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ObjectiveTo investigate the risk factors and construct a predictive model for severe myelosuppression due to chemotherapy in triple negative breast cancer （TNBC）. MethodsPatients with TNBC who received anthracycline combined with cyclophosphamide sequential paclitaxel chemotherapy regimen at the Second Affiliated Hospital of Nanchang University from September 2， 2016 to September 2， 2021 were selected and assigned to severe myelosuppression group and no/mild myelosuppression group. The χ2 test and binary logistic regression were used to analyze the risk factors for severe myelosuppression due to chemotherapy and to develop a prediction model. Hosmer-Lemeshow test and receiver operating characteristic （ROC） curve were used to evaluate the predictive efficiency of the regression model. Kappa consistency test was used to verify the regression model externally. ResultsA total of 207 patients who met the inclusion were enrolled and 106 patients （51%） had severe myelosuppression. Binary logistic regression multivariate analysis showed that age 40 to 60 years （OR = 3.463， 95% CI： 1.144 to 10.486， P = 0.028）， age >60 years （OR = 3.474， 95% CI： 1.004 to 12.020， P = 0.049）， body mass index （BMI） 18.5 to 24.0 （OR = 1.445， 95% CI： 0.686 to 3.087， P = 0.328）， BMI <18.5 （OR = 3.582， 95% CI： 1.260 to 10.182， P = 0.017）， tumor TNM stage Ⅱ （OR = 1.698， 95% CI： 0.831 to 3.468， P = 0.146）， tumor TNM stage Ⅲ （OR = 2.943， 95% CI： 1.199 to 7.227， P = 0.019）， previous diabetes （OR = 2.441， 95% CI： 1.076 to 5.539， P = 0.033）， low pre-treatment albumin level （OR = 2.759， 95% CI： 1.141 to 6.669， P = 0.024） and low pre-treatment lymphocytes （OR = 3.428， 95% CI： 1.689 to 6.958， P = 0.001） were independent risk factors for severe myelosuppression due to chemotherapy. The χ2 value for the logistic regression model Hosmer-Lemeshow test was 11.507， P= 0.175， the area under the ROC curve was 0.763， standard error 0.033， 95% CI： 0.698-0.828， P=0.000. External validation showed that the prediction model had a specificity of 88% and a sensitivity of 80%； the kappa value was 0.679， standard error 0.081， P=0.000. conclusionThis logistic regression model had high predictive efficacy and is useful for clinicians to predict whether patients with TNBC develop severe myelosuppression.
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@#Abstract: Objective To investigate the clinical characteristics and incidence of Brucella encephalitis and meningitis in children. Methods We report the clinical data of a child with Brucella melitensis meningitis in children, and summarize the incidence, diagnosis methods and treatment of Brucella encephalitis or meningitis in children, taking into account the relevant domestic and foreign literature from January 2014 to December 2020. Results A 4-year-old girl was admitted to the hospital with status epilepticus on March 15, 2021 because of interrupted right limb numbness for 16 hours and convulsions for 2 hours. She had 2 non-febrile convulsions three months before admission and was diagnosed with epilepsy. This incident was acute, accompanied by low fever, with epilepsy as the main manifestation. Cerebrospinal fluid test suggested central nervous system infection, but the nature of infection could not be determined by routine and biochemistry of cerebrospinal fluid.The cerebrospinal fluid next generation sequencing confirmed that the pathogen of the infection was B. melitensis, which was further verified by the peripheral blood antibody test. After effective antibiotics combined with a full course of treatment, the patient recovered after six months of treatment. A total of 60 articles were retrieved in the database, including 29 in Chinese. During this period, a total of 7 cases of brucellosis in children with nervous system involvement were reported, one of which was a case report, and the other 6 cases were mentioned in the comprehensive analysis of children with brucellosis. Conclusions Brucella encephalitis or meningitis in children has a low incidence and various clinical features, which are easy to be misdiagnosed or missed.
