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As one of the tyrosine kinase receptors, Axl is an important downstream regulator of epithelial-mesenchymal transition (EMT) and can bind to its ligand Gas6 protein. By activating the downstream signal transduction pathways, Axl is closely associated with vascular invasion, tumor metastasis, recurrence, and low survival rate of hepatocellular carcinoma. Current studies on the Gas6/Axl signaling pathway have confirmed that Axl inhibitors play an important role in the treatment of liver cancer and the Gas6/Axl signaling pathway may be a potential therapeutic target for liver cancer. This article mainly introduces the association of Axl and its ligand Gas6 with the development and progression of liver cancer and their application in the diagnosis and treatment of liver cancer, in order to provide new ideas for the early diagnosis of liver cancer and clinical research on anti-cancer treatment.
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Objective To investigate the efficacy of ultrasound-guided transveses abdominis plane block ( TAP) on anesthesia and postoperative analgesia in patients undergoing gynecological laparoscopic surgery. Methods From January 2015 to July 2017,60 patients aged 46 -68 yeas,of American Society of Anesthesiologists (ASA) physical status I-II,scheduled for elective gynecological laparoscopic surgery in Nanxiang Hospital of Jiading District of Shanghai were randomly divided into control group( A group) and ultrasound-guided TAP group( B group) ,with 30 cases in each group,In B group,ultrasound-guided TAP was performed 30 min before induction of anesthesia. The patients in both two groups received patient-controlled intravenous analgesia ( PCIA) for 48 h started from 10 min before the end of surgery. The VAS score ≥4points,sufentanil 5μg was injected intravenously. The consumption of anesthesia drugs during operation,time of consciousness and extubation,the consumption of sufentanil per hour in 24h after operation,requirement for rescue medication,and the adverse reactions within 24h after surgery were also recor-ded. Results Compared with those in A group,the consumption of propofol[(210 ± 32) mg vs. (324 ± 45) mg], sufentanil[(31 ± 3. 6)μg vs. (42 ± 3. 8)μg] in operation and consumption of sufentanil per hour in 24h after operation [(3.2±0.5)μgvs.(5.4±0.7)μg?inBgroupweresignificantlylower(P<0.001).Thetimeofconsciousness [(12 ± 3)min vs. (20 ± 5)min]and extubation[(15 ± 4)min vs. (25 ± 7)min]were significantly reduced in B group (P<0. 001). The requirement for rescue medication(13％ vs. 40％) and the incidence rate of nausea(10％ vs. 33％) and vomiting(0％ vs. 10％) within 24h after surgery were significantly decreased in B group compared with those in A group (P<0. 05). Conclusion Ultrasound-guided TAP performed in patients undergoing gynecologicallaparoscopic surgery can reduce the consumption of anesthesia drugs in operation and optimize postoperative analgesia.
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Objectives To observe the clinical efficacy and safety of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemia.Methods 29 older patients with acute myeloid leukemia treated from June 2010 to December 2016 were randomly divided into observation group and control group.Observation group(n=14)were treated with decitabine combined with half of CAG(aclacinomycin,cytarabine,granulocyte colony-stimulating factor)regimen.The control group(n=15)were treated with CAG regimen.Results The overall effective rate was higher in observation group(78.6%)than in control group(53.5%),but there was no statistically significant difference(χ2=2.042,P=0.153).The rate of lung infections was significantly lower in observation group(28.6%)than in control group(73.3%),(χ2=5.811,P=0.016).The survival time of patients was significantly longer in observation group(17.5±5.7 months)than in control group(12.6±6.2 months),the difference was statistically significant(t=2.211,P=0.018).Conclusions The treatment program of Decitabine combined with half of CAG regimen in older patients with acute myeloid leukemiais is safe and effective,which is worthy of clinical promotion.
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OBJECTIVE:To explore the effect of prophylactic use of vitamin B6 with chlorpheniramine on the adverse reactions in fundus fluorescein angiography (FFA). METHODS:326 patients with FFA were randomly divided into observation group and control group. Observation group was orally given Vitamin B6 tablet 10 mg 30 min before angiography+Chlorpheniramine maleate tablet 4 mg;control group was orally given Metoclopramide tablet 10 mg+Chlorpheniramine maleate tablet 4 mg. The occurrence time and incidence of adverse reactions in 2 groups were observed and correlation analysis was conducted. RESULTS:There was no significant difference in the occurrence time of adverse reactions between 2 groups(P>0.05);the incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant(P0.05). CONCLUSIONS:Prophylactic use of vitamin B6 with chlorphenir arnine can reduce the occurrence of adverse reactions in FFA.
