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Objective:To compare and analyze the efficacy and safety of intraoperative radiotherapy (IORT) combined with conventional therapy (surgery combined with radiochemotherapy) and conventional therapy alone for pancreatic cancer.Methods:Literature review was conducted from PubMed, Cochrane Library, Web of Science, Embase, Chongqing VIP, CNKI, Wanfang Data and China Biomedical Literature Service System (SinoMed). The literatures that met the inclusion criteria were screened and the data were extracted. Meta-analysis was carried out by RevMan 5.4 software.Results:A total of 11 studies consisting of 813 patients were included. According to the combined results, compared with conventional therapy, IORT combined with conventional therapy could improve the overall survival rate of pancreatic cancer ( HR=0.66, 95% CI=0.54-0.81, Z=4.03, P<0.001), and did not increase the treatment-related side effects ( OR=1.00, 95% CI=0.69-1.46, Z=0.01, P=0.99), but failed to bring benefit to the local control rate ( HR=0.56, 95% CI=0.31-1.01, Z=1.93, P=0.05). Conclusions:The overall survival rate in the IORT combined with conventional therapy group is significantly better than that in the conventional therapy group. No significant difference is found in the treatment-related adverse reactions between two groups. IORT combined with conventional therapy is worthy of clinical application.
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Objective To investigate the protective mechanism of MEK1/2 inhibitor PD98059 on ox-LDL induced injury of human umbilical vein endothelial cells (HUVEC),and its influence on the expression of LOX-1.Methods HUVEC damage models were established by using ox-LDL and were treated with PD98059 later,divided into the negative control group,the ox-LDL group,the positive control group and the PD98059+ox-LDL group.The effect of inhibition of MEK1/2 on ox-LDL induced HUVEC damage was measured.Results Compared with the negative control group,the levels in the ox-LDL group of LOX-1,pMEK1/2,RhoA,ROCK1,ROCK2,TNF-α and IL-6 were increased significantly,the proliferations of HUVEC and the productions of NO were decreased (P＜0.05).Compared with the ox-LDL group,the levels in the positive control group and the PD98059+ox-LDL group of pMEK1/2,RhoA,ROCK1,ROCK2,TNF-α and IL-6 were decreased,the proliferation of HUVEC and the production of NO were increased (P＜0.05).Conclusion PD98059 inhibit the MEK1/2 signaling pathway to suppress the ox-LDL induced damage of HUVEC by decreasing the expression of LOX-1.
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Objective@#To evaluate the characteristics and performance of various prediction models for early-onset preeclampsia, and to provide a reference for further study of preeclampsia prediction methods.@*Methods@#(1) Databases of PubMed, Medline, Embase, China National Knowledge Infrastructure (CNKI) and Wanfang Database were searched since their inception to October 2016. Studies in models for predicting early-onset preeclampsia during the first trimester were included. (2) Two reviewers independently checked potentially eligible articles, assessed risk of bias and extracted data. (3) Subtotals for the performance of different models were created and their properties were analyzed. Differences between simple models (based upon high risk factors such as demographic figures, medical history and family history, etc) and complex models (based upon blood pressure, uterine artery Doppler and biomarkers) were compared by analyzing forest plot created by SAS 9.4.@*Results@#(1) Seventeen studies met the inclusion criteria were screened out, including nine prospective cohort studies, two case-control studies and six nested case-control studies. A total of 76 436 gravidas from tendifferent populations were assessed by the established models in these studies. (2) The area under the curve (AUC) of 13 simple models ranged from 0.64 to 0.81 with the sensitivity of 21%-60% when the false positive rate (FPR) was 10%. The AUC of 17 complex models ranged from 0.77 to 0.98 and the sensitivity was between 48.0% and 95.2% at a fixed FPR of 10%. (3) Compared with the simple models, the best complex models could ensure a promotion of 0.171 (range from 0.060 to 0.245) in median AUC, and a promotion of 40.8% (16.0% to 52.2%) in sensitivity at a FPR of 10%. Based on the simple models, additional mean arterial pressure (MAP) would increase the AUC and sensitivity by 0.092 (0.079 to 0.104) and 28.7% (16.2% to 55.0%), respectively, while additional uterine artery pulsatility index (UtA-PI) would bring an increase of 0.106 (0 to 0.137) and 31.8% (-1.0% to 41.9%), respectively. Moreover, when both MAP and UtA-PI were included into the simple models, the AUC and sensitivity would increase by 0.157 (0.094 to 0.218) and 31.6% (12.0% to 52.2%).@*Conclusions@#Complex prediction models perform better than simple models in prediction of early-onset preeclampsia. However, further confirmation is required in different population.