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Objective:To evaluate the left ventricular diastolic dyssynchrony (LVDD) and its influencing factors early after acute myocardial infarction (AMI) using phase analysis of SPECT gated myocardial perfusion imaging (GMPI).Methods:Bama miniature swines ( n=16) were subjected to establish AMI models. GMPI was performed before and 1 d after AMI to obtain the extent of myocardial perfusion defect (Extent, %) and left ventricular systolic dyssynchrony (LVSD)/LVDD parameters, namely the phase histogram bandwidth (PBW) and phase standard deviation (PSD). Meanwhile, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), and the ratio of early to late peak mitral diastolic flow (E/A) were obtained by echocardiography. Independent-sample t test, paired t test and Pearson correlation analysis were used to analyze the data. Results:Sixteen AMI swines were successfully created. Compared to baseline, Extent, LVEDV and LVESV significantly increased on 1 d after AMI ( t values: -11.14, -4.55, -6.12, all P<0.001), while LVEF and E/A significantly decreased ( t values: 10.16, 2.18, P<0.001, P=0.046). GMPI showed that the LVDD parameters PBW and PSD increased significantly on 1 d after AMI when compared to those at baseline((142.25±72.06)° vs (33.06±8.98)°, (56.15±26.71)° vs (12.51±5.13)°; t values: -6.11, -6.60, both P<0.001). There were significant differences between LVSD parameters and LVDD parameters (PBW: (109.06±62.40)° vs (142.25±72.06)°, PSD: (44.40±25.61)° vs (56.15±26.71)°; t values: -2.73, -2.20, P values: 0.016, 0.044). LVDD parameters PBW, PSD were negatively correlated with E/A after AMI ( r values: -0.569, -0.566, P values: 0.021, 0.022), and positively correlated with the Extent ( r values: 0.717, 0.634, P values: 0.002, 0.008). The phase analysis of SPECT GMPI to evaluate LVDD showed good intra-observer and inter-observe reproducibility (intraclass correlation coefficient (ICC): 0.953-0.984, all P<0.001). Conclusions:LVDD occurs early on 1 d after AMI, and can reflect left ventricular diastolic dysfunction. The Extent is correlated with LVDD significantly. Phase analysis of SPECT GMPI is an accurate method to evaluate LVDD and left ventricular diastolic function.
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ObjectiveTo explore the active ingredients， therapeutic targets， and relative signaling pathways of Tripterygium wilfordii in the treatment of triple negative breast cancer （TNBC） based on network pharmacology， and to verify the mechanism through in vitro cell model. MethodThe active ingredients of T. wilfordii were screened from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）. The targets of TNBC were obtained from DisGeNET and GeneCards. Venny was used to identify the potential therapeutic targets of T. wilfordii against TNBC. Protein-protein interaction （PPI） network was constructed with String database. Gene ontology （GO） annotation and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment were carried out with DAVID to predict the mechanisms of potential targets. The molecular docking between triptolide and key targets were performed with AutoDock Vina. The effect of triptolide （0， 5， 10， 20， 30， 40， 50， 60， 80 nmol·L-1） on the proliferation of MDA-MB-231 cells was determined through methyl thiazolyl tetrazolium （MTT） assay. The effect of triptolide （0， 12.5， 25， 50 nmol·L-1） on the apoptosis of MDA-MB-231 cells was detected with Hoechst 33342 staining. Western blot was performed to detect the effect of triptolide （0， 25， 50 nmol·L-1） on the expression levels of key targets. ResultT. wilfordii had 23 active ingredients related to 55 potential targets of TNBC. GO and KEGG enrichment revealed that the potential targets were associated with 103 biological processes， 15 cellular components， and 35 molecular functions， and were involved in 140 signaling pathways including atherosclerosis and apoptosis. The results of molecular docking demonstrated that triptolide could bind with the targets including threonine kinase 1 （Akt1）， vascular endothelial growth factor A （VEGFA）， cellular tumor antigen p53 （p53）， transcription factor AP-1 （JUN）， signal transducer and activator of transcription 3 （STAT3）， tumor necrosis factor （TNF）， mitogen-activated protein kinase 8 （MAPK8）， prostaglandin G/H synthase 2 （PTGS2）， and Caspase-3. According to the results of MTT assay， triptolide （20， 30， 40， 50， 60， 80 nmol·L-1） inhibited the proliferation of MDA-MB-231 cells compared with blank control （P<0.05， P<0.01）. Hoechst 33342 staining showed that triptolide （12， 25， 50 nmol·L-1） induced the apoptosis of MDA-MB-231 cells compared with black control （P<0.05， P<0.01）. Western blot showcased that 50 nmol·L-1 triptolide down-regulated the relative expression levels of p-Akt， TNF-α， and VEGFA， while 25 and 50 nmol·L-1 triptolide up-regulated the relative expression level of p53 in a dose-dependent manner compared with the blank control （P<0.05， P<0.01）. ConclusionT. wilfordii has multiple ingredients， targets， and pathways in the treatment of TNBC. It may regulate p53， VEGFA， TNF-α and other key targets to induce cell apoptosis and suppress angiogenesis and inflammatory response， which provides a scientific basis for the further investigation and clinical application of T. wilfordii.
