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Objective:To evaluate the safety of thymic surgery in patients aged 65 years and over.Methods:A total of 696 patients who underwent thymectomy/thymoma resection in the Department of Thoracic Surgery of Beijing Hospital from November 2011 to March 2022 were collected and divided into two groups according to the age of 65 years old.The preoperative course of disease, MG stage, dosage of pyridostigmine bromide, American College of Anesthesiologists(ASA)score, surgical method, intraoperative bleeding, postoperative drainage, postoperative complications, Clavien-dindo score(CDC), and myasthenic crisis were recorded and statistically analyzed.Results:A total of 696 patients were enrolled, including 364 males and 332 females, aged 15~86 years, with an average age of 49.1 years.There were 309 patients with thymoma, 565 patients with MG, and 178 patients with both.There were 124 cases in the elderly group(≥65 years old)and 572 cases in the non-elderly group(<65 years old). The incidence of thymoma was higher in the elderly group(54.8 % versus 42.1 %, χ2=6.664, P=0.010), while the incidence of MG was lower(67.7 % versus 84.1 %, χ2=17.827, P<0.001). The ASA score of the elderly group was higher than that of the non-elderly group( χ2=52.372, P=0.000), and the preoperative ventilation function FEV1 and FEV1/FVC were also significantly lower than those of the non-elderly group( z=8.187, 4.580, P=0.000 for all). The drainage volume in the first 3 days after operation and postoperative drainage tube time in the elderly group were significantly higher than those in the non-elderly group( P=0.018, P=0.003). The incidence of postoperative myasthenia crisis in the elderly group was higher than that in the non-elderly group( P=0.034). There was no significant difference in the incidence of postoperative complications between the two groups, but after Clavien-dindo classification, the score of the elderly group was higher than that of the non-elderly group( P=0.003). Although the ASA score and Clavien-dindo score of the elderly group were both higher than those of the non-elderly group, there was no correlation between the two. Conclusions:Although the preoperative ASA score and pulmonary function of elderly patients were poorer than those in the non-elderly group, while the incidence of postoperative myasthenia crisis was higher, and the incidence of postoperative complications was not higher, the Clavien-dindo classification, however, was higher in elderly patients than that of the non-elderly group.After careful preoperative evaluation and strengthening perioperative management, most elderly patients can receive thymus surgery safely with acceptable risks.
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Objective:To evaluate the clinical characteristics and the surgical safety in patients aged 65 years and over with thymic epithelial tumor, and analyze the prognosis of 3-10 years postoperative tumor and myasthenia gravy.Methods:A total of 228 patients diagnosed as thymic tumor and undergoing surgical surgery to remove the tumor in Beijing Hospital from Jan.2011 to Dec.2018 were retrospectively enrolled.Patients were divided into a young(≤ 65 yrs)and old(>65 yrs)groups.The operation time, intra-operative bleeding, drainage volume in the first 3 days after operation, days with drainage tube after operation, postoperative days of hospital stays, the diameter of the tumors, pathological classification, Tumor-Node-Metastasis(TNM)staging, Masaoka-Koga staging, whether or not complicated with myasthenia gravis and complications were compared between two groups.The patients were followed up by outpatient or telephone, and recurrence of thymoma, survival status and improvement of myasthenia gravis were tracked.Results:There were significant differences in pathological classification between the two groups( P=0.002). The postoperative days with drainage tube were longer in patients≥65 years old than in patients<65 years old[4(2-17)days and 3(1-9), Z=2.316, P=0.021]. Thymic atrophy was more common in patients ≥ 65 years old than in patients <65 years old(10.2% and 1.7%, χ2=5.937, P=0.015). Incidence of thymoma plus myasthenia gravis were higher in patients aged <65 years than those aged ≥65years(68.2% vs.40.8%, χ2=12.240, P<0.001), and incidence of thymic hyperplasia were higher in patients aged <65 years than those aged ≥65years(58.1% and 38.8%, χ2=2.316, P=0.016). The recurrence of thymoma was a poor prognostic factor affecting the survival of patients.Meanwhile, Masaoka-Koga stage Ⅲ and Ⅳ and TNM stage Ⅲ and Ⅳ were independent risk factors for postoperative recurrence of thymoma. Conclusions:Thymectomy is safe and effective in the patients aged 65 and over, and may have a better long-term prognosis.
