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Exosomes are nanoscale extracellular vesicles that are secreted by a variety of cells in the body. They carry particular miRNA, protein molecules, transcription factors, and other information molecules, and they play a role in the pathophysiological regulation of a number of diseases in the body. Exosomes can persist steadily in biological tissues and bodily fluids. Exosomes have quickly advanced in ophthalmology in recent years due to the extensive studies of exosomes in a variety of fields, such as diabetic retinopathy, age-related macular degeneration, autoimmune uveitis, corneal disease, glaucoma, and other diseases. The number of people who are blind caused by diabetic retinopathy is rising as living standards rise. However, it is still unclear how diabetic retinopathy works. In recent years, many studies have found that exosomes play an important role in diabetic retinopathy. In this paper, the most recent developments in exosome studies as they relate to the pathogenesis and progression of diabetic retinopathy are reviewed.
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Objective To develop the knowledge-attitude-practice scale for evaluating intra-abdominal pressure measurement in ICU nurses and assess its reliability and validity preliminary. Methods Applied the methods of literature review and Delphi expert consultation to form the knowledge-attitude-practice scale for evaluating intra-abdominal pressure measurement in ICU nurses on the basis of the knowledge-attitude-practice framework. A total of 165 nurses from ICU department were finally involved. Items analysis, exploratory factor analysis, content validity, internal consistency test and split-half reliability were used to evaluate the scale. Results Factor analysis revealed five factors (23 items), accounting for 52.5%of the total variance. The Cronbach αcoefficient was 0.869 for the total scale and 0.612, 0.749 and 0.848 for the subscales of knowledge, attitude and practice. The split-half coefficient was 0.784. Conclusions The knowledge-attitude-practice scale has good reliability and validity, and can be used to assess the intra-abdominal pressure measurement in ICU nurses.
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Objective To assess the effects of music intervention on physiological and psychological responses of patients with cancer. Methods A computerized search in China Biology Medicine, China National Knowledge Infrastructure,Wanfang data ,VIP, Cochrane library, Web of Science and PubMed was performed for relevant randomized control trials comparing the effects of music intervention on physiological and psychological responses of patients with cancer. The quality of studies was critically appraised and data were extracted by two reviewers independently. The Cochrane-Handbook5.0 was used to evaluate the quality of studies. Data was analyzed by RevMan5.0 software. Results A total of 29 randomized control trials were involved. Eleven studies about the effects of music intervention on anxiety level of patients with cancer were assessed with Self-rating Anxiety Scale,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-11.74, 95%CI-11.94--8.53, P<0.01). Four studies about the effects of music intervention on anxiety level of patients with cancer were assessed with state-trait anxiety inventory,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-8.24, 95%CI-9.44--7.04, P<0.01). Meta-analysis showed that music intervention was able to relieve anxiety, depression, pain of patients with cancer. Two studies about the effects of music intervention on anxiety level of patients with cancer were assessed with Hamilton Anxiety Scale,Meta analysis confirmed that music intervention could effectively reduce the anxiety level of patients with cancer (WMD=-3.37, 95%CI-4.93--1.82, P<0.01). Fourteen studies about the effects of music intervention on depression level of patients with cancer were assessed with Self-rating Depression Scale,Meta analysis confirmed that music intervention could effectively reduce the depression level of patients with cancer (WMD=-8.12, 95%CI-10.75--5.49, P<0.01). Three studies about the effects of music intervention on depression level of patients with cancer were assessed with Hamilton Depression Scale,Meta analysis confirmed that music intervention could effectively reduce the depression level of patients with cancer (WMD=-3.27, 95%CI-6.34--0.21, P=0.04). A total of 9 studies were conducted to evaluate the effects of music intervention on patients with the pain Visual Analogue Scale,Meta analysis confirmed that music intervention could effectively reduce the pain level of patients with cancer (WMD=-0.83, 95%CI-1.23--0.44, P<0.01).A total of 6 studies were conducted to evaluate the effects of music intervention on heart rate in cancer patients,Meta analysis confirmed that music intervention could stabilize the heart rate of patients (WMD=-3.38, 95%CI-5.13--1.62, P=0.002).A total of 6 studies were conducted to evaluate the effects of music intervention on systolic blood pressure in patients with cancer,the results of Meta analysis showed that music intervention could stabilize the systolic pressure in patients (WMD=-5.34, 95%CI-7.95--2.73, P<0.01). Conclusions Music intervention has effects on reducing potentially harmful psychological responses of patients with cancer,which deserve to be explored and spread in clinical practice.
