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Detection of serum biomarkers is an important strategy for the diagnosis of cardiovascular diseases. The roles of serum biomarker detection have become increasingly valuable in the baseline risk stratification among cancer patients in recent years. The Cardio-oncology Study Group of the Heart Failure Association and the Cardio-Oncology Council of the European Society of Cardiology newly proposed the “role of serum biomarkers in cancer patients receiving cardiotoxic cancer therapies”. By evaluating the characteristics of cardiac biomarkers in cancer patients receiving cardiotoxic cancer therapy, this statement discussed the mechanism, clinical application, value on monitoring and prognosis of the two main biomarkers,cardiac troponin and natriuretic peptide on chemotherapy induced cardiac toxic responses. The purpose of this statement is to help establish the multidisciplinary collaborative diagnosis and treatment strategies and provide a clinical framework, and guide clinicians to select appropriate serum biomarker monitoring programs based on risk stratification to prevent cardiovascular disease in cancer patients.
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Cardio-oncology has developed into a new subspecialty of modern cardiology, and the clinical mentors usually need to guide students to focus on this frontier field. However, there are many deficiencies in the field of cardio-oncology training in China, and there is a lack of perfect teaching and training objectives and evaluation system. In order to adapt to the goal and orientation of talent training in cardio-oncology, the First Affiliated Hospital of Dalian Medical University adopts a multi-disciplinary teaching mode. Corresponding teaching contents and training objectives are set according to the trainees at different levels of training, and various teaching methods and assessment forms are cooperated to explore and establish the training and assessment system of cardio-oncology for doctors at different levels. The system is put into practice, and the teaching effect is outstanding which has been widely recognized by teachers and students.
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OBJECTIVE： To investigate the protective effect of total flavonoids from the leaves of Choerospondias axillaris （TFLC） on myocardial ischemia reperfusion injury （MIRI） model rats. METHODS： Male SD rats were randomly divided into sham operation group， model group， positive control group （verapamil， 0.02 g/kg）， TFLC low-dose and high-dose groups （0.1， 0.4 g/kg）， with 10 rats in each group. Administration groups were intragastrically given relevant medicine （2 mL/100 g）； sham operation group and model group were given constant volume of normal saline intragastrically， once a day， for consecutive 7 d. After last medication， MIRI model was induced by modified ligation method. The times and duration of ventricular tachycardia （VT） and ventricular fibrillation （VF） in rats were recorded with biological function experiment system during reperfusion period.The activity of CK and contents of TNF-α， IL-6， NF-κB and NO in serum were determined by ELISA double antibody clip art assay. The morphological characteristics of myocardial tissue was observed by HE staining. The myocardial infarction scope （i.e. the ratio of myocardial tissue mass to ventricular mass） was measured by TTC method. RESULTS： Compared with sham operation group， the times and duration of VT and VF were increased or prolonged significantly in model group； CK activity， serum contents of TNF-α， IL-6 and NF-κB were enhanced or increased significantly， while NO content was decreased significantly （P＜0.05 or P＜0.01）. Obvious myocardial infarction focus， serious cell structure damage， disorderly muscle fibers arrangement， cell nucleus pyknosis and accompanied inflammatory cell infiltration were all observed in cardiac tissue； the mass of infarcted myocardial tissue and ventricular as well as the scope of myocardial infarction increased significantly （P＜0.01）. Compared with model group， the times and duration of VT and VF were decreased or shortened significantly in administration groups； CK activity， serum contents of TNF-α， IL-6， NF-κB were decreased significantly， while NO content was increased significantly （P＜0.05 or P＜0.01）. The above symptoms of myocardial injury were improved；the mass of infarcted myocardial tissue and ventricular as well as the scope of myocardial infarction was significantly reduced （P＜0.05 or P＜0.01）. CONCLUSIONS： TFLC can relieve MIRI-induced ischemic arrhythmia and myocardial damage， reduce the release of inflammatory factors， promote the recovery of myocardial and endothelial cell function， reduce the scope of myocardial infarction and has a certain protective effect.
