ABSTRACT
Objective:To investigate the feasibility of individualized primary clinical target volume (CTV) delineation in intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC).Methods:Clinical data of 87 consecutive patients newly diagnosed with lateralized NPC in Jiangsu Cancer Hospital between October 2016 and February 2018 were retrospectively analyzed. Lateralized NPC is defined as tumor invasion not exceeding the contralateral wall. According to the tumor spread, the primary CTV was optimized as follows: CTV2 only covered the medial part of the contralateral pterygopalatine fossa, whereas the contralateral foramen oval was not included; on the level of parapharyngeal space, the contralateral side of CTV only covered the posterior lateral lymph nodes, whereas the contralateral internal jugular vein was not regularly covered. Failure patterns and 5-year survival [local control rate (LCR), progression-free survival (PFS) and overall survival (OS)] were evaluated by Kaplan-Meier method. Paired t-test and rank-sum test were used to analyze the dose variation in the optimized region and adverse reactions. Results:The median follow-up time was 59.5 months. The 5-year LCR, PFS, and OS were 98.9%, 86.5% and 92.1%, respectively. There was no local recurrence in the optimized area of CTV. Dosimetric comparison results showed that the doses of parotid gland, temporal lobe, cochlea and middle ear on the contralateral side were reduced by 13.45%, 9.14%, 38.83%, and 29.36%, respectively. Four cases (4.6%) developed grade 3 hearing loss, all on the ipsilateral side. The optimized scheme significantly alleviated the hearing loss on the contralateral side compared to that on the ipsilateral side ( P<0.001). Other grade 3 late adverse reactions included cranial nerve injury, subcutaneous fibrosis in the neck and visual impairment, with 1 case each. Conclusion:Individualized primary CTV for lateralized NPC is feasible and safe, with obvious dosimetric advantages and reduced adverse reaction rate, which is worthy of clinical promotion.
ABSTRACT
Objective:To observe the analgesic effect of local anesthesia combined with nerve block anesthesia on golden microneedles for improving facial aging.Methods:Between December 2018 and December 2019 in Burn and Plastic Surgery of Nanchong Central Hospital, sixty female patients (between 30 and 58 years old, with an average of 45.2 years old) with natural facial skin aging were randomly divided into two groups: Group A: surface anesthesia group (30 cases); Group B: local anesthesia combined with nerve block anesthesia (30 cases). Intraoperative and postoperative pain scores, length of operation, and incidence of adverse reactions were compared between groups A and B.Results:Pain score during surgery was (6.90±0.96) points in Group A, (3.63±0.72) points in Group B. The difference between the two groups was statistically significant ( t=14.93, P<0.05); Pain score at 30 minutes after operation was (2.03±0.62) in Group A, (0.77±0.73) in Group B, the difference between the two groups was statistically significant ( t=7.28, P<0.05). There was no statistically significant difference between the two groups in the pain score at 24 hours after operation ( P>0.05); The operation process in group B was simplified, and the treatment time was significantly shortened. The difference between the two groups was statistically significant ( t=17.93, P<0.05). Conclusions:The method of local anesthesia combined with nerve block anesthesia is used in the treatment of gold microneedles to improve the analgesic effect in facial aging, which significantly shortens the treatment time and has fewer adverse reactions. This method is worth popularizing.
