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Currently, the epidemic of 2019 coronavirus disease (COVID-19) is still ongoing. The characteristics including high contagiousness, herd susceptibility and clinical phenotype diversity, made a serious influence on people’s daily life and rountine therapy for other diseases. Breast dieases are clinical common diseases. In the central epidemic area of COVID-19, Hubei province, especially Wuhan, the clinical specialists of breast diseases should consider all of the following factors comprehensively: the prevention of COVID-19, the diagnosis and treatment of breast diseases and the accessibility of medical resources. Besides, we should select the appropriate therapy and optimize treatment process so as to prevent the propagation and cross infection of COVID-19 as well as manage the breast diseases without delay. Therefore, we carried out some management proposals of the patients with breast diseases in the central epidemic area during the epidemic of COVID-19 on the basis of conventional treatment guidelines and clinical experiences. The suggestions and corrections from colleagues will be welcomed.
ABSTRACT
Currently, the epidemic of 2019 coronavirus disease (COVID-19) is still ongoing. The characteristics including high contagiousness, herd susceptibility and clinical phenotype diversity, made a serious influence on people’s daily life and rountine therapy for other diseases. Breast dieases are clinical common diseases. In the central epidemic area of COVID-19, Hubei province, especially Wuhan, the clinical specialists of breast diseases should consider all of the following factors comprehensively: the prevention of COVID-19, the diagnosis and treatment of breast diseases and the accessibility of medical resources. Besides, we should select the appropriate therapy and optimize treatment process so as to prevent the propagation and cross infection of COVID-19 as well as manage the breast diseases without delay. Therefore, we carried out some management proposals of the patients with breast diseases in the central epidemic area during the epidemic of COVID-19 on the basis of conventional treatment guidelines and clinical experiences. The suggestions and corrections from colleagues will be welcomed.
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Objective :To study therapeutic effect of levosimendan on aged patients with acute decompensated heart failure (ADHF) and its influence on cardiac function ,serum levels of galectin‐3 (Gal‐3) and copeptin (CPP).Methods :A total of 96 aged ADHF patients ,who were treated in our hospital from Jan 2014 to May 2017 ,were selected .Patients were ran‐domly and equally divided into routine treatment group and levosimendan group (received levosimendan based on routine treatment group) ,both groups were treated for 7d.HRV indexes :SDANN ,SDNN ,SDNNI ,PNN50 ,rMSSD ,LF ,HF , LVEDd ,LVEF ,transmitral early diastolic peak flow velocity／late diastolic peak flow velocity (E／A) ,serum levels of Gal‐3 and CPP before and after treatment ,and incidence of adverse reactions were observed and compared between two groups . Results :Compared with before treatment ,after treatment ,there were significant rise in SDANN ,SDNN ,SDNNI ,PNN50 , rMSSD ,LF ,HF ,LVEF and E／A ,and significant reductions in LVEDd ,serum levels of Gal‐3 and CPP in two groups ,P＜0.01 all.Compared with routine treatment group after treatment ,there were significant rise in SDANN [(63.65 ± 6.38) ms vs.(91.32 ± 9.15)ms] ,SDNN[(89.75 ± 9.04)ms vs.(118.65 ± 12.85)ms] ,SDNNI [(37.86 ± 3.81)ms vs.(45.32 ± 4.62)ms] ,PNN50[(5.15 ± 0.52 )% vs.(5.42 ± 0.58 )%] , rMSSD [(31.98 ± 3.31 )ms vs.(37.44 ± 3.77 )ms] , LF [(189.87 ± 19.92)ms2 vs.(223.85 ± 22.57)ms2 ] ,HF [(79.93 ± 8.22) ms2 vs.(94.12 ± 9.53)ms2 ] ,LVEF [(47.38 ± 4.75)% vs.(52.84 ± 5.31)%]and E／A[(0.98 ± 0.26) vs.(1.38 ± 0.31)] ,and significant reductions in serum levels of Gal‐3[(28.69 ± 2.93)ng／L vs.(16.37 ± 1.65)ng／L]and CPP[(1.50 ± 0.16)μg／L vs.(0.93 ± 0.11)μg／L]in levosimendan group , P＜0.05 or ＜0.01. There was no significant difference in incidence rate of adverse reactions during treatment be‐tween two groups , P＝0.473. Conclusion :Levosimendan can effectively reduce serum levels of Gal‐3 and CPP ,improve HRV and cardiac function with good safety in ADHF patients ,which is worth extending .
