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Objective:To investigate the effect of liraglutide combined with metformin on overweight and obese patients with type 2 diabetes mellitus (T2DM) after short-term intensive insulin pump therapy.Methods:A total of 80 overweight and obese patients with T2DM admitted to Ningguo People′s Hospital from November 2018 to December 2020 were selected as the research subjects. After 1 week of intensive insulin pump therapy, they were divided into two groups according to the random number table method. The observation group received liraglutide combined with metformin therapy, the control group received metformin combined with sitagliptin therapy, both for 16 weeks. The blood glucose, blood lipids, body weight and other indicators were compared between the two groups after treatment. The occurrence of adverse drug reactions in the two groups was compared.Results:The levels of fasting plasma glucose (FPG), 2 h postprandial blood glucose (2hPG), and glycosylated hemoglobin (HbA 1c) in the observation group after treatment were lower than those in the control group :(5.14 ± 0.54) mmol/L vs. (5.92 ± 0.71) mmol/L, (5.91 ± 0.83) mmol/L vs. (6.84 ± 0.92) mmol/L, (5.33 ± 0.57)% vs. (6.30 ± 0.82)%, there were statistical differnces ( P<0.05). The triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels had no significant differences ( P>0.05). After treatment, the islet beta cell function index (HOMA-β) and insulin sensitivity index (ISI) in the observation group were higher than those in the control group: 26.84 ± 3.32 vs. 22.15 ± 3.11, -3.84 ± 0.17 vs. -4.09 ± 0.20, and the insulin resistance index (HOMA-IR) was lower than that in the control group: 2.01 ± 0.17 vs. 2.64 ± 0.21, the differences were statistically significant ( P<0.05). After treatment, the waist circumference (WC), body mass index (BMI) and hip-to-waist ratio in the observation group were lower than those in the control group: (95.10 ± 4.08) cm vs. (97.14 ± 4.48) cm, (24.33 ± 1.62) kg/m 2 vs. (26.15 ± 1.40) kg/m 2, 0.89 ± 0.11 vs. 1.11 ± 0.20, the differences were statistically significant ( P<0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups during treatment ( P>0.05). Conclusions:Liraglutide combined with metformin has better clinical effect on overweight and obese T2DM patients after short-term intensive insulin pump therapy, and can better improve their pancreatic islet function.
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OBJECTIVES@#To explore the value of metagenomic next-generation sequencing (mNGS) in the pathogen identification in children with hematological malignancies complicated with infections.@*METHODS@#A retrospective analysis was conducted on clinical data and pathogenic test results of 43 children with hematological malignancies who underwent microbial culture and mNGS due to infections in the Third Xiangya Hospital of Central South University between June 2020 and July 2022. Differences in detection rates and characteristics of pathogenic microorganisms detected by mNGS and microbial culture were compared.@*RESULTS@#A total of 54 specimens were examined, and the overall detection rate of pathogen by mNGS (80%, 43/54) was significantly higher than that by microbial culture (30%, 16/54) (P<0.001). The most commonly detected infection type by mNGS was viral infection, followed by fungal infection combined viral infection, while that by microbial culture was bacterial infection, followed by fungal infection. The detection rate of fungi by mNGS (33%, 18/54) was higher than that by microbial culture (6%, 3/54) (P<0.001). The detection rate of two or more pathogenic microorganisms by mNGS was higher at 48% compared to microbial culture at 9% (P<0.05). The detection rate of two or more types of pathogenic microorganisms by mNGS was also significantly higher at 33% compared to microbial culture at 2% (P<0.05). The most commonly detected bacteria and fungi by mNGS were Pseudomonas aeruginosa and Candida tropicalis, respectively, in peripheral blood, while Streptococcus pneumoniae and Pneumocystis jirovecii were most commonly detected in bronchoalveolar lavage fluid. Treatment adjustments based on mNGS results were beneficial for 35% (15/43) of the cases.@*CONCLUSIONS@#mNGS has a higher detection rate than microbial culture and has obvious advantages in diagnosing mixed and fungal infections, making it a useful supplementary diagnostic method to microbial culture.