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To explore the effect of tanshinone IIA (TanIIA) on the occurrence and development of breast cancer, we employed the mouse mammary tumor virus-polyomavirus middle T antigen (MMTV-PyMT) transgenic mice as a spontaneous breast cancer mouse model. Animal welfare and experimental procedures were in accordance with the regulations of the Animal Ethics Committee of Nanjing University of Chinese Medicine. The animals were divided into control group, low-dose TanIIA treatment group (30 mg·kg-1·day-1), and high-dose TanIIA treatment group (60 mg·kg-1·day-1). The treatment was administered orally and daily for 5 weeks. The mice were sacrificed after final treatment. Mammary gland and lung were collected for histopathology studies. We evaluated the chemoprophylaxis effect of TanIIA on breast cancer in mice according to the pathological characteristics of breast cancer at different stages of development. Immunofluorescence staining were employed for blood vessel analysis. The expression levels of E-cadherin, proliferating nuclear antigen (PCNA), and oncogene c-Myc were detected by immunohistochemistry. Flow cytometry was used to analyze cell cycle and Cytoscape was used to construct drug-disease protein-protein interaction (PPI) network. Our results showed that TanIIA inhibits breast tumor progression by delaying malignancy from adenoma to early carcinoma, and inhibits blood vessel formation during tumor development. TanIIA (60 mg·kg-1·day-1) inhibits the expression levels of PCNA and c-Myc, upregulates the expression of E-cadherin. In addition, cell cycle experiments showed that the cell cycle of PyMT primary mammary cells in the high-dose TanIIA group was arrested in the G0/G1 phase. Our study demonstrated that TanIIA can significantly inhibit breast tumor progression in MMTV-PyMT mouse model, which may be related to the inhibition of angiogenic switch and cell cycle arrest.
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Objective:To analize the selection rules of acupoints treating diarrhea-predominant irritable bowel syndrome (IBS-D).Methods:To earch for the clinical research literatures on acupuncture treating IBS-D from the database of China National Knowledge Resource Database (CNKI), Chinese science and technology journal database (Chongqing VIP) and Chinese academic journal database (Wanfang Data) by December 31, 2019. The acupuncture prescriptions of IBS-D were selected and statistically analyzed, and a database was established. IBM SPSS 25.0 and clintine 12.0 were used to cluster and correlate the acupuncture point prescriptions.Results:A total of 190 literatures and 215 acupuncture prescriptions were included, including 75 acupoints, among which the most commonly used acupoints were Tianshu, Zusanli, Shangjuxu, Taichong, Guanyuan, Zhongwan, Sanyinjiao, Dachangshu, Shenque, Pishu. The most frequently used Meridian is Stomach Meridian of Foot-Yangming, St; The acupoints are mainly located in the lower limbs and the abdomen and Thorax; the most commonly used specific acupointis He-sea point; Zusanli and Tianshu both play an important role in treating IBS-D. Conclusion:Treating IBS-D with acupuncture and moxibustion follow the principles of choosing acupoints mainly according to Meridians, while selecting the acupoints with syndrome differentiation as the assistance, and also use the specific acupoints.to treat IBS-D.