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Objective To observe the effect of serum containing Dahuang Zhechong Pills on vascular endothelial growth factor ( VEGF) expression in K562 cells of chronic myelogenous leukemia ( CML) and to develop new antiangiogenic drugs for CML treatment. Methods Enzyme-linked immunosorbent assay ( ELISA) was used for the detection of serum VEGF content in 38 CML patients, 11 acute myelogenous leukemia patients and 9 healthy volunteers. SD rats were used for the preparation of serum containing Dahuang Zhechong Pills, and then ELISA was applied for the detection of VEGF content in K562 cells pretreated with serum containing Dahuang Zhechong Pills. Results Compared with the healthy volunteers, myelogenous leukemia patients at chronic phase and acute phase had high serum VEGF content ( P<0.05 or P<0.01) . Compared with blank serum control group, the secretion of VEGF in K562 cells pretreated with serum containing Dahuang Zhechong Pills was decreased obviously ( P<0.01) , and VEGF expression decreased with the increase of drug concentration. Conclusion VEGF content is increased in myelogenous leukemia patients at chronic phase and acute phase, which may be related to the pathogenesis, progress and prognosis of chronic myelogenous leukemia. Serum containing Dahuang Zhechong Pills can inhibit the expression of VEGF in chronic myelogenous leukemia K562 cells and decrease VEGF protein expression in concentration-dependent manner.
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BACKGROUND:Abdominal incision healing is not only related with the patient’s own situation, but also closely related with the surgeon's suture technique, suture method, choice of stitches. ＜br> OBJECTIVE:To compare the absorbable sutures and silk sutures for abdominal incision. ＜br> METHODS:Total y 153 colorectal cancer patients, including 91 males and 62 females, aged 30-82 years, were randomly divided into observation group (n=78) and control group (n=75). An abdominal midline incision was made in al patients receiving radical surgery of colorectal cancer. The Vicryl suture and silk suture were respectively used in the observation and control groups for abdominal incision closure. Suturing time, length of hospital stay, incision infection, disruption of wound, fat liquefaction of wound and rejection were compared between two groups. ＜br> RESULTS AND CONCLUSION:The suturing time and length of hospital stay were less in the observation group than the control group (P＜0.05). In the observation group, there were three cases of incision infection, but no incision dehiscence and rejection occurred;in the control group, there were 10 cases of incision infection, 4 cases of incision dehiscence, and 5 cases of rejection. A significant difference was found in the incision infection, dehiscence and rejection between the two groups (P＜0.05). Hospitalization expenses and fat liquefaction of incision had no difference between the two groups. these findings indicate that the Vicryl plus as an absorbable suture is simple, effective and safe that can promote wound healing and reduce complications.
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Objective To explore the value of neutrophils gelatinases related lipid a carrier protein (NGAL),renal injury molecule-1 (KIM-1) and serum creatinine (SCr) for early diagnosis in adult cardiac surgery after acute renal injury (AKI).Methods Blood and urine samples of 65 cardiac surgery patients before and 24,48,72 h after surgery were collected,SCr,urine NGAL and KIM-1 levels was detected,among whom AKI occurred in 34 cases(AKI group),did not occur in 31 cases (non AKI group),and they were compared with 20 cases of healthy physical examination (control group).Logistic regression model was used to judge the value of early diagnosis of SCr,urine NGAL and KIM-1.Results The incidence of AKI after cardiac surgery was 52.31％ (34/65).The SCr,urine NGAL and KIM-1 levels in AKI group and non AKI group before and 24,48,72 h after surgery were significantly higher than those in control group [SCr:(62.44 ±22.26),(77.38 ±24.38),(98.24 ±25.02),(98.14 ±45.26)μmol/L and (56.67 ±21.68),(59.25 ± 15.58),(55.40 ±22.91),(40.10 ±23.45)μmol/L vs.(16.43 ±5.01)μmol/L;urine NGAL:(4.81 ±0.65),(9.48 ±3.29),(11.87 ±3.93),(7.66 ± 1.52) μg/L and (4.67 ±0.53),(8.89 ± 2.64),(11.46 ± 3.60),(7.47 ± 1.63)μg/L vs.(2.87 ± 0.48) μg/L; KIM-1:(47.93 ± 5.54),(61.89 ± 12.44),(100.21 ± 27.32),(67.69 ± 8.72) μ g/L and (47.12 ± 4.08),(56.38 ± 9.27),(90.14 ± 27.26),(69.40 ±8.90) μ g/L vs.(32.21 ± 12.54)μ g/L] (P ＜ 0.01).Urine NGAL and KIM-1 levels in AKI group and non AKI group 24,48,72 h after surgery were significantly higher than those before surgery (P＜ 0.01).SCr,urine NGAL and KIM-1 levels in AKI group 24 h after surgery were significantly higher than those in non AKI group (P＜ 0.01).Twenty-four hours after surgery,the sensitivity and specificity of urine NGAL,KIM-1 in the diagnosis of AKI,compared with that of SCr had no statistical significance (P ＞ 0.05).Conclusions The adults who accept extracorporeal circulation cardiac surgery appear high incidence of AKI.Twenty-four hours after surgery,early biological markers-urine AKI,KIM-1,has similar sensitivity and specificity with traditional diagnostic gold standard of SCr.
