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Type 2 diabetes mellitus (T2DM) therapy is facing the challenges of long-term medication and gradual destruction of pancreatic islet β-cells. Therefore, it is timely to develop oral prolonged action formulations to improve compliance, while restoring β-cells survival and function. Herein, we designed a simple nanoparticle with enhanced oral absorption and pancreas accumulation property, which combined apical sodium-dependent bile acid transporter-mediated intestinal uptake and lymphatic transportation. In this system, taurocholic acid (TCA) modified poly(lactic-co-glycolic acid) (PLGA) was employed to achieve pancreas location, hydroxychloroquine (HCQ) was loaded to execute therapeutic efficacy, and 1,2-dilauroyl-sn-glycero-3-phosphocholine (DLPC) was introduced as stabilizer together with synergist (PLGA-TCA/DLPC/HCQ). In vitro and in vivo results have proven that PLGA-TCA/DLPC/HCQ reversed the pancreatic islets damage and dysfunction, thus impeding hyperglycemia progression and restoring systemic glucose homeostasis via only once administration every day. In terms of mechanism PLGA-TCA/DLPC/HCQ ameliorated oxidative stress, remodeled the inflammatory pancreas microenvironment, and activated PI3K/AKT signaling pathway without obvious toxicity. This strategy not only provides an oral delivery platform for increasing absorption and pancreas targetability but also opens a new avenue for thorough T2DM treatment.
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Objective:To analyze nine cases of pregnancy and lactation-associated osteoporosis(PLO) along with a literature review to improve clinicians′ knowledge of the disease.Methods:We collected medical history, laboratory examination, bone mineral density(BMD) scan, treatment and follow-up data of 9 inpatients with PLO in the Endocrinology Department of the First Affiliated Hospital of Zhengzhou University from January 2014 to June 2021.Results:The median age of onset of 9 patients with PLO was 30 years(22-37 years). All 9 patients presented low back pain, and the median time of low back pain after childbirth was 2.5 months(0.5-7 months). 89% of the patients presented vertebral compression fractures, and the mean number of vertebral fractures was 4.6. Eight patients with PLO showed osteoporosis by dual X-ray absorpiometry(DXA) scan, and one patient showed bone loss by quantitative CT scan. Osteoporosis predominated in the trabecular bone. After the diagnosis, nine patients with PLO stopped breastfeeding and were given calcium and vitamin D preparations. Seven patients were given bisphosphonates and one patient was treated with teriparatide followed by denosumab. The back pain of all patients was relieved, with the median of relief time being 3 months(7 d-6 m). After treatment initiation, BMD was increased in eight patients, especially obvious in the lumbar spine. No new clinical fractures occurred during the follow-up.Conclusions:For women with low back pain and shortened height in late pregnancy or breastfeeding, the possibility of PLO should be considered. Prompt diagnosis and early medical interventions are of utmost importance to reduce the risk of subsequent fractures and improve the prognosis.
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Objective:To explore the differential diagnosis methods between nonclassical 21-hydroxylase deficiency(NC21-OHD) and polycystic ovary syndrome(PCOS).Methods:The clinical data of 31 women with NC21-OHD were compared with those of 29 women with PCOS.Results:Women with NC21-OHD showed a higher prevalence of adrenal hyperplasia and lower likelihood of polycystic ovary(PCO) than those with PCOS( P<0.05), with lower height( P<0.05). The levels of adrenocorticotropic hormone (ACTH), 17-hydroxyprogesterone(17-OHP), androstenedione(AD), total testosterone(TT), and progesterone were higher in women with NC21-OHD compared with those with PCOS( P<0.05). Women with PCOS had higher levels of luteinizing hormone(LH) and higher ratio of LH to follicle stimulating hormone(FSH) than those with NC21-OHD( P<0.05). The best two identification indexes for the two diseases were 17-OHP and progesterone, with the optimal cut-off points 3.34 ng/ml(sensitivity 89.7%, specificity 93.1%) and 0.64 ng/ml(sensitivity 90.0%, specificity 75.9%), respectively. During the 1-day mid-dose dexamethasone suppression test(DST), women with NC21-OHD had higher inhibition rates of 17-OHP, progesterone, AD, and TT( P<0.01) than those with PCOS. Their optimal cut-off values of suppression rates were 73.5%(sensitivity 95.2%, specificity 100.0%), 55.5%(sensitivity 100%, specificity 88.9%), 61.4%(sensitivity 84.2%, specificity 100.0%), 68.3%(sensitivity 65.0%, specificity 100.0%), respectively. Conclusion:The clinical manifestations of women with NC21-OHD are similar to those with PCOS. 17-OHP is the best differential indicator and the 1-day mid-dose DST plays an important role in the identification of the two diseases. Genetic analysis is the gold standard for distinguishing the two diseases.