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Objective@#To detect the inhibitory ability of histatin 5 on the auto-aggregation of Porphyromonas gingivalis (Pg), and the co-aggregation of Pg with Fusobacterium nucleatum (Fn); and to provide a theoretical basis for the role of oral innate immunity played in the inhibition of chronic periodontitis.@*Methods@#Saliva and supragingival, subgingival plaque samples were collected from 49 chronic periodontitis patients in School of Stomatology, China Medical University and 27 periodontal healthy individuals. Enzyme linked immunosorbent assay was used to assess the amount of histatin 5 in saliva, absolute quantitative real-time PCR (qPCR) was applied to detect the DNA copies of Fn, Pg and total bacteria in supragingival and subgingival plaque samples. The effects of histatin 5 on auto- and co-aggregation were assessed by bacterial adhesion test and scanning electron microscopy. Hemagglutinin gene, arginine-gingipains gene in Pg and FomA gene in Fn were tested by relative qPCR. Independent samples t-test was used to calculate the significance between the experimental group and the control group. P-value<0.05 was considered statistically significant.@*Results@#For chronic periodontitis patients, there was an inverse correlation between the concentration of histatin 5 and Fn and Pg in supragingival plaque samples (r=-0.379, r=-0.624). Similarly, an inverse correlation was also observed between the concentration of histatin 5 and subgingival Fn and Pg, respectively (r=-0.404, r=-0.314). As for periodontally healthy individuals, there was an inverse correlation between the concentration of histatin 5 and supragingival and subgingival Pg (r=-0.572, r=-0.533). Bacterial adhesion test and scanning electron microscopy certified that 25 mg/L histatin 5 inhibited the auto-aggregation of Pg-Pg and the co-aggregation of Pg-Fn. Results of qPCR showed that 25 mg/L histatin 5 up-regulated hemagglutinin gene by (14.52±3.25) fold and down-regulated FomA gene to (0.22±0.10) fold.@*Conclusions@#Histatin 5 could inhibit the auto-aggregation of Pg-Pg and the co-aggregation of Pg-Fn by regulating hemagglutinin gene and FomA gene expression.
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Objective To investigate the effect and mechanism of combined therapy using anti-CTLA-4 antibody and doxoru-bicin on mice bearing breast cancer.Methods Balb/c mice inoculated with 4T-1 mouse breast cancer cell were used as tumor mod-els,which were randomly divided into blank group,solvent control group,anti-CTLA-4 antibody only group,doxorubicin only group and combined therapy group.Tumor growth of mice was observed.The ratio of spleen and bone marrow cell subgroup were evaluated.Tumor microenvironment apoptosis and microvessel density (MVD)were evaluated.Results The tumor volume of an-ti-CTLA-4 antibody only group,doxorubicin only group and combined therapy group were lower than those in the rest groups(P <0.05).The tumor volume and mass of combined therapy group was significantly higher than those of anti-CTLA-4 antibody only group,doxorubicin only group (P <0.05).Compared with blank group,solvent control group,CD8 + Tand CD4 + T ratio in anti-CTLA-4 antibody only group,doxorubicin only group,combined therapy group increased with significant difference (P <0.05). The positive cell apoptosis rate of combined therapy group was significantly higher than those of other groups(P < 0.05 ).The MVD of combined therapy group was significantly lower than those of other groups(P <0.05).The positive cell apoptosis rate and MVD of anti-CTLA-4 antibody only group,doxorubicin only group were better than those of blank group,solvent control group. Conclusion Combined therapy using anti-CTLA-4 antibody and doxorubicin could improve the immune,significantly inhibit the growth of tumor,promote cancer cell apoptosis and decrease MVD.