ABSTRACT
Objective:To investigate the changes in peripheral blood and liver-infiltrating natural killer-like B (NKB) cells in patients with primary hepatocellular carcinoma (HCC), and to assess the influence of IL-18 on NKB cells in vitro and the underlying mechanism. Methods:Forty-three HCC patients and 21 normal controls (NC) were enrolled in the study. Peripheral blood samples were collected to isolate plasma and peripheral blood mononuclear cells (PBMC). Intrahepatic lymphocytes (IHL) were isolated from tumor tissues and para-tumor tissues obtained from 16 HCC patients who received surgery. IL-12, IL-18 and IL-18 binding protein (IL-18BP) levels in plasma were measured by enzyme linked immunosorbent assay. The percentages of CD3 -NKp46 + CD19 + NKB cells and IL-18 + NKB cells in PBMC and IHL were analyzed by flow cytometry. Changes in the percentages of NKB cells and IL-18 + NKB cells were measured after stimulating PBMC and IHL with recombinant human IL-18 (1 ng/ml and 10 ng/ml). Changes in IL-18BP levels in the culture supernatants and phosphorylated nuclear factor-κB (NF-κB) in NKB cells were also assessed. Student′s t test, one-way analysis of variance or LSD-t test was used for statistical analysis. Results:There was no significant difference in plasma IL-12 level between HCC patients and NC ( P=0.245). Compared with NC, HCC patients had decreased IL-18 level in plasma [(224.3±58.89) pg/ml vs (327.0±52.27) pg/ml, P<0.000 1], but increased IL-18BP level [(4.421±0.97) ng/ml vs (0.92±0.18) ng/ml, P<0.000 1]. The percentages of peripheral blood NKB cells and IL-18 + NKB cells were lower in HCC patients than in NC [(2.68±1.23)% vs (8.88±2.95)% and (54.42±12.60)% vs (69.74±12.65)%, both P<0.000 1]. The percentage of NKB cells in IHL was reduced in tumor tissues as compared with that in para-tumor tissues [(2.89±0.86)% vs (4.66±1.17)%, P<0.000 1]. Moreover, the percentage of IL-18 + NKB cell was also down-regulated in tumor tissues as compared with that in para-tumor tissues [(51.50±13.18)% vs (62.13±9.24)%, P=0.013]. Recombinant human IL-18 stimulation reduced the IL-18BP level in the culture supernatants ( P<0.05). IL-18 stimulation at 1 ng/ml did not affect NKB cell percentage, IL-18 + NKB cell percentage or NF-κB phosphorylation in NKB cells from PBMC or IHL ( P>0.05), while 10 ng/ml of IL-18 not only elevated NKB cell percentage and IL-18+ NKB cell percentage, but also promoted NF-κB phosphorylation in NKB cells ( P<0.01). Conclusions:In vitro stimulation with high concentration of IL-18 might promote NF-κB phosphorylation by inhibition of IL-18BP expression. This process might play a positive feedback role to induce the activation of NKB cells and IL-18 secretion.
ABSTRACT
Objective:To investigate the role and clinical significance of T follicular helper (Tfh) cells in the pathogenesis of eosinophilic gastroenteritis (EG) in children.Methods:A total of 17 children diagnosed with EG in the Department of Gastroenterology, Children′s Hospital of Nanjing medical University from October 2018 to January 2020 were recruited as EG group.During the same period, 15 children diagnosed with colon polyps were included as control group.Flow cytometry was used to detect Tfh cells and their functional molecules, including inducible costimulatory molecules (ICOS) and programmed cell death protein 1 (PD-1) in peripheral blood of the 2 groups.Results:The median (interquartile range) of Tfh cell frequency in peripheral blood of children with EG group was 7.3 (2.6)%, which was significantly higher than that of controls 2.8 (1.4)% ( P<0.05). There were significant differences in the median (interquartile range) of ICOS [1.5 (1.3)% vs.0.1 (0.2)%] and PD-1 expressions [1.8 (3.2)% vs.0.7 (0.6)%] on Tfh cells between children with EG group and control group (all P<0.05). The frequency of Tfh cells in the peripheral blood of children with EG was positively correlated with the expressions of ICOS ( r=0.746, P<0.05) and PD-1 ( r=0.893, P<0.05), and immunoglobulin E (IgE) level ( r=0.587, P<0.05). Conclusions:The frequency of Tfh cells in peripheral blood of children with EG significantly increases, which are proliferative and overexpressed with ICOS and PD-1.Moreover, the frequency of Tfh cells of EG patients is positively correlated with the level of IgE.The abnormal expression of Tfh cells may play a promoting role in the mechanism of EG.