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Objective:To investigate the association of abdominal fat distribution with glycolipid metabolism and diabetic complications in patients with T2DM.Methods:Totally 357 inpatients with T2DM were collected from the Endocrinology Department of our hospital. All patients received quantitative computed tomography to measure the visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), and were divided into three groups depending on the tertile of VAT value: T1 group (VAT<162.0 cm 2), T2 group (162.0≤VAT<221.1 cm 2), T3 group (VAT≥221.1 cm 2). The incidences of diabetic kidney disease, diabetic retinopathy, diabetic peripheral neuropathy, peripheral atherosclerosis, and cardia-cerebrovascular disease were examined in all patients. Results:HbA 1C level in T1 group was higher than that in T3 group( P<0.05). High density lipoprotein-cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR) in T1 group were higher compared with those in T2 and T3 groups ( P<0.05). Male proportion, age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), 24h urinary albumin, diabetic kidney disease and peripheral atherosclerosis in T2 and T3 groups were higher than those in T1 group ( P<0.05). Fasting C- peptide (FCP) and modified homeostasis model assessment for insulin resistance (HOMA-IR) in T3 group were higher than those in T1 and T2 group ( P<0.01). VAT and SAT were positively correlated with BMI, FCP, and HOMA-IR (p<0.01). VAT was positively correlated with age, SBP, DBP, TG, 24h urinary albumin, diabetic kidney disease, peripheral atherosclerosis, and cardia-cerebrovascular disease ( P<0.05), while inversely correlated with HbA 1C, HDL-C, and eGFR ( P<0.05). SAT was positively correlated with total cholesterol and low density lipoprotein-cholesterol ( P<0.01), while negatively correlated with peripheral atherosclerosis ( P<0.01). Multivariate logistic regression analysis showed that VAT was still a risk factor for diabetic kidney disease after adjusted by age, BMI, SBP and fasting plasma glucose( P=0.013). Conclusion:VAT and SAT are associated with blood lipids and insulin resistance, while VAT seems to be a risk factor for diabetic kidney disease.
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Objective:To resolve the issue of poor automatic segmentation of the bowel in women with pelvic tumors, a Dense V-Network model was established, trained and evaluated to accurately and automatically delineate the bowel of female patients with pelvic tumors.Methods:Dense Net and V-Net network models were combined to develop a Dense V-Network algorithm for automatic segmentation of 3D CT images. CT data were collected from 160 patients with cervical cancer, 130 of which were randomly selected as the training set to adjust the model parameters, and the remaining 30 were used as test set to evaluate the effect of automatic segmentation.Results:Eight parameters including Dice similarity coefficient (DSC) were utilized to quantitatively evaluate the segmentation effect. The DSC value, JD, ΔV, SI, IncI, HD (cm), MDA (mm), and DC (mm) of the small intestine were 0.86±0.03, 0.25±0.04, 0.10±0.07, 0.88±0.05, 0.85±0.05, 2.98±0.61, 2.40±0.45 and 4.13±1.74, which were better than those of any other single algorithm.Conclusion:Dense V-Network algorithm proposed in this paper can deliver accurate segmentation of the bowel organs. It can be applied in clinical practice after slight revision by physicians.