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Objective To understand the effects of different water iodine level on iodine nutrition and thyroid function in pregnant women,and provide a reference for prevention and treatment of iodine deficiency disorders in the future.Methods According to the background material of water iodine in provinces given non-iodized salt,the administrative villages with water iodine content ＜ 10,10-49,50-99,100-299 and ≥ 300 μg/L were selected as survey sites in Shandong,Shanxi,Hebei,Henan,Jiangsu and Anhui provinces.Urine,blood,drinking water and salt samples were collected from pregnant women at the site of investigation,and urinary iodine,serum iodine,thyroid function and antibody index,water iodine,and salt iodine were measured;thyroid volume was also examined.Results A total of 575 pregnant women were investigated.The medians urinary iodine of pregnant women with water iodine ＜ 10,10-49,50-99,100-299 and ≥300 μg/L groups were 175.55,180.90,139.70,330.15 and 817.70 μg/L,respectively,and the differences were statistically significant in different water iodine groups (H =152.593,P ＜ 0.01).The levels of serum iodine and free thyroxine (FT4) were significantly different among pregnant women in different water iodine groups (H =82.843,F =3.070,P ＜ 0.01 or ＜ 0.05).However,there was no significant difference in serum thyroid stimulating hormone (TSH) levels (H =1.774,P ＞ 0.05).And with the increase of water iodine levels,the abnormal rate of TSH showed the phenomenon of middle low and both ends high ("U" type,x2 =16.729,P ＜ 0.01).There were no significant differences in the positive rates of serum thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb),any antibody and double antibodies in pregnant women among different water iodine groups (P ＞ 0.05).And there was a statistically significant difference in the detection rate of subclinical hypothyroidism (x2 =11.869,P ＜ 0.05).The rates of goiter in pregnant women among different water iodine groups were less than 5％.The difference in detection rates of thyroid nodules was statistically significant (x2 =13.591,P ＜ 0.05),and the rate was the highest in water iodine ≥300 μg/L group (21.33％,16/75).Conclusions In water iodine ≥300 μg/L group,urinary iodine level of pregnant women is in the level of iodine excess,and serum iodine level,FT4 level,thyroid nodules detection rate are higher.The abnormal rate of serum TSH and the detection rate of hypothyroidism show a "U" curve that increases at iodine deficiency and iodine excess.
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BACKGROUND: Hemolysis is an important problem in the design and development of artificial heart pumps. Hemolysis is associated with the shear force of blood cells in the pump and the movement time in the pump. OBJECTIVE: To analyze the relationship between the operating parameters of blood pump (flow rate of blood pump), the structure of blood pump (outlet width of blade) and the shear stress of blood cells in artificial heart pump. METHODS: The basic structure of the centrifugal blood pump was designed according to the velocity coefficient method. The three-dimensional model of the blood pump, mesh division and flow field simulation were established by using CFturbo, ANSYS ICEM and FLUENT software respectively to study the best mesh division method. The results of the numerical simulation corrected the diameter of the impeller outlet to finally obtain an artificial heart pump meeting the needs of the human heart. In order to reduce the shear stress and movement time of blood cells in the heart pump, the optimal design and analysis of the impeller inlet flow rate Q (2, 3, 4, 5, 6, 7 L/min) and the operating parameter blade outlet width b2 (2.0, 2.1, 2.2, 2.3, 2.4, 2.5 mm) of the centrifugal artificial heart pump were designed to reduce the probability of hemolysis. RESULTS AND CONCLUSION: (1) As the flow rate increased, the shear stress of the blood cells in the blood pump gradually increased, and the movement time gradually decreased. As the flow rate increased, the standard hemolysis value in the blood pump gradually decreased, and the damage to the blood cells in the blood pump alleviated. When the flow rate was 7 L/min, the standard hemolysis value in the blood pump was the lowest. (2) With the increase of blade outlet width, the shear stress of the blood in the pump decreased, and the movement time of the blood in the pump increased. When the blade outlet width was 2.0-2.5 mm, the hemolysis value in the blood pump decreased with the increase of the blade outlet width. When the blade outlet width was about 2.5 mm, the hemolysis value in the blood pump was the lowest.
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Objective To investigate the value of ECG-gated dual-source computed tomography angiography (DSCTA) in the diagnosis of single atrium (SA).Methods DSCTA was performed in 29 patients with SA.The classification diagnosis was made,and the complicated deformities were observed.Results Among 29 patients,atrial situs solitus was found in 14 (14/29,48.28％),atrial situs inversus was found in 6 (6/29,20.69％) and atrial situs ambiguous was found in 9 (9/29,31.03％,including right atrial isomerism in 8 and left atrial isomerism in 1 patient).The patients complicated with 39 kinds,totally 228 deformities.The bronchi and lung structures were found in the same position as atrium in 23 patients (23/29,79.31％),including atrial situs solitus in 13,right atrial isomerism in 7 and atrial situs inversus in 3 patients.Conclusion DSCTA can accurately diagnose SA and associated abnormalities.The features of bronchus and lung structures are helpful to identifying left and right atrial appendage.