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Objective:This study aimed to explore the effects of trichosanthin on the proliferative inhibition and apoptosis induc-tion in human lung carcinoma A549 cells. Methods:A549 cells were treated with various concentrations of TCS. The inhibitory effects in proliferation were detected by the MTT method. The microfilament changes were observed by transmission electron microscopy. Apoptosis rate and cell cycle were determined by flow cytometry. Results:A549 cells treated with TCS presented apoptotic changes and decreased cell activity. When the concentration increased and time was prolonged, the inhibition rate increased correspondingly. Conclusion:Pharmacological doses of TCS inhibited the proliferation and differentiation in lung carcinoma A549 cells and affected the function in A549 cells by changes in the cytoskeleton.
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<p><b>OBJECTIVE</b>To investigate the incidence, pathogens, and clinical features of infection in consecutive cases from 2010 to 2012 in Peking Union Medical College Hospital.</p><p><b>METHOD</b>The incidence, pathogen, treatment, and outcomes of patients with hematological diseases who had positive findings of bacterium in their samples from 2010 to 2012 were retrospectively analyzed.</p><p><b>RESULTS</b>There were 449 positive samples (5.8%) from 4 890 patients during this period, among which 388 were proved to be with pathogenic bacteria. Samples separated from patients with community-aquired infections accounted for 8.4% of all positive samples. Most community-aquired infections were caused by Gram-negative bacteria (75%), although no multidrug-resistant bacteria was observed. Samples separated from patients with nosocomial infections accounted for 91.6% of all positive samples. Respiratory tract (49.4%) and peripheral blood (32.6%) were the most common samples with positive results. Skin soft tissues (10.4%), and urine (3.7%) were less common samples. Most of the pathogenic bacteria of the nosocomial infections were Gram-negative (66.9%). The most common Gram-negative bacteria included Escherichia coli (13.8%), Pseudomonas aeruginosa (12.1%), and Klebsiella pneumonia (12.1%), while Staphylococcus aureus (10.4%), Enterococcus faecium (7.0%), and Staphylococcus epidermidis (5.1%) were the most common Gram-positive bacteria. Gram-negative bacteria consisted of most of sputum samples and peripheral blood samples. Samples from the surface of skin wound and anal swab were composed largely by Gram-positive bacteria (63.8%). The detection rates of extended-spectrum beta-lactamase-producing Klebsiella pneumonia/Klebsiella oxytoca, Escherichia coli, and Proteus mirabilis were 24.0%, 87.9% and 38.4%, respectively. The resistance to Acinetobacter baumannii was serious. Multidrug-resistant, extensive drug resistant and pan drug resistant A. baumannii acountted for 74% of all A. Baumannii infections. Stenotrophomonas maltophilia showed low resistance to sulfamethoxazole/trimethoprim, levofloxacin and minocycline. Also, 22 methicillin-resistant Staphylococcus aureus and 9 methicillin-resistant Staphylococcus Epidermidis were detected, which were only sensitive to vancomycin, teicoplanin, and linezolid. All patients were treated in the haematology wards and most of them were under agranulocytosis or immunosuppression. Finally, 22 patients reached clinical recovery through anti-infective therapy, whereas 49 patients died. Among those deaths, 42 patients attributed to severe infections and infection-associated complications. Fourteen of all the deaths might be infected with drug-resistance bacteria. There were 61 samples proved to be bacteria colonization. Nonfermenters such as Acinetobacter baumannii and Stenotrophomonas maltophilia made up for a large amount of bacteria colonization.</p><p><b>CONCLUSIONS</b>The pathogens of nosocomial infections in the hematology ward are mainly Gram-negative bacteria. The incidences and pathogens vary from different infection sites. Nosocomial infection still has a higher mortality rate. Once nonfermenters are detected positive, the pathogenic or colonial bacteria should be distinguished.</p>