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Objective:To investigate the nurses' attitude towards open visitation policy in intensive care unit (ICU) and its potential influence factors, and further to provide evidence for carrying out this policy in ICU.Methods:A self-designed, anonymous online questionnaire of "attitude of ICU nurses to open visiting system in ICU" was performed in 31 provinces, autonomous regions and municipalities in China from October to December 2019, using convenient sampling method approach. Only nurses working in ICU (including specialized ICU, but excluding the critical ward in general ward) and willing to participate in the survey were included. The survey included 35 items, including the general information of each participant, the attitude towards the implementation of the open visitation system in ICU and its potential influencing factors. Ordinal Logistic regression analysis was used to identify the significant influencing factors.Results:A total of 1 558 questionnaires were sent out and 1 546 effective questionnaires were retrieved, with a response rate of 99.2%. Overall, 32.2% of them agreed with the policy, 41.3% of them disagree with the policy and 26.5% of them were uncertain. The Ordinal Logistic regression analysis showed that the independent influencing factors of ICU nurses' attitude towards open visitation policy including the possibility of increasing healthcare-associated infection [disagree: β = 1.327, 95% confidence interval (95% CI) was 0.242 to 2.413, P = 0.017; uncertain: β = 0.697, 95% CI was 0.244 to 1.151, P = 0.003], the improvement of nurses' job satisfaction (disagree: β = -1.406, 95% CI was -1.750 to -1.062, P = 0.000; uncertain: β = -0.748, 95% CI was -1.030 to -0.466, P = 0.000), the information support for medical staffs from family members (disagree: β = -0.644, 95% CI was -1.048 to -0.240, P = 0.002; uncertain: β = -0.422, 95% CI was -0.721 to -0.124, P = 0.006), the feasibility that the family members can assist the nurses in the basic nursing for patients (uncertain: β = -0.465, 95% CI was -0.729 to -0.202, P = 0.001), reducing the time that a nurse spent on caring for the patients (uncertain: β = 0.349, 95% CI was 0.052 to 0.646, P = 0.021), improving early rehabilitation (disagree: β = -0.593, 95% CI was -1.166 to -0.019, P = 0.043), and getting psychological support for patients from family members (disagree: β = 1.293, 95% CI was 0.426 to 2.159, P = 0.003), family members' satisfaction (disagree: β = -0.981, 95% CI was -1.431 to -0.531, P = 0.000). Conclusion:ICU nurses in China have realized that open visitation policy has positive effect on patients' early rehabilitation, willing to live and satisfaction; meanwhile, this policy may need more improvement in many ways such as healthcare-associated infection control, disinfection and isolation, allocation of human resources and time spent treating and caring for patients.
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2019 Novel coronavirus (2019-nCoV) destroys angiotensin converting enzyme 2 (ACE2) and breaks the balance of renin-angiotension system (RAS) by interacting with ACE2. The imbalance of RAS takes part in the development of organ injury of different systems through pro-inflammation, oxidative stress, cell proliferation and so on. 2019-nCoV not only attacks the lung, but also influences many other systems. It is speculated that RAS imbalance plays an important role in the development of multi-organ dysfunction caused by 2019-nCoV, and the usage of angiotensin converting enzyme inhibitor/angiotensin Ⅱ receptor blocker (ACEI/ARB) may become a new treatment of 2019-nCoV-related organ injury. Further studies are need to confirm the relationship between coronavirus infection, multi-organ injury and RAS imbalance.
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ObjectiveTo investigate the clinical features of drug-induced liver injury (DILI) caused by antitumor drugs during the treatment of malignant tumors. MethodsA retrospective analysis was performed for the clinical data of 56 patients who were diagnosed with malignant tumors in Henan Provincial People′s Hospital from January 2015 to December 2016 and experienced DILI during the treatment with antitumor drugs, including sex, age, type of primary tumor, hepatotropic virus infection, liver function, type of chemotherapeutics, onset time of liver injury, application of liver-protecting drugs, and outcome of liver injury. ResultsAmong the 56 patients with DILI caused by antitumor drugs, 30 (53.6%) had hepatocellular injury, and 45 (80.4%) had mild liver injury. FOLFOX, GP/DP, and CHOP were the most common regimens for DILI, and of all 56 patients, 50 (89.3%) had DILI caused by multiple drugs. Platinum-based drugs, anti-microtubule agents, and alkylating agents were the common drugs causing DILI. Of all 56 patients, 35 (62.5%) developed DILI within 1-2 weeks after medication. ConclusionDILI caused by antitumor drugs mainly has a mild degree and hepatocellular injury type is the most common clinical type. Platinum-based antitumor drugs and related chemotherapeutic regimens are the most common drugs for DILI. A combination of multiple antitumor drugs is more likely to cause DILI, and patients with such DILI often have a good prognosis.