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Humans , Child , Retrospective Studies , Hematologic Neoplasms/complications , High-Throughput Nucleotide Sequencing , Bronchoalveolar Lavage Fluid , Hospitals , Sensitivity and SpecificityABSTRACT
AIM: To investigate the clinical efficacy of suture-guided gonioscopy-assisted transluminal trabeculotomy(GATT)combined with phacoemulsification in the treatment of primary open angle glaucoma(POAG).METHODS: A total of 84 patients(84 eyes)with POAG and cataract who underwent surgery in our hospital from January 2021 to July 2022 were selected and randomly divided into two groups. There were 43 cases(43 eyes)in the combined group who underwent suture-guided GATT combined with phacoemulsification, and 41 cases(41 eyes)in the simple group who underwent suture-guided GATT. The two groups were followed up for 3mo to compare the surgical success rate, intraocular pressure, topical intraocular pressure-lowering drugs, visual acuity and postoperative complications.RESULTS: There was no significant difference in overall success rate between the combination and simple groups at 3 mo after surgery(88% vs. 85%, P>0.05). The intraocular pressure levels and topical intraocular pressure-lowering drugs at 1wk, 1 and 3mo after surgery in the two groups were significantly lower than those before surgery(all P<0.05), but there was no significant difference between the two groups(all P>0.05). The visual acuity at 1wk, 1 and 3mo after surgery of patients in the combined group was significantly better than that in the simple group(P<0.01). During the follow-up period, the incidence of anterior chamber hemorrhage and transient hypertension in the combined group was significantly lower than that in the simple group(P<0.05).CONCLUSION: Both suture-guided GATT combined with cataract phacoemulsification and suture-guided GATT are effective treatment for POAG, however, suture-guided GATT combined with phacoemulsification has a lower incidence of anterior chamber hemorrhage and transient ocular hypertension.
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The incidence and mortality of hepatocellular carcinoma (HCC) is very high in China, which seriously threatens human life and health. There were limited treatment options for advanced HCC in the past, and the overall survival of HCC patients was poor. In recent years, immuno-therapy and targeted therapy have been recommended as effective means for the treatment of advan-ced HCC. The authors report a case of advanced huge HCC which has achieved a maintained partial response for 6 months after the treatment of atezolizumab combined with bevacizumab. The tumor shrunk by 32.4% and 47.5% after 3 and 6 months of treatment. Besides, the alpha-fetoprotein and abnormal tumor protein value of the patient continued to decrease without any adverse reactions. The treatment is evaluated as partial response and patients has a good short-term effect.
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Objective:To evaluate the feasibility of measuring pulmonary venous blood flow spectrum by transesophageal ultrasound in assessing intraoperative left atrial pressure (LAP) in pediatric patients with complex congenital heart disease.Methods:Twenty-five pediatric patients with complex congenital heart disease of either sex, aged < 3 yr, of American Society of Anesthesiologists physical status Ⅲ or Ⅳ, with New York Heart Association class Ⅲ or Ⅳ, undergoing surgery with general anesthesia and requiring LAP monitoring during surgery, were selected.Transesophageal echocardiography was used to record the left pulmonary venous blood flow spectrum during surgery.S wave velocity (PV S), D wave velocity (PV D), AR wave velocity (PV AR), and deceleration time of pulmonary venous diastolic flow (DT D) were measured at 15 min after termination of CPB.The ratio of S wave peak velocity to D wave peak velocity (S/D ratio) was calculated.Measurement was carried out for 3 consecutive cardiac cycles, and the average value was calculated.The LAP was simultaneously measured through the left atrial piezometer.Pearson correlation analysis was performed between PV S, PV D, PV AR, DT D, S/D ratio and LAP. Results:PV S, PV D, PV AR and S/D ratio had no correlation with LAP ( r=-0.06, 0.21, 0.19, -0.38, respectively, P>0.05), while DT D was negatively correlated with LAP ( r=-0.84, P<0.05). Conclusions:DT D measured by transesophageal ultrasound can be used to evaluate intraoperative LAP in pediatric patients with complex congenital heart disease.
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Objective To analyze the epidemiological characteristics of tuberculosis in Haikou from 2016 to 2020, and to provide theoretical support for the implementation of TB prevention and control measures in this region . Methods Collect data of active tuberculosis patients registered and managed in Haikou for 2016-2020 years, analyze the registration rate of tuberculosis in Haikou in 5 years. Comparison of tuberculosis registration rates among different gender, age groups, nationalities and occupation. Results In 2016-2020 years, 3 256 cases of tuberculosis were registered in Haikou. The average annual TB registration rate was 27.09/100 000, showing a gradual decrease. The incidence rate was the highest in 2016 (34.99/100 000) and the lowest in 2020 (17.99/100 000). The registration rate of tuberculosis in men was significantly higher than that of women (P<0.05). Compared with the registration rate of tuberculosis in different age groups, the incidence rate of the 0-14 year old group was the lowest, and the registration rate of people aged 60 or above was the highest, with a statistically significant difference (P<0.05). From 2016 to 2020, the highest tuberculosis registration rate among different ethnic groups was Han nationality (92.63%), followed by Li nationality (3.53%), Miao nationality (2.09%), Hui nationality (1.14%) and others (0.61%).The three highest occupation rates of tuberculosis were farmers, unemployed workers and workers, 55.80%, 14.74% and 8.88% respectively. Conclusion The registration rate of pulmonary tuberculosis in Haikou has a downward trend overall, and prevention and control work needs to focus on the male and the elderly in order to better prevent and control the epidemic of tuberculosis in this area.