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Objective To quantitatively analyze the dynamic changes of amino acid levels in serum of osteoarthritis rats,and to provide clues for further studies on biomarkers and metabolic mechanisms of osteoarthritis.Methods Sixty healthy male Sprague-Dawley (SD) rats were randomly divided into model group and control group according to their body weight by random number table method,the experimental period was 4,8 and 12 weeks,respectively,ten rats in each group.The left knee hind joints of rats in model group were operated by the modified Hulth method.After 5 days,rats of model group were driven to move for 30 minutes a day.Rats of two groups were fed ordinary solid fodder and drank tap water.At the end of the experimental period,the knee joints were collected for pathological observation.The amino acid content in serum was determined by high performance liquid chromatography-quadrupole ion trap tandem mass spectrometer (HPLC/Q-TRAP-MS/MS).The area under the receiver operating characteristic (ROC) curve (AUC) was used to determine the ability of differential amino acids to diagnose disease,AUC ＞ 0.7-0.9 was certain accuracy,＞ 0.9 was high accuracy.Results Under the light microscope,in control group,the articular cartilage surface was smooth and continuous,and the chondrocytes had good overall morphological structure and distinct layers;in model group,the articular cartilage of rats thinned,the surface was roughness and defect,the chondrocytes degenerated,necrosis and disappeared,and the lesions were aggravated with the extension of observation period.Forty kinds of amino acids were detected.Compared with control group,at 4 weeks after surgery,the level of 24 kinds of amino acids in model group decreased and 14 kinds of amino acids were increased,among which the differences in taurine,glutamine,serine,glutamic acid,aspartic acid,γ-aminobutyric acid and hydroxyproline were statistically significant (P ＜ 0.05);at 8 weeks after surgery,24 kinds of amino acids in model group were increased and 16 were decreased,among which the differences in histidine,serine,glutamic acid,homoarginine,lysine,isoleucine and glycine were statistically significant (P ＜ 0.05);at 12 weeks after surgery,36 kinds of amino acids in model group were decreased,among which the differences in 21 kinds of amino acids were statistically significant (P ＜ 0.05),all of their AUC were not less than 0.740,and the AUC of 14 amino acids were not less than 0.800,and the highest was kynurenine (0.980).Conclusions The model of knee osteoarthritis in rats is established successfully.With the increased time,the progress of osteoarthritis lesions increases,and the amino acid metabolism in osteoarthritis rats is out of order.
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Abstract Ion mobility spectrometry ( IMS) based explosives detectors is wieldy deployed at the check points of airport, etc, so the development of new ionization method to replace the radioactive 63 Ni ion source in IMS is highly demanded. In this study, a novel negative corona discharge was developed for ion mobility spectrometer for rapid detection of trace explosives, which was running in the unidirectional mode to efficiently remove nitrogen oxides and ozone produced from the discharge process. The diameter of target electrode was 3 mm, the distance between the needle and the target electrode was 2 mm, the discharge voltage was 2400 V and the flow rate of drift gas was 1200 mL/min. Under the optimized conditions, the dominant reactant ions was O-2(H2O)n and could be used to directly detect the common explosives, such as trinitrotoluene (TNT), ammonium nitrate (AN), nitroglycerin (NG), pentaerythritol tetranitrate (PETN) and hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX). The limit of detection of TNT was 200 pg/μL. These results indicated that negative corona discharge ionization source, with the advantanges of the high sensibility, simple structure and no radioactivity, could be used as a potential and promising ionization source for ion mobility spectrometry to detect explosives.
