ABSTRACT
Redirecting immune cells to the tumor cells and enhancing its anti-tumor immune response is a very promising cancer treatment strategy. AS1411 aptamers have high affinity for malignant tumors with high nucleolin expression, and cytotoxic T lymphocyte associated protein 4 (CTLA-4) aptamers can specifically bind to CTLA-4, which is expressed by T cells. In this study, a dual-affinity aptamer targeted liposome (Dat. Lipo) was constructed based on AS1411 aptamer and CTLA-4 aptamer, and its immunotherapeutic effect on T cells was studied. After the aptamer was modified with cholesterol, Dat. Lipo was prepared by instillation method; its effect of redirecting T cells was determined by confocal micrographs; its T cell immunotherapy effect was evaluated by cell counting kit-8 (CCK8) and T cell penetration was evaluated by tumor spheroids. The results showed that compared with liposomes loaded with one type aptamer, Dat. Lipo could effectively promote the redirection of T cells to tumor cells; Dat. Lipo had good biosafety and immunotherapeutic effect on MCF-7 and HepG2 cells in a concentration-dependent manner; Dat. Lipo could also promote T cells to infiltrate into the tumor spheroids and enhance the immunotherapy effect of T cells in different dimensions. In summary, Dat. Lipo can use the high affinity of aptamers to redirect T cells to tumor cells, enhance the effect of immunotherapy, and has a promising application prospect in tumor therapy. This study was approved by the Examination Committee of Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital.
ABSTRACT
Objective:To construct a virtual simulation training platform for peripheral inserted central catheter (PICC) catheterization and discuss its application in clinical training.Methods:A total of 118 nurses who attended the PICC professional and technical advanced training courses in a province in 2020 and 2021 were enrolled in this study. In 2020, the training was conducted in the form of theoretical teaching combined with practical training ( n=51), and in 2021, virtual simulation platform was introduced as a supplement on the basis of the original training ( n=67). SPSS 23.0 was used for independent-samples t-test to compare the theoretical and operational assessment results of the two years and evaluate the application effect of the platform. Through the satisfaction survey and learning log, the nurses' experience of using the platform was understood. Results:The theoretical performance and the operational performance of nurses who participated in the training in 2021 were (96.56±3.17) and (94.06±2.16) respectively, and the operational performance was better than that of nurses who participated in the training in 2020 ( t=-11.37, P<0.001), and the difference in theoretical performance was not statistically significant ( t=0.17, P=0.853). In 2021, 63 nurses (94.0%) who used the virtual simulation platform believed that the platform could assist to improve the training effect; 61 nurses (91.0%) expected the application of virtual simulation technology in the teaching and training of other knowledges. Conclusion:As a new teaching form, virtual simulation technology can significantly improve the training effect and satisfaction, and provide reference for the development of relevant teaching and training.
ABSTRACT
Objective: To compare the clinical characteristics of different types of human adenovirus (HAdV) infection in hospitalized children with acute respiratory infection in Beijing, and to clarify the clinical necessity of adenovirus typing. Methods: In a cross-sectional study, 9 022 respiratory tract specimens collected from hospitalized children with acute respiratory infection from November 2017 to October 2019 in Affiliated Children's Hospital, Capital Institute of Pediatrics were screened for HAdV by direct immunofluorescence (DFA) and (or) nucleic acid detection. Then the Penton base, Hexon and Fiber gene of HAdV were amplified from HAdV positive specimens to confirm their HAdV types by phylogenetic tree construction. Clinical data such as laboratory results and imaging data were analyzed for children with predominate type HAdV infection using t, U, or χ2 test. Results: There were 392 cases (4.34%) positive for HAdV among 9 022 specimens from hospitalized children with acute respiratory infection. Among