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ObjectiveTo investigate the clinical features of drug-induced liver injury (DILI) caused by antitumor drugs during the treatment of malignant tumors. MethodsA retrospective analysis was performed for the clinical data of 56 patients who were diagnosed with malignant tumors in Henan Provincial People′s Hospital from January 2015 to December 2016 and experienced DILI during the treatment with antitumor drugs, including sex, age, type of primary tumor, hepatotropic virus infection, liver function, type of chemotherapeutics, onset time of liver injury, application of liver-protecting drugs, and outcome of liver injury. ResultsAmong the 56 patients with DILI caused by antitumor drugs, 30 (53.6%) had hepatocellular injury, and 45 (80.4%) had mild liver injury. FOLFOX, GP/DP, and CHOP were the most common regimens for DILI, and of all 56 patients, 50 (89.3%) had DILI caused by multiple drugs. Platinum-based drugs, anti-microtubule agents, and alkylating agents were the common drugs causing DILI. Of all 56 patients, 35 (62.5%) developed DILI within 1-2 weeks after medication. ConclusionDILI caused by antitumor drugs mainly has a mild degree and hepatocellular injury type is the most common clinical type. Platinum-based antitumor drugs and related chemotherapeutic regimens are the most common drugs for DILI. A combination of multiple antitumor drugs is more likely to cause DILI, and patients with such DILI often have a good prognosis.
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Objective To evaluate the accuracy and validate the feasibility of auto-segmentation based on self-registration and Atlas in adaptive radiotherapy for cervical cancer using MIM-Maestro software.Methods The CT scan images and delineation results of 60 cervical cancer patients were obtained to establish the Atlas template database.The planning CT (pCT) and replanning CT (rCT) images were randomly selected from 15 patients for the contouring of clinical target volume (CTV) and organs at risk (OAR) by an experienced radiation oncologist.The rCT images of 15 patients were auto-contoured using Atlas-based auto-segmentation (Atlas group),and mapping contours from the pCT to the rCT images was performed by rigid and deformable image registration (rigid group and deformable group).The time for the three methods of auto-segmentation was also recorded.The similarity of the auto-contours and reference contours was assessed using dice similarity coefficient (DSC),overlap index (OI),the average hausdorff distance (AHD) and the deviation of centroid (DC),and the results were statistically compared among three groups by using one-way analysis of variance.Results The mean time was 89.2 s,22.4 s and 42.6 s in the Atlas,rigid and deformable groups respectively.The DSC,OI and AHD for the CTV and rectum in the rigid and deformable groups significantly differed from those in the Atlas group (all P＜0.001).In the rigid and deformable groups,the OI for the intestine significantly differed from that in the Atlas group.The mean DSC for CTV was 0.89 in the rigid and deformable groups,and 0.76 in the Atlas group.The optimal delineation of the bladder,pelvis and femoral heads was obtained in the deformable group.Conclusions AIl three methods of auto-segmentation can automatically and rapidly contour the CTV and OARs.The performance in the deformable group is better than that in the rigid and Atlas groups.