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To explore the optimal therapy time for the treatment of severe coronavirus disease 2019(COVID-19)by traditional Chinese medicine(TCM)and its influence on the therapeutic effect and prognosis. The clinical data,laboratory findings,and outcomes of 64 patients with severe COVID-19 treated with TCM and western medicine in Chongqing from January 20,2020, to March 11,2020 were retrospectively analyzed.Patients were divided into early intervention group[TCM was initiated within 3 days (including day 3) after the first diagnosis of severe type/critical type COVID-19]and late intervention group[TCM was initiated after 7 days (including day 7) after the first diagnosis of severe type /critical type COVID-19].The changes in clinical parameters during the course of disease were compared between the two groups. On day 14,the oxygenation index was 292.5(252.0,351.0)mmHg in the early intervention group,which was significantly higher than that in the late intervention group [246.0(170.0,292.5)mmHg](=0.005).The length of hospital stay [(18.56±1.11)d (24.87±1.64)d,=0.001],duration of ICU stay [(14.12±0.91)d (20.00±1.53)d,=0.000] and time to negativity [(16.77±1.04)d (22.48±1.66)d,=0.001] in the early intervention group were significantly shorter than those in the late intervention group.The intubation rate(7.3%)in the early intervention group was significantly lower than that in the late intervention group(30.4%)(=0.028). Early TCM therapy within three days after a diagnosis of severe COVID-19 can shorten the length of hospital stay,duration of ICU stay,and time to negativity and decrease intubation rate.
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Humans , Betacoronavirus , Coronavirus Infections , Drug Therapy , Medicine, Chinese Traditional , Pandemics , Pneumonia, Viral , Drug Therapy , Prognosis , Retrospective StudiesABSTRACT
Portal hypertension (PH) was defined as an increase in portal pressure caused by various etiologies. The formation of portosystemic collateral circulation was a compensatory form of PH. Gastrointestinal varices were one of the clinical manifestations of PH, and which clould be broadly divided into esophageal varices (EV), gastric varices (GV) and ectopic varices (EcV). At present, it is found that EcV has difficulty in diagnosis, large amount of bleeding, difficulty in hemostasis and poor prognosis. So far, the study of EcV is very limited. There was no guideline and expert consensus on EcV treatment. This review will focus on the epidemiological features of EcV and the research status of endoscopic treatment.
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Objective :To comprehensively analyze therapeutic effect of clopidogrel combined aspirin on acute myo-cardial infarction (AMI).Methods :A total of 100 AMI patients treated in our hospital were selected ,and equally divided into clopidogrel group and combined treatment group (received clopidogrel combined aspirin ).Both groups received routine treatment for 4 weeks .Total effective rate ,platelet aggregation rate (PAR) ,coronary recanaliza-tion time ,prothrombin time (PT) ,left ventricular ejection fraction (LVEF) and incidence rate of cardiovascular e-vents during hospitalization were compared between two groups .Results :Total effective rate of combined treatment group was significantly higher than that of clopidogrel group (96. 00% vs.80.00%, P＝0.014).Compared with clopidogrel group after treatment ,there were significant reductions in PAR [ (47.63 ± 7.83)% vs.(38.45 ± 8.55)%] ,incidence rate of cardiovascular events (24.00% vs.4.00%) and coronary recanalization time [(45.44 ± 4.42) vs.(41.93 ± 5.85)] ,P and significant rise in LVEF [ (48.56 ± 5.79)% vs.(55.51 ± 6.44)%] in combined treatment group , P＜0. 01 all.Conclusion : The clinical effect of clopidogrel combined with aspirin in the treatment of acute myocardial infarction is significant .