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Objective:To identify the risk factors for perioperative atelectasis in pediatric patients undergoing day surgery.Methods:The data of pediatric patients (aged 28 days-7 yr) undergoing elective surgery in our hospital from January 2021 to April 2021 were retrospectively collected.The pediatric patients were divided into atelectasis group and non-atelectasis group according to the results of postoperative ultrasound examination of the lung.The basic conditions and perioperative indicators of the children were recorded, and logistic regression analysis was used to identify the independent risk factors.Results:A total of 122 pediatric patients were enrolled, there were 68 pediatric patients in atelectasis group, and the incidence of atelectasis was 55.7%.Compared with non-atelectasis group, significant changes were found in the amount of sufentanil, rate of laryngeal mask insertion, and rate of intraoperative inhalation of high-concentration oxygen in atelectasis group ( P<0.05). After adjusting variables such as age, upper respiratory tract infection, and overweight, intraoperative inhalation of high-concentration oxygen (FiO 2>60%) ( OR=2.863, 95% confidence interval 1.148-7.137, P=0.024) and consumption of sufentanil >0.2 μg/kg ( OR=1.214, 95% confidence interval 1.069-1.379, P=0.003) were independent risk factors for perioperative atelectasis in pediatric patients undergoing day surgery. Conclusion:Inhalation of high-concentration oxygen (FiO 2>60%) and consumption of sufentanil >0.2 μg/kg during operation are independent risk factors for perioperative atelectasis in pediatric patients undergoing day surgery.
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Objective:To compare the clinical efficacy of transperitoneal robot assisted laparoscopic radical prostatectomy (RARP) versus extraperitoneal single port RARP.Methods:A retrospective analysis was perfoumed on 142 cases of RARP from July 2019 to June 2020 in Robotic Minimally Invasive Center of Sichuan Provincial People's Hospital, including 82 cases(Group A) , aged 70.0(65.6-78.0), undergoing transperitoneal RARP and 60 cases(Group B), aged 68.2 years old(60.1-79.2), undergoing extraperitoneal single port RARP. For group A, PSA was 12.9(5.6-64.0) ng/ml, with 26 cases of less than 10 ng/ml(31.7%), 40 cases of 10-20 ng/ml(48.8%), and 16 cases of more than 20 ng/ml(19.5%), the Gleason score was 7.2(6.0-10.0), with 14 cases(17.1%) of ≤6, 56 cases(68.3%) of 7, and 12 cases(14.6%) of ≥8, and the prostate volume was 61.3(29.0-112.0) ml. There were 49 cases with BMI≤25 kg/m 2, accounting for 59.8%, and 33 cases with BMI>25 kg/m 2, accounting for 40.2%. There were 17 cases(20.7%) of T 1, 44 cases(53.7%) of T 2 and 21 cases(25.6%) of T 3. The proportion of lymph node dissection was 17.1%, and 4 cases(4.9%)had a history of operation. For group B, the PSA was 12.2(1.0-42.6)ng/ml, with 20 cases (33.3%) of <10 ng/ml, 31 cases(51.7%)of 10-20 ng/ml, and 9 cases (15%) of >20 ng/ml. Gleason score was 7.1(6.0-9.0), with 12 cases (20.0%) of ≤6, 42 cases (70.0%) of 7, and 6 cases (10.0%)of ≥8. Prostate volume was 42.4(31.2-72.8)ml on average. There were 37 cases (61.7%) with BMI≤25 kg/m 2, and 23 cases (38.3%)with BMI >25 kg/m 2 . There were 17 cases(28.3%)of T 1, 32 cases(53.3%)of T 2 and 11 cases(18.3%)of T 3.The proportion of lymph node dissection was 11.7% and 4 cases (6.7%) had a history of operation.There was no statistically significant difference in term of age, PSA level, Gleason score, BMI, clinical stage, proportion of lymph node dissection or history of operation between the two groups( P>0.05), but there was statistically significant difference for prostate volume( P<0.05). All operations were performed by the same operator. Four different ways of bladder neck and urethral dissociation was selected according to the intraoperative conditions in Group