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Objective@#To explore the effect of aspirin combined with metformin on the apoptosis of thyroid cancer TPC-1 cells and its mechanism.@*Methods@#The proliferation and apoptosis of TPC-1 cells treated with different concentrations of aspirin and metformin were detected using cell count kit-8 (CCK-8) assay and flow cytometry, respectively. Western blot was used to detect the expressions of microtubule-associated protein light chain 3 (LC3), p62 and cysteinyl aspartate specific proteinase 3 (caspase-3) after treatment with aspirin, metformin and 3-Methyladenine (3-MA).@*Results@#The relative cell viability of TPC-1 cells treated with 0.5, 1.0, 2.0, 4.0 mmol/L aspirin for 24 and 48 hours were (85.6±9.1)%, (79.9±8.6)%, (57.0±5.3)%, (55.7±5.4)%; (76.7±2.8)%, (75.4±6.1)%, (46.1±4.1)%, (36.3±3.2)%, respectively. The value of half maximal inhibitory concentration (IC50) for 24 and 48 hours were 4.297 mmol/L, 2.133 mmol/L, respectively. The apoptotic rate in the 1 mmol/L aspirin treatment group and negative control group were (29.2±8.5)%, (4.2±2.9)%, respectively (P<0.05). Moreover, treatment with metformin increased the protein expression of LC3Ⅱ/Ⅰ ratio, and decreased the expression of p62, while treatment with aspirin decreased the expression of LC3Ⅱ/Ⅰ ratio and increased the expression of p62. The relative cell viability of TPC-1 cells treated with metformin, 3-MA, an autophagy inhibitor, and 3-MA combined with metformin were (73.2±9.2)%, (95.8±3.3)%, (59.9±9.2)%, respectively. The apoptotic rates in these groups were (35.5±1.5)%, (12.3±1.4)%, (49.9±5.4)%, respectively. Compared with the metformin group, the relative cell viability in metformin combined with 3-MA group was significantly lower while the apoptotic rate was higher (P<0.05), which indicated that treatment with 3-MA enhanced the metformin-induced apoptosis of TPC-1 cells. The relative cell viability of TPC-1 cells in metformin group, aspirin group, metformin combined with aspirin group were (87.3±11.8)%, (85.7±9.6)%, (72.4±8.8)%, respectively. The apoptotic rates in these groups were (29.7±4.0)%, (30.5±6.5)%, (52.5±4.6)%, respectively. Compared with the metformin or aspirin group, the relative cell viability in metformin combined with aspirin group was significantly lower, while the apoptotic rate was higher (P<0.05), which indicated that aspirin enhanced the metformin-induced apoptosis of TPC-1 cells.@*Conclusions@#Our findings indicate that metformin-mediated autophagy plays a protective role in metformin-induced apoptosis and proliferation inhibition. Aspirin enhances the metformin-induced apoptosis of thyroid cancer TPC-1 cells through inhibition of autophagy.
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Objective@#To improve the understanding of 17α-hydroxylase/17, 20-lyase deficiency(17OHD)disease.@*Methods@#The clinical data of six patients suffering from 17OHD were analyzed retrospectively.@*Results@#Two patients with complete combined defect had typical clinical presentations, including absence of secondary sexual characteristics, primary amenorrhea, hypertension, hypokalamia, lower gonadal hormone levels, as well as elevated corticotropin and progesterone levels. TAC329AA homozygous mutation, IVS1+ 2T>C, and c. 775_776delAT complex heterozygous mutation were found in 2 cases. Four cases of partial combined defect showed high progesterone, lower gonadal hormones and dehydroepiandrosterone-sulfate levels. Three females(46, XX)showed spontaneous menstrual and primary infertility, and two of them got successful pregnancy with assisted reproductive technology. TAC329AA heterozygous mutation was found in those 4 cases.@*Conclusions@#TAC329AA mutation is common in 17OHD, and heterozygous or homozygous mutation of TAC329AA may be the genetic and molecular basis for determining whether these patients present as partial or complete defect. The elevated plasma progesterone in non-pregnancy combined with lower gonadal hormones and dehydroepiandrosterone-sulfate is the main character of patients with partial 17OHD. Less severe patients may be able to get successful pregnancy with assisted reproductive technology.
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Objective To improve the understanding of 17α-hydroxylase/17, 20-lyase deficiency ( 17OHD ) disease. Methods The clinical data of six patients suffering from 17OHD were analyzed retrospectively. Results Two patients with complete combined defect had typical clinical presentation, including absence of secondary sexual characteristics, primary amenorrhea, hypertension, hypokalamia, lower gonadal hormone levels, as well as elevated corticotropin and progesterone levels. TAC329AA homozygous mutation,IVS1+2T＞C, and c.775 776delAT complex heterozygous mutation were found in 2 cases. Four cases of partial combined defect showed high progesterone, lower gonadal hormones and dehydroepiandrosterone-sulfate levels. Three females (46, XX) showed spontaneous menstrual and primary infertility, and two of them got successful pregnancy with assisted reproductive technology. TAC329AA heterozygous mutation was found in those 4 cases. Conclusions TAC329AA mutations are common in 17OHD, and heterozygous or homozygous mutation of TAC329AA may be the genetic and molecular basis for determining whether these patients present as partial or complete defect. The elevated plasma progesterone in non-pregnancy combined with lower gonadal hormones and dehydroepiandrosterone-sulfate is the main character of patients with partial 17OHD. Less severe patients may be able to get successful pregnancy with assisted reproductive technology.