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AIM:To investigate the synergistic effect of imperatorin on enhancing the anti -tumor effect of TNF-related apoptosis-inducing ligand(TRAIL)on breast cancer and the mechanisms.METHODS:T-47D and MCF-7 breast cancer cells were divided into control group ,imperatorin group,TRAIL group,imperatorin+TRAIL group and imperatorin+TRAIL+death receptor 5(DR5)siRNA group.The viability of T-47D and MCF-7 cells was measured by MTT assay. The apoptosis and mitochondrial membrane potential in T-47D cells were analyzed by flow cytometry.Western blot and flow cytometry analysis were performed to evaluate the expression of DR 5 on T-47D cell surface and the activation of caspase-8 and caspase-3.RESULTS:Imperatorin significantly enhanced the inhibition of cell viability induced by TRAIL of T -47D and MCF-7 cells,and significantly increased the apoptosis of T-47D cells induced by TRAIL.Imperatorin treatment ob-viously induced upregulation of DR5 expression and production of reactive oxygen species in the T-47D cells.In addition,imperatorin enhanced the TRAIL-induced damage of mitochondrial membrane potential and activation of caspase -8 and caspase-3.CONCLUSION:Imperatorin enhances the anti-tumor effect of TRAIL on breast cancer via upregulating the ex-pression of DR5.
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Objective To investigate the relationship of stress hyperglycemia,cystatin C and estimated glomerular filtration rate (eGFR) with short-term prognosis in elderly patients with acute myocardial infarction.Methods 242 consecutive patients with acute myocardial infarction were divided into two groups according to age:the elderly group (n=182),and the non elderly group (n=60).The clinical data including cystatin C (Cys C),eGFR and stress hyperglycemia levels were collected.The major adverse cardiovascular events (MACE) were observed during hospitalization and 30 days after discharge.Results The incidences of stress hyperglycemia,the levels of creatinine,Cys C and brain natriuretic peptide (BNP),as well as the total MACE were higher and eGFR was lower in elderly group than in non-elderly group (all P＜0.05).Cys C level was positively correlated with age,body mass index and levels of creatinine and BNP (all P＜0.05),and negatively correlated with fasting glucose and eGFR in elderly group (both P＜0.05).The eGFR was positively correlated with body mass index (P＜0.05),and negatively correlated with age,creatinine and BNP levels in elderly group (all P＜0.05).Logistic regression analysis indicated that stress hyperglycemia [OR=1.871,95％CI:1.071-3.269,P=0.03],Cys C [OR=7.093,95％CI:2.261-22.249,P=0.00] were the independent risk factors for MACE.Conclusions Cys C level and eGFR can predict the early renal dysfunction and its prognosis in elderly patients with acute myocardial infarction.The incidence of stress hyperglycemia is higher in the elderly,and stress hyperglycemia and Cys C level are the independent risk factors for MACE.
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Objective Measuring the therapeutic effect of the isolated duodenal exclusion for type 2 diabetes mellitus rats by observing the post-surgery change of glycometabolism-related indicators which could be contributed to the isolation between food and the duodenal mucosa with an endoluminal sleeve placing into the duodenum intestine duodennal of type 2 diabetes mellitus Rats.Methods In this experiment,12 male type 2 diabetes mellitus Goto-Kakizaki (GK) rats were randomized to endoluminal exclution as the experimental group and 12 to sham surgery as the control group,The body mass,the average daily food intake and fasting plasma glucose were determined before (0 week) and 1,3,6,12 weeks after operation;For testing the hematoglobinA1c(HbA1c) level,blood samples were collected before and 6,12 weeks after operation.Results No statistical significant differences between two groups before operation index.In both groups,The body mass and average daily food intake decreased markedly at 1 week after surgery:the experimental group body mass preoperative(262.6 ± 5.6 g)vs postoperative(224.0 ± 6.3 g) ;the average daily food intake preoperative(25.5 ± 2.7 g) vs postoperative (16.5 ± 3.0 g),P ＜ 0.05.Changes in the experimental group with control group,P ＜0.05.The 3 week,6 week,12 week body weight was gradually increased in rats of two groups.The experimental group daily feed intake is always lower than the preoperative postoperative,P ＜ 0.05.In the 3 weeks,the control group's body weight and daily food intake were higher than those before operation,P ＜ 0.05.The experimental group post-FPG level (7.5 ± 1.1) mmol/L,(7.2 ± 1.2) mmol/L,(7.3 ± 0.9) mmol/L,(7.1 ± 1.0) mmol/L vs preoperation (12.2 ± 1.2) mmol/L were decreased significantly,P ＜ 0.05.Compared to the preoperation,the HbA1c concentration of the experimental group decreased significantly,6 w (7.8 ± 0.9) ％,12 w(8.2 ± 1.2) ％ vs the preoperation (10.3 ± 1.4) ％,P ＜0.05.These indicators of the control group showed no significant changes,P ＞ 0.05.Conclusion The isolated duodenal exclusion can achieve the therapeutic effect for type 2 diabetes mellitus on GK rats,and which might be attributed to the improvement of the glycometabolism.