those 205 cases who were successfully typed, 131 were male and 74 were female, age of 22.6 (6.7, 52.5) months,102 cases (49.76%) were positive for HAdV-3 and 86 cases (41.95%), HAdV-7, respectively, while 17 cases were confirmed as HAdV-1, 2, 4, 6, 14 or 21. In comparison of clinical characteristics between the predominate HAdV type 7 and 3 infection, significant differences were shown in proportions of children with wheezing (10 cases (11.63%) vs. 25 cases (24.51%)), white blood cell count >15 ×109/L (4 cases (4.65%) vs.14 cases (13.73%)), white blood cell count <5×109/L (26 cases (30.23%) vs.11 cases (10.78%)), procalcitonin level>0.5 mg/L (43 cases (50.00%) vs. 29 cases (28.43%)), multilobar infiltration (45 cases (52.33%) vs.38 cases (37.25%)), pleural effusion (23 cases (26.74%) vs. 10 cases (9.80%)), and severe adenovirus pneumonia (7 cases (8.14%) vs. 2 cases (1.96%)) with χ²=5.11, 4.44, 11.16, 9.19, 4.30, 9.25, 3.91 and P=0.024, 0.035, 0.001, 0.002, 0.038, 0.002, 0.048, respectively, and also in length of hospital stay (11 (8, 15) vs. 7 (5, 13) d, Z=3.73, P<0.001). Conclusions: HAdV-3 and 7 were the predominate types of HAdV infection in hospitalized children with acute respiratory tract infection in Beijing. Compared with HAdV-3 infection, HAdV-7 infection caused more obvious inflammatory reaction, more severe pulmonary symptoms, longer length of hospital stay, suggesting the clinical necessity of further typing of HAdVs.
Subject(s)
Child , Female , Humans , Infant , Male , Adenovirus Infections, Human/epidemiology , Adenoviruses, Human/genetics , Beijing/epidemiology , Child, Hospitalized , Cross-Sectional Studies , Phylogeny , Respiratory Tract Infections/epidemiologyABSTRACT
Hemophilia is an X-linked recessive inherited bleeding disorder. Despite the improved treatment in recent years with the advent of replacement therapies, the progression of atherosclerosis is not slowed down after the reduction of clotting factors in hemophilia. As life expectancy increases, more hemophilia patients will suffer from age-related cardiovascular diseases. Since cardiac surgery needs heparinization and cardiopulmonary bypass (CPB), it is extremely challenging to balance hemostasis and coagulation in patients with hemophilia. Here we report three cases of hemophilia patients who underwent cardiac surgery successfully.
Subject(s)
Humans , Cardiac Surgical Procedures/adverse effects , Cardiopulmonary Bypass , Hemophilia A/complicationsABSTRACT
Objective:To investigate the clinical effect of Jiedu Limai decoction in septic patients with syndrome of heat-toxin exuberance.Methods:A prospective randomized controlled trial was conducted. From March 2019 to April 2020, septic patients with syndrome of heat-toxin exuberance admitted to intensive care unit (ICU) of Shanghai General Hospital and Songjiang Branch of Shanghai General Hospital were enrolled as the research objects, and they were divided into routine treatment group and Jiedu Limai decoction group by the random number table method. Patients in both groups were given standard treatment in accordance with the guidelines, and patients in the Jiedu Limai decoction group were given Jiedu Limai decoction in addition to the standard treatment, once a day for 14 days. The 28-day survival of patients of the two groups were recorded, the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, coagulation indexes, infection indexes, inflammatory cytokines and organ function indicators before treatment and 7 days after treatment in both groups were recorded, and the prognosis of the two groups were recorded.Results:A total of 259 patients with infection or clinical diagnosis of infection admitted during the experimental observation period were included, and those who did not meet the Sepsis-3 diagnostic criteria, more than 80 years old or less than 18 years old, with multiple tumor metastases, autoimmune system diseases, with length of ICU stay less than 24 hours, with acute active gastrointestinal bleeding and with incomplete data were excluded. One hundred patients were finally enrolled, with 50 patients in the routine treatment group and 50 patients in the Jiedu Limai decoction group. There were no statistically significant differences in coagulation indexes, infection indicators, inflammatory cytokines and organ function indicators before