A, include VIP style, T-shape incision style, VIP plus T-shape incision style or the style along the lateral side of the bladder neck. Small and single anterograde incision stripping of bladder neck was routinely performed in the Group B. Postoperative follow-up was performed to compare the operation time, intraoperative blood loss, bladder neck and urethral anastomosis time, postoperative hospital stay, postoperative exhaust time, postoperative complications, positive rate of surgical margin, indwelling time of urinary catheter, urinary continence satisfaction rate of immediately after operation, 3 months and 6 months after operation, wound healing and aesthetics. Results:All of the operations were successfully completed under robot-assisted laparoscopy, and there was no conversion to open surgery. The operation time was 56.0(45.0-112.0) min in the Group A and 65.4(55.5-96.8) min in the Group B, and there was no statistically significant difference( P>0.05). The intraoperative blood loss was 76.2(30.0-120.5) ml and 55.6(45.5-114.6) ml, respectively, and the difference was not statistically significant( P>0.05). The time of bladder neck urethral anastomosis was 18.9(12.6-25.6) min and 16.2(10.7-19.3) min, respectively, and the difference was not statistically significant( P>0.05). The postoperative hospital stay days were 9.3(8.0-16.0) d and 8.4(7.0-13.0) d, respectively, and the difference was not statistically significant( P>0.05). The postoperative exhaust time was 1.3(0.7-3.0) d and 3.4(2.0-7.0) d, respectively, and the difference was statistically significant( P<0.05). There was 1 case of anastomotic fistula with ureteral injury in Group A, and no serious complication in Group B, and the difference was not statistically significant( P>0.05). The number of positive surgical margin in the two groups was 13(15.9%)and 9(15.0%)respectively, and the difference was not statistically significant( P>0.05). The indwelling time of urinary catheter after operation was 9(7-21) d and 6(4-8) d, respectively, and the difference was statistically significant( P<0.05). The number of patients with satisfactory urinary continence immediately after surgery, 3 months and 6 months after surgery in the two groups were 8(9.8%), 51(62.2%), 62(75.6%) and 17(28.3%), 43(71.7%) and 54(90.0%), respectively. The differences were statistically significant( P<0.05). The total incision lengths in the two groups were 12.1(10.4-13.4) cm and 5.6(5.0-6.0) cm, respectively, and the difference was statistically significant( P<0.05). Conclusions:The extraperitoneal single port RARP is safe and feasible, and the postoperative effect is similar to that of transperitoneal RARP. It has the advantages of shorter recovery time, higher urinary continence satisfaction rate, neater and more beautiful incision. The long-term therapeutic effect needs further confirming by prospective study.
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Pulmonary hypertension (PH) is a severe pathophysiological condition characterized by pulmonary artery remodeling and continuous increases in pulmonary artery pressure, which may eventually develop to right heart failure and death. Although newly discovered and incredible treatment strategies in recent years have improved the prognosis of PH, limited types of effective and economical drugs for PH still makes it as a life-threatening disease. Some drugs from Chinese materia medica (CMM) have been traditionally applied in the treatment of lung diseases. Accumulating evidence suggests active pharmaceutical ingredients (APIs) derived from those medicines brings promising future for the prevention and treatment of PH. In this review, we summarized the pharmacological effects of APIs derived from CMM which are potent in treating PH, so as to provide new thoughts for initial drug discovery and identification of potential therapeutic strategies in alternative medicine for PH.