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Objective To explore the value of application of immediate coagulation monitor, with the use of Sonoclot analyzer in the treatment of disseminated intravascular coagulation (DIC). Methods Two hundred and thirty-seven DIC patients were randomly divided into Sonoclot group (n=116, guided by Sonoclot analyzer) and control group (n=121, guided by traditional coagulation indexes) according to the principle of random number. The type, dose and duration of replacement treatment, and the outcomes such as complication rate, ICU stay and 30-day survival rate were recorded and compared. Results There were no difference in the demographic data between two groups (P>0.05). In Sonoclot group, the ratio of heparin used was much higher, though with shorter duration and lower dose than those in control group (P<0.05). The regional bleeding rate was significantly lower in Sonoclot group than that of control group (P<0.05). The replacement doses of the fresh frozen plasma, PLT, and cryoprecipitate were also much lower in the Sonoclot treatment group (P<0.05). A shorter ICU stay was found in the Sonoclot group (P<0.05). In sonoclot group the prognosis was significantly improved as shown by Kaplan-Meier analysis curve (P<0.05). Conclusions Sonoclot analysis is helpful in choosing rational blood products and necessary dosage. It is also useful for effectively guiding anticoagulant therapy in order to reduce the bleeding risk and mortality rate in DIC patients.
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Objective To observe the extracellular content of dopamine (DA)and expression of D1 receptors in hippocampal dentage gyrus (DG)in the model rats with vascular dementia (VD),and to investigate the relationship between them.Methods 12 male SD rats were randomly divided VD group and sham-operation group,and the VD model was prepared by permanent bilateral carotid occlusion.The extracellular content of DA in the DG was determined by in vivo microdialysis and HPLC,and the expression of D1 receptors was measured by immunehisto-chemistry.Results The DA content in the DG of the rats in VD group was lower than that in sham-operation group (P 0.05).Conclusion The DA content in the hippocampal DG is decreased in the VD rats,and its function may be compensated by the up-regulation of D1 receptors in the DG hilus.
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Objective To evaluate diagnostic value of Sonoclot in the diagnosis of heat stroke complicated with disseminated intravascular coagulation (DIC). Methods 43 patients with heat stroke and coagulation dysfunction were retrospectively included and divided into 2 groups according to scores by International Society of Thrombosis and Hemostasis (ISTH): DIC dominant group (22 case) and DIC non-dominant group (21case). Regular coagulation tests , routine blood test , D-dimer and Sonoclot tests were performed at admission and their clinical data were compared. Logistic regression analysis was applied to evaluate the relationships between DIC occurrence and Sonoclot parameters. ROC curves were used to evaluate diagnostic value of Sonoclot for the patients with DIC and heat stroke. Results There were no differences in age, sex, central temperature and total hospital stay between the 2 groups except ICU stay, DIC symptoms, outcome, ISTH scores and APACHEⅡscores (P <0.05). ACT and CR correlated with the occurrence of DIC (P < 0.05). The AUC of ACT and ACT combined with CR were 0.854 and 0.877 respectively. The specificity of ACT in predicting DIC was 69.2%with the sensitivity of 90.3%. When combined with CR, both the specificity and the sensitivity were increased to 80.2% and 93.5%, respectively. Conclusions Sonoclot can predict DIC quickly and is effective in the diagnosis of heat stroke patients with DIC.