ABSTRACT
Objective@#To investigate the high-risk factors for parotid lymph node (PLN) metastasis from nasopharyngeal carcinoma (NPC) and evaluate the feasibility of local intensity-modulated radiotherapy (IMRT) in patients with high-risk NPC.@*Methods@#Clinical data of 440 NPC patients admitted to Department of Radiotherapy of Jiangsu Cancer Hospital from May, 2011 to March, 2017 were collected. The imaging features, treatment strategies and clinical prognosis of PLN metastasis were retrospectively analyzed. The whole group adopts the technique of intensity modulated radiotherapy. Total parotid or partial parotid irradiation, selective PLN irradiation, X-Ray and/or electronic line supplementation, dose 45-60 Gy. The χ2 test or Fisher′s accurate probability method test and single factor analysis, Logistic regression model multi-factor analysis. Kaplan-Meier survival analysis, log-rank test differences.@*Results@#PLN was observed in the parotid of 230 cases. At the end of follow-up, 11 patients (2.5%, 11/440) were diagnosed with PLN metastases. Among 11 cases, 9 patients (81.8%) had PLN size ≥5 mm. Multivariate analysis demonstrated that extracapsular spread of level Ⅱ was an independent risk factor for PLN metastasis. The patients with PLN size ≥5 mm or extracapsular spread of level Ⅱ were assigned into the high-risk PLN metastasis group. The patients in the high-risk group were further divided into the radiotherapy and non-radiotherapy subgroups. Survival analysis demonstrated that for 230 patients with PLN metastasis, the local recurrence-free survival (LRFS) significantly differed, whereas the overall survival (OS), disease metastasis-free survival (DMFS) and progression-free survival (PFS) did not considerably differ between the radiotherapy and non-radiotherapy subgroups in the high-risk PLN metastasis patients.@*Conclusions@#The PLN metastasis rate of NPC is low. Extracapsular spread of level Ⅱ is an independent risk factor. Radiotherapy of the parotid region is considered for patients with PLN size≥5 mm or those with PLN size<5 mm complicated with extracapsular spread of level Ⅱ.
ABSTRACT
Objective To investigate the high-risk factors for parotid lymph node (PLN) metastasis from nasopharyngeal carcinoma (NPC) and evaluate the feasibility of local intensity-modulated radiotherapy (IMRT) in patients with high-risk NPC.Methods Clinical data of 440 NPC patients admitted to Department of Radiotherapy of Jiangsu Cancer Hospital from May,2011 to March,2017 were collected.The imaging features,treatment strategies and clinical prognosis of PLN metastasis were retrospectively analyzed.The whole group adopts the technique of intensity modulated radiotherapy.Total parotid or partial parotid irradiation,selective PLN irradiation,X-Ray and/or electronic line supplementation,dose 45-60 Gy.The x2 test or Fisher's accurate probability method test and single factor analysis,Logistic regression model multifactor analysis.Kaplan-Meier survival analysis,log-rank test differences.Results PLN was observed in the parotid of 230 cases.At the end of follow-up,11 patients (2.5％,11/440) were diagnosed with PLN metastases.Among 11 cases,9 patients (81.8％) had PLN size ≥5 mm.Multivariate analysis demonstrated that extracapsular spread of level Ⅱ was an independent risk factor for PLN metastasis.The patients with PLN size ≥ 5 mm or extracapsular spread of level Ⅱ were assigned into the high-risk PLN metastasis group.The patients in the high-risk group were further divided into the radiotherapy and non-radiotherapy subgroups.Survival analysis demonstrated that for 230 patients with PLN metastasis,the local recurrence-free survival (LRFS) significantly differed,whereas the overall survival (OS),disease metastasis-free survival (DMFS) and progression-free survival (PFS) did not considerably differ between the radiotherapy and nonradiotherapy subgroups in the high-risk PLN metastasis patients.Conclusions The PLN metastasis rate of NPC is low.Extracapsular spread of level Ⅱ is an independent risk factor.Radiotherapy of the parotid region is considered for patients with PLN size≥5 mm or those with PLN size＜5 mm complicated with extracapsular spread of level Ⅱ.