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Humans , China , Drugs, Chinese Herbal , Hypertension, Pulmonary/drug therapy , Materia Medica , Medicine, Chinese TraditionalABSTRACT
OBJECTIVE： To study improvement effect and mechanism of Shuangshen yin on liver function and the degree of liver fibrosis in liver fibrosis model rats. METHODS： Healthy SD rats were collected and given 40％ CCl4 olive oil solution intraperitoneally for consecutive 7 weeks to induce liver fibrosis model. 47 model rats were randomly divided into model group， positive control group and Shuangshen yin low-dose， medium-dose and high-dose groups， with 9， 9， 9， 10， 10 rats respectively； another 10 healthy SD rats were included in normal group. From the next week after model induction， model group and normal group were given water intragastrically； positive control group [colchicines 0.2 mg/（kg·d）] and Shuangshenyin groups [Shuangshen yin water decoction 3， 6， 12 g/（kg·d）， by crude drug] were given corresponding medicines respectively for consecutive 28 d. The serum levels of liver function indicators （ALT， AST， TBIL， ALB， GLB） were determined by Rye’s analysis method. The serum levels of liver fibrosis indexes （HA， LN， Ⅲ-PC， Ⅳ-C） were determined by ELISA. The pathological changes of liver tissues were observed by HE staining and VG staining. The levels of SOD， MDA and HYP in liver tissues were determined by spectrophotometry. The expression of α-SMA was detected by immunohistochemistry. RESULTS： Compared with normal group， the serum levels of ALT， AST， TBIL， HA， LN， PC-Ⅲ and Ⅳ-C in model group were increased significantly， and the level of ALB was decreased significantly （P＜0.05）. There were some pathological phenomena such as vacuolar degeneration and fibrous tissue proliferation in rat liver. The levels of SOD in liver tissue were decreased significantly， while the levels of MDA and HYP were increased significantly （P＜0.05）. A large number of positive staining granules of α-SMA protein were observed in liver tissue， and the expression level of α-SMA protein was significantly increased （P＜0.05）. Comparison of model group， the serum levels of ALT， AST and liver fibrosis indexes were significantly decreased and ALB level was significantly increased in Shuangshen yin groups， while the TBIL levels in Shuangshen yin medium-dose， high-dose groups were significantly decreased （P＜0.05）； the phenomena of hepatocyte degeneration and fibrosis tissue proliferation were significantly improved； the levels of SOD in liver tissue were significantly increased， and the levels of MDA and HYP were significantly decreased （P＜0.05）； the positive staining of α-SMA protein decreased significantly， and the expression level of α-SMA protein was decreased significantly （P＜0.05）. CONCLUSIONS： Shuangshen yin has protective and anti-fibrotic effects on liver in rats with hepatic fibrosis， the mechanism of which may be associated with enhancing antioxidant capacity， down-regulating the expression of α-SMA， inhibiting the activation of hepatic stellate cells， reducing extracellular matrix synthesis so as to reverse liver fibrosis.
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Advanced severe lung cancer means the stage IIIB, IIIC, and IV lung cancer patients with a PS score of 2 to 4 points due to various related causes of lung cancer itself or the complication of anti-tumor drugs, with a high probability of benefiting from the existing systemic anti-tumor treatments. The diagnosis and treatment strategies emphasize the implementation of minimally invasive dynamic monitoring mutation targets and curative effects. Every drug that is useful to the patient should be used as possible, and making the best use of every drug as possible with the help of respiratory support therapy. Specific treatment concepts include combination therapy,alternating medication, paying equal attention to systemic therapy and local therapy, PS score assessment, upgrading and downgrading of drug use, and simultaneous treatment of cancer and lung itself.
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BACKGROUND@#Late-onset multiple acyl-coA dehydrogenase deficiency (MADD) is an autosomal recessive inherited metabolic disorder. It is still unclear about the muscle magnetic resonance image (MRI) pattern of the distal lower limb pre- and post-treatment in patients with late-onset MADD. This study described the clinical and genetic findings in a cohort of patients with late-onset MADD, and aimed to characterize the MRI pattern of the lower limbs.@*METHODS@#Clinical data were retrospectively collected from clinic centers of Peking University People's Hospital between February 2014 and February 2018. Muscle biopsy, blood acylcarnitines, and urine organic acids profiles, and genetic analysis were conducted to establish the diagnosis of MADD in 25 patients. Muscle MRI of the thigh and leg were performed in all patients before treatment. Eight patients received MRI re-examinations after treatment.@*RESULTS@#All patients presented with muscle weakness or exercise intolerance associated with variants in the electron transfer flavoprotein dehydrogenase gene. Muscle MRI showed a sign of both edema-like change and fat infiltration selectively involving in the soleus (SO) but sparing of the gastrocnemius (GA) in the leg. Similar sign of selective involvement of the biceps femoris longus (BFL) but sparing of the semitendinosus (ST) was observed in the thigh. The sensitivity and specificity of the combination of either "SO+/GA-" sign or "BFL+/ST-" sign for the diagnosis of late-onset MADD were 80.0% and 83.5%, respectively. Logistic regression model supported the findings. The edema-like change in the SO and BFL muscles were quickly recovered at 1 month after treatment, and the clinical symptom was also relieved.@*CONCLUSIONS@#This study expands the clinical and genetic spectrums of late-onset MADD. Muscle MRI shows a distinct pattern in the lower limb of patients with late-onset MADD. The dynamic change of edema-like change in the affected muscles might be a potential biomarker of treatment response.