treatment between the two groups. After 7 days of treatment, the coagulation indexes, infection biomarkers and inflammatory cytokines in the Jiedu Limai decoction group were significantly lower than those in the routine treatment group [D-dimer (mg/L): 2.2 (1.8, 8.5) vs. 4.0 (1.5, 8.7), fibrinogen (Fib, g/L): 3.7 (3.4, 4.3) vs. 4.2 (3.7, 4.3), fibrinogen degradation product (FDP, mg/L): 7.2 (5.4, 10.2) vs. 13.2 (9.2, 15.2), procalcitonin (PCT, μg/L): 0.4 (0.2, 2.9) vs. 0.5 (0.2, 0.9), C-reactive protein (CRP, mg/L): 50.1 (9.5, 116.0) vs. 75.1 (23.5, 115.2), interleukin-6 (IL-6, ng/L): 31.6 (21.6, 81.0) vs. 44.1 (14.0, 71.3), all P < 0.05], and the levels of B-type brain natriuretic peptide (BNP) and kidney injury molecule-1 (KIM-1) were significantly lowered [BNP (ng/L): 261.1 (87.5, 360.3) vs. 347.3 (128.8, 439.4), KIM-1 (μg/L): 0.86 (0.01, 1.40) vs. 1.24 (1.05, 1.57), both P < 0.05]. Compared with the routine treatment group, the number of new organ failure in the Jiedu Limai decoction group was decreased (30.0% vs. 50.0%, P < 0.05). Although there was no significant difference in 28-day mortality between the two groups ( P > 0.05), the 28-day mortality in the Jiedu Limai decoction group was lower than that in the routine treatment group (18.0% vs. 24.0%). Conclusion:Combining Jiedu Limai decoction to the sepsis guideline in treating syndrome of heat-toxin exuberance can effectively improve patients' coagulation function, the situation of heart and renal injury, reduce the level of inflammatory cytokines, and fewer people develop new organ failure after treatment.
ABSTRACT
Objective:To explore the status of nursing information ability and its relationships with information consciousness, information anxiety in intern nursing students, provide basis for the cultivation of nursing information ability of intern nursing students.Methods:From December 2019 to January 2020,185 nursing students working as interns in Jinan Central Hospital Affiliated to Shandong University were surveyed by general information questionnaire, information anxiety questionnaire, information consciousness questionnaire and nursing information ability assessment scale.Results:The total score of nursing information ability of nursing students in practice was 111.6±19.7; nursing information ability was positively correlated with information consciousness ( r=0.358, P<0.001), and not related to information anxiety ( r=0.136, P=0.065); information consciousness had a predictive effect on nursing information ability( β=0.287, P<0.001), and information anxiety could moderate the relationship between information consciousness and nursing information ability ( β=0.175, P=0.011). Conclusions:The score of nursing information ability is above the medium level, while improving the nursing information ability through the development of information consciousness, and the information anxiety level of nursing students should also be paid attention to.
ABSTRACT
Background and Objectives@#The effective use of MSCs for the treatment of some B cell-mediated immune diseases is quite limited. The main reason is that the immunomodulatory effects of mesenchymal stem cells (MSCs) on B cells are unclear, and their underlying mechanisms have not been fully explored. @*Methods@#and Results: By co-culturing B cells with MSCs without (MSC/CTLsh) or with suppressor of cytokine signaling 1 (SOCS1) knockdown (MSC/SOCS1sh), we found that MSCs inhibited B cell proliferation, activation and terminal differentiation. Remarkably, the highest inhibition of B cell proliferation was observed in MSC/SOCS1sh co-culture. Besides, MSC/SOCS1sh reversed the inhibitory effect of MSCs in the last stage of B cell differentiation. However, MSC/SOCS1sh had no effect on inhibiting B cell activation by MSCs. We also showed that IgA+ B cell production was significantly higher in MSC/SOCS1sh than in MSC/CTLsh, although no difference was observed when both MSCs co-cultures were compared to isolated B cells. In addition, MSCs increased PGE2 production after TNF-α/IFN-γ stimulation, with the highest increase observed in MSC/SOCS1sh co-culture. @*Conclusions@#Our results highlighted the role of SOCS1 as an important new mediator in the regulation of B cell function by MSCs. Therefore, these data may help to develop new treatments for B cell-mediated immune diseases.
