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Objective:To compare the application of epidural analgesia (EA) with intravenous analgesia (IA) in radical gastrectomy for gastric cancer.Methods:A systematic review and meta-analysis of randomized controlled trials of EA and IA in radical gastrectomy was conducted. Primary outcome was pain scores at 24 h after surgery, while the secondary outcomes included incidence of postoperative complications, first flatus time and (LOS).Results:A total of 6 randomized controlled studies was identified and 393 patients were enrolled in this review, 4 published in English and 2 in Chinese. Meta-analysis revealed that, the EA group had lower pain score at 24h either pain at rest ( WMD=-0.74, 95% CI: -1.35~-0.13, P=0.02) or pain on movement or coughing( WMD=-1.5, 95% CI: -1.95~-1.05, P<0.001) than that of the IA group. In terms of complications, postoperative nausea and vomiting ( RR=0.32, 95% CI: 0.18~0.58, P<0.001) and respiratory complications ( RR=0.50, 95% CI: 0.29~0.85, P=0.01) in EA group were obviously lower than those of the IA group. No difference was observed in postoperative urinary complications between the two groups ( RR=0.87, 95% CI: 0.38~1.96, P=0.73). However, the incidence of hypotension was obviously higher than that of IA group ( RR=3.27, 95% CI: 1.28~8.32, P=0.01). Time of first exhaust time after operation ( WMD=-14.01, 95% CI: -22.85~-5.17, P=0.002), postoperative length of hospital stay ( WMD=-0.69, 95% CI: -0.90~-0.49, P<0.001) were shorter than IA group. Conclusions:For patients who undergoing radical gastrectomy for gastric cancer, epidural analgesia could provide better pain control either pain at rest or on movement, although a rising incidence of hypotension was leaded, reduced pulmonary complications, nausea and vomiting were found, and promote the bowel function and shorten the duration of hospital stay.
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Objective@#To understand the mortality and influencing factors on injecting drug users (IDUs) with HIV/AIDS, in Guizhou province, 1996-2015.@*Methods@#A retrospective cohort study was conducted on IDUs with HIV/AIDS that were reported through national comprehensive HIV/AIDS information system, in Guizhou province during 1996-2015. Cox proportional hazard regression model was used to analyze the influencing factors on the mortality of HIV/AIDS.@*Results@#A total of 3 958 cases of IDUs with HIV/AIDS were recruited in this study, with all-cause mortality rate of 44.01% (1 742/3 958) and total mortality rate of 7.80/100 person-years, respectively. The median survival time between diagnosis and death was 8.08 years. Mortality rate was 3.57/100 person-years in the group receiving antiretroviral therapy (ART). The mortality appeared to be 4.08/100 person-years in the group who were on methadone maintenance treatment (MMT). Data from the multiple regression analysis indicated that factors of gender, ethnicity, age when HIV/AIDS diagnosis was made, CD4+T lymphocyte (CD4) count at the first testing, ART and MMT were significantly associated with deaths among these people. The risk of death in females was 0.82 times (95%CI: 0.69-0.98) higher than that in males. The risk of deaths among the ethnic minority subjects was 1.39 times (95%CI: 1.21-1.60) higher than that of the Hans. The risk of death appeared to be 2.44 times higher (95%CI: 1.07-5.56) in the over-50-year of age group than in the <20 year-old group, when HIV/AIDS was diagnosed for the first time. The risk of death in CD4 ≥500/μl group in the first time was 0.27 times (95%CI: 0.22-0.32) more than CD4 <200/μl group in the firs time. The risk of death in cases who were treated with ART or MMT was 2.83 times (95%CI: 2.45-3.26) and 1.35 times (95%CI: 1.15-1.59) higher than those who did not receive any treatment, respectively.@*Conclusion@#Higher risks on death seemed to be related to the following factors: being male, older age at the time of diagnosis, lower CD4 at diagnosis, not on ART or MMT among the IDUs with HIV/AIDS in Guizhou province, between 1996-2015.