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Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Biopsy , Methods , Carnitine , Blood , Electron-Transferring Flavoproteins , Genetics , Hamstring Muscles , Diagnostic Imaging , Metabolism , Pathology , Iron-Sulfur Proteins , Genetics , Magnetic Resonance Imaging , Methods , Multiple Acyl Coenzyme A Dehydrogenase Deficiency , Diagnostic Imaging , Genetics , Pathology , Muscle, Skeletal , Diagnostic Imaging , Metabolism , Pathology , Oxidoreductases Acting on CH-NH Group Donors , Genetics , Retrospective StudiesABSTRACT
BACKGROUND@#Long noncoding RNAs (lncRNAs) play pivotal roles in various malignant tumors. Epidermal growth factor receptor (EGFR) signaling is associated with the pathogenesis of cutaneous squamous cell carcinoma (cSCC). This study aimed to explore the role of LINC00520 in the development of cSCC via EGFR and phosphoinositide 3-kinase-protein kinase B (PI3K/Akt) signaling pathways.@*METHODS@#A microarray analysis was applied to screen differentially expressed lncRNAs in cSCC samples. The A431 cSCC cell line was transfected and assigned different groups. The expression patterns of LINC00520, EGFR, and intermediates in the PI3K/Akt pathway were characterized using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Western blotting analysis. Cell proliferation, migration, and invasion were detected using the MTT assay, scratch test, and Transwell assay, respectively. Cell-based experiments and a tumorigenicity assay were conducted to assess the effect of LINC00520 on cSCC progression. This study was ended in September 2017. Comparisons between two groups were analyzed with t-test and comparisons among multiple groups were analyzed using one-way analysis of variance. The nonparametric Wilcoxon rank sum test was used to analyze skewed data. The enumerated data were analyzed using the chi-square test or Fisher exact test.@*RESULTS@#Data from chip GSE66359 revealed depletion of LINC00520 in cSCC. Cells transfected with LINC00520 vector and LINC00520 vector + si-EGFR showed elevated LINC00520 level but decreased levels of the EGFR, PI3K, AKT, VEGF, MMP-2 and MMP-9 mRNAs and proteins, and inhibition of the growth, migration and adhesion of cSCC cells, while the si-LINC00520 group showed opposite trends (all P < 0.05). Compared with the LINC00520 vector group, the LINC00520 vector + si-EGFR group showed decreased levels of the EGFR, PI3K, AKT, VEGF, MMP-2 and MMP-9 mRNAs and proteins, and inhibition of the growth, migration and adhesion of cSCC cells, while the LINC00520 vector + EGFR vector group showed opposite results (all P < 0.05).@*CONCLUSION@#Based on our results, LINC00520-targeted EGFR inhibition might result in the inactivation of the PI3K/Akt pathway, thus inhibiting cSCC development.
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Animals , Female , Humans , Mice , Carcinoma, Squamous Cell , Pathology , Cell Line, Tumor , Cell Movement , Cell Proliferation , Disease Progression , ErbB Receptors , Lymphatic Metastasis , Neoplasm Invasiveness , Phosphatidylinositol 3-Kinases , Physiology , Proto-Oncogene Proteins c-akt , Physiology , RNA, Long Noncoding , Physiology , Signal Transduction , Physiology , Skin Neoplasms , PathologyABSTRACT
OBJECTIVE@#To investigate the effects of electroacupuncture (EA) on endolymphatic hydrops (EH) and the regulation of arginine vasopressin (AVP)-aquaporin-2 (AQP2) pathway in guinea pigs.@*METHODS@#EH was induced in male guinea pigs by an intraperitoneal injection of AVP. For the treatment, EA was delivered to Baihui (GV 20) and Tinggong (SI 19) acupoints, once per day for 10 consecutive days. In histomorphological studies, cochlear hydrops degree was evaluated by hematoxylin-eosin (HE) staining, and then the ratio of scala media (SM) area to SM + scala vestibuli (SV) area (R value) was calculated. In mechanical studies, a comparison of plasma AVP (p-AVP) concentrations, cyclic adenosine monophosphate (cAMP) levels, vasopressin type 2 receptor (V2R) and AQP2 mRNA expressions in the cochlea were compared among groups.@*RESULTS@#EA significantly reduced cochlear hydrops in guinea pigs (P=0.001). EA significantly attenuated the AVPinduced up-regulation of p-AVP concentrations (P=0.006), cochlear cAMP levels (P=0.003) and AQP2 mRNA expression (P=0.016), and up-regulated the expression of V2R mRNA (P=0.004) in the cochlea.@*CONCLUSIONS@#The dehydrating effect of EA might be associated with its inhibition of AVP-AQP2 pathway activation.