ABSTRACT
The formation, consolidation and retrieval of spatial memory depend on sequential firing patterns of place cells assembling in the hippocampus. Theta sequences of place cells during behavior play a role in acquisition of spatial memory, trajectory prediction and decision making. In awake rest and slow wave sleep, place cell sequences occur during the sharp wave-ripples (SWRs), called "replay", which is crucial for memory consolidation and retrieval. In this review, we summarize the functional significances of theta sequences and SWRs replay sequences and the mechanism of these sequences. We also discuss the relationship between theta and replay sequences with the formation of spatial memory. We propose the research direction in this field in future and aim to provide new ideas for related researches.
Subject(s)
Hippocampus , Sleep , Spatial Memory , WakefulnessABSTRACT
Objective::To investigate the effect of polyethylene glycol 400 (PEG400) on rat bile excretion of baicalin and its main metabolite [baicalein 6-O-β-D-glucuronide (B6G)], and to analyze its mechanism of action. Method::Rats were randomly divided into baicalin+ water group and baicalin+ PEG400 group, the anesthesia was induced by intraperitoneal injection of 10% chloral hydrate (dose of 4 mL·kg-1) to prepare a rat bile duct intubation model. After the rats were fully awake, rats were given baicalin aqueous solution and baicalin PEG400 solution with dose of 168 mg·kg-1 for baicalin, respectively. And bile was collected from 0 h to 12 h after administration. UPLC-MS/MS was used to determine the concentration of drug excreted through bile at different time periods. Thermo Hypersil GOLD C18 column was used with acetonitrile (A)-0.1% formic acid solution (B) as the mobile phase for gradient elution (0-9 min, 90%-27%B; 9-10 min, 27%-90%B; 10-12 min, 90%B), the flow rate was 0.3 mL·min-1, the column temperature was 30 ℃, the injection volume was 5 μL. The mass spectra were obtained in positive ion mode with electrospray ionization (ESI). The effects of PEG400 on the activities and expressions in rat liver of uridine diphosphate glucuronyltransferase (UGT) 1A8 and UGT1A9 were studied in vitro incubation assay and enzyme linked immunosorbent assay (ELISA). Result::Compared with the baicalin+ water group, in the baicalin+ PEG400 group, the bile cumulative excretions of baicalin and B6G increased by 1.8 times and 2.1 times within 12 h, respectively. PEG400 increased the enzyme activities of UGT1A8 and UGT1A9 by 2.0 times and 1.5 times, and their concentrations in liver were increased by 2.2 times and 1.3 times, respectively. Conclusion::PEG400 can significantly increase the bile excretion of baicalin and its main metabolite B6G by enhancing the activities and expressions of UGT1A8 and UGT1A9, and its promoting effect on bile excretion of B6G is greater than that of baicalin, which provides a basis for the rational clinical application of PEG400 and the design of new dosage forms of flavonoids such as baicalin.
ABSTRACT
TACE is effective for treatment of advanced liver cancer, but residual or recurrence of cancer is an important factor affecting the efficacy of TACE. Imaging assessment plays an important role in the follow-up after TACE. The advancements and the status of imaging assessment for active lesions of liver cancer after TACE were reviewed in this article.
ABSTRACT
Collateral circulation is a characteristic manifestation of Budd-Chiari syndrome (BCS), also an important compensatory factor for the relief of intrahepatic and extrahepatic congestion. Collateral circulation not only provides important information for the diagnosis of BCS, but also has important significance in the treatment of BCS. The advancements of collateral circulation in the diagnosis and treatment of BCS were reviewed in this article.