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Idiopathic Pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic interstitial lung disease with unknown cause, which is closely related to lung cancer. A serious complication called Acute exacerbation of IPF (AE-IPF) is prone to occur after lung resection. It progresses rapidly without effective treatment and has a poor prognosis. A typical case of AE-IPF after lung cancer surgery was reported, and its clinical characteristics, imaging features, diagnosis and treatment were summarized. .
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Humans , Disease Progression , Idiopathic Pulmonary Fibrosis/surgery , Lung Neoplasms/surgery , Treatment OutcomeABSTRACT
Objective:To proceed a comparative study of characteristics and safety of video-assisted thoracoscopic thymectomy between artificial pneumothorax combining subxiphoid-costal margin approach versus right thoracic cavity approach.Methods:From January 2018 to December 2021, 251 patients(including myasthenia gravis with thymic hyperplasia or thymoma, thymic cysts and anterior mediastinal occupying lesions)undergoing thoracoscopic extended thymectomy in our department were retrospectively studied, and their clinical data were collected.The surgical methods were divided into artificial pneumothorax combining xiphoid costal margin approach(artificial pneumothorax group, n=165)and via right thoracic approach(right thoracic group, n=86). Clinical data such as preoperative information, operative duration, blood loss, postoperative drainage, drainage duration, and surgical complication were compared between two groups.Results:There were no statistical differences in age, gender and pathology between two groups(all P>0.05). Compared with the right thoracic group, operative duration[(108.6±45.2)min vs.(127.6±42.1)min, t=-3.628, P=0.000], intraoperative blood loss[(37.9±131.7)ml vs.(107.4±284.8)ml, t=-8.215, P=0.000], postoperative drainage volume[(379.0±285.5)ml vs.(646.6±373.3 ml), t=-6.277, P=0.000]and drainage duration[(2.2±1.0)d vs.(3.1±1.0)d, t=-7.275, P=0.000]were statistically significantly decreased in the artificial pneumothorax group.No significant difference was found(all P>0.05)in phrenic nerve injury(1/165 vs.0/86, P=1.000), myasthenia crisis(3/89 vs.2/66, χ2=0.014, P=0.906), and the conversion to thoracotomy(3/165 vs.2/86, P=1.000). Conclusions:VATS thymectomy by artificial pneumothorax combining subxiphoid-costal margin approach is a safer method, having a less trauma, less bleeding and less incidence rate of complication.Especially, it is more suitable for elderly female patients who cannot be intubated in double lumen, cannot tolerate one-lung ventilation, and have pulmonary insufficiency.
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Objective:To investigate the effects of polyethylene glycol 400 （PEG400） on the pharmacokinetics and anti-inflammatory effect of baicalin， and to preliminarily explore the anti-inflammatory effects of baicalin and its main metabolite baicalein 6-<italic>O</italic>-<italic>β</italic>-<italic>D</italic>-glucuronide （B6G） by molecular docking. Method:Rats were randomly divided into two groups with water and PEG400 as the dissolving matrix， and rats were administrated the equal dose of baicalin aqueous solution （baicalin+water group） and baicalin PEG400 solution （baicalin+PEG400 group）. After the plasma samples were processed at different time periods， the concentrations of baicalin and B6G in rat plasma were determined by ultra performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS）， and pharmacokinetic parameters were processed by DAS 3.2.2 software. Mice were randomly divided into a blank group （normal saline， 20 mL·kg<sup>-1</sup>）， aspirin group （dose of 0.2 g·kg<sup>-1</sup>）， baicalin/baicalin+PEG400 high and low dose （3.0， 1.5 g·kg<sup>-1</sup>） groups， after continuous administration for 7 days， the mouse ear swelling and foot swelling models were established， and the swelling degree and swelling inhibition rate were calculated. Result:The pharmacokinetic study showed that compared with baicalin+water group， the plasma concentrations of baicalin and B6G increased after administration of baicalin PEG400 solution， and the area under the curve （AUC<sub>0-</sub><italic><sub>t</sub></italic>） increased by 2.36， 1.97 times， and the peak concentration （<italic>C</italic><sub>max</sub>） increased by 2.12， 1.65 times， respectively. The results of mouse ear and foot swelling inflammation models showed that the anti-inflammatory effect was enhanced after intragastric administration of baicalin PEG400 solution. In addition， molecular docking results showed that baicalin and B6G could site bind to multiple target proteins ［tumor necrosis factor （TNF）-<italic>α</italic>， interleukin （IL）-6， IL-1<italic>β</italic>， prostaglandin E<sub>2</sub> （PGE<sub>2</sub>） and nuclear transcription factor-<italic>κ</italic>B （NF-<italic>κ</italic>B）］ with higher affinity， which was superior to the positive drug aspirin. Conclusion:PEG400 can increase the plasma concentration of baicalin and its main metabolite B6G， and enhance the anti-inflammatory effect. Baicalin and B6G can form strong hydrogen bonds with various inflammatory factors and of nuclear transcription factors， it is speculated that baicalin and B6G jointly play an anti-inflammatory role.