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Objective To detect the preliminary results of combined periacetabular and intertrochanteric osteotomies for complex hip dysplasia.Methods From January 2006 to August 2011,23 patients (25 hips) with complex hip dysplasia were treated with combined periacetabular and intertrochanteric osteotomies (ITO).Valgus ITO was performed on 2 hips and varus ITO on others.The averagc age of patients at the time of index procedure was 20.5± 3.9 years (range:15 to 26).The hip pain period before surgery varied from 5 to 24 months (mean 11±4.7 months).The Shenton's line was broken in every hip and the mean preoperative lateral central edge angle (LCEA) was 5.6°±4.6°.The average preoperative fenoral neck-shaft (CCD) angles were 158°±3.2° and 110° in 23 valgus hips and both of two varus hips respectively.The preoperative Harris hip score was 76.7±3.7.According to T(o)nnis osteoarthritis grades,there were 7 hips at grade 0,12 hips at grade Ⅰ and 6 hips at grade Ⅱ.Results The mean followup period was 40±18 months (range:12 to 78).The CCD angle (130°±2.1°),LCEA (28.6°±2.9°) and Harris hip score (90.8±3.3)were all improved postoperatively,whereas no progression was found in preoperative T(o)nnis grades.The postoperative Harris hip scores were excellent in 17 hips and good in 8 hips.The T(o)nnis osteoarthritis grades were grade 0 in 6 hips,grade Ⅰ in 11 hips and grade Ⅱ in 8 hips.There wcre six cases with lateral femoral cutaneous nerve injury,three cases with limp and two cases with broken Shenton's line.Neither femoral head necrosis nor bone nonunion was found in this study.Conclusion Satisfactory preliminary results could be obtained through combined periacetabular and intertrochanteric osteotomies among patients with complex hip dysplasia.The risk of femoral head necrosis and bone nonunion was low.
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<p><b>OBJECTIVE</b>To investigate the effects of bromodomain-containing protein 4 (BRD4) inhibitor GSK525762A on the proliferation and apoptosis of primary common B-cell acute lymphoblastic leukemia (common B-ALL) cells from adult patients, then to further explore the possible mechanisms.</p><p><b>METHODS</b>Purified leukemia cells from 14 common B-ALL adult patients (4 Ph⁺ and 10 Ph⁻ cases) were obtained by flow cytometry sorting, and maintained in a mimic bone marrow microenvironment culture system for short-term culture. Leukemia cells were treated with various concentrations of GSK525762A. The inhibitory effects of BRD4 inhibitor on common B-ALL leukemia cells were measured by CCK-8 assay and the apoptosis of those cells was determined by AnnexinⅤ/7-AAD staining using flow cytometry. The transcripts of c-MYC, CDK6 and Bcl-2 were detected by quantitative RT-PCR, and the expression of c-MYC, CDK6 and Bcl-2 proteins were detected via Western blot.</p><p><b>RESULTS</b>GSK525762A could inhibit the proliferation of leukemia cells from all 14 common B-ALL patients in a dose-dependent manner, the median value of IC50 was 256.25 (90.64-1 378.39)nmol/L. GSK525762A could promote cells apoptosis of B-ALL leukemia cells in a dose-dependent manner, the median apoptosis rates respectively were 45.17%(9.38%-70.91%), 66.02% (24.36%-96.34%) and 89.29% (39.29%-99.37%) after treated by 500, 1 000 and 2 500 nmol/L GSK525762A. GSK525762A has a similar effect on Ph⁺ ALL and Ph⁻ B-ALL, but the effect of proliferation inhibition and apoptosis enhancement on Ph+ B-ALL is weaker than that on Ph⁻ B-ALL. Compared with vehicle control group, the levels of c-MYC, Bcl-2 and CDK6 transcripts in leukemic cells were reduced after treatment for 24 h and 48 h by 1 000 nmol/L GSK525762A, and there are no significant differences in the downregulation of c-MYC and CDK6 mRNA between Ph⁺ and Ph⁻ B-ALL; however, the inhibitory effect on Bcl-2 transcription was weaker in Ph⁺ B-ALL cells than that in Ph⁻ B-ALL cells. Moreover, c-MYC, Bcl-2 and CDK6 protein levels decreased in GSK525762A treated group.</p><p><b>CONCLUSION</b>GSK525762A could strongly inhibit the proliferation of common B-ALL and trigger apoptosis; meanwhile it has certain effects against Ph⁺ ALL in vitro. The effect may be achieved by down-regulation of c-MYC, CDK6 and Bcl-2 expression.</p>
Subject(s)
Humans , Apoptosis , Benzodiazepines , Pharmacology , Cell Line, Tumor , Cyclin-Dependent Kinase 6 , Metabolism , Down-Regulation , Flow Cytometry , Nuclear Proteins , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma , Pathology , Proto-Oncogene Proteins c-bcl-2 , Metabolism , Proto-Oncogene Proteins c-myc , Metabolism , Transcription FactorsABSTRACT