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Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Bacteria , Bone Marrow Transplantation , Cross Infection , Microbiology , Hematologic Diseases , Microbiology , Hematology , Hospital Departments , Retrospective StudiesABSTRACT
This study is to evaluate the therapeutic effect of fibroblast growth factor 21 (FGF21) on NAFLD in MSG-IR mice and to provide mechanism insights into its therapeutic effect. The MSG-IR mice with insulin resistance were treated with high dose (0.1 micromol.kg-1d-1) and low dose (0.025 micromol.kg-1d-1) of FGF21 once a day for 5 weeks. Body weight was measured weekly. At the end of the experiment, serum lipids, insulin and aminotransferases were measured. Hepatic steatosis was observed. The expression of key genes regulating energy metabolism were detected by real-time PCR. The results showed that after 5 weeks treatment, both doses of FGF21 reduced body weight (P<0.01), corrected dyslipidemia (P<0.01), reversed steatosis and restored the liver morphology in the MSG model mice and significantly ameliorated insulin resistance. Additionally, real-time PCR showed that FGF21 significantly reduced transcription levels of fat synthetic genes, decreased fat synthesis and promoted lipolysis and energy metabolism by up-regulating key genes of lipolysis, thereby liver fat accumulation was reduced and liver function was restored to normal levels. In conclusion, FGF21 significantly reduces body weight of the MSG-IR mice, ameliorates insulin resistance, reverses hepatic steatosis. These findings provide a theoretical support for clinical application of FGF21 as a novel therapeutics for treatment of NAFLD.
Subject(s)
Animals , Female , Male , Mice , Body Weight , Dose-Response Relationship, Drug , Dyslipidemias , Metabolism , Energy Metabolism , Fatty Liver , Fibroblast Growth Factors , Pharmacology , Therapeutic Uses , Insulin Resistance , Lipolysis , Liver , Metabolism , Pathology , Non-alcoholic Fatty Liver Disease , Drug Therapy , Sodium GlutamateABSTRACT
This study is to evaluate the therapeutic effect of fibroblast growth factor 21 (FGF21) on hypertension induced by insulin resistance in rats and to provide mechanistic insights into its therapeutic effect. Male Sprague-Dawley (SD) rats were fed with high-fructose (10%) water to develop mild hypertensive models within 4 weeks, then randomized into 4 groups: model control, FGF21 0.25, 0.1 and 0.05 micromol x kg(-1) x d(-1) groups. Five age-matched normal SD rats administrated with saline were used as normal controls. The rats in each group were treated once a day for 4 weeks. Body weight was measured weekly, systolic blood pressure (SBP) was measured noninvasively using a tail-cuff method, insulin sensitivity was assessed using oral glucose tolerance test (OGTT) and HOMA-IR assay. At the end of the treatment, blood samples were collected, and blood glucose, serum cholesterol, serum triglyceride and serum insulin were measured. The results showed that blood pressure of the rats treated with different doses of FGF21 returned to normal levels [(122.2 +/- 3.5) mmHg, P < 0.01] after 4-week treatment, whereas, SBP of untreated (model control) rats maintained a high level [(142.5 +/- 4.5) mmHg] throughout the treatment. The observation of blood pressure in 24 h revealed that SBP of FGF21 treated-rats maintained at (130 +/- 4.5) mmHg vs. (143 +/- 5.5) mmHg for model control (P < 0.01). FGF21 treatment groups improved serum lipids obviously, total cholesterol (TC) and triglyceride (TG) levels decreased significantly to normal levels. The serum NO levels of three different doses FGF21 treatment group were significantly higher than that of the model control group [(7.32 +/- 0.11), (7.24 +/- 0.13), (6.94 +/- 0.08) vs. (6.56 +/- 0.19) micromol x L(-1), P < 0.01], and the degree of improvement showed obvious dose-dependent manner, indicating that FGF21 can significant increase serum NO in fructose-induced hypertension rat model and improve endothelial NO release function. The results of OGTT and HOMA-IR showed that insulin resistance state was significantly relieved in a dose-dependent manner. Thus, this study demonstrates that FGF21 significantly ameliorates blood pressure in fructose-induced hypertension model by relieving insulin resistance. This finding provides a theoretical support for clinical application of FGF21 as a novel therapeutics for treatment of essential hypertension.