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The aim of this study was to investigate the effects of polyethylene glycol (PEGs) with different molecular weights (MW: 400, 1 000, 4 000) on the pharmacokinetics of baicalin, and preliminarily analyze its mechanism. Rats were gavaged with baicalin (168 mg·kg-1) + aqueous solution or baicalin + PEGs solution and plasma samples were collected from 0 to 24 h after administration. The concentration of baicalin and its main metabolite baicalein 6-O-β-D-glucuronide (B6G) were determined at different time points by UPLC-MS/MS, and the pharmacokinetic parameters were calculated with DAS 3.0 software. The results showed that PEGs with different molecular weights could effectively increase the AUC0-t of baicalin and B6G, increase the Cmax, and prolong the t1/2, effectively increasing the concentration of baicalin and B6G in vivo. The mechanism may be by promoting the activity of uridine diphosphate glucuronosyl-transferases 1A8 (UGT1A8) and 1A9 (UGT1A9), thereby increasing the transformation rate of baicalin and B6G. The rate of metabolism of B6G was faster than that of baicalin, suggesting that PEGs had a higher affinity for UGT1A8, and PEG400 had the most significant effect. The purpose of this study was to provide a basis for the clinical safe use of baicalin and other flavonoids and the design of new dosage forms with the participation of PEGs. The animal experiment protocol in this study was approved by the Experimental Animal Ethics Committee of Guizhou Medical University.
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Objective@#To summarize the clinical features, diagnosis and treatment of postoperative acute exacerbation of interstitial lung disease (ILD) after pneumonectomy.@*Methods@#The clinical data of 4 patients with postoperative acute exacerbation of ILD after pneumonectomy admitted in Beijing Hospital from October 2014 to November 2015 were retrospectively analyzed and related literatures were reviewed.@*Results@#Four patients were aged 60 to 74 years, including 3 males and 1 female, 2 of whom were idiopathic pulmonary fibrosis and 2 were connective tissue diseases related ILD. Chest high resolution computed tomography (HRCT) showed multiple lobular septal thickening, ground glass opacities, reticular shadow and strip shadow in both lungs. The patients developed acute dyspnea 2 to 3 days after pneumonectomy. In 2 cases, HRCT showed new patchy ground-glass opacities, reticular shadow and strip shadow in both lungs on the basis of preoperative pulmonary fibrosis. The sputum smear and culture showed no pulmonary infection in all 4 cases. Three patients were treated with glucocorticoids and 3 received mechanical ventilation with endotracheal intubation. One patient was successfully treated by early using adequate glucocorticoids, one patient improved after treatment but died after re-exacerbation, and the other two patients died after treatment failed.@*Conclusions@#Acute exacerbation of ILD after pneumonectomy often occurs in early postoperative period and it is characterized by progressive dyspnea. Chest CT and respiratory pathogen examination are helpful for early diagnosis. Postoperative acute exacerbation of ILD often lacks effective treatment, requires mechanical ventilation, and the prognosis is poor. Although glucocorticoids may be effective, re-exacerbation should be alert during treatment.