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Objective To evaluate the characteristics and performance of various prediction models for early-onset preeclampsia,and to provide a reference for further study of preeclampsia prediction methods.Methods (1) Databases of PubMed,Medline,Embase,China National Knowledge Infrastructure (CNKI) and Wanfang Database were searched since their inception to October 2016.Studies in models for predicting earlyonset preeclampsia during the first trimester were included.(2) Two reviewers independently checked potentially eligible articles,assessed risk of bias and extracted data.(3) Subtotals for the performance of different models were created and their properties were analyzed.Differences between simple models (based upon high risk factors such as demographic figures,medical history and family history,etc) and complex models (based upon blood pressure,uterine artery Doppler and biomarkers) were compared by analyzing forest plot created by SAS 9.4.Results (1) Seventeen studies met the inclusion criteria were screened out,including nine prospective cohort studies,two case-control studies and six nested case-control studies.A total of 76 436 gravidas from tendifferent populations were assessed by the established models in these studies.(2) The area under the curve (AUC) of 13 simple models ranged from 0.64 to 0.81 with the sensitivity of 21％-60％ when the false positive rate (FPR)was 10％.The AUC of 17 complex models ranged from 0.77 to 0.98 and the sensitivity was between 48.0％ and 95.2％ at a fixed FPR of 10％.(3) Compared with the simple models,the best complex models could ensure a promotion of 0.171 (range from 0.060 to 0.245) in median AUC,and a promotion of 40.8％ (16.0％ to 52.2％) in sensitivity at a FPR of 10％.Based on the simple models,additional mean arterial pressure (MAP) would increase the AUC and sensitivity by 0.092 (0.079 to 0.104) and 28.7％ (16.2％ to 55.0％),respectively,while additional uterine artery pulsatility index (UtA-PI) would bring an increase of 0.106 (0 to 0.137) and 31.8％ (-1.0％ to 41.9％),respectively.Moreover,when both MAP and UtA-PI were included into the simple models,the AUC and sensitivity would increase by 0.157 (0.094 to 0.218) and 31.6％ (12.0％ to 52.2％).Conclusions Complex prediction models perform better than simple models in prediction of early-onset preeclampsia.However,further confirmation is required in different population.
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Objective To explore the immunopathological mechanism for the imbalance between the positive signal mediated by inducible costimulator (ICOS) and the negative signal mediated by programmed death-1 (PD-1) in patients with myasthenia gravis (MG).Methods Eighty-two patients with MG,56 healthy controls (HC) and 20 non-MG (NMG) patients,collected in the First Affiliated Hospital of Suzhou University from February 2014 to December 2016,were chosen to participate in the study.The expression of ICOS and PD-1 on peripheral blood mononuclear cells was detected by immuno-fluorescence staining and flow cytometry.The levels of soluble programmed death-1 (sPD-1),soluble programmed death ligand 1 (sPD-L1),IL-4 and other cytokines were detected by enzyme-linked immunosorbent assay.Results (1) Flow cytometry analysis:The co-expression of PD-1,ICOS on CD4 + T cells from MG group (9.64％ (8.82％)) was higher than in HC (1.81％ (2.10％),Z =-7.389,P ＜0.05) and NMG group (2.86％ (1.49％),Z =-4.636,P ＜ 0.05).The expression of ICOS on CD4 + T cells,ICOS ligand (ICOSL) on CD14+ monocytes and CD19+ B cells were increased in MG group comparing with that of the control groups.The proportion of PD-1 + CD4 + T cells (MG group 16.82％ (10.66％),HC 9.34％ (9.18％),Z =-4.345,P＜0.05;NMG group 7.07％ (3.40％),Z=-4.594,P＜0.05) and PD-1 Ligand (PD-L1) + CD14+ monocytes was higher in MG patients.All of these were detected by flow cytometry.(2) ELISA analysis:Serum sPD-1 expression significantly increased in MG group compared with that in the control groups (MG group (1.87 ± 0.64) ng/ml,NMG group (1.49 ± 0.70) ng/ml,t =2.04,P ＜ 0.05;HC (1.05 ± 0.50)ng/ml,t =2.08,P ＜ 0.05),while for serum sPD-L1,there was no significant difference between MG and control groups.(3) Serum cytokines detection:The expression of IL-4 was increased in MG patients (MG group (61.88 ±5.15) pg/ml,HC (32.03 ±1.84) pg/ml,t=2.50,P＜0.05;NMG group (42.62± 3.31) pg/ml,t =2.34,P ＜0.05),and there was a negative correlation between the expression of sPD-1 and the concentration of IL-4.Conclusions The increased expression of PD-1 + ICOS + CD4 + T cells suggested the subset involved in the pathological progress of MG.sPD-1 might disturb the ligation of PD-1 on T cells and PD-L1 on antigen presenting cells,while the ligation of ICOS and ICOSL passed positive signal,leading to over activity of the subsets and the progression of disease.
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Objective To investigate the effects ofpravastatin on the expression ofmicroRNA-155 (miR-155) and the functions of lipopolysaccharide (LPS)-treated extravillous trophoblast cells.Methods In vitro cultured HTR-8/SVneo cells were divided into the following groups:control group,enhanced plasmid with green fluoscent protein (pEGFP)-miR-155 group (transfected with green fluorescent protein-tagged miR-155),LPS group (treated with 100 ng/mL of LPS),miR-155 inhibitor+LPS group,pravastatin+LPS group (treated with 100 ng/mL of LPS following pretreatment with 12.50,25.00,50.00 and 100.00 μ g/ml of pravastatin),and pravastatin+pEGFP-miR-155 group (transfected with pEGFP-miR-155 following pretreatment with 50 μ g/ml of pravastatin).Levels of miR-155 in HTR-8/SVneo cells treated with different strategies were measured by real-time polymerase chain reaction.Expression of phosphorylated JunB (p-JunB) and p-FosB proteins was analyzed by Western blotting.Migration,invasion and apoptosis of HTR-8/SVneo cells were also analyzed.All data were analyzed with t test.Results (1) Compared with the control group,HTR-8/SVneo cells in the pEGFP-miR-155 group were characterized by shorter migration distance [(274.70± 18.82) vs (181.00±8.62) μ m],less transmembrane cells [(123.00±4.36) vs (63.00±6.08)] and enhanced apoptosis [(5.40± 0.68)％ vs (9.27±0.68)％] (all P＜0.05).(2) Compared with the LPS group,the miR-155 inhibitor+LPS group showed longer migration distance of HTR-8/SVneo cells [(166.30±5.07) vs (242.00±18.07) μm,P＜0.05],more transmembrane cells [(71.67±6.12) vs (109.00±7.81),P＜0.05] and decreased cell apoptosis [(14.40±1