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Objective To investigate the diagnosis of diffusion-weighted imaging (DWI) in cervical lymph nodes lesions.Methods Twenty patients with metastatic lymph node,10 patients with tuberculosis lymph node and 10 volunteers were underwent both conventional MRI and DWI,and the ADC values of lymph nodes' solid components were measured.The difference of ADC values between three kinds of lymph nodes were analyzed.Results ADC values of metastatic lymph nodes was (0.842 ± 0.156) × 10-3 mm2/s,ADC values of tuberculosis lymph nodes was (1.249 ± 0.142) × 10-3 mm2/s,and ADC values of normal lymph nodes was (1.291 ± 0.176) × 10-3 mm2/s.There was significant difference between ADC values of metastatic lymph nodes and with the two later kinds of lymph nodes (P＜ 0.01),and no difference in the two later kinds of lymph nodes (P ＞ 0.05).Conclusion ADC values with features of conventional MR is helpful for differentiate metastatic lymph node,tuberculosis lymph node and normal lymph nodes.
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In order to investigate the relationship between the VEGF level and the counts of dendritic cells (DCs) in peripheral blood of patients with hepatocellular carcinoma (HCC) before and after transcatheter arterial chemoembolization (TACE), the peripheral blood was obtained from 37 patients with HCC who treated by TACE. The blood was obtained on the day before TACE, the first day, the 7th day and the 15th day after TACE respectively. The counts of DCs were quantified by flow cytometry. The plasma VEGF level was measured by ELESA kit. It was shown after TACE, the counts of DCs in peripheral blood were decreased significantly (P＜0.05), and the VEGF level in peripheral blood was increased significantly (P＜0.05). The counts of DCs in peripheral blood had an inverse correlation with the plasma VEGF level (r=-0.57, P＜0.05) after TACE. It was concluded that in patients with HCC after TACE, the increased plasma VEGF level appeared to have the effect to suppress the maturation of DCs, which may contribute to reduction of the body's anti-tumor immunity effect, with a consequence of recur and metastasis of tumor.
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In order to investigate the relationship between the VEGF level and the counts of dendritic cells (DCs) in peripheral blood of patients with hepatocellular carcinoma (HCC) before and after transcatheter arterial chemoembolization (TACE), the peripheral blood was obtained from 37 patients with HCC who treated by TACE. The blood was obtained on the day before TACE, the first day, the 7th day and the 15th day after TACE respectively. The counts of DCs were quantified by flow cytometry. The plasma VEGF level was measured by ELESA kit. It was shown after TACE, the counts of DCs in peripheral blood were decreased significantly (P<0.05), and the VEGF level in peripheral blood was increased significantly (P<0.05). The counts of DCs in peripheral blood had an inverse correlation with the plasma VEGF level (r=-0.57, P<0.05) after TACE. It was concluded that in patients with HCC after TACE, the increased plasma VEGF level appeared to have the effect to suppress the maturation of DCs, which may contribute to reduction of the body's anti-tumor immunity effect, with a consequence of recur and metastasis of tumor.