ABSTRACT
Objective To explore the clinical value of magnetic resonance diffusion-weighted imaging ( MR-DWI ) in the early diagnosis of cervical lymph node recurrence after radiotherapy of nasopharyngeal carcinoma, aiming to provide reference for targeted diagnosis and treatment of these patients. Methods The MR-DWI features of 17 patients with recurrent cervical lymph nodes after radiotherapy from 2005 to 2016 were retrospectively analyzed. The results of diagnosis and treatment after lymph node recurrence were summarized. Results The recurrent lymph nodes of 17 patients showed a high signal or mixed signal on MR-DWI images. The sensitivity of MR-DWI and T2WI fat suppression sequence was 100% and 60%. Positron emission tomography-computed tomography ( PET-CT) or biopsy was performed to validate the diagnosis in patients with highly suspected single cervical recurrence. Besides, surgical treatment yielded better clinical prognosis. Conclusions MR-DWI is highly sensitive to recurrent cervical lymph nodes of nasopharyngeal carcinoma after radiotherapy, especially for the small lymph nodes of 5-10 mm in diameter, which are easily ignored. PET-CT examination should be performed, the nature of the lymph nodes should be confirmed by multi-modality imaging diagnosis, and timely operation has important clinical significance in improving the therapeutic effect and quality of life for patients with cervical lymphnode recurrence.
ABSTRACT
Objective To clarify the diagnostic value of diffusion-weighed imaging ( DWI) in the medial group of retropharyngeal lymph nodes in nasopharyngeal carcinoma, understand the clinical characteristics of retropharyngeal lymph nodes and explore the feasibility of optimizing the target volume of CT V60. Methods Clinical data of 437 patients with clinical stage Ⅰ-IVa nasopharyngeal carcinoma admitted to Jiangsu Cancer Hospital from 2011 to 2017 were retrospectively analyzed. All patients underwent magnetic resonance imaging (MRI),DWI (1 000 s/mm2) and enhanced CT scans to analyze the clinical characteristics of retropharyngeal lymph nodes and investigate the dosimetric advantage and safety of CT V60 lower margin on the upper margin of C2. Results The medial lymph nodes with a transverse diameter of 2. 0-19. 0 mm were detected 13 of 437 patients,and 53. 8% of the lymph nodes were measured 2-5 mm in transverse diameter. The medial lymph nodes were distributed between the superior margin of C1and 1/3 of C3.Its occurrence was related to N stage,double cervical lymph node metastases,especially the transverse diameter of cervical lymph node＞ 3 cm.The sensitivity of DWI,T2and enhanced CT were 100%,61. 5% and 23. 1%.After the special cases were excluded,the lower margin of CT V60on the superior margin of C2was separated. The radiation dose and volume of the swallowing structures were significantly decreased. The 5-year survival rate was 80% without recurrence in the optimized region. Conclusions The incidence of the medial group of retropharyngeal lymph nodes is low with a diameter of less than 5 mm. DWI possesses advantages in displaying the medial group of retropharyngeal lymph nodes. Isolating the lower margin of CT V60from the superior margin of C2is safe and feasible and has dosimetric advantages for protecting swallowing structure.
ABSTRACT
Objective To explore the influence of candesartan (an angiotensin II receptor 1 antagonist,AT1R) in radioresistance of human nasopharyngeal carcinoma CNE1 cells.Methods Cell growth of CNE1 with or without candesartan treatment was measured in vitro by MTT method;radiosensitivity of CNE1 with or without candesartan treatment was tested under normoxic or hypoxic conditions by clone formation assay.The expression of hypoxia-induced factor 1α(HIF-1α)in CNE1 cells was analysed by western blotting.Results Candesartan did not significantly inhibit the growth of CNE 1 cells in both normoxic and hypoxic conditions.Candesartan also did not influence the radiosensitivity of CNE1 cells in normoxic condition;however,it significantly increased the radiosensitivity of CNE1 cells in hypoxic condition.The expression of hypoxia-induced factor 1 α (HIF-1 α)in hypoxic CNE1 cells was significantly inhibited by candesartan treatment.Conclusion Candesartan does not significantly influence the proliferation of CNE1 cells in both normoxic and bypoxic conditions but significantly enhances the radiosensitivity of hypoxic CNE1 cells,in which the mechanisn may be involved in its inhibiting HIF1α expression in hypoxic CNE1 cells.