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Animals , Male , Rats , Antihypertensive Agents , Therapeutic Uses , Blood Glucose , Metabolism , Blood Pressure , Body Weight , Cholesterol , Blood , Dose-Response Relationship, Drug , Fibroblast Growth Factors , Therapeutic Uses , Fructose , Glucose Tolerance Test , Hypertension , Blood , Drug Therapy , Insulin Resistance , Nitric Oxide , Blood , Rats, Sprague-Dawley , Triglycerides , BloodABSTRACT
Insulin is the most common medicine used for diabetic patients, unfortunately, its effective time is short, even the long-acting insulin cannot obtain a satisfactory effect. Fibroblast growth factor (FGF)-21 is a recently discovered glucose mediator and expected to be a potential anti-diabetic drug that does not rely on insulin. In this study, db/db mice were used as the type 2 diabetic model to examine whether mFGF-21 has the long-term blood lowering effect on the animal model. The results showed that mFGF-21 could stably maintain the blood glucose at normal level for a long-term in a dose-dependent manner. Administration of mFGF-21 once a day with three doses (0.125, 0.25 and 0.5 mg x kg(-1)) could maintain blood glucose of the model animals at normal level for at least 24 h. Administration of mFGF-21 every two days with the same doses could maintain blood glucose of the model animals at normal level for at least 48 h, although it took longer time for blood glucose to reach to normal level depending on doses used (twenty injections for 0.125 mg x kg(-1) and 0.25 mg x kg(-1) doses, ten injections for 0.5 mg x kg(-1) dose). Surprisingly, the blood glucose of the treated model animals still maintained at normal level for 24 h after the experiment terminated. Glycosylated hemoglobin level of the animals treated with mFGF-21, which represented long-term glucose status, decreased significantly compared to the control group and the insulin group. The results suggest that FGF-21 has potential to become a long-acting and potent anti-diabetic drug.
Subject(s)
Animals , Male , Mice , Blood Glucose , Metabolism , Diabetes Mellitus, Experimental , Blood , Metabolism , Dose-Response Relationship, Drug , Fibroblast Growth Factors , Pharmacology , Glucose Transporter Type 1 , Metabolism , Glucose Transporter Type 4 , Metabolism , Glycated Hemoglobin , Metabolism , Hypoglycemic Agents , Pharmacology , Liver , MetabolismABSTRACT
Objective To evaluate the effect of the high concentration of sevoflurane wash-in in induction of anesthesia on the cardiac function in young infants.Methods ASA Ⅰ young infants,aged 28-60 days,undergoing resection of hemangioma on body surface under general anesthesia,were studied.According to the principle of randomized block design,8 blocks were designed based on the body weight (3.0-3.4 kg,3.5-3.9 g,4.0-4.4 kg,4.5-4.9 kg,5.0-5.4 kg,5.5-5.9 kg,6.0-6.4 kg,6.5-6.9 kg),with 3 infants in each block.The infants were randomly divided into 3 groups (n =8 each):anesthesia induction with 6％,7％ and 8％ sevoflurane groups (groups S1-3).In groups S1-3,the infants inhaled 6 ％,7 ％ and 8 ％ sevoflurane respectively for induction of anesthesia.Transthoracic echocardiographic examinations were performed before sevoflurane inhalation (baseline,T1) and at 4 min of sevoflurane inhalation (T2) to record the stroke volume (SV),left ventricle end-diastolic volume (LVEDV),ejection fraction (EF),stroke volume index (SI),heart rate (HR),cardiac output (CO),cardiac index (CI),peak early diastolic velocity of mitral annulus (Ea),peak late diastolic velocity of mitral annulus (Aa),peak systolic velocity of mitral annulus (Sa),and Tei index.The mitral annulus poteroseptal Ea/Aa (Ea/Aa) was calculated.Results Compared with the baseline value,SV,EF,SI,Ea/Aa and Tei index were significandy increased,HR,Sa,Ea and Aa were significantly decreased (P ＜ 0.05),and no significant change was found in LVEDV,CO and CI at 4 min of sevoflurane inhalation in groups S1-3 (P ＞ 0.05).Tei index was significantly higher in groups S2.3 than in group S1 (P ＜ 0.05).There was no significant difference in the parameters of cardiac function between group S2 and group S3 (P ＞ 0.05).Conclusion 6 ％,7 ％ and 8 ％ sevoflurane wash-in in induction of anesthesia exert no effect on the cardiac function in young infants,and the 3 concentrations can be recommended for clinical use.