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BACKGROUND@#Interstitial lung disease (ILD) is a group of diffuse lung diseases that mainly involve the interstitial and alveolar cavities and result in loss of alveolar-capillary functional units, leading to restrictive ventilatory dysfunction and diffusion impairment. There was an increased incidence of lung cancer on the basis of ILD, and perioperative risk of patients with lung cancer combined with ILD (LC-ILD) was significantly increased. The aim of this study is to summarize the safety and experience of surgical treatment of LC-ILD.@*METHODS@#A retrospective analysis was performed on 23 patients with LC-ILD who underwent pneumonectomy in Beijing Hospital from January 2012 to December 2019, and their clinical manifestations, image feature, pathology, surgical safety, perioperative complications and treatment experience were summarized.@*RESULTS@#A total of 23 patients were included in this study, including 20 males (87.0%) with an average age of (69.1±7.8) years, and 19 cases (82.6%) were smokers. Of the ILD types, 14 cases (60.9%) were idiopathic pulmonary fibrosis, 7 cases (30.4%) were idiopathic nonspecific interstitial pneumonia, and 2 (8.7%) were interstitial lung disease associated with connective tissue diseases. The pathology of lung cancer included adenocarcinoma (30.4%, 7/23), small cell carcinoma (30.4%, 7/23), squamous cell carcinoma (26.1%, 6/23), small cell carcinoma mixed with squamous cell carcinoma (4.3%, 1/23) and large cell neuroendocrine carcinoma (8.7%, 2/23). Surgical approaches included video assisted thoracoscopy (69.6%, 16/23) and anterolateral thoracotomy (30.4%, 7/23), with lobectomy (52.2%, 12/23), double lobectomy (4.3%, 1/23), and sublobectomy (39.1%, 9/23). There were 11 cases (47.8%) of postoperative complications, including 8 cases (34.8%) of pulmonary complications, 4 cases (17.4%) of acute exacerbation of ILD (AE-ILD), 6 cases (26.1%) of atrial fibrillation, and 1 case (4.3%) of acute left ventricular dysfunction. The 90-day mortality is 8.7% (2/23) and the cause of death was acute exacerbation of ILD.@*CONCLUSIONS@#Most of LC-ILD were elderly patients with multiple comorbidities and decreased pulmonary function, leading to significantly increased surgical risk. The ILD should be fully evaluated and controlled before surgery, intraoperative trauma should be minimized, and special attention should be paid to pulmonary complications and AE-ILD after surgery. Postoperative AE-ILD has a poor prognosis and glucocorticoids may be effective. Early diagnosis and treatment is the key to treatment of AE-ILD.
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Objective:To summarize the clinical features, diagnosis and treatment of postoperative acute exacerbation of interstitial lung disease (ILD) after pneumonectomy.Methods:The clinical data of 4 patients with postoperative acute exacerbation of ILD after pneumonectomy admitted in Beijing Hospital from October 2014 to November 2015 were retrospectively analyzed and related literatures were reviewed.Results:Four patients were aged 60 to 74 years, including 3 males and 1 female, 2 of whom were idiopathic pulmonary fibrosis and 2 were connective tissue diseases related ILD. Chest high resolution computed tomography (HRCT) showed multiple lobular septal thickening, ground glass opacities, reticular shadow and strip shadow in both lungs. The patients developed acute dyspnea 2 to 3 days after pneumonectomy. In 2 cases, HRCT showed new patchy ground-glass opacities, reticular shadow and strip shadow in both lungs on the basis of preoperative pulmonary fibrosis. The sputum smear and culture showed no pulmonary infection in all 4 cases. Three patients were treated with glucocorticoids and 3 received mechanical ventilation with endotracheal intubation. One patient was successfully treated by early using adequate glucocorticoids, one patient improved after treatment but died after re-exacerbation, and the other two patients died after treatment failed.Conclusions:Acute exacerbation of ILD after pneumonectomy often occurs in early postoperative period and it is characterized by progressive dyspnea. Chest CT and respiratory pathogen examination are helpful for early diagnosis. Postoperative acute exacerbation of ILD often lacks effective treatment, requires mechanical ventilation, and the prognosis is poor. Although glucocorticoids may be effective, re-exacerbation should be alert during treatment.