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OBJECTIVE： To prepare Adriamycin hydrochloride （DOX） magnetic thermosensitive liposome （MTSL）， investigate its physicochemical properties， magnetic effect and photothermal effect， so as to provide reference for tumor chemo- therapy and photodynamic/photothermal therapy. METHODS： Using DOX as model drug， TiO2@Fe3O4 as photosensitizers and magnetic materials， DOX-TiO2@Fe3O4-MTSL was prepared with membrane dispersion method. The morphology and dispersibility were observed； particle size and Zeta potential were detected； encapsulation efficiency of the liposome were determined by centrifugal ultrafiltration and HPLC. Its paramagnetism property was also detected by magnetometer. Compared with DOX solution， in vitro release behavior of the liposome was investigated by dialysis method， and the release curves at different temperatures （at 37， 43 ℃） were compared. The photothermal conversion effect of the liposome and the production of reactive oxygen species （ROS） in human breast cancer MCF-7 cells were investigated by near infrared laser irradiation at 808 nm. RESULTS： Prepared DOX-TiO2@Fe3O4-MTSL was brown-black with good water dispersion， and was spherical in shape and uniform in size under electron microscopy. Average particle size was 250.6 nm； polydispersity index was 0.107； Zeta potential was （－7.76±3.41）mV； encapsulation efficiency was （92.3±3.2）％. Under the external magnetic field， the liposome could move in a directional direction and had obvious paramagnetism. Compared with DOX solution， the liposomes released slowly and showed obvious sustained- release characteristics. Compared with at 37 ℃， the drug release of liposome speeded up significantly at 43 ℃.With the increase of laser （808 nm） irradiation time， the temperature of the liposome kept rising， which had obvious photothermal conversion effect and could induce the increase of ROS in MCF-7 cells. CONCLUSIONS： DOX-TiO2@Fe3O4-MTSL is prepared succe- ssfully， which has uniform appearance， good physical and chemical properties. It has obvious paramagnetism sustained release effect and photothermal conversion efficiency， and can promote ROS production in MCF-7 cells under near infrared laser irradiation at 808 nm.
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Caffeine is a methylxanthine,clinically used to treat apnea in preterm infants. However,it has been found that the drug also has a role in reducing the incidence of bronchopulmonary dysplasia( BPD) in pre-term infants in recent years. It may be related to improvement of lung function,improvement of extubation suc-cess rate and shortening of ventilator assisted ventilation time. Further study found that caffeine could play a pro-tective role in the prevention and control of BPD by antagonistic adenosine receptors, inhibiting inflammatory mediators,inhibiting the transforming growth factors-β1 ,and inhibiting matrix metalloproteinases.
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The tasks of artificial intelligence (AI) in tumor histopathology include image segmentation and classification. Currently, the specific contents including lymph node metastasis, pathological classification, grade and prognostic evaluation of malignant diseases, such as breast cancer, lung cancer and prostate cancer, have been studied by AI. Evaluation of sentinel lymph node metastasis of breast cancer has been the most mature application of AI technology, whose level can be analogous to the excellent pathologists. In the future, with the close cooperation of pathologists and engineers, the research of AI will be focus on improving the technology of simple and repetitive clinical diagnosis and differential diagnosis, such as the diagnosis of sentinel lymph node metastasis of breast cancer from biopsy frozen section and the judgment of incisal margin. Ultimately, AI will help us to precisely diagnose the tumor.
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Objective A case would be discussed on suspected demyelination due to electrolyte disturbance to provide references for clinical pharmacists to carry out pharmaceutical care. Methods A pharmaceutical care case on PCI postoperative acute heart failure and contrast induced nephropathy with suspected demyelization due to electrolyte disturbance was introduced through a combination of analysis on clinical symptoms,renal function,electrolyte,blood glucose level and further discussion on consciousness change reason, diuretic use, electrolyte management, and other related issues. Results Clinical pharmacist should provide more care to patients with abnormal blood sodium and osmotic pressure,pay more attention to the calculation and evaluation of rehydration sodium/filling quantity and speed, accumulate more knowledge of contrast induced nephropathy, and raise their awareness on the identification of high risk population. Conclusion Arrhythmia,heart failure,renal failure,infection can beincentives to one another,and thus doctors and pharmacists must pay more attention to the comprehensive situations.