Objective To construct a eukaryotic expression plasmid of pcDNA 3.1-Ag85A-CD226, and to use it as DNA vaccine then further evaluate its immunogenicity through oral administration in a mouse model.Methods The CD226-PCR2.1-ToPo plasmid was used as the template to clone CD 226 gene by PCR.The CD226 gene was then inserted into pcDNA 3.1-Ag85A plasmid to construct the recombinant plas-mid of pcDNA3.1-Ag85A-CD226.After identified by restriction enzyme analysis and sequencing , the re-combinant plasmid was transfected into HEK 293 cells by using lipofection .The expression of Ag85A-CD226 gene in HEK293 cells was detected by RT-PCR, Western blot and indirect immunofluorescence assay .The purified recombinant plasmid was used to prepare the Ag 85A-CD226 DNA vaccine by liposomal encapsula-tion.The vaccine was administered intragastrically to mice .The activities of NK cells , the cytokine levels in the supernatants of spleen cell cultures and the mRNA level of cytokines in the intestines were evaluated to analyze the immunogenicity of Ag85A-CD226 DNA vaccine.Results The Ag85A-CD226 DNA vaccine was prepared successfully .The expression of Ag85A-CD226 fusion protein was detected in HEK293 cells.The activities of NK cells from mice vaccinated with Ag 85A-CD226 DNA vaccine were higher than those from other control groups (P0.05).Conclusion The Ag85A-CD226 DNA vaccine could significantly enhance Th1 type immune responses systemically and in the intestine as in comparison with those vaccinated with single dose of Ag 85A DNA vaccine or CD226 DNA vaccine.
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Objective To explore the risk factors analysis of infection after total hip replacement and its early diagnosis .Methods 86 patients with total hip replacement were selected ,the clinical data and surgical process were obtained retrospective ,to analysis the risk factors analysis of infection after total hip replacement .Results The age of infected patients with total hip replacement was significantly higher than non-infected patients (P0 .05) .After the early diagnosis and treatment ,the joints function of infected patients were recovery good , and without serious effects .Conclusion The infection after total hip replacement is associated with a variety of factors ,it should give positive prevention in the clinical work .For suspected patients should be early diagnosis ,and should choose suitable treatment according to the patient′s specific situation .
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Objective To evaluate the efficacy of dexmedetomidine combined with nicardipine for controlled hypotension in patients undergoing orthopedic surgery.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 32-64 yr,weighing 45-76 kg,scheduled for orthopedic surgery under general anesthesia,were randomly allocated into 2 groups (n =30 each):nicardipine group (group N) and dexmedetomidine + nicardipine group (group DN).A loading dose of dexmedetomidine 1 μg/kg was injected intravenously 10 min before induction of anesthesia,followed by infusion at 0.5.μg ·kg-1 ·h-1 until 30 min before the end of operation in group DN.While the equal volume of normal saline was given in group N.BIS value was maintained at 40-49 during operation.Controlled hypotension was performed with iv infusion of nicardipine at a rate of 2.5 μg· kg-1 · min-1,MAP was reduced to 60-65 mm Hg,then the infusion rate was adjusted to maintain MAP at this level,and nicardipine infusion was stopped while closing the skin.The amount of anesthetics and nicardipine consumed,blood loss,volume of fluid infused,and allogeneic blood transfusion during operation and the operation time,emergence time and extubation time were recorded.Results No patient received allogeneic blood transfusion in both groups.Compared with group N,the amount of anesthetics and nicardipine consumed was significantly decreased,the emergence time and extubation time were significantly shortened (P ＜ 0.05),and no significant change in the volume of fluid infused and blood loss was found in group DN (P ＞ 0.05).Conclusion Dexmedetomidine combined with nicardipine can reduce the requirements for nicardipine and anesthetics during operation,shorten the time for recovery from anesthesia and improve the efficacy of nicardipine for controlled hypotension when used for controlled hypotension in patients undergoing orthopedic surgery.