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Objective:To compare the characteristics and therapeutic effects of video-assisted thoracoscopic(VATS)extended thymectomy by subxiphoid-costal margin approach versus right intercostal approach for the treatment of myasthenia gravis(MG).Methods:A retrospective analysis was conducted on 230 non-thymomatous MG patients undergone VATS extended thymectomy in our department from August 2015 to August 2019.According to the operation approach and method, patients were divided into two groups: the subxiphod-costal margin approach group(n=102)and the right intercostal approach group(n=128).Results:Intraoperative blood loss and the postoperative drainage were less in the subxiphod-costal margin approach group than in the right intercostal approach group[(30.3±25.2) ml vs. (45.1±30.6) ml, (178.6±90.5) ml vs.(205.4±87.6) ml, t=-3.935 and -2.27, P=0.003 and 0.024)]. Postoperative pain degree was lower in the subxiphod-costal margin approach group than in the right intercostal approach group [the Numerical Rating Scale(NSR)scores: 3.1±1.0 vs. 4.6±1.5, t=-8.677, P=0.001]. A difference in incidence rate of pore malunion also existed between the subxiphod-costal margin approach group and the right intercostal approach group, but it had no statistical significance(1/102 vs. 7/128, χ2=2.200, P=0.138). The complete remission rate and the overall effectiveness rate had no significant difference between the two groups(29.6% vs.32.4%, 85.7% vs. 84.7%, χ2=0.196 and 0.044, P=0.658 and 0.834). Conclusions:VATS extended thymectomy by subxiphoid-costal margin approach shows excellent safety and effectiveness in treating MG.It has advantages of low trauma and complications, and is particularly suited for elderly and female MG patients who are unable to receive double-lumen endotracheal intubation, are intolerant to one-lung ventilation or have pulmonary insufficiency.
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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.
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Objective:To compare the surgical effect of single-utility port and three port video-assisted thoracoscopic surgery(VATS) for patients of thoracic esophageal cancer.Methods:Patients who underwent McKeown surgery with single-utility port and three port VATS in Department of Thoracic Surgery at Beijing Hospital from January 2013 to December 2018 were enrolled. During the thoracic procedure, patients were placed forwardly in left lateral decubitus position. The video port was made at the eighth mid-axillary intercostal space, and the single-utility port was at the fourth intercostal space between antero-axillary and mid-axillary line. For three port VATS, another incision was made at the eighth posto-axillary intercostal space. The posterior mediastinum was exposed by the "suture-drawing exposure" method, then the thoracic esophagus was carefully dissected and mediastinal lymphadenectomy was done. Information was collected including demographic, perioperative and pathological data. Patients were followed up by telephone or outpatient record.Results:A total of 62 patients of single-utility port VATS and 28 three port VATS were included. All cases were accomplished by VATS, and none of them were converted to thoracotomy or adding additional ports. Sex proportion and ages of the two groups were comparable( P>0.05). The surgery duration[(336.9±55.7) min vs.(319.7±66.3)min, P=0.205] and thoracic procedure duration[(112.5±36.7)min vs.(108.9±43.6)min, P=0.686] of two groups were also similar. There were no statistical differences in volume of drainage, postoperative stay, thoracic complications, number of lymph nodes dissected, and survival after surgery between two groups( P>0.05). Peripheral blood oxygen saturation in first 3 days after surgery of single-utility port VATS patients was significantly higher[ Day 1: (97.00±1.57)% vs.(96.10±1.23)%, P=0.009; Day 2: ( 96.60±1.84 )% vs.(95.70±1.19)%, P=0.020; Day 3: (97.40±1.56)% vs.(96.30±1.42)%, P=0.002] and respiratory rate was significantly lower[(19.70±1.48) times/min vs.(20.70±1.70) times/min, P=0.006]than three-port VATS patients. Conclusion:Single-utility port VATS for McKeown surgery is safe and feasible, which tends to reduce the surgical trauma and can be a routine surgical procedure for minimally invasive esophagectomy.