ABSTRACT
Objective To investigate the relationship between the incidence of radiation-induced brain stem injury after intensity-modulated radiotherapy (IMRT) and the radiation dose volume in patients with nasopharyngeal carcinoma.Methods A retrospective analysis was performed on the data of 258 patients newly diagnosed with nasopharyngeal carcinoma who received IMRT in our group from 2005 to 2013.The radiation dose per unit volume of brain stem was analyzed.The relationship between the incidence of brain stem injury induced by IMRT and the radiation dose volume was studied.The survival rate was calculated using the Kaplan-Meier method.The factors influencing the radiation-induced brain stem injury were analyzed using the Cox regression model.Results Two patients with stage T3 disease and three patients with T4 disease had radiation-induced brain stem injury.The 3-and 5-year injury incidence rates were 1.6％ and 2.4％,respectively.The latency ranged between 9 and 58 months,with a median latency of 19 months.The median D1％ and Dmax for the brain stem were 54.24 and 59.22 Gy in all patients,54.31 and 59.45 Gy in patients with stage T3 disease,and 61.29 and 66.37 Gy in patients with stage T4 disease,respectively.In the five patients with brain stem injury,the D1％ and Dmax were larger than 60 and 63 Gy,respectively.The univariate analysis showed that the incidence of radiation-induced brain stem injury was correlated with D1％,Dmax,D0.1 cm3,D0.5 cm3,and D1.0 cm3 (all P=0.01).The incidence of radiation-induced brain stem injury was significantly lower in patients with D1％,Dmax,D0.1 cm3,D0.5 cm3,and D1.0 cm3 no larger than 60,63,60,58,and 56 Gy,respectively (all P =0.00).Conclusions The incidence of radiation-induced brain stem injury after IMRT is relatively low in patients with nasopharyngeal carcinoma.Strict control of the dose to the brain stem may help to reduce the incidence of brain stem injury and improve the long-term quality of life.
ABSTRACT
Objective To explore the upper bound of Ⅱb region in the clinical target volume ( CTV ) for intensity?modulated radiotherapy ( IMRT ) for nasopharyngeal carcinoma ( NPC ) , and to establish a standard for personalized reduction in the range ofⅡb region. Methods A retrospective analysis was performed on the IMRT results of 142 patients newly diagnosed with NPC who were admitted to our hospital from 2012 to 2014. According to the American Joint Committee on Cancer 2010 staging system, there were 8 patients with stageⅠ disease, 37 stage Ⅱ, 41 stage Ⅲ, and 56 stage Ⅳ. The distribution pattern of cervical lymph nodes in NPC was studied based on the imaging results. Comparison of the dose to parotid glands between patients with and without reduction in the range ofⅡb region was made by t test and t'test. Results The metastasis rates of the most common diseased lymph nodes, lateral retropharyngeal lymph node and Ⅱb lymph node, were 75?4% and 67?6%, respectively. In the patients with metastases inⅡb region, 51?0% had high?risk positive lymph nodes and 6?3% had positive lymph nodes beyond the upper bound of Ⅱb region defined by the Radiation Therapy Oncology Group system. It was safe to narrow down Ⅱb region in patients who met the formulated standard. The D50 and V26 values for parotid glands were significantly reduced after optimization of CTV ( P=0?000) . Conclusions The upper bound ofⅡb region, in principle, should reach the lateral skull base during the delineation of the cervical CTV for NPC. In order to protect the parotid glands, however, personalized reduction in the upper bound of Ⅱb region is recommended for patients who meet the formulated standard.