ABSTRACT
Objective@#To explore the clinical efficacy of plate fixation via the lateral transverse incisions and double-window approaches for the treatment of intra-articular calcaneal fractures.@*Methods@#A retrospective analysis was performed on the data of 21 intra-articular calcaneal fractures (22 feet) which had been treated at Department of Orthopaedics, The Second Affiliated Hospital to Anhui Medical University from May 2014 to April 2016. There were 19 males and 2 females, aged from 20 to 60 years (average, 38.3 years). The fracture affected 13 left feet and 9 right feet. According to the Sanders classification, 10 feet were type Ⅱ, 11 type Ⅲ and one type Ⅳ. They were treated by plate fixation via the lateral transverse incisions and double-window approaches. Early complications within 3 months after operation, the length, width, height, Böhler angle and Gissane angle of the calcaneus one year after operation, functional recovery of the affected feet at the last follow-up, and complications were recorded.@*Results@#The 21 patients were followed up for 21 to 44 months (mean, 36.7 months). Incisions were all healed at the first postoperative stage with no serious skin or soft tissue complications like superficial infection, deep infection or wound dehiscence. At the early stage, one patient suffered epidermal necrosis at the margin of incision, which was cured after dressing change. None of the patients developed subtalar arthritis by the last follow-up. The preoperative length, width, height, Böhler angle and Gissane angle of the calcaneus (respectively, 68.6±1.2 mm, 46.7±0.8 mm, 39.1±2.0 mm, 5.4°±12.1° and 104.3°±10.2°) were significantly improved to 71.7±1.6 mm, 48.8±2.0 mm, 32.8±1.3 mm, 29.2°±6.8°, and 120.8°±6.2° one year after operation(P<0.05). At the last follow-up, their AOFAS ankle-hind foot scores averaged 92.7 points (from 73 to 98 points); 17 feet were rated as excellent, 3 as good and 2 as moderate, giving an excellent and good rate of 90.1%.@*Conclusion@#Plate fixation via the lateral transverse incisions and double-window approaches can reduce incidences of postoperative soft tissue complications and subtalar arthritis, leading to good clinical results in the treatment of intra-articular calcaneal fractures.
ABSTRACT
Objective To explore the clinical efficacy of plate fixation via the lateral transverse incisions and double-window approaches for the treatment of intra-articular calcaneal fractures.Methods A retrospective analysis was performed on the data of 21 intra-articular calcaneal fractures (22 feet) which had been treated at Department of Orthopaedics,The Second Affiliated Hospital to Anhui Medical University from May 2014 to April 2016.There were 19 males and 2 females,aged from 20 to 60 years (average,38.3 years).The fracture affected 13 left feet and 9 right feet.According to the Sanders classification,10 feet were type Ⅱ,11 type Ⅲ and one type Ⅳ.They were treated by plate fixation via the lateral transverse incisions and double-window approaches.Early complications within 3 months after operation,the length,width,height,B(o)hler angle and Gissane angle of the calcaneus one year after operation,functional recovery of the affected feet at the last follow-up,and complications were recorded.Results The 21 patients were followed up for 21 to 44 months (mean,36.7 months).Incisions were all healed at the first postoperative stage with no serious skin or sofi tissue complications like superficial infection,deep infection or wound dehiscence.At the early stage,one patient suffered epidermal necrosis at the margin of incision,which was cured after dressing change.None of the patients developed subtalar arthritis by the last follow-up.The preoperative length,width,height,B(o)hler angle and Gissane angle of the calcaneus (respectively,68.6 ± 1.2 mm,46.7 ± 0.8 mm,39.1 ± 2.0 mm,5.4° ± 12.1° and 104.3°± 10.2°) were significantly improved to 71.7 ± 1.6 mm,48.8 ±2.0 mm,32.8 ± 1.3 mm,29.2° ± 6.8°,and 120.8° ± 6.2° one year after operation(P ＜ 0.05).At the last follow-up,their AOFAS ankle-hind foot scores averaged 92.7 points (from 73 to 98 points);17 feet were rated as excellent,3 as good and 2 as moderate,giving an excellent and good rate of 90.1％.Conclusion Plate fixation via the lateral transverse incisions and double-window approaches can reduce incidences of postoperative soft tissue complications and subtalar arthritis,leading to good clinical results in the treatment of intra-articular calcaneal fractures.