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Fetal adenocarcinoma of the lung (FLAC) is an extremely rare subtype of lung cancer, accounting for only 0.1% to 0.5% of primary pulmonary malignancy. In 2011, international multidisciplinary classification of lung adenocarcinoma developed by the International Association for the Study of Lung Cancer (IALSC), the American Thoracic Society (ATS) and the European Respiratory Society (ERS) classified FLAC as a variant of invasive adenocarcinoma. FLAC has been further divided into low-grade fetal adenocarcinoma (L-FLAC) and high-grade fetal adenocarcinoma (H-FLAC) as these two categories exhibit different clinicopathological features and biological behaviors. Here we report a case of high-grade fetal adenocarcinoma and summarize clinicopathologic features of fetal lung adenocarcinoma. .
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Humans , Male , Middle Aged , Adenocarcinoma of Lung , Diagnostic Imaging , Pathology , General Surgery , Fetus , Neoplasm Grading , Prognosis , Tomography, X-Ray ComputedABSTRACT
BACKGROUND@#DNA polymerase β is one of the key enzymes for DNA repair and it was reported that about 30 percent of different types of cancers carried mutations in its coding gene Polb. However, it is still controversial whether it is true or false because of the small sample size in these studies. In current study, we performed genetic screening of promoter and coding regions of Polb gene in 69 Chinese lung cancer patients using Sanger sequencing method, so as to elucidate real mutation frequency of Polb mutations in Chinese Han population.@*METHODS@#Salting out extraction method was used to get the genome DNAs from tumor and normal matched tissues of 69 lung cancer patients. The promoter and 14 coding regions of Polb gene were then amplified using these DNAs as the template. After purification, amplicons were sequenced and aligned to the wild type Polb gene in NCBI database, in order to find out the mutated sites of Polb gene in Chinese lung cancer patients.@*RESULTS@#In this study, we totally found only 5 mutated sites in Polb gene. In detail, 3 mutations (-196G>T, -188_-187insCGCCC, -168C>A) were located in the promoter region; 2 mutations (587C>G, 612A>T) were found in coding regions. Specially, mutations of -188_-187insCGCCC and 587C>G (resulting to the amino acid substitution of Thr to Ser at position 196) had never been reported by other groups before. However, all these 5 mutated sites could be detected in both tumor and matched normal tissues, which inferred that they are not lung tumor specific mutations.@*CONCLUSIONS@#No lung tumor specific mutations of Polb gene could be found in Chinese lung cancer patients and Polb gene mutation might not be a molecular marker for Chinese lung cancer patients.
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AIM:To investigate the effect of CUDC-907, a dual histone deacetylase (HDAC) and phosphatidylinositol 3-kinase (PI3K) inhibitor, on the DNA damage, cell cycle distribution and autophagy in human glioma U251cells.METHODS:U251 cells were treated with CUDC-907 of different concentrations, and the cell viability was detected by MTT assay.The quantitativeγ-H2AX foci were determined by laser scanning confocal microscopy.The cell cycle distribution of U251 cells was examined by flow cytometry.The protein expression was determined by Western blot analysis.RESULTS:CUDC-907 inhibited the cell viability and the phosphorylation of Akt and p70 ribosomal protein S6 kinase (p70s6K) in the U251 cells (P<0.05).In CUDC-907-treated cells, the number ofγ-H2AX foci and protein expression ofγ-H2AX were increased significantly (P<0.05).CUDC-907 also induced cell arrest in theM phase by up-regulating the expression of p21, and inhibiting the protein level of cyclin B1 and the phosphorylation of cell division cycle protein2 (Cdc2).In addition, CUDC-907 triggered cell autophagy, and inhibition of autophagy increased CUDC-907-induced DNA damage of U251 cells.CONCLUSION:CUDC-907 significantly inhibits PI3K/Akt signaling pathway, induces DNA damage and arrests cell cycle inM phase.Blockage of autophagy promotes CUDC-907-induced DNA damage of U251cells.