ABSTRACT
Objective To investigate the effects of hyperbaric Oxygen (HBO)exposure on Caspase-3 and Bcl-2 mRNA ex-pressions in both internal carotid artery (ICA)and basal artery (BA)in rabbits.Methods Twenty-four healthy adult New Zealand rabbits were randomly divided into 2 groups:HBO group and the control group,with each group consisted of 12 animals.The rab-bits in the HBO group were exposed to HBO at 2.2 ATA for 60 minutes each day for 3 successive days.The rabbits in the control group were normally fed without any treatment.Real-time PCR was used to detect Caspase-3 and Bcl-2 mRNA expressions in both ICA and BA in 2 groups.Results HBO significantly decreased the Caspase-3 mRNA expression [(0.038 ±0.006 )vs .(1.000 ± 0.225)]and increased the Bcl-2 mRNA expression [(1.877 ±0.1 69)vs .(1.000 ±0.364)].In ICA,HBO similarly decreased the Caspase-3 mRNA expression [(0.41 9±0.091)vs .(1.000 ±0.1 75)]and increased the Bcl-2 mRNA expression [(1.269 ±0.270) vs .(1.000±0.1 1 7)]in BA.All the differences mentioned above were of statistical significance (P <0.01).Conclusion HBO ex-erts an inhibition effect on apoptosis in cerebral vascular endothelial cells.The mechanism may be related to inhibiting the expres-sion of Caspase-3 mRNA and promoting the expression of Bcl-2 mRNA.
ABSTRACT
Objective To analyze clinical features of and hypertrophy-related factors in patients with hypertrophic port-wine stains (PWS). Methods Patients with PWS were enrolled into this study from Anhui Provincial Hospital and the First Affiliated Hospital of Anhui Medical University between January 2010 and August 2014. Clinical features of hypertrophic PWS were investigated. The factors related to hypertrophy in PWS were analyzed by univariate and multivariate unconditional logistic regression analyses. Results A total of 262 patients with PWS were enrolled, 82 (30 males and 52 females)of whom had hypertrophic PWS with a median age of 32.5 years (range, 18 - 54 years). Among the 82 patients, 66(80.48%)had plaque-like hypertrophic PWS, 9(10.98%)had papular or nodular type, and 7 (8.54%)had mixed type; 56.10% (46/82)were aged ≥ 30 years, 41.46% (34/82)varied from 11 to 30 cm2 in lesional area, and 85.36% (70/82)showed purple lesions. There was a significant difference between patients with hypertrophic PWS and those with flat PWS in the distribution of age, lesional area and color(χ2 = 25.559, 10.580, 90.630, respectively, all P 0.05). Multivariate unconditional logistic regression analysis revealed that an age ≥ 30 years(OR = 2.889, 95%CI: 1.459 - 5.721)and purple lesions(OR = 19.984, 95% CI: 5.704 - 70.023)were factors related to skin hypertrophy in PWS. Conclusion An age ≥ 30 years and purple lesions seem to be hypertrophy-related factors in PWS.
ABSTRACT
[ ABSTRACT] AIM:To investigate the effect of DEK downregulation on the apoptosis of gastric carcinoma SGC-7901 cells, and to explore its associations with NF-κB signaling pathway and apoptosis related proteins.METHODS:SGC-7901 cells with different treatments were divided into 3 groups including untreated group, control siRNA group and DEK siRNA group.The expression of DEK at mRNA and protein levels in the SGC-7901 cells was detected by real-time PCR and Western blot.The cell apoptosis was examined by flow cytometry.Furthermore, the activities of caspase-3 and caspase-9 in the SGC-7901 cells were investigated by Caspase-Glo?-3/9 kit.Finally, the expression of key regulatory pro-tein p65 of NF-κB signaling pathway and apoptosis-related proteins Bcl-2 and Bax in the SGC-7901 cells was investigated by Western blot.RESULTS:Compared with untreated group and control siRNA group, the expression of DEK at mRNA and protein levels was significantly downregulated in DEK siRNA group (P<0.05).In addition, the ratios of early phase apoptosis and total apoptosis in DEK siRNA group were markedly higher than those in untreated group and control siRNA group (P<0.05).Most notably, the decrease in p65 and Bcl-2 proteins, increase in Bax protein and the increases of caspase-3 and caspase-9 activities were observed in DEK siRNA group.CONCLUSION:Downregulation of DEK mediates cell apoptosis of gastric carcinoma may be tightly associated with NF-κB signaling pathway.
