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Objective:To investigate the effect of large bone flap craniotomy on acute craniocerebral trauma and its influence on stress response.Methods:From January 2015 to December 2018, 80 patients with acute craniocerebral trauma were randomly divided into control group (40 cases) and observation group (40 cases) by random number table method.The patients in the control group were treated with conventional craniotomy and decompression, while the patients in the observation group were treated with craniotomy with large bone flaps.The changes of intracranial pressure, Glasgow coma index (GCS score), stress response index, prognosis and complications after 6 months were compared between the two groups before treatment and 2 weeks after treatment.Results:Two weeks after treatment, the intracranial pressure in the observation group [(8.48±2.10)mmHg] was lower than that in the control group [(11.86±1.74) mmHg], while the GCS score[(10.35±1.87)points] was higher than that in the control group [(7.69±1.15)points]( t=19.434, 7.663, all P<0.05). Two weeks after treatment, the serum levels of ACTH [(35.19±5.46)mg/L] and cortisol [(17.41±4.56)mg/L] in the observation group were lower than those in the control group [(48.91±4.95)mg/L and (28.93±7.48)mg/L] ( t=11.774, 8.317, all P<0.05). Six months after treatment, the prognosis of the observation group(60.00%) was better than that of the control group (32.50%) (χ 2=6.084, P<0.05). The incidence of complications of the observation group (5.00%) was lower than that of the control group (22.50%) (χ 2=5.165, P<0.05). Conclusion:Craniotomy with large bone flaps has good effect in the treatment of patients with acute craniocerebral trauma, and can reduce stress response and with fewer complications, which is worthy of clinical reference.
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Objective:To investigate the clinical effect of directional soft-channel puncture and suction drainage in the treatment of spontaneous cerebral hemorrhage in basal ganglia and its influence on neurological function.Methods:From January 2017 to December 2018, 61 patients with spontaneous cerebral hemorrhage in basal ganglia were selected in the First People's Hospital of Jiande.According to the random table method, they were divided into control group (30 cases) and observation group (31 cases). The control group was treated conservatively, while the observation group was treated with directional soft-channel puncture and suction drainage combined with conventional therapy.The therapeutic effects, NIHSS score, ADL score, brain edema volume change and complications were compared before treatment, 1 week after treatment and 2 weeks after treatment.Results:The total effective rate of the observation group (96.77%) was higher than that of the control group (76.67%) (χ 2=3.989, P<0.05). The NIHSS score of the observation group was (16.54±2.19)points at one week after treatment and (9.12±1.24)points at two weeks after treatment, which were lower than those of the control group [(19.98±1.65)points and (13.25±2, 37)points] ( t=6.911, 8.568, all P<0.05). The ADL score of the observation group was (43.42±5.67)points at one week after treatment and (63.98±3.46)points at two weeks after treatment, which were higher than those of the control group [(37.89±2.86)points and (52.37±4.10)points] ( t=4.785, 11.967, all P<0.05). The volume of brain edema of the observation group was (12.08±2.14)mL at 1 week after treatment and (4.37±0.89)mL at 2 weeks after treatment, which were lower than those of the control group [(16.89±3.20)mL and (9.74±1.07)mL] ( t=6.922, 21.339, all P<0.05). The incidence of complications in the observation group (6.45%) was lower than that in the control group (30.00%) (χ 2=5.720, P<0.05). Conclusion:Directional soft-channel puncture and suction drainage is effective in the treatment of spontaneous cerebral hemorrhage in basal ganglia, which can reduce the degree of neurological deficit and with fewer complications, and it is worthy of clinical study.
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Objective@#To explore the safety and feasibility of associating diaphragm resection and liver-diaphragmatic metastasis lesions resection for patients with advanced ovarian cancer.@*Methods@#Retrospectively analysis 83 cases(98 times) of advanced ovarian cancer with liver-diaphragmatic metastasis between January 2012 and December 2016 at Department of Liver Surgery, Peking Union Medical College Hospital.The patients were aged from 19 to 75 years.Surgical procedure included metastatic lesions resection(43 times) and stripping(55 times). Operation status, post-operative complications, pathology results and follow-up of the patients were analyzed.@*Results@#Fifteen patients received twice surgical treatment and 68 patients received one time surgical treatment. Postoperative hemorrhage in chest and between liver and diaphragm was not occurred in all cases.Dyspnea and low oxygen saturation were occurred in two cases of stripping patients and 1 case of metastatic lesions resection patients.Results of CT examination indicated that there was medium to large amount of ascites in right chests.The symptoms were relieved after placing thoracic closed drainage.Other patients were recovered smoothly.All patients were diagnosed as ovarian cancer by pathological examination.@*Conclusion@#Associating diaphragm resection is safe and feasible for liver-diaphragmatic metastasis lesions from ovarian cancer.