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Objective:To investigate the treatment and aesthetic restoration of anterior tooth loosening and falling in the patient with severe periodontitis,and to clarify the curative effect of multidisciplinary treatment in the anterior esthetic zone,and to provide reference for its clinical application.Methods:The male patients was 57 years old,and saw a dcotor becasuse of anterior teeth loosening and discomfort for more than half a year.The specialized examination:11,21,22,41 Ⅲ°loose,42 Ⅱ°loose.After multidisciplinary consultation,the teeth were treated with periodontal therapy.After inflammation was controlled,11,21,22,41,42 were removed for immediate implantation.The platelet rich fibrin(PRF)combined with guided bone regeneration(GBR)was used to repair the bone defect around the implants.Because of the aesthetic requirements of the patients,tooth preparation was performed for 12,13,23,31,32,33,43 after root canal therapy.Fixed restorations were performed in 13-23 and 33-43.Results:After operation,the implant was well positioned and the bone surrounding the implant was adequate.The soft tissue in the mouth healed well and the degree of the alveolar ridge was better.After restoration, the masticatory and phonation function of the teeth were restored,and the patients were satisfied with the aesthetic effect.Conclusion:Through the application of multidisciplinary treatment,the implant repair of the anterior esthetic zone of the patient with severe periodontitis is successfully achieved,which opens a new way for the diagnosis and treatment of the anterior esthetic zone.
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Objective:To discuss the therapeutic effect of related periodontal surgical treatment and aesthetic rerepair in the patient with residual root and crown of anterior teeth induced by unfitting prosthesis and to clarify the curative effect of periodontal surgical treatment and aesthetic re-repair in the anterior teeth area,and to provide guidance for making the program of clinical treatment.Methods:Two years after repair of the anterior teeth of a patient,the restorations loosed;on the one hand the patient had a toothache of chewing food accompanying gingival bleeding,on the other hand the upper labial frenum was too high,furthermore the upper left incisor apical area showed low density images.After the consultation of periodontics,endodontics,prosthodontics and other disciplines doctors,anterior teeth root canal re-treatment and periodontal basic treatment were adopt as well ascrown lengthening combined with labial freneetomy to restore the normal biological width,additionally apply not only guided bone regeneration (GBR) but also platelet rich fibrin (PRF) to repair the defects of apical bone.One month later,provisional restorations were put into use and then three months later permanent repairs were conducted.Results:The corresponding gingival and gingival papilla shape recoverd perfectly and the height of gingiva coordinated with that of adjacent teeth,in the meantime the upper labial frenum attached normally and there was not obvious space between upper incisors;the morphology and function examination of restoration in maxillary anterior region were both well.The follow-up X-ray showed that the bone density of the defect area was the same as that of the peripheral bone without obvious boundaries.Conclusion:The aesthetic repair of thin biotype referring to anterior area,especially in the complicated re-treatment cases,the intervention of the appropriate periodontal surgical treatment is not only beneficial to obtain the obvious short-term effect,but also positive to stabilize longterm effects.
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Objective: To investigate the treatment and aesthetic restoration of anterior tooth loosening and falling in the patient with severe periodontitis, and to clarify the curative effect of multidisciplinary treatment in the anterior esthetic zone, and to provide reference for its clinical application. Methods: The male patients was 57 years old, and saw a dcotor becasuse of anterior teeth loosening and discomfort for more than half a year. The specialized examination: 11, 21, 22, 41 III° loose, 42 II° loose. After multidisciplinary consultation, the teeth were treated with periodontal therapy. After inflammation was controlled, 11, 21, 22, 41, 42 were removed for immediate implantation. The platelet rich fibrin (PRF) combined with guided bone regeneration (GBR) was used to repair the bone defect around the implants. Because of the aesthetic requirements of the patients, tooth preparation was performed for 12, 13, 23, 31, 32, 33, 43 after root canal therapy. Fixed restorations were performed in 13-23 and 33-43. Results: After operation, the implant was well positioned and the bone surrounding the implant was adequate. The soft tissue in the mouth healed well and the degree of the alveolar ridge was better. After restoration, the masticatory and phonation function of the teeth were restored, and the patients were satisfied with the aesthetic effect. Conclusion: Through the application of multidisciplinary treatment, the implant repair of the anterior esthetic zone of the patient with severe periodontitis is successfully achieved, which opens a new way for the diagnosis and treatment of the anterior esthetic zone.