ABSTRACT
Objective To establish a simple and effective method for isolation and culture of mouse adipose-derived stem cells (mASCs)in vitro,in order to provide the sufficient sources of seed cells for the research of mesenchymal stem cells.Methods The mouse inguinal fat tissues were isolated in vitro and performed a digestion with 0.1% collagenase type NB4,then adipose-derived stem cells(ASCs)were seeded and adhered to the culture dishes in low glucose DMEM containing 10% fetal calf serum.The cellu-lar morphology,in vitro proliferation capacity,multidifferentiation potential and immunophenotype were assessed.Results The mASCs showed good cell morphology,extremely strong proliferation capacity and potential of adipogenesis,osteogenesis and chon-drogenesis via in vitro three-dimensional induction.The cellular surface antigen phenotype was consistent with that reported by lit-erature,and the expression of CD34 and CD105 was positive,Sca-1 was highly expressed,CD45 and SSEA-1 were not expressed. Conclusion Using the experimental methods in this research can culture the high purity of mASCs with the excellent stem cell properties and extremely strong proliferative ability.
ABSTRACT
Objective To detect the changes of peripheral blood T lymphocyte subsets in patients with hand,foot and mouth disease (HFMD) and investigate its clinical significance.Methods Three hundred and eighty-six patients with HFMD and 78 healthy children were detected the peripheral blood T lymphocyte subsets levels using the flow cytometry (FCM).The patients were divided into 325 common patients and 61 critically ill patients according to the severity of disease.Among the 386 patients,264 were in infection stage and 122 were in recovery stage.Compared the differences of peripheral blood T lymphocyte subsets levels in patients and healthy controls,common patients and critically ill patients,infection patients and recovery patients respectively.Results The patients' numbers of CD3 +,CD4 +,CD8 + cells and CD4 +/CD8 + ratio were (47.4 ± 10.6) ％,(24.0 ±8.0) ％,(23.2 ± 7.4) ％ and 1.0 ± 0.5 respectively.These parameters were significantly different with those in the control group ((68.4±7.5)％,(38.2 ±6.9)％,(18.8 ±4.6)％ and 2.0 ±0.4 respectively;t =3.16,4.62,2.23 and 2.51 respectively,P ＜ 0.05).The common patients' numbers of CD3 +,CD4 +,CD8 + cells and CD4+/CD8 + ratio were (53.0 ±9.8)％,(26.5 ±7.9)％,(20.4±7.5)％and 1.3 ±0.6,which had significant differences compared with those of the critically ill patients ((42.3 ± 10.9) ％,(18.7 ± 4.7) ％,(24.2 ± 7.4) ％ and (0.7 ± 0.4) respectively; t =2.25,2.47,1.91 and 2.32 respectively,P ＜ 0.05).The infection patients' CD3 +,CD4 +,cell numbers and CD4 +/CD8 + ratio were (45.3 ± 10.5) ％,(21.6 ± 8.4) ％and 0.9 ± 0.5.These parameters were significantly different with those of the recovery patients ((54.7 ±9.9)％,(27.5 ± 9.1)％ and 1.4 ± 0.6 respectively; t =2.41,1.87 and 2.92 respectively,P ＜ 0.05).Conclusion The cellular immunity of patients with HFMD was impaired.The T lymphocyte function was suppressed,and the level of suppression was positively correlated to severity of the illness.