ABSTRACT
Objective To explore the feasibility of interventional therapy in rat models of Budd-Chiari syndrome (BCS).Methods A total of 50 male clean SD rats were divided into model group and control group using random number table method,with 25 rats in each group.In the model group,BCS rat model was constructed by adopting partial ligation of the inferior vena cava (IVC),and the control group only had separation of surrounding tissues of IVC.Liver function was studied 12 weeks after postoperative raising,and digital subtraction angiography (DSA) and interventional therapy were performed,coupled with liver histopathology staining.Results Twenty BCS rats survived till the 12th week of raising,with the survival rate reaching 80.0％,and 22 survived in the control group.Compared with the control group,ALT [(43.1±5.5) U/L vs.(62.6±4.6) U/L] and AST [(84.7±26.5) U/L vs.(161.7±25.8) U/L)] in serum of rats in the model group increased,the differences were statistically significant (P＜0.05).HE staining showed that obvious hepatocyte necrosis and inflammatory cell infiltration were observed in BCS rats,and liver fibrosis was spotted via Masson staining.DSA examination found IVC obstruction in the model group,among which 14 (70.0％,14/20) received interventional therapy after successful probing of IVC obstructed segment,and 7 had balloon dilatation with a diameter of 3.5 mm,with 6 (85.7％,6/7) successfully dilatatedand the other 1 (14.3％,1/7) failed;the remaining 7 had balloon dilatation with a diameter of 4.5 mm,with 2 (28.6％,2/7) successfully dilatated,and the other 5 (71.4％,5/7) died of IVC rupture.Conclusion The BCS rat models by partial ligation of IVC can well simulate the pathophysiological changes and angiopathy characteristics of IVC obstructive BCS patients,which provide a platform for the basic research of interventional therapy of BCS.
ABSTRACT
Objective • To generate a doxycycline (Dox)-inducible multiplexed CRISPR interference (CRISPRi) system for multiple gene inhibition in human embryonic stem cells (hESCs) to explore the function of gene families and model multigene diseases. Methods • A Dox-inducible multiplexed CRISPRi system was developed by Golden Gate assembly in hESCs. This system consisted of two plasmids, one expressing modified repressive nuclease-deactivated CRISPR-associated protein 9 (dCas9) and Krüppel-associated box (KRAB) transcriptional repressor domain under the control of Dox, the other carrying eight independent guide RNA (gRNA) expression cassettes. PCR was conducted using total genomic DNA as a template to confirm whether these two plasmids were integrated into genome. Western blotting was performed to confirm whether the expression of dCas9-KRAB could be induced by Dox treatment. Results • Using this tunable CRISPRi system, multiple genes were successfully silenced simultaneously in hESCs. The silence of genes and related to hESC self-renewal caused obvious cell differentiation in terms of changed cell morphology, decreased activity of alkaline phosphatase, and reduced expression of stage-specific embryonic antigen 4 (SSEA4), a marker of undifferentiated hESCs. Conclusion • This Dox-inducible multiplexed CRISPRi system can be used for quick and efficient silence of multiple genes in hESCs in a highly controlled manner.
ABSTRACT
Objective To investigate the expression and significance of inducible nitric oxide synthase (iNOS), platelet-derived growth factor (PDGF)-B and lipopolysaccharide (LPS) in rat models with Budd-Chiari syndrome (BCS) . Methods BCS model was established by partial ligation of inferior vena cava in the posterior segment of the liver. The experimental rats were divided into control group (n=20), model group (n=20) and sham group (n=20) . Liver tissues were collected for immunohistochemistry, HE and Masson staining, and the expression levels of iNOS, PDGF-B and LPS were determined. Results The LPS value in model group was higher than that in both control group and sham group (P=0.001) . The mRNA and protein expressions of iNOS and PDGF-B in model group were higher than those in both control group and sham group (P=0.001) . Statistically significant differences in mRNA and protein expressions of iNOS and PDGF-B existed between each other among the subgroups (P=0.001) . In model group iNOS was positively correlated with PDGF-B and LPS; liver fibrosis was positively correlated with LPS and negatively correlated with PDGFB. Conclusion The damage and repair of BCS is a complicated process. The iNOS, PDGF-B and LPS may play different roles in different stages of BCS. How to regulate their balance in liver fibrosis may be a direction that deserves further study.