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MicroRNAs (miRNAs), a non-encoding small molecular RNA, is entitled to regulate gene expression after transcription, which plays a key role in the progress of tumorigenesis, growth and metastasis. MiR-29 family consists in miR-29a, miR-29b and miR-29c, all featured by the regulation of breast cancer. This review will summarize the regulation and molecular mechanism of miR-29 family in all critical stages of breast cancer, and evaluate the value of miR-29 as a new diagnostic and prognostic biomarker or therapeutic target.
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The prognosis of advanced gastric cancer and gastroesophageal junction (GEJ) adenocarcinoma is poor. Although che-motherapy prolongs patient survival and improves quality of life to a greater extent best supportive care compared to, the median over-survival of patients with advanced gastric cancer is limited to approximately 7-10 months. With remarkable progress in the understand-ing of molecular mechanisms, molecular-targeted agents have been developed and evaluated in international randomized phaseⅢclini-cal trials. These agents may change the treatment mode of this disease. A ToGA study initially demonstrated that the trastuzumab, the monoclonal antibody of HER-2, as a molecular-targeted agent, in combination with chemotherapy, can prolong the overall survival of patients to 13.8 months. Several agents targeting angiogenesis, c-Met, PARP, and immunotherapy are currently subjected to clinical tri-als. This review summarizes the current status of molecular-targeted therapies for gastric cancer and GEJ adenocarcinoma.
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Objective To explore the effects of silencing Livin gene by RNA interference mediated by lentiviral vector on colorectal cancer HT-29 cell xenograft growth and sensitivity to radiotherapy in nude mice.Methods BALB/c nude mice models were established by subcutaneously inoculating differently treated HT-29 cells into nude mice and the tumor growth situation of tumors was observed by measuring the volume of tumors and the weight of the nude mice at different time points after cell seeding.Livin expression was detected by RT-PCR and immunohistochemistry,respetively.Apoptosis rate was detected by TUNEL.Normal saline,lentivirus carring unrelated sequences,lentivirus caning Livin shRNA were injected intratumorally.All the nude mice were given 10 Gy of 6 MV X-ray irradiation.The changes of mice weight and the tumor volume were measured at different time points and the weight and tumor growth curves were drawn.Results The inhibition rate of tumor volume was(50.04 ± 0.07)％ and the tumor weight of the RNA interfering group was significantly less than that in experimental group compared to the blank and negative groups(F=4.85,P＜0.05),and the inhibition rate of tumor weight was(50.27 ±0.17)％.Relative Livin mRNA expression level in the RNA interfering experimental group was(17.75 ±0.08)％,and was significantly lower than that of the blank group(67.60 ± 0.05)％ and the negative group(68.54 ± 0.03)％(F=89.97,P＜0.01).Livin protein expression level in the RNA inferring group was also significantly lower[(36.00 ± 3.40)％ versus(85.00 ± 3.15)％,(80.33 ± 3.08)％,F=107.32,P＜0.01].The apoptosis rate in the RNA interfering experimental group was significantly higher than that in the blank and the negative groups[(23.67 ± 2.25)％ versus(5.00 ± 1.50)％,(8.33 ± 1.82)％,F=56.94,P＜0.01].Combined with radiotherapy,the tumor volume at different groups had significant difference(F=10.70,P＜0.01),and RNA interfering group was significantly less than negative group and blank group(F=7.01-9.32,P＜0.01).Conclusions Silencing of Livin gene expression by lentiviral vector-mediated RNA interference could inhibit the growth of colorectal HT-29 cell xenograft and increase the sensitivity of the transplanted tumors to radiotherapy.
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Objective:To observe the effects of AFP gene silencing by siRNA on the Survivin mRNA of hepatocellular carcino-ma cell line HepG2. Methods:AFP gene expression was downregulated in HepG2 cell by RNAi, and the AFP content in the superna-tant was detected by ELISA. Survivin mRNA level was tested by RT-PCR. MTT was applied to evaluate cell proliferation. Flow cytom-etry was employed to observe cell apoptosis. Results:At 48 h after transfection, AFP expression was almost completely inhibited, cell proliferation activity was decreased by 43.1%, cell apoptosis rate was increased by 24.3%, and the Survivin mRNA expression was re-duced to 22.0%in the experimental group. No evident changes were observed in negative control and blank groups. Conclusion:AFP gene silenced by RNAi induces growth inhibition and apoptosis promotion of hepatocellular carcinoma cell line HepG2. This gene may be associated with the suppression of Survivin mRNA.