ABSTRACT
Objective To evaluate the myocardial protective effect of dexmedetomidine during non-cardiac surgery in patients with coronary heart disease.Methods Eighty ASAⅡor Ⅲ patients with coronary heat disease (NYHA Ⅱ or Ⅲ)aged 43-76 yr weighing 52-80 kg scheduled for elective upper abdominal surgery were randomly divided into 2 groups(n=40 each)：control group(group C)and dexmedetomidine group(group D).Anesthesia was induced with etomidate 0.25 mg／kg，sufentanil 0.5 μg／kg and vecuronium 0.1 mg／kg.The patients were tracheal intubated and mechanically ventilated.A loading dose of dexmedetomidine 1μg/kg was injected intravenously 10 min before induction followed by infusion at 0.4 μg·kg-1·h-1 until the end of operation in group D.While equal volume of normal saline was given in group C.BIS was maintained at 40-49.Blood samples were taken before induction and at the end of operation for determination of serum concenlrations of IL-6，TNF-α，cardiac troponin Ⅰ(cTnI)and glycogen phosphorylase BB(GP-BB).The adverse cardiovascular events were recorded during operation.Results The serum concentrations of IL-6，TNF-α，cTnI and GP-BB and incidences of tachycardia and myocardial ischemia were significantly lower，while the incidences of bradycardia highcr in group D than in group C (P<0.05).Conclusion Dexmedetomidine Can exert the myocardial protective effect during non-cardiac surgery in patients with coronary heart disease and the mechanism may be related to the inhibition of the release of pro-inflammatory cytokines.
ABSTRACT
Objective To explore the relationship between expressions of C-type lectin receptors on natural killer(NK) cells and infant human cytomegalovirus (HCMV) infection. Methods Seventynine cases of HCMV infection infants and 39 cases of HCMV non-infection control infants admitted during January 2006 to June 2008 were recruited in this study. According to HCMV pp65 antigenemia levels in the peripheral blood, 79 cases of HCMV infection infants were divided into two groups: 48cases of active HCMV infection and 31 cases of inactive HCMV infection. The 48 cases of infants with active HCMV infection were treated with ganciclovir for 2 weeks. The expressions of NKG2A,NKG2C, and NKG2D receptors on NK cells in the peripheral blood were examined by flow cytometry.Data analysis was done using SPSS 17.0 software. Comparisons among 3 groups were performed by Kruskal-Wallis nonparametric test for independent samples and comparisons between groups were done by Mann-Whiteney nonparametric test for paired samples. Results There was no difference of the inhibitory receptor NKG2A expression on NK cells among groups of active HCMV infection, inactive HCMV infection and HCMV non-infection controls (x2 = 3. 95, P＞0. 05). However, there was obvious difference of activating receptors of NKG2C and NKG2D expressions on NK cells among the three groups (x2 =24.91 and x2 =47. 80, respectively; both P＜0.01). The expressions of NKG2C and NKG2D on NK cells in the HCMV infection group were both higher than the control group (Z=-4.72 and Z=-5.15, respectively; both P＜0.01). The expression of NKG2D on NK cells in the active HCMV infection group was higher than that in the inactive HCMV infection group (Z= -5.08,P＜0.01). The expression of NKG2D on NK cells decreased after ganciclovir treatment (Z= - 1.34,P=0. 07). Conclusion Expressions of NKG2C and NKG2D on NK cells might play a significant role in regulating NK cell function and anti-HCMV immunity in infants.
ABSTRACT
Purpose To observe the effect of Rongban Tongmai Granules on thrombosis and blood viscosity of in vitro rat model of blood stasis, and to study the activating blood circulation effect of the drug.Methods To observe the effect of the Rongban Tongmai Granules on thrombosis and blood viscosity of in vitro rat model of stasis, subcutaneous inject rat with epinephrine hydrochloride, and then copy "blood stasis" model by ice water stimulation in rats.Results According to a continuous 7 days′intragastric administration of Rongban Tongmai Granules, thrombus length of blood stasis model rats in vitro reduced significantly (P<0.05-0.01),wet and dry weight of thrombus reduced significantly (P<0.05), the shear rate of the whole blood viscosity under 100 S~(-1), 30 S~(-1), 5 S~(-1) decreased significantly as well (P<0.05-0.01), and the shear rate of whole blood viscosity had decreasing tendency under 200 S~(-1).Conclusion Rongban Tongmai Granules can inhibit thrombosis and lower blood viscosity.