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ObjectiveTo report the preliminary results and surgical technique of Stoppa approach used in treatment of acetabular fracture.MethodsFrom May 2005 to May 2010,23 patients with acetabular fracture were treated using modified Stoppa approach.The mean age was 37 years old(range,21-71years old).According to Letournel classification,there were 7 cases in anterior column fracture,6 cases in anterior column with posterior hemitransverse fracture,6 cases in transverse fracture,4 cases in associated with both column fractures.All patients in the study were operated under general anesthesia on a radiolucent table in a supine position and underwent Stoppa approach.Fracture reduction was evaluated by Matta's score system.The clinical outcome was judged by modified Merle d' Aubigne and Postel score system.Four cases of associated both column fractures,4 cases of anterior column with posterior hemitransverse fracture required the use of the lateral window.ResultsThe mean surgical time was 166 min (range,110-320 min).The mean blood lose was 647 ml (range,300-2500 ml).Blood transfusion was 3.3 unites (0-12 unites).All the factures healed in 3 months.The fracture reduction was evaluated according to the Matta's score system:an excellent reduction was obtained in 15 patients(65％),a good reduction was obtained in 5 patients (22％),and three(13％) were considered poor.Clinical results were excellent in 11 patients(48％),good in 7 patients (30％),fair in 3 patient (13％),and poor in 2 patients (9％).Superficial wound infection happened in 1 case.It healed after debridment.One patient noted to have significant weakness of the hip adductors (obturator nerve palsy) after surgery.It reached grade Ⅳone year later.No sciatic nerve,femoral nerve and vascular injury happened in this study.ConclusionFor the selected acetabualar fracture,Stoppa approach can get satisfied exposure and fixation of the fracture,especially in the patient with central dislocation of the femoral head as well as medial displacement of quadrilateral plate.
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Objective To assess the effects of positions on circulation and neonatal during Caesarean section under epidural anaesthesia. Methods Eighty healthy parturients undergoing selective Caesarean section were randomly allocated in four groups with 20 cases each, who were positioned in supine (group S), left oblique 30 degress(group L), left oblique 15 degrees with 15 degrees Trendelenburg(group LT), or supine with 15 degrees Trendetenburg (group ST) position. MAP, HR,SpO_2 were recorded before and at 5 min, 10 min, 15 min during anesthesia. Apgar scores of 1-and 5-min were observed as well. Results MAP in groups of S, LT and ST was significantly lower at 10 min during anesthesia than that before or group L(P<0. 05) There was no significant difference in 1-and 5-min Apgar scores among four groups. Conclusion The left oblique 30 degrees position could effectively reduce the incidence of hypotension during Caesarean section under epidural anaesthesia
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OBJECTIVE:To evaluate the efficacy and safety of telmisartan in the treatment of hypertension.METHODS:The efficacy and safety of telmisartan versus losartan in treating hypertension reported in 5 studies were comprehensively evaluated with the meta-analysis in homogeneity test and combined test.RESULTS:Of the five randomized controlled trials(RCT) in which 771 patients who met the inclusion criteria were included,two studies were of high methodological quality according to Jadad scale.Meta analysis indicated that there was statistical significance between telmisartan and losartan in effectiveness(OR=1.55,95% confidence interval(1.12,2.16),P0.05).CONCLUSION:The effectiveness of telmisartan in the treatment of hypertension is significantly higher than that of losartan;however,there is no signficant differce in safety between the two drugs.
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The success of total hip replacement relies on detailed preoperative pla nning and reliable localization during operation.Currently,great advances have been made in the research and application of localization s ystem.The traditional preoperative planning is based on plain radiographs of the p elvis and femur as well as the profile outline of each prosthetic component.Now image-gu ided system(IGS)is used to perform virtual implantation.Surgeons used to localize during total hip replacement only wi th eyes or unreliable localization d evices,but now they begin to use imag e-guided system for surgical navigation during operation.[
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Objective: To explore the anatomy of tibiofibular syndesmosis for the clinic treatment of tib-iofibular syndesmosis injury. Methods: Twelve embalmed adult lower legs were selected. The configurations , structures and plane which ligaments attached to were observed. Results:Tibiofibular syndesmosis consists of ligaments, plica and synostosis. It's tower-shaped. The plane which ligaments attached to has a shape of swallow's tail. Conclusion:Tibiofibular syndesmosis is strong and elastic. The fixation of injuried tibiofibular syndesmosis should be elastic.