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<p><b>OBJECTIVE</b>To investigate the feasibility and effect of transurethral seminal vesiculoscopy in the diagnosis and treatment of refractory or recurrent hemospermia.</p><p><b>METHODS</b>We retrospectively analyzed 162 cases of refractory or recurrent hemospermia examined and treated by transurethral seminal vesiculoscopy. The patients ranged in age from 19 to 76 years and had a hemospermia history of 3 months to 11 years, admitted due to poor therapeutic results or recurrence after 4 weeks of antibiotic medication. All the patients underwent serum PSA examination, transrectal ultrasonography, seminal vesicle ultrasonography and pelvis CT or MRI before surgery.</p><p><b>RESULTS</b>Wine- or magenta-colored colloid and inflammation were found in one or both sides of the seminal vesicle in all the cases. Pathological biopsy revealed chronic inflammatory mucosa of the seminal vesicle in all the patients, and even calculi in the ejaculatory duct or seminal vesicle in 15 cases. Postoperative follow-up averaged 21.7 (12 -29) months. Hemospermia disappeared or was alleviated in 150 (92.64%) of the cases after 1-15 ejaculations, in which 7 experienced recurrence 3 months later. Four cases failed to respond, and 1 developed acute bilateral epididymitis after surgery. No such complications as retrograde ejaculation, urinary incontinence or rectal injury were observed postoperatively.</p><p><b>CONCLUSION</b>Transurethral seminal vesiculoscopy is a safe, effective and feasible new method for the treatment of refractory or recrudescent hemospermia.</p>
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Adult , Aged , Humans , Male , Middle Aged , Young Adult , Feasibility Studies , Hemospermia , Diagnosis , General Surgery , Recurrence , Retrospective Studies , Seminal Vesicles , General Surgery , Treatment Outcome , Ureteroscopy , MethodsABSTRACT
Objective: To isolate and identify the phenolic constituents with anti-oxidant and anti-α-glucosidase activities from the methanol extract in the twigs of Acer rubrum. Methods: The twigs of A. rubrum were extracted by methanol then partitioned by system solvents with different polarity. The ethyl acetate extract was separated on silica gel, Sephadex LH-20, ODS columns, and by semi-preparative HPLC. The isolated compounds were identified by physicochemical properties and spectral analyses. The DPPH free radical scavenging and anti-α-glucosidase activities of the compounds were also evaluated. Results: Ten phenolic compounds were isolated and purified from the twigs of A. rubrum and were identified as catechin (1), epicatechin (2), epicatechin-3-O-gallate (3), quercetin-3-O-α-L-rhamnoside (4), quercetin-3-O-3″-galloyl-rhamnoside (5), quercetin-3-O-2″-galloyl-rhamnoside (6), phloridzin (7), ginnalin A (8), ginnalin B (9), and ginnalin C (10). Conclusion: Compounds 3 and 5-7 are isolated from the twigs of A. rubrum for the first time. Compound 7 is the only one chalcone isolated from the plants in Aceraceae for the first time. All of the compounds show the good anti-oxidant activities. Compounds 3 and 8 show the strong anti-α-glucosidase activities.
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Objective To summarize the clinical features,diagnosis and treatment of autologous urologic neoplasms in renal transplant recipients.Methods A retrospective analysis on the clinical data of 25 renal transplant recipients was done in our center.The onset time of new neoplasms was between 29 to 72 months after transplantation,with an average of 48.2 months.Intermittent hematuria was the first symptom in 23 patients,and the rest two cases were diagnosed through routine examination. The pathological diagnoses of thee cases were renal carcinoma,which were treated by transperitoneal laparoscopic radical nephrectomy.Eight cases were diagnosed as having renal pelvic tumor,which was treated by radical resection for the renal pelvic carcinoma.Fourteen cases were diagnosed as having bladder cancer,which was treated by transurethral resection of bladder tumor (13 cases) or radical cystectomy (one case).All patients were subjected to surgical treatment.The dosage of MMF,CSA/Tacrolimus was decreased to 1/2-2/3 of their original dosage. Sirolimus was used in place of calcineurin inhibitors in four patients.Immunosuppressive regimes and adjuvant therapy were given after surgery treatment.Results Twenty-five patients were followed up for 12-84 months.Contralateral renal carcinoma combined with lung and chest multiple metastases occurred in one case after radical nephrectomy,who died after targeted therapy 6 months later.Two patients with lymph node metastasis died 14 months and 20 months after surgery respectively.The rest 22 patients were closely followed up,whose creatinine remained 98-163μmol/L.Conclusion More attention should be paid to patients with hematuria after renal transplantation to screen the autologous urinary neoplasms.Patients should be treated with surgical procedures,and immunosuppressive regimens should be adjusted postoperatively.