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Fibroblast growth factor 21 (FGF21) is a member of FGF family. It has been demonstrated that FGF21 is an independent, safe and effective regulator of blood glucose levels in vivo. In order to improve the activity of FGF21, we exchanged the beta10-beta12 domain of the human FGF21 with that of the mouse FGF21 to construct a novel FGF21 gene (named hmFGF21), and then subcloned hmFGF21 gene into the SUMO expression vector to create pSUMO-hmFGF21 and transformed it into E. coli Rosetta for expression of the fusion protein SUMO-hmFGF21. Both in vitro and in vivo glucose regulation activity of hmFGF21 was evaluated. The SDS-PAGE result showed that compared with wild-type hFGF21, the soluble expression of hmFGF21 increased about 2-fold. HmFGF21 was more potent in stimulation of glucose uptake in HepG2 cells in vitro. The results of anti-diabetic effect on db/db mice demonstrated that hmFGF21 had better efficacy on controlling the blood glucose of the db/db diabetic animals than wild-type hFGF21. These results suggest that the biological properties of FGF21 are significantly improved by optimization.
Subject(s)
Animals , Humans , Male , Mice , Amino Acid Sequence , Blood Glucose , Metabolism , Cysteine Endopeptidases , Diabetes Mellitus, Experimental , Blood , Endopeptidases , Genetics , Escherichia coli , Fibroblast Growth Factors , Genetics , Metabolism , Pharmacology , Genetic Vectors , Glucose , Metabolism , Hep G2 Cells , Metabolism , Hypoglycemic Agents , Metabolism , Pharmacology , Mutation , Plasmids , Recombinant Fusion Proteins , Genetics , Metabolism , Pharmacology , Transformation, GeneticABSTRACT
The present paper is aimed to investigate the correlation between the fat mass and the bone mass, and to investigate the effect of leptin on bone metabolism in female ovariectomic rats. Forty Wistar female rats, 6-month-old, were randomly divided into the sham surgical (Sham) group and ovariectomic (OVX) group. The body weight, the fat mass inside the abdominal cavity, the bone mineral density (BMD) were determined by DEXA method, and the concentration of leptin was measured by ELISA after operation. The Rats' body mass in ovariectomized group increased significantly (P < 0.05), while the fat mass in abdominal cavity was not increased obviously in ovariectomized group (P = 0.499). The concentration of leptin was no difference between the two groups (P = 0.166). Bone mineral content (BMC)/weight in ovariectomized group was decreased significantly than the sham group (P = 0. 003). The weight at 8th week post-operation was negative correlation with BMC/weight in Sham group and was positive with BMD in OVX group. The fat mass and the leptin concentration were negative correlation with BMC/ weight in Sham group. It was concluded that the fat mass and the leptin were raleted to the BMC/weight.
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Animals , Female , Rats , Adipose Tissue , Metabolism , Bone Density , Leptin , Blood , Osteoporosis , Ovariectomy , Random Allocation , Rats, WistarABSTRACT
<p><b>OBJECTIVE</b>To investigate the diagnosis, treatment and prognosis of colorectal neuroendocrine carcinoma.</p><p><b>METHODS</b>Clinical data of 39 patients with colorectal neuroendocrine carcinoma from Jan 1995 to Jan 2010 were analyzed retrospectively and the related literatures were reviewed.</p><p><b>RESULTS</b>There were 27 males and 12 females. No patients presented endocrinal dysfunction symptoms. Fourteen patients were diagnosed as neuroendocrine cancer by preoperative pathological examination. All the patients received postoperative adjuvant chemotherapy including cis-platinum and etoposide. Twenty-two patients underwent curative resection, while 14 underwent palliative resection and 3 underwent biopsy alone. Of the 36 surgical resection specimens, vascular invasion was found in 27 patients (75.0%) and regional lymph node metastasis was found in 29 patients (80.6%). Length of follow-up ranged from 4 to 67 months. The 1-year, 3-year and 5-year survival rates were 48.2%, 16.5% and 6.8%, respectively. Statistically significant differences in survival were observed and associated with tumor staging, vascular invasion and surgery type (P<0.05), but not related to gender, age, tumor location, or diameter (P>0.05).</p><p><b>CONCLUSIONS</b>Clinical symptoms and signs of colorectal neuroendocrine carcinoma are nonspecific with poor prognosis. Tumor staging, vascular invasion and surgical type have potential impact on survival.</p>