ABSTRACT
Objective To investigate the expression and significance of malonaldehyde (MDA), superoxide dismutase (SOD) and endotoxin (ET) in liver injury model of Budd-Chiari syndrome (BCS) in rats. Methods The animal model of BCS was established by partially ligating the inferior vena cava of the posterior segment of liver in rats. The experimental animals were divided into three groups: control group (12 rats), model group (48 rats) and sham operation group (48 rats). The model group and sham operation group were divided into four subgroups (1, 3, 6, 12 weeks) of 12 rats each. After the success of modeling,being confirmed by digital subtraction angiography (DSA), nine rats in each group were sacrificed at random respectively, where their serums and liver tissues was collected. The levels of MDA, SOD and ET in both liver homogenate and serum were examined respectively. ANOVA was used to compare the total difference between groups and within group of each measurement data. The LSD method was used to do multiple comparison within group and between groups. Pearson method was used to do correlation analysis of hypoxia markers. Results The levels of MDA, SOD and ET in liver homogenate and serum at different time points in model group were significantly different from those in control group and sham operation group (MDA: liver homogenate (F=52.906, 219.016), serum (F=21.573, 43.878); SOD: liver homogenate (F=22.927, 19.317), serum (F=10.841, 31.643);ET: liver homogenate (F=33.588, 105.515), serum (F=40.832, 46.323);P＜0.05). The total difference of the MDA level in serum at each time point after the operation was not statistically significant in model group(F=1.965,P=0.139), but that of liver homogenate in the model group was statistically significant (F=7.716, P=0.001). The SOD and ET levels in both liver homogenate and serum of model group were compared within groups at different time points after operation respectively, and the overall difference was statistically significant (SOD: F=17.053, 7.903; ET: F=19.870, 39.372; P＜0.05). The time-varying curves of MDA and ET in liver homogenate and serum in model group were similar, which both increased from 1 week after operation,peaked at 6th week and slightly decreased at 12th week. The increase levels of MDA and ET in liver homogenate were significantly higher than those in serum. There was a negative correlation between MDA and SOD in liver homogenate and serum (r=－0.814,－0.591;P=0.001, 0.001), a positive correlation between MDA and ET (r=0.761, 0.422; P=0.004, 0.001), and a negative correlation between SOD and ET (r=－0.726,－0.490;P=0.001, 0.001). Conclusions The levels of hypoxia related markers, such as MDA, SOD and ET in liver and serum of BCS animal model, change to varying degrees in the early stage, and will be aggravated as the disease continues to advance. In the later stage, with the establishment of collateral circulation, hypoxia will be slightly eased, but is still significantly higher than normal, which indicates that congestion and hypoxia run through the whole process of BCS, and could be the key and initiating factors.
ABSTRACT
<p><b>Background</b>As a major complication after orthotopic liver transplantation (OLT), the occurrence of acute kidney injury (AKI) is frequently defined by serum creatinine (Cr); however, the accuracy of commonly used blood urea nitrogen (BUN), uric acid (UA), and β-microglobulin (β-MG) remains to be explored. This retrospective study compared the accuracy of these parameters for post-OLT AKI evaluation.