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OBJECTIVE To investigate the clinical characteristics and risk factors of nosocomial infection in advanced lung cancer patients during and after chemotherapy. METHODS A retrospective analysis of 119 cases suffered from nosocomial infections from 628 cases with lung cancer was made. RESULTS The nosocomial infection rate was 18.9%.The most common infection site was respiratory tract,followed by gastrointestinal and urinary tracts.The ratio of G-bacilli to total bacteria examined was 49.5%,and the bacilli were mainly Pseudomonas aeruginosa,followed by Escherichia coli.The ratio of G +bacilli and fungi to total bacteria examined were 27.8% and 22.7%,respectively. CONCLUSIONS It is found that the risk factors of nosocomial infection in lung cancer patients are central type of lung cancer,retreated patients,hypoalbuminosis,lower CD4 +/CD8 + ratio,invasive operation,time of using broad-spectrum antibiotics and longer hospital stay and the higher risk factors are grades 3-4 neutropenia and infections due to accompanying persons.
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Acute pancreatitis is a common serious disease, and considered to be inflammatory disturbance course. The early storm of proinflammatory cytokine releasing evokes systemic inflammatorome response syndrome (SIRS) ,and leads to multiple organ dysfunction syndrome(MOPS). At the late phase, because massive of antiin-flammatory cytokines initiate compensatory anti-inflammatory response syndrome ( CARS), the body immune func-tions suffer suppressed and result in infection or toxemia. So reestablishing baulance of SIRS/CARS has considera-ble clinical meaning to the AP patient morbidity. In this article, we will overview the relevant factors and mecha-nisms of the SIRS/CARS induced by AP.
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Objective To explore the efficacy of tentorium cerebelli hiatus incision for treatment of severe brain injury complicated with tentorial herniation. Methods Tentorium cerebelli hiatus incision was performed in 38 patients of severe brain injury with secondary brain stem damage resulted from tentorial herniation after intracranial hematoma evacuation and bone flap craniotomy decompression. The changes of four sides cistern, ambient cistern and interpeduncular cistern before and after operation were observed. Results There was a siginificant difference in the appearance ratio of four sides cistern, ambient cistern and interpeduncular cistern between the preoperation and postoperation(P
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Objective:To establish the quality standard for Tongduhuoxue Tablets.Methods: Radix Salvia miltiorrhiza and Rhizoma Corydalis in this prescription were identified by TLC. Tanshinone Ⅱ A was determined by HPLC and astragaloside was determined by dual wavelength TLC Scanning.Results:Radix Salvia miltiorrhiza and Rhizoma Corydalis could be detected by TLC. Determination method of tanshinone Ⅱ A and astragaloside was linear at the range of 0.04 ～ 0.8 ?g( r= 0.99998 ,n=7 ) and 0.3 ～ 6.0 ?g( r= 0.9991 ,n=7 ),average recovery was 98.6% ( RSD= 1.1% ,n=5 ) and 97.7% ( RSD= 1.8% ,n=5 ),respectively. Conclusions: The established method is accurate and reproducible. This study provides a method for the quality control of Tongduhuoxue Tablets.
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AIM: To explore the mechanism underlying the therapeutic effects of hypoxia inhalation on asthma. METHODS: Guinea pigs were randomized into the normal group(NG), asthmatic group(AG) and the hypoxia inhalation-treated group(HITG). The model of asthma was established in the latter two groups through sensitization and induction with 10% ovalbumin(OA) and 1% OA, respectively. The animals in HITG were treated with hypoxia inhalation (13.0%?0.5% O 2/N 2 mixed gas). The content of serum cortisol, the number of eosinophils(EOS) and percentage of hypodense eosinophils(HEOS) in bronchoalveolar lavage fluid(BALF),the number of CD 4 +T-lymphocyte in peripheral blood(PB) and the tension of airway muscle were determined. RESULTS: (1)The content of serum cortisol was significantly higher in NG and HITG than in AG( P
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Objective To investigate the ultrastructural changes of hippocampus in the guinea pigs with chronic asthma and the effects of hypoxia treatment on the hippocampal ultrastructures. Methods The replicated animal model of chronic asthma was divided into hypoxia(low pressure chamber) treatment group, normal pressure hypoxia inhaling treatment group, non treatment group and control group. The ultrastructural changes of hippocampus were observed with electron microscope. Results Expanded rough endoplasmic reticulum, ruptured cloudy mitochondrion carina, decreased synaptic vesicles and swollen postsynaptic membrane, proliferation of astrocytes and microglia proliferated, swelling of cytoplasm, vacuolation, broadened milieu interspace of blood vessels, swelling of cloudy basement membrane with constricted duct cava were found. After hypoxia, clear neuron nucleoli, plenty organells, slightly expanded rough endoplasmic reticulum, fairly plenty synaptic vesicles, more dense post synaptic membrane and slightly broadened synaptic space were also found. No apparent pathologic changes were found in glial cells and the blood vessels. Conclusion Recurrent chronic asthma may result in the ultrastructural changes of hippocampus due to hypoxia. Treatment with low pressure hypoxia and normal pressure hypoxia may be helpful to the improvement of ultrastructural injury of hippocampus due to asthma.