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AIM To investigate the protective effects of Miaoling Natto Capsules (MNC) on myocardial ischemia-reperfusion injury (MIR) in rats.METHODS Forty-eight healthy male Sprague-Dawley (SD) rats randomly divided into sham group,model group,positive control group (propranolol),MNC groups (low dose,medium dose,and high dose groups) underwent corresponding 7-day oral administration at a frequency of twice daily (rats of the sham group and the model group were dosed with saline water at 1 mL/100 g).Anesthetized by 8％ chloral hydrate,rat models were made by left anterior descending coronary artery ligation,30 min coronary occlusion followed by 3 h of reperfusion for ST segments and T waves monitoring,and rats in the sham group were performed opening and suture procedures.The rats had their serum levels of acetic transaminase (AST),lactate dehydrogenase (LDH),creatine kinase isoenzyme (CK-MB),cardiac troponin-Ⅰ (cTn-Ⅰ),superoxide dismutase (SOD),malondialdehyde (MDA),and tumor necrosis factor-α (TNF-α) detected,real time ECG changes monitored and myocardial infarction area assessed by TTC.RESULTS Compared with the sham group,the model group was observed with markedly elevated ST segments or high T waves rise,significantly increased activities of CK-MB,LDH,AST and the content of cTnⅠ,MDA,TNF-α,and decreased activity of SOD (P ＜ 0.01 or P ＜ 0.001).Compared with the model group,the positive control group and the low,medium and high dose MNC groups achieved controlled ST segments elevation or greater T waves amplitude,significantly decreased activities of CKMB,LDH,AST and the content of cTnⅠ,MDA,TNF-α increased activity of SOD (P ＜0.01 or P ＜0.05) and mycocardial infact range reduction (P ＜ 0.001).CONCLUSION MNC is protective to rats with myocardial ischemia-reperfusion injury.
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Objective:To investigate the effect of Chinese traditional medicine-Shuanghuangbu combined with Xipayi Mouth Rinse on the periodontal indexes of the peri-implantitis patients,and to detect the curative effect of Shuanghuangbu combined with Xipayi Mouth Rinse in the treatment of peri-implantitis.Methods: A total of 40 patients diagnosed as peri-implantitis were randomly divided into control group and Chinese traditional medicine group (n=20).All of the patients received supragingival scaling and subgingival scaling,and then the peri-implant pocket of the patients in Chinese traditional medicine group were washed with Xipayi Mouth Rinse,while the fine probe slided slowly along the inner wall of peri-implant pocket into the bottom and retained the Shuanghuangbu,and retreated gently and made the medicine overflow the gingival margin.The patients in control group were given 3% hydrogen peroxide and 0.9% sodium chloride injection washed by turns.The indexes of covering modified plaque index (mPLI),probing pocket depth (PPD),modified sulcular bleeding index (mSBI)of the patients in two groups at baseline and after treatment were detected;Whatman# 1 was applied to aspirate the peri-implant sulcus fluid (PISF)which were weighed at baseline and after treatment,and the level of interleukin-1β (IL-1β)in PISF was analyzed by ELISA method.Results:No differences were observed in age,sex,periodontal indexes, weights of PISF and IL-1βlevels of the patients in two groups before treatment (P >0.05).Compared with before treatment,the indexes including PPD,mSBI,mPLI,weight of PISF and IL-1βlevel in PISF of the patients in two groups were decreased after treatment (P < 0.05).After treatment,the differences in mSBI,mPLI,weight of PISF and IL-1β level in PISF of the patients between control group and Chinese traditional medicine group were significant (P <0.05).Compared with control group,the PPD level of the patients in Chinese traditional medicine group was decreased,but the difference was not significant (P >0.05).Conclusion:The curative effect of Chinese traditional medicine-Shuanghuangbu combined with Xipayi Mouth Rinse is obsious,and the treatment can improve the periodontal status and reduce the level of IL-1βin PISF.