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Female , Humans , Male , Carcinoma, Neuroendocrine , Diagnosis , Therapeutics , Cisplatin , Therapeutic Uses , Colorectal Neoplasms , Diagnosis , Therapeutics , Etoposide , Therapeutic Uses , Neoplasm Staging , Prognosis , Retrospective Studies , Survival RateABSTRACT
Background: Conjugated equine estrogen (CEE) treatment, a hormone replacement therapy, is restricted for use in perimenopausal and postmenopausal women because of security issues. Consequently, traditional Chinese herbal medicine has become an alternative choice for the patients with contraindications to hormone replacement therapy. Objective: To evaluate the efficacy and safety of Kuntai Capsule and CEE in treating cognitive function disorder and mental symptoms of early postmenopausal women. Design, setting, participants and interventions: A total of 57 cases of early postmenopausal women from Outpatient Department of West China Women and Children's Hospital were included. The subjects were randomly divided into two groups: Kuntai group with 28 cases and CEE group with 29 cases. The patients in Kuntai group received 6 g Kuntai capsules three times a day. The patients in CEE group received CEE 0.3 mg and 0.6 mg alternately once a day (average dose of 0.45 mg/d). The patients with intact uterus in CEE group were treated with 2 mg medroxyprogesterone acetate daily. Main outcome measures: In one-year treatment course, the recognition function and mental symptoms of each patient were investigated by questionnaires of Mini-Mental State Examination (MMSE), Kupperman, and quality of life (QOL) every three months. Both intention-to-treat (ITT) and per-protocol set (PPS) analyses were done. Results: The MMSE, Kupperman index and QOL scores at each time point were improved as compared with those before treatment (P0.05). The MMSE scores showed a tendency to escalate while mental symptoms investigated by Kupperman index and QOL scale showed a downtrend. No severe adverse effects occurred in the study phase and no statistical difference in incidence of side effects between the two groups was found except for vaginal bleeding. The incidence rates of vaginal bleeding in CEE and Kuntai groups were 39.3% and 11.1% respectively (P=0.029). Conclusion: Both Kuntai Capsule and CEE may contribute to maintain the cognitive function and ameliorate mental symptoms of early postmenopausal women.
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Objective To systematically evaluate the effect of routine insertion of double-J stents to prevent major urological complications(MUCs)in kidney transplant recipients.Methods Medline,Embase,Cochrane Library,and Chinese Biomedicine database were searched to locate relevant randomized controlled trials(RCT).Data extraction and assessment of methodologic quality were performed independently by two reviewers.Meta-analysis was performed by Revman 5.0 software.Results Ten RCT(including 1616 patients)were identified.By comparing the routine stent group with the no stent group,the meta-analysis showed:(1)incidence of urine leak,urinary obstruction and UTI was 4 times lower,6 times lower,increased by 52 % respectively(P＜0.0001);(2)Patient and graft survival,rate of acute rejection,delayed graft function and hematuria were of no significant difference.In subgroup analysis,it was found:(1)Compared with the no stent group,the group in which stent duration was≤ 4 weeks had a lower incidence of MUCs and a higher incidence of UTI;meanwhile,the group in which stent duration was ＞ 4 weeks had a much lower incidence of MUCs and the rate of UTI was increased without significant difference;(2)In the RCT of which urethral catheter duration was ＜ 5 days,there were no significant differences between the two groups in MUCs and UTI.In the RCT of which urethral catheter duration was ≥5 days,the stent group had a lower incidence of MUCs and a higher incidence of UTI.Conclusion Routine stenting reduces the incidence of MUCs.Although the double-J stent increases the risk of UTI,it seems that UTI doesn't affect the outcome of transplantation.The stent duration should be within 4 weeks.For the stent recipients,the longer duration of urethral catheter,the lower incidence of MUCs,the higher incidence of UTI;thus,it is up to clinicians to decide the optimal duration of urethral catheter.Long term prescription of 480 mg cotrimoxazole once daily,from the operation day till after stent removal,effectively reduces the risk of UTI associated with stent placement.