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Objective@#To compare the efficacy and safety of plasma exchange (PE) combined with double plasma absorption and simple PE in the treatment of acute-on-chronic liver failure.@*Methods@#We retrospectively analyzed 251 cases of acute-on-chronic liver failure treated with artificial liver treatment since January 2015. Changes in clinical manifestations, laboratory tests, and complications of the patients before and after different modes of treatment were compared and short-term efficacy was tracked. In accordance with different data, t-test, Pearson's chi-squared test and Fisher's exact test were used for statistical analysis.@*Results@#The effectiveness of low-volume PE combined with double plasma molecular adsorption system (DPMAS) and equal amount of PE combined with DPMAS was significantly better than simple PE (83.7%, 84.05% and 82.15 vs 55.6%, P < 0.05) in early stage of liver failure. In late-stage of liver failure, there was no significant difference in the treatment efficiency of each group (P > 0.05). Bilirubin and bile acid levels were significantly decreased in combined treatment groups than that to simple PE group (P < 0.05). PTA and albumin improvement rate of DPMAS PE groups were significantly lower than that of simple PE group (P < 0.05). There was no statistical difference in adverse reactions between each group.@*Conclusion@#PE combined with DPMAS improves the treatment efficiency of early hepatic failure and decrease dosage of plasma when compared with simple PE. A beforehand DPMAS treatment after PE treatment can improve the adverse effects of DPMAS on blood coagulation function and albumin levels.
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Objective To explore the clinical efficacy and safety of off-clamping in robotic-assisted partial nephrectomy (RAPN) for the treatment of renal tumors.Methods From January 2015 to March 2017,the data of 48 patients who underwent off-clamping RAPN were reviewed retrospectively.There were 31 males and 17 females,and the mean age was 57 years (range:23-84 years).The mean tumor size was 3.1 cm (range:1.2-6.4 cm),with the upper,middle,and lower polar tumors account for 35.4％,27.1％,and 37.5％,respectively.The clinical tumor stage was T1N0M0 in all 48 cases,according to the AJCC tumor staging system for renal cancer.Results RAPNs were performed successfully in all 48 cases,without conversion to open surgery.In those patients,the application of off-clamping in robotic-assisted partial nephrectomy was performed in 44 cases.The renal artery and vein was exposed,dissected,isolated and then clamped in 4 cases due to bleeding.The mean surgical time was 85 min (range:75-185 min).The mean estimated blood loss was 134 ml (range:60-270 ml),and no blood transfusion was needed.The wound surface was closed using interrupted suture with Hem-o-lok clips securing each needle point.The mean time for renorrhaphy was 22 min (rang:11-31 min).No intraoperative severe complications such as vascular injury,trauma of abdominal organ occurred.There were 5 complications,including 2 cases of hematuria,2 cases of delayed healing of incision,and 1 case of pneumohypoderma.The pathological diagnosis included 40 cases of renal clear cell carcinoma,3 cases of papillary renal cell carcinoma,and 5 cases of angiomyolipomas.No tumor recurrence or distant metastasis was observed during the average follow-up of 17 months (range 3-27 months).Conclusions Off-clamping RAPN is safe and feasible approach to excise certain kidney tumors.It carries the benefits of less complication,quick recovery,and less ischemia reperfusion renal injury.Off-clamping RAPN would be suitable for those patients with solitary kidneys,renal insufficiency,and bilateral tumors.
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Objective This study was to analysis the epidemiologic characteristics of hand-foot-month (HFMD) in Shenzhen during 2015-2016,to provide reference for the prevention and treatment of HFMD.Methods 7 758 statistical data from Shenzhen children's hospital clinical lab during 2015-2016 was included.We used real time fluorescent reverse transcription polymerase chain reaction (RT-PCR) to detect enterovirus general (EV),enterovirus 71 (EV71) and coxsackievirus A group 16 (CoxA16),and analyzed the age,sex and epidemic time of the patients.Results In 2015 and 2016,the positive rate of EV was 67.19％ (2679/3987) and 52.61％ (1 984/3 771) respectively,with statistically significant difference (x2 =71.84,P ＜ 0.05).The radio of male to female children was 1.91∶1 (1 757/922) and 1.83∶1 (l 283/701) in 2015 and 2016,with statistically significant difference (P ＜ 0.05).The age of the children was ＜ 5 years old,accounting for more than 90％ of the total number of patients.April to July and September were the two peaks of HFMD.The enterovirus of hand foot and mouth disease in Shenzhen was dominated by other enteroviruses (more than 82％ of the total number of patients).With the increase of age,the proportion of EV71 in children with severe hand and foot was increasing,and the proportion of other enteroviruses was decreasing.Conclusions Vaccination is one of the important measures of HFMD control.It's beneficial for the diagnosis and treatment of HFMD to collected epidemiologic characteristics data about HFMD in Shenzhen.