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Objective To explore the effect of metformin on the apoptosis of thyroid cancer TPC-1 cells and its mechanism.Methods The proliferation and apoptosis of TPC-1 cells treated with different concentrations of metformin were detected using cell count kit-8(CCK-8)assay and flow cytometry respectively.Western blot and Real-time PCR were used to detect the expression of endoplasmic reticulum chaperone immunoglobulin heavy chain binding protein(Bip)and endoplasmic reticulum stress associated apoptosis protein CCAAT/enhancer-binding protein homologous protein(CHOP)and cysteinyl aspartate specific proteinase(Caspase-12)on mRNA and protein levels.TPC-1 cells were injected into nude mice to investigate the effect of metformin on the tumorigenesis in vivo.In addition,the expressions of Bip and CHOP were detected by an immunohistochemical method.Results Metformin could decrease proliferation and promote apoptosis of TPC-1 cells.Moreover,metformin increased the expression of Bip and endoplasmic reticulum stress-associated apoptosis protein Caspase-12 and CHOP,both in protein and mRNA levels.4-phenylbutyrate,the endoplasmic reticulum stress inhibitor,could reverse the metformin-induced apoptosis of TPC-1 cells.By contrast,activating endoplasmic reticulum stress by thapsigargin enhanced the metformin-mediated apoptosis.The average tumor weight and size in metformin group was significantly lower than that in the control group.Meanwhile,the metformin group had higher expression of Bip and CHOP.Conclusion Metformin may induce the apoptosis of thyroid cancer TPC-1 cells through endoplasmic reticulum stress activation.
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Objective To summarize the nursing care measures about patients with Epstein-Barr virus related post-transplantation lymphoproliferative disorder (EBV-PTLD) after allogeneic hematopoietic stem cell transplantation. Methods The nursing care measures about five patients with EBV-PTLD after allogeneic hematopoietic stem cell transplantation from October 2014 to May 2015 were summarized and analyzed. Results After carefully treating and nursing care, three patients were discharged. One patient with exacerbations, respiratory, epilepsy, liver failure, and disseminated intravascular coagulation was automatically discharged and then died. And the other patient died of other diseases. Conclusions Epstein-Barr virus infection is a complication after allogeneic hematopoietic stem cell transplantation. The key points to prevention and treatment of EBV infection included monitoring regularly, diagnosing and early intervention, which was proved to be effective, timely and active.
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Objective This study examined the effects of repaglinide on the proliferation, differentiation, and apoptosis of mouse pre-osteoblasts MC3T3-E1 subclone 14 cell under high glucose condition.Methods MC3T3-E1 cells cultured in vitro for 48h were divided into the following groups: control group and repaglinide with different concentrations (0.01, 0.1, 1, and 10 μmol/L).Cell proliferation was measured by CCK-8 assay.mRNA levels of type I collagen(COL-Ⅰ), osteopontin(OPN) and alkaline phosphatase(ALP) were assayed using quantitative real-time PCR.Expression of apoptosis related proteins (Bcl-2, Bax) was measured by western blot analysis.Results (1)Compared with control group, the proliferation rate of repaglinide with different concentrations increased, while the proliferation rate of the 1 μmol/L repaglinide group significantly higher than that of the control group(P0.05).Compared with control group, the OPN and ALP mRNA expression increased significantly in the 1 μmol/L repaglinide group(P<0.05), while the OPN expression was significantly declined in the 10 μmol/L repaglinide group(P<0.05).(3)The protein expression of Bcl-2 was positively related with repaglinide concentration(P<0.05), while the protein expression of Bax went down in the 1 and 10 μmol/L repaglinide groups(P<0.05).Conclusion When exposed to high glucose concentration, repaglinide in a certain concentration range may promote the proliferation and differentiation of MC3T3-E1 subclone 14, while restrain its apoptosis.