating strains in China.
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<p><b>OBJECTIVE</b>To observe the therapeutic effects of S-Adenosyl-L-methionine(SAMe) in the treatment of cholestasis after total parenteral nutrition (TPN).</p><p><b>METHODS</b>Thirty SD rats were randomly divided into control group, hypercalorie group, hypercalorie adds SAMe group; sepsis group and sepsis adds SAMe group; their stages of cholestasis were compared. Sixteen patients received SAMe because of cholestasis after prolonged TPN.</p><p><b>RESULTS</b>Bile flow, serum levels of total bile acid and gamma-glutamyl transpeptidase were elevated markedly in hypercalorie and sepsis groups. Hepatocellular fatty degeneration, dilatation of cholangiole, and bile sludge could be seen microscopically, while SAMe administration in hypercalorie adds SAMe and sepsis adds SAMe groups could increase bile flow, decrease serum total bile acid and gamma-glutamyl transpeptidase levels. Microscopic findings were normal, no dilated cholangiole or bile sludge could be found. Cholestasis and abnormal results of liver function test were the main clinical manifestations of 16 patients before SAMe administration. Three weeks after SAMe administration, their serum levels of total bilirubin, alkaline phosphotase, gamma-glutamyl transpeptidase, alanine aminotransferase(ALT), and aspartate aminotransferase(AST) were decreased markedly; they became normal in the 4 th week.</p><p><b>CONCLUSION</b>SAMe could prevent and treat cholestasis without discontinuation of TPN.</p>
Subject(s)
Adult , Animals , Female , Humans , Male , Middle Aged , Rats , Cholestasis , Drug Therapy , Metabolism , Pathology , Liver , Pathology , Parenteral Nutrition, Total , Rats, Sprague-Dawley , S-Adenosylmethionine , Therapeutic UsesABSTRACT
Objectives:This study was designed to observe the effect of S adenosyl L methionine (SAMet) on total parenteral nutrition (TPN) induced cholestasis in infected rats and to analyse the change of the bile acids in the bile. Methods:18 Sprague Dawley rats were divided randomly into 3 groups,control group,infection plus TPN group,and infection plus TPN and SAMet group.Each contained 6 rats.Caecum was ligated to induce intra abdominal infection.Nutritional support was maintained for 5 days.Bile was collected by cannulating catheter.The bile flow was determined.The blood samples were gathered to measure the levels of serum total bile acid(STBA),gammaglutamyltranspeptidase (GGT),alanine aminotransferase (ALT)and alkaline phosphatase (AKP).The pathological change in the liver was observed under light microscope and electron microscope.The billiary bile acid contents were determined by high performance liquid chromatographic (HPLC) method. Results:The infection plus TPN group showed that the bile flow was reduced,levels of STBA,GGT and AKP were elevated,and fat infiltration,bile capillary dilatation and bile embolism were obvious in the liver.However,the infection plus TPN and SAMet group showed that the bile flow was increased,levels of STBA,GGT,ALT and AKP were decreased,and the liver was kept normal. Conclusions:The use of SAMet is helpful to could prevent TPN induced cholestasis in infected rats.
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Objective To clarify the morphological features,types,regional distributions and cell densities of gastrointestinal endocrine cells in various parts of the digestive tracts of Canis lupus and Canis familiaris. Methods Immunohistochemical techniques of streptavidin-peroxidase(SP) method was used. Results Seven kinds of gastrointestinal endocrine cells were found positive in the digestive tracts of Canis lupus and Canis familiaris.The endocrine cells were mainly located between the epithelia cells of gastric gland,intestinal villus and intestinal gland.There were also some endocrine cells distributed in the lamina propria and submucosa.The endocrine cells found in the digestive tract were in various shapes.Most of the endocrine cells had long cell processes run ning out to the lumen or the nearby cells.Among these endocrine cells,5-hydroxytryptamine(5-HT) positive cells had a widest distribution,followed by vasointestinal poplypetide(VIP) positive cells.The distributions of other cells were limited.From the comparison of the characters of endocrine cells of Canis lupus and Canis familiaris,most of the endocrine cells had similar morphological features and regional distributions except pancreatic polypeptide(PP) positive cells and substance P(SP) positive cells.There were differences in cell densities of some endocrine cells.Conclusion The results of Canis lupus and Canis familiaris reflect the similarity of mammals in the characteristics of the morphological features,types,regional distributions and cell densities of gastrointestinal endocrine cells,as well as the similarity in digestive physiology of canine animals.At the same time,the results of Canis lupus also exhibit characteristics of gastrointestinal endocrine cells of wild animals.