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<p><b>OBJECTIVE</b>To evaluate the effect of Premarin and Kuntai capsule (a traditional Chinese patent medicine) on the quality of life (QOL) and their cost-utility in early postmenopausal women.</p><p><b>METHODS</b>Fifty-seven women with menopausal syndrome in the early postmenopausal stage were randomly allocated into Premarin group (0.3 mg/day and 0.6 mg/day alternately, n=29) and Kuntai group (4 g/day, n=28). The therapies lasted for one year and the patients were followed up every 3 months. The QOL of the patients was evaluated and the utility scores were obtained from rating scale to conduct a cost-utility analysis (CUA).</p><p><b>RESULTS</b>At each follow-up examination, no significant difference was found in the QOL between the two groups (P>0.05). The QOL obviously increased after the 1-year-long therapy in both the groups, and Kuntai required longer treatment time than Premarin to take effect. The cost-utility ratio of Premarin and Kuntai were 13581.45 yuan/QALY (quality adjusted life year) and 25105.12 yuan/QALY, respectively. Both incremental cost analysis and sensitivity analysis showed that Kuntai was more costly than Premarin. The result of per-protocol analysis was consistent with that of intention-to-treat analysis.</p><p><b>CONCLUSION</b>At early stage of menopause, the QOL of women with menopausal syndrome can be significantly improved by low-dose Premarin and Kuntai capsule, but the latter is more costly.</p>
Subject(s)
Female , Humans , Middle Aged , Cost-Benefit Analysis , Drug Therapy, Combination , Drugs, Chinese Herbal , Economics , Therapeutic Uses , Estrogens, Conjugated (USP) , Economics , Therapeutic Uses , Phytotherapy , Postmenopause , Quality of LifeABSTRACT
BACKGROUND: Metal ions released from the corrosion process of metal materials used in prosthodontics are directly related to the material biocompatibility, and decide the clinical application value and prospect in the clinical practice.OBJECTIVE: To review the metal ions released from the prosthodontic materials in the oral cavity and their biological effects.RETRIEVAL STRATEGY: Using the terms" biocompatibility, dental alloys", we retrieved PubMed data to identify studies published between January 1997 and October 2006 in the English language. A total of 67 manuscripts were researched. Inclusive criteria: mental materials used in prosthodontics. Exclusive criteria: reparative studies.LITERATURE EVALUATION: The included 67 manuscripts were all from PubMed database. After screening, 23 manuscripts were selected, among which, 20 were about original articles, and the maintaining 3 were review.DATA SYNTHESIS: At present, the research of the biological effects of metal ions released from prosthodontic materials focused on the following three areas:① The corrosion process of prosthodontic metal and the release of metal ions in the oral cavity: Two or even more kinds of metal restorations coexist in one man's oral cavity. Different metal components posed by the potential difference between the original battery will strengthen electrochemical corrosion role. This effect will accelerate the corrosion process and metal ion release, and may have a negative impact on the biocompatibility of prosthodontic materials, but the mechanism of this influence remains unclear. ②The local toxicity of the mental ions released from prosthodontic metal materials used commonly: These ions more or less have the risk of potential toxicity, but at the molecular biological level the mechanism of the adverse reaction in oral tissues acquires to be further explored. ③The hypersensitivity reaction induced by the metal ions released from prosthodontic metal materials: The ions could have an impact on the expression level of Th1 cytokines during the process of delayed-type hypersensitivity. The future research will focus on the mechanism and the establishment of immunohistochemical detection standards of biocompatibility of these prosthodontic metal materials.CONCLUSION: The metal ions released from prosthodontic materials used commonly have certain cytotoxicity, which can inhibit cell proliferation and cause mucosal diseases, oral contact gingivitis and delayed-type hypersensitivity, but at the molecular biological level the mechanism of these adverse reactions acquires to be further explored.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate gender-related differences in risk factors, clinical manifestation and outcomes in patients with aortic dissection (AD) from Guangzhou.</p><p><b>METHODS</b>Consecutive patients with AD admitted to our institute over the past 10 years were included in this retrospective analysis. Prevalence of hypertension, smoking, thickness of intraventricular septum and left ventricular posterior wall measured by echocardiography, and outcomes were compared between male and female AD patients.</p><p><b>RESULTS</b>There were more male AD patients than female AD patients (5.33:1) from the 418 patients. Prevalence of hypertension, thickness of intraventricular septum and left ventricular posterior wall were similar in male and female AD patients. Heavy smoking history was 56.5% in males and 13.6% in females (P = 0.000). Acute survival rate in female patients tended to be better than that in male patients.</p><p><b>CONCLUSIONS</b>There were significantly more male AD patients than female AD patients in this cohort. Prevalence of heave smoking in male patients is 3 times higher than that in female population.</p>