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ObjectiveTo study the pathological characteristics of intra-acinar pulmonary artery inflammation and its correlation with smoking index and disease progression in smokers with normal lung function and smokers with chronic obstructive pulmonary disease (COPD).MethodsPatients requiting lung resection for peripheral lung cancer were divided into group A (nonsmokers with normal lung function,n = 10), group B (smokers with normal lung function, n = 13), and group C (smokers with stable COPD,n = 10).The lung tissue far away from rumor were resected to compare the pathological changes of intraacinar pulmonary arteries and infiltration level of inflammatory cell in pulmonary non-muscularized arteries (NMA), pulmonary partially muscularized arteries (PMA) and muscularized arteries (MA) among the three groups.The correlation analysis was made among infiltration level, smoking index, percentage of predicted value of forced expiratory volume in one second (FEV,％ Pred), six-minute-walk distance (6MWD) and BODE index.Results (1) Both group B and group C showed the intima and media thickness of MA was significantly higher, the lumen area of MA was narrower and the proportion of MA was higher, and collagenous fiber of MA adventitial proliferated and area increased in group C(P ＜0.05 or P ＜0.01).(2) In group B and group C, the percentage of the intra-acinar pulmonary arteries that contained leukocytes, T lymphocytes, CD8+ T lymphocytes and the number of these positive cells infiltrating the intraacinar pulmonary arteries were increased, especially an increased number of CD8+ T lymphocytes infiltrating in the arterial adventitia as compared with group A, moreover there were significant difference between group C and group B (P ＜ 0.05 or P ＜ 0.01).In group B and group C, the degree of these positive cellsinfiltrating NMA, PMA and MA presented a decreasing sequence (P ＜ 0.05 or P ＜ 0.01).Among the intima, media and adventitia of MA, the infiltration of these positive cells was the highest in the adventitia.Among group A, group B and group C, infiltration degree of CD4+ T lymphocyte, B lymphocyte, macrophage and neutrophil demonstrated no significant difference, also among NMA, PMA and MA (P ＞ 0.05).(3)The number of leukocytes, T lymphocytes, CD8+T lymphocytes infiltrating MA showed a positive correlation with the thickness of MA (r =0.563,0.627,0.589 ,P ＜0.01 ,respectively) and smoking index (r =0.551,0.665, 0.600, P ＜ 0.01, respectively), moreover the degree of these cells infiltrating MA demonstrated negative correlation with FEV1 ％ Pred (r = - 0.763, - 0.703, - 0.767, P ＜ 0.01, respectively).Also infiltrating degree of T lymphocytes and CD8+ T lymphocytes was positively correlated with BODE(r = 0.390,0.476,P ＜ 0.05, respectively). Furthermore the infiltrating degree of CD8+ T lymphocytes had negative correlation with 6MWD (r = - 0.356, P ＜ 0.05).Conclusions(1) Pulmonary arterial inflammation appears in smokers with normal lung function and smokers with COPD patients.It involves in all types of intra-acinar pulmonary arteries especially NMA and infiltrates whole layer of MA with a characteristic of CDs+T lymphocytes infiltrating in the adventitia of intra-acinar pulmonary arteries. (2)Pulmonary inflammation is closely correlated to cigarette smoking and clinical parameters such as BODE index, FEV1％pred and 6MWD.It is one of the key factors affecting the progression of COPD.
ABSTRACT
With the rapid development of molecular nutrition, the urgent demand of rationalizing and individual clinical enternal nutrition support was realized. The enteral nutrition was added with special nutrition substrate. The application of carbohydrate in enteral nutrition and the status of comprehensive use of polysaccharides were summarized in this article. Based on the study of traditional fiber in enteral nutrition(EN) , the application of marine polysaccharides on the diseases oriented EN was analyzed and discussed. So, new nutrition substrate from marine polysaccharides is proposed for exploitation of various diseases oriented EN. Therefore, the individual nutrition support becomes possible.