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Summary: To investigate the difference in expression of hTERT gene between HbsAg-positive human hepatocellular carcinoma (HCC) and HbsAg-negative HCC and to explore the relationship between HBV infection and hTERT gene expression in HCC. The expression of hTERT protein in 30 cases of HbsAg positive HCC and 17 cases of HbsAg negative HCC was detected by immunohistochemistry (SP method), and the expression of hTERT mRNA was analyzed by reverse transcription polymerase chain reaction (RT-PCR). t-test, Chi-squared test and cochran- armitage trend test were used to see whether there was an interrelation between HBsAg and hTERT gene in HCC. The expression of hTERT protein was mostly located in plasm and occasionally in the nucleus of liver cancer cells. The positive rate of hTERT protein and hTERT mRNA in HbsAg positive HCC- 93.33 % (28/30) and 83.33 % (25/30) respectively which were much higher than those in HbsAg negative HCC- 52.94 % (9/17), 47.06 % (8/17) (P<0.01) respectively. HbsAg is related to hTERT gene expression in human hepatocellular carcinoma. The hTERT gene activated by the efficacious ingredient of HBV may play an important role in hepatocellular transformation and carcinogenesis.
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Objective To investigate the features of multiple pelvic injuries (fracture combined with multiple traumas) and their effects on management and prognosis. Methods A total of 233 cases of hemodynamically unstable pelvic fractures were grouped according to the patterns of violence, fracture and associated injuries. They were assessed with measured indexes in physiological state, anatomic injury and blood requirement. Their possibilities of survival (Ps) were also predicted. All the data were statistically analyzed. Results The pelvic fractures were often combined with multiple traumas and frequently resulted from high energy traffic accidents. The correlations among sources of bleeding, amounts of blood loss and hemodynamical changes were disproportional. In unstable pelvic fractures with extra pelvic bleeding, BP and blood requirement were significantly different, and their AIS and ISS of the pelvis were higher and their Ps was lower than in the other groups. Conclusions Multiple pelvic injuries caused by high energy are often highly risky and combined with multiple traumas and several sources of bleeding. A clear and precise assessment of the total injuries and sources of bleeding will help treat the patients with different managements.
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Objective To study the relationship between Ephrin-A1 and its receptor with angiogenesis in hepatocellular carcinoma(HCC).Methods Immunohistochemistry staining method(S P methods)and reverse transcription polymerase chain reaction(RT-PCR) were used to determine the protein and mRNA expression of Ephrin-A1 and its receptor EphA1、EphA2 in tumor tissues and their corresponding adjacent liver tissues from 52 HCC patients;then,analyse of the relationship between Ephrin-A1 and clinicopathologyfactor and microvessel density(MVD) in HCC was made.Results The protein expression rate of Ephrin-A1 and EphA1,EphA2 in HCC was 59.6%(31/52),53.8%(28/52)and 17.3%(9/52),respectively,but in the paired liver tissues adjacent to HCC the expression rate was 23.1%(12/52),and respectively.The protein expression rate of Ephrin-A1 and EphA1 was significantly higher than that in the paired liver tissues adjacent to HCC(P0.05).The mRNA express rate of Ephrin-A1 and EphA1 in HCC [67.3%(35/52) and 73.7%(38/52)] were prominently higher than those in the paired liver tissues adjacent to HCC [42.3%(22/52) and 48.1%(25/52)](P0.05).The higher expression of Ephrin-A1 was correlated with the AFP level and thrombus in the portal vein(P
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Objective To investigate the effect of TGF ? 1 and TGF ? on hepatic apoptosis in hepatocelluler carcinoma (HCC) after transcather arterial chemoembolization (TACE).Methods The specimens were surgically obtained from 36 patients who had been treated by TACE (TACE group) and 19 patients without any treatments (no TACE group). Expression of TGF ? 1 and TGF ? in HCC tissues was detected by immunohistochemical method. Apoptosis was detected by ISEL method.Results Expression rates of TGF ? 1 in HCC tissues of TACE group and no TACE group were 86.11% and 36.84% respectively.expression rates of TGF ? in HCC tissues of TACE group and on TACE group were 0.0088 and 0.1901 respectively.Conclusions After TACE, the expression of TGF ? 1 was enhanced to accelerate the hepatic apoptosis in HCC.TGF ? was mainly related to the cell proliferation in HCC.That the expression of TGF ? was inhibited after TACE might accelerate the hepatic apoptosis of HCC.