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Objective To investigate the combined effects of fluoride (NaF) and arsenate (NaAsO2) exposure on proliferation,differentiation and bata-catenin expression in SD rat osteoblasts.Methods Osteoblasts were isolated from calvarias of twelve SD rats born in 1-3 days and cultured.The method was divided into 9 groups [F0.0As0.0 (control group),F0.5As0.0,F4.0As0.0,F0.0As0.1,F0.0As10.0,F0.5As0.1,F0.5As10.0,F4.0As0.1,F4.0As10.0] by factorial experiment design (3 factors and 2 levels).Osteoblasts were exposed to NaF (F-:0.0,0.5,4.0 mmol/L,F0.0,F0.5,F4.0),NaAsO2 (As3+:0.0,0.1,10.0 μmol/L,As0.0,As0.1,Asi10.0) and cultured for 72 hours.The proliferation and alkaline phosphatase (ALP) was determined by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl (MTT) and Enzyme-linked immunosorbent assay (ELISA).The expression of beta-catenin was analyzed by quantitative real-time PCR (qPCR) and Western blotting after 72 hours of experiment.Results ①There was significant difference in cell proliferation and the activity of ALP among groups after 72 hours (F =14.022,14.425,all P ＜ 0.05).Compared with control group,the proliferation and the activity of ALP were significantly induced in F0.5 treated osteoblasts groups (0.313 ±0.023 vs0.455 ± 0.152,4.46 ± 0.72 vs 6.09 ± 0.68,all P ＜ 0.05),and the proliferation was significantly suppressed in F4.0As0.0 group (0.029 ± 0.014,P ＜ 0.05),the activity of ALP was significantly induced in F0.0As10.0 group (0.156 ± 0.010,6.29 ± 0.67) and the proliferation was significantly suppressed in F0.0As0.1 group (0.370 ± 0.029,3.68 ± 0.45,all P ＜ 0.05).②There was statistical difference in beta-catenin mRNA and protein expressions among groups with F-(F =7.782,559.455,all P ＜ 0.05) at As0.0 condition.There was significant difference in the expression of betacatenin mRNA and beta-catenin protein in F0.5As0.0 group compared with control group (1.00 ± 0.32 vs 1.99 ± 0.14,3.56 ± 0.15 vs 5.11 ± 0.26,all P ＜ 0.05),the beta-catenin protein was significantly suppressed in F4.0As0.0 group (1.10 ± 0.02,P ＜ 0.05).There was significant difference in the expression of beta-catenin protein of all groups with As3+ (F =154.736,P ＜ 0.05) at F0.0 condition.③Factorial analysis showed that fluoride or arsenic alone could affect the proliferation and the expression level of beta-catenin mRNA and protein (F =82.081,11.991,514.741;19.302,8.753,523.698,all P ＜ 0.05),the effect of arsenic on ALP activity of osteoblasts was also the main effect (F =17.444,P ＜ 0.05);and there was an interaction between fluoride or arsenic to cell proliferation and the activity of ALP and the expression of beta-catenin mRNA and protein (F =13.085,18.157,4.936,426.036,all P ＜ 0.05).Conclusions A biphasic pattern of fluoride or arsenic on proliferation and differentiation has been induced in SD rat osteoblasts.Fluoride or arsenic can affect bone metabolic by beta-catenin.
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Objective:To investigate the effects of interleukin-17 on tumor,we transfected interleukin-17 gene into mouse colon cancer cells(C26)and set up an animal model in tumor.Methods:By plasmid vector,IL-17 gene was transfected into C26.Meanwhile, empty plasmid vector(pcDNA3.1)and C26 cells were transfected as control groups.C26/pcDNA3.1-IL-17,C26/pcDNA3.1,and C26 cells were subcutaneously inoculated into mice respectively and the tumor volume and the survival time were observed.Proliferation of splenocyte and NK activity were detected.Detect the characteristic cytokines and transcriptional factors of Th1,Th2,Th17 and Treg cells in splenic lymphocyte.Proliferation of TIL was detected.The characteristic cytokines IL-10 of M1 and the characteristic cytokines IL-12 of M2 in tumor infiltrating macrophages were detected.Results: The growth of tumor in mice inoculated with C26/pcDNA3.1-IL-17 cells was significantly retarded ( P0.05).The proliferation of the splenocytes from C26/pcDNA3.1-IL-17 inoculated mice was higher than those of C26/pcDNA3.1,C26 groups(P0.05),the proliferation of the splenocytes from C26/pcDNA3.1 and C26 inoculated mice was slow than those of normal groups(P0.05 ).The splenocytes from the mice inoculated with C26/pcDNA3.1-IL-17 cells secreted more IFN-γ( the characteristic cytokines of Th1 ) , IL-4 ( the characteristic cytokines of Th2),GATA-3,ROR-γt,IL-10(the characteristic cytokines of Treg)mRNA(P<0.05).The proliferation of TIL from C26/pcDNA3.1-IL-17 inoculated mice was higher than those of C26/pcDNA3.1,C26 groups(P<0.05),the proliferation of TIL from C26/pcDNA3.1-IL-17,C26/pcDNA3.1 and C26 inoculated mice was lower than those of normal groups( P<0.05).And there′s no differences among every groups of the express of cytokines IL-10 and IL-12 mRNA in tumor infiltrating macrophages(P<0.05).Conclusion: The transfection of IL-17 gene inhibited tumor growth in the mice,inoculated with enhancing the immune function.
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Objective To detect the immune effect of FbaAmAb2 against the surface protein of group A Straptococcus (GAS),and explore the pathogenesis and therapy of GAS infections.Methods By subclonal and bacterial ELISA,the positive hybridoma cells were screened that can produce better titers of FbaAmAb2 against GAS-surface FbaA protein,and were injected into the peritoneal cavities of BALB/c mice to produce ascites.The collected ascites were performed to dilute,as follows,original ascite,1:2,1:4,1:8,and 1:16 to test tube agglutination.Based on the results,we selected appropriate dilution to passively immunize mice,and then challenged the mice with GAS,evaluating FbaAmAb2 neutralizing ability with GAS in mice by the survival rate of the immunized mice.Whether FbaAmAb2 could inhibit the binding of factor H to GAS was confirmed by the invasive inhibition assay.Results The IgG titer of bacteria solution ELISA is 1:160 and the titer of tube agglutination is 1∶8.The protect rates of FbaAmAb2 on preventing mice with GAS infections are as follows:66.67％ in original ascite and 1:2 diluted groups,and 50％ in 1:4 diluted group.Mice in each experimental group were evoked significantly protective immune responses compared with the PBS control by SPSS analysis.FbaAmAb2 can competitively inhibit factor H binding to the surface proteins FbaA of GAS,which decreased the entry of GAS into the cytoplasm of human epithelial cells through the binding of factor H.Conclusion FbaAmAb2 is promising to be used in emergent prevention or the clinical therapy for GAS infection and it is promising starting points for pharmacologic targeting and further development of new therapeutic agents for GAS.