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AIM:To investigate the role of fatty acid translocase(FAT/CD36)on palmitate-induced inflam-mation in human monocyte-derived macrophage THP-1.METHODS:THP-1 cells were treated with palmitate(0,0.1 and 0.2 mmol/L)for 24 h.Transwell chamber assay was used to examine the migration ability of THP-1 cells.The mRNA ex-pression of CD36,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and monocyte chemotactic protein 1(MCP-1) was measured by real-time PCR.The protein levels of TNF-αand IL-6 in the supernatant of cultured cells were measured by ELISA.The protein level of CD36 was examined by Western blot.Small interfering RNA(siRNA)targeting CD36 (siCD36)was used to inhibit the expression of CD 36 in the THP-1 cells,and the changes of the cell migration and inflam-matory response were monitored as mentioned above.RESULTS:Palmitate increased the expression of CD36 in the THP-1 cells(P<0.05).Palmitate also up-regulated inflammatory cytokine and chemokine levels,and the differences were sta-tistically significant(P<0.05).Compared with control group,palmitate promoted migration of THP-1 cells.siCD36 was transfected into the THP-1 cells and the silencing efficiency was approximately 54%.The protein levels of TNF-αand IL-6 were also decreased in siCD36 group compared with scrambled RNA(scrRNA)group,and the differences were statisti-cally significant(P<0.05).The migrated cells in siCD36 group were significantly less than those in scrRNA group(P<0.05).CONCLUSION:Palmitate promotes migration ability and triggers inflammatory response in the THP-1 macropha-ges by upregulating CD36 expression.
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There are some problems such as the limited diseases, the shortage of teaching resources and lack of certain cases in infectious diseases teaching owing to the obvious narrowing spectrum of dis-eases and the decreasing incidence of infectious diseases, etc. We have made good progress in clinical practice teaching for medical students in infectious diseases by reforming teaching methods including enriching practice knowledge of younger teacher, collecting typical cases from hospitals in rural areas, the adjustment of teaching contents, making full use of the experience of the old professor and the advanced teaching measures in clinical practice teaching.
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Objective To explore the clinical feasibility of robot-assisted laparoscopic radical cystectomy (RARC) with total intracorporeal othotopic ileal neobladder (TIOIN).Methods A consecutive series of 4 patients (2 male,2 female),who underwent RARC with TIOIN by a single surgeon,were included in the retrospective study,between March 2017 and June 2017.Their age ranged from 59 to 71 years,which the mean age was (65.7 ± 4.9) years.Preoperative urinary CT scan,cystoscopic examination and transurethral resection of bladder tumor were performed for diagnosis.Among these,2 patients underwent side-to-side bowel anastomosis using a linear stapler,while hand-sewn anastomosis was performed in the other 2 patients.The detubularized bowel segment was arranged in a U shape,and then the two medial borders were closed to create the posterior wall of the neobladder,which completed a partial U shape and anastomosed with the end of urethra.After placing the single J stents into the ureter,the uretero-neobladder was anastomosed.To close the urine reservoir,each border of the U-shaped segment was folded again and sutured to form a sealed pouch.Results All operations were performed successfully.The average operation time for RARC was 93.2 min (ranging 79-117 min).The average operation time for urinary diversion was 214.2 min (ranging 163-251 min).The mean estimated blood loss was 304.5 ml (ranging 200-400 ml).The mean hospital stay was 20.5 d (ranging 13-32 day).The number of dissected lymph node ranged from 11 to 16 (mean 3.7 ± 2.6).All the surgical margins were negative.The time for postoperative out-of-bed activity and bowel function recovery was 2-3 days and 3-4 days,respectively.The single-J stents were removed 1 months after operation,generally.No urine leakage was noticed after removing the drainage tube and catheter.The lymph leakage was observed in one case,which was resolved 15 days post-operatively after given nutrient therapy.The performance of urinary continence was satisfactory,except one patient complained about the nocturnal incontinence.After the regular pelvic exercise,the symptom improved two months after the operation.Hydronephrosis and intestinal leakage were not observed.Conclusions Our initial experience showed that RARC with TIOIN is feasible and alterative for experienced surgeon.