</p><p><b>Methods</b>Patients who underwent OLT in three centers between July 2003 and December 2013 were enrolled. The postoperative AKI group was diagnosed by the Kidney Disease Improving Global Outcomes (KDIGO) criteria and classified by stage. Measurement data were analyzed using the t-test or Wilcoxon rank-sum test; enumerated data were analyzed using the Chi-square test or Fisher's exact test. Diagnostic reliability and predictive accuracy were evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><b>Results</b>This study excluded 976 cases and analyzed 697 patients (578 men and 119 women); the post-OLT AKI incidence was 0.409. Compared with the no-AKI group, the AKI group showed very significant differences in Model for End-stage Liver Disease score (14.74 ± 9.91 vs. 11.07 ± 9.54, Z = 5.404; P < 0.001), hepatic encephalopathy (45 [15.8%] vs. 30 [7.3%], χ = 12.699; P < 0.001), hemofiltration (28 [9.8%] vs. 0 [0.0%], χ = 42.171; P < 0.001), and 28-day mortality (23 [8.1%] vs. 9 [2.2%], χ = 13.323; P <0.001). Moreover, mean values of Cr, BUN, UA, and β-MG in the AKI group differed significantly at postoperative days 1, 3, and 7 (all P < 0.001). ROC curve area was 0.847 of Cr for the detection of AKI Stage 1 (sensitivity 80.1%, specificity 75.7%, cutoff value 88.23 μmol/L), 0.916 for Stage 2 (sensitivity 87.6%, specificity 82.6%, cutoff value 99.9 μmol/L), and 0.972 for Stage 3 (sensitivity 94.1%, specificity 88.2%, cutoff value 122.90 μmol/L).</p><p><b>Conclusion</b>The sensitivity and specificity of serum Cr might be a high-value indicator for the diagnosis and grading of post-OLT AKI.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Acute Kidney Injury , Blood , Blood Urea Nitrogen , Creatinine , Blood , Liver Transplantation , Retrospective Studies , Uric Acid , Blood , beta 2-Microglobulin , BloodABSTRACT
Objective To investigate the safety and efficacy of CT-guided 125I seed implantation in the treatment of metastatic lymph nodes within the abdomen.Methods Data of 55 patients who underwent CT-guided 125I seed implantation with a total of 63 metastatic lymph nodes within the abdomen were retrospectively analyzed.The efficacy was evaluated.Results 125I seeds were successfully implanted in all 55 patients,and the radiation dose reached the pre-operation plan requirements.The response rate of 1,3,6,9 and 12 months after operation was 76.19％ (48/63),80.65％ (50/62),71.43％(30/42),77.50％(31/40) and 78.95％(30/38),respectively.And the clinical benefit rate was 93.65％(59/63),88.71％(55/62),80.95 ％ (34/42),85.00％(34/40) and 84.21％(32/38),respectively.There were 42 patients combined with abdominal pain and back pain before the operation.Among them,39 patients (39/42,92.86％) relieved 1 month after operation.No severe complication occurred intraoperatively or postoperatively,such as inhibition of bone marrow,bleeding or infection.The survival rate of 1,3,6,9 and 12 months postoperatively was 100％,98.20％,61.80％,58.20％ and 54.50％,respectively.Conclusion CT-guided 125I seed implantation is one of the safe and effective methods for treating metastatic lymph nodes within the abdomen.
ABSTRACT
Objective To investigate the efficacy of implantation of radioactive iodine-125 (125I) seeds combined with chemotherapy in treatment of stage Ⅲb and Ⅳ non-small cell lung cancer (NSCLC).Methods Ninety patients with stage Ⅲb and Ⅳ NSCLC were divided into two groups.The combined group (n=43) received chemotherapy with TP (paclitaxe plus cispla tin) or GP (gemcitabine plus cisplatin) 3 days after 125I particles implantation,and the control group (n=47) only received TP or GP chemotherapy.The effective rate,1-year and 2-year survival rate,the median survival time were compared between the 2 groups.Results The total effective rates of the combined group and the control group of stage Ⅲ b NSCLC were 84.00％ and 48.28％,and the effective rates of stage Ⅵ NSCLC were 72.22％ and 33.33％ (both P＜0.05).The 1-year and 2-year survival rate of the combined group and control group of stage Ⅲb NSCLC were 67.80％,36.00％ and 37.90％,13.83％,respectively (both P＜0.05).The median survival time was 15.7 months and 8.6 months.However,the survival rates of the combined group and the control group of stage Ⅳ NSCLC were 44.44％,16.70％ and 22.22％,11.10％,respectively,while the difference was not statistically significant (P＞0.05).The median survival time was 8.9 and 6.0 months.Conclusion The implantation of radioactive 125I seeds combined with chemotherapy can obtain a significant efficacy in the treatment of stage Ⅲb and stage Ⅳ NSCLC.For patients with stage Ⅲb NSCLC,combined therapy can improve the survival rate.