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<p><b>OBJECTIVE</b>To investigate the clinical characteristics and treatment strategies of severe complications induced by esophageal foreign bodies.</p><p><b>METHODS</b>The clinical data of 44 patients with severe complications of esophageal foreign bodies treated from July 2004 to July 2014 were retrospectively analyzed. The type of complications was recorded.</p><p><b>RESULTS</b>The ratio of severe complications in patients with esophageal foreign bodies was 9.05% (44/486). The most common type of foreign body was animal bone, with a total of 34 cases (77.3%); Onset of the disease were 2-40 days, mostly above 6 days, accounting for 61.4%. Severe complications of esophageal foreign bodies included 16 cases (36.3%) of simple esophageal perforation or combined with esophageal regional inflammation, 14 cases (31.8%) of cervical abscess, 7 cases (15.9%) of abscess around esophagus, 3 cases (6.8%) of mediastinal abscess, one case (2.3%) of cervical subcutaneous emphysema, one case of tracheoesophageal fistula, one case (2.3%) of aortic fracture, and one case (2.3%) of subclavian artery pseudoaneurysm. Among the 44 patients with severe complications, 40 patients (90.9%) were cured and 3 patients (6.8%) died. One case didn't receieve treatment.</p><p><b>CONCLUSIONS</b>Occurrence of the severe complications induced by esophageal foreign bodies is closely related to the type of foreign bodies and time before presentation. Early diagnosis and prompt treatments for esophageal foreign bodies are crucial for preventing of severe complications.</p>
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Humans , Abscess , Esophageal Perforation , Foreign Bodies , Pathology , Neck , Pathology , Retrospective Studies , Subcutaneous Emphysema , Tracheoesophageal FistulaABSTRACT
Objective To study the effect and toxicity ofgefitinib combined with selected radiotherapy in the treatment of patients with advanced non-small-cell lung cancer (NSCLC). Methods From March 2006 to February 2009,10 of 13 advanced NSCLC patients who got benefit from gefitinib were enrolled to treatment group (gefitinib concurrent selected radiotherapy) and control group (gefitinib only), with 5 cases in each group. The response was evaluated as progression free survival (PFS) and overall survival (OS).Results No patient got complete remission (CR). Ten of 13 patients got partial remission (PR) and stable disease (SD). The 1 year and 2 years survival rate was 53.8%(7/13) and 46.2%(6/13) respectively. The median PFS in treatment group and control group was 24 months and 8 months respectively(P= 0.0019). The median OS was 32 months and 10 months respectively (P= 0.0062). The main toxicities were reversible skin rash and diarrhea,and 3 patients developed asymptomatic radiation pulmonary fibrosis. Conclusions Gefitinib combining with selected radiotherapy is effective and tolerated in patients with advanced NSCLC. It may prolong PFS and OS. It may be a rational choice for the standard and individualized treatment of NSCLC.
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Objective To study the function of ginsenoside Rg3 on proliferation in human breast cancer cell line MCF-7 and effect of ginsenoside Rg3 on Cx26 gene expression and gap junctional intercellular communication (GJIC) in MCF-7, cultured in vitro. MethodsHuman breast cancer cells MCF-7 was exposed to ginsenoside Rg3 at differential concentrations for 24 h, respectively. The cell proliferation inhibition was measured by 3-[4,5-dimethylthiazo-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. The expression of Cx26 mRNA was measured by RT-PCR in experimental groups and control goup. The GJIC function of MCF-7 cell was examined with scrape-loading dye transfer assay.ResultsHuman breast cancer cell line MCF-7 was exposed to ginsenoside Rg3 at a concentration of 10, 20, 40, 80, 160 μg/ml, respectively.The inhibition ratio was 3.1%, 5.2 %, 16.0 %, 26.3 %, 29.1% respectively after 24 h. Compared with control group, the concentration of 40 μg/ml above could significantly inhibit MCF-7 cell proliferation (P ＜0.05), so the experimental groups were exposed to ginsenoside Rg3 at a concentration of 40, 80, 160 μg/ml,respectively. The expression of Cx26 mRNA in every experimental group compared with control group was enhanced when MCF-7 cell was exposed to ginsenoside Rg3 at a higher concentration. It was observed that Lucifer yellow fluorescent staining was limited to a single cell in control group through fluorescent microscope,but Lucifer yellow fluorescent transfered through gap junction cells to neighboring cells, then came into being flake fluorescent staining in experiment groups. ConclusionGinsenoside Rg3 can enhance the expression of Cx26 mRNA in MCF-7 cell and restore the gap junctional intercellular communication, which may be one of important mechanisms of ginsenoside Rg3 in antitumor.
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Objective This study assessed whether the best overall response rate(ORR) of cetuximab combined with oxaliplatin,leucovorin and fluorouracil/Xeloda was superior to that of this method alone as first-line treatment for metastatic colorectal cancer.The influence of KRAS mutation status was investigated.Methods Patients received cetuximab(400mg/m2 initial dose followed by 250mg/m2,wk thereafter)less than 2 times plus chemotherapy(oxaliplatin 130mg/m2 on day 1,plus leucovorin 200mg/m2 and fluorouracil as a 400mg/m2 bolus followed by a 600mg/m2 infusion during 22 hours on days 1 and 2) or chemotherapy alone.Treatment was continued until disease progression or unacceptable toxicity.KRAS mutation status was assessed in the subset of patients with assessable tumor samples.Results The confirmed ORR for cetuximab plus oxaliplatin,leucovorin and fluorouracil/Xeloda was higher than that with alone(42.86% vs 21.74%).A statistically significant increase in the odds for a response with the addition of cetuximab to oxaliplatin,leucovorin and fluorouracil/Xeloda could be established.In patients with KRAS wild-type tumors,the addition of cetuximab to oxaliplatin,leucovorin and fluorouracil/Xeloda was associated with a clinically significant increased chance of response(ORR 54.55% vs 21.74%) and a lower risk as compared with chemothrapy alone.Cetuximab plus oxaliplatin,leucovorin and fluorouracil/Xeloda was generally well tolerated.Conclusion The clinical effcacy of chemothrapy(oxaliplatin,leucovorin and fluorouracil/Xeloda) plus cetuximab is better than only chemothrapy.KRAS mutational status was shown to be a highly predictive selection criterion in the treatment decision regarding the addition of cetuximab to oxaliplatin,leucovorin and fluorouracil/Xeloda for previously untreated patients with metastatic colorectal cancer.
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Objective To investigate the effect of megestrolacetate(MA)in improving the quality of life in patients with advanced malignant neoplasms. Methods Seventy-two patients with advanced malignant neoplasms were randomized into two groups,treatment group(37 patients) were treated with MA plus supportive care,control group(35 patients) were treated with supportive care only.The changes of appetite,weight,pain,KPS and overall survival were observed in each group.Results In the treatment group,29 cases(80.6%) got appetite improving,19 cases(52.8%) gained weight,15 cases((41.7)%)got pain relief,21 cases(58.3%)got KPS score increasing;In the control group,8 cases((22.9)%) got appetite improving,4 cases(11.4%) gained weight,3 cases(8.6%)got pain relief,5 cases(14.3%)got KPS score increasing.The differences in two groups were significant(P
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0.05 ) .In group A and group B ,the mean time to pain relief was (3.46?2.66) days and (4.35?1.83) days respectively , and the mean duration of the pain relief was (28.4?2.35) days and ( 15.6 ?3.85) days respectively , with no significant difference between the two groups (P0.05). Conclusions Zoledronic acid has a perfect therapeutic effect for the bone pain caused by metastatic bone cancer, with long duration of the pain relief and mild side effects. Zoledronic acid is an effcctive drug for metastatic bone cancer.
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Objective:To define the expression levels of MDM2 gene in nasopharyngeal carcinoma (NPC)and its relationship with p53 protein expression and EB virus latent infection. Method :MDM2 gene expression atmRNA and protein levels,p53 protein and EB virus DNA were detected by nonradioactive in situ hybridization(ISH) ,immunohistochemistry(IHC) and polymerase chain reaction (PCR) separately in 46 cases of NPC tissuesand 12 cases of chronic inflammation of nasopharyngeal epithelium (CINE). Result: Fourteen cases of NPCshowed MDM2 mRNA and protein overexpression, 38 cases were p53 protein positive,and 43 cases were EBV-DNA positive. Neither MDM2 nor p53 protein was expressed in any case of CINE. MDM2 expression was signifi-cantly related to p53 protein expression ( P ＜0. 05), but not to EB virus latent infection in NPC. Conclusion:MDM2 gene may play an important role in the pathogenesis of NPC through interacting with p53 protein.
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Objective To study mechanism and relationship of acute lung injury that be complicated with severe acute pancreatitis(SAP).To analyze the chest imaging feature of X-ray and CT of SAP and improve the recognition of clinical value of diagnosis and prognosis.Methods Thirtynine SAP patients(17 male,22 female)age ranged from 26 to 64 of SAP that be diagnosed by clinic and CT were analysed retrospectively.All cases were checked by chest X-ray film and rechecked at least three times,of them chest CT were taken in 11 cases.Results Ascites was found in 34 cases,pleural effusion was found in 19 cases.Pulmonary edema sign of X-ray and CT was found in 16(41%) cases when SAP was diagnosed by pancreas CT.The sign was found in 24(61.5%) cases in 24 hours and in 37(94.9%)cases in 48 hours and all cases in 72 hours.In the 16 early pulmonary edema cases,There were pleural effusion in 11 and pericardiac effusion in one case,10 cases of them developed to acute respiratory distress syndrome(ARDS)and 7 cases died.Conclusion The chest imaging feature of SAP has important significance for early diagnosis of ARDS and prognosis of SAP,and can be served as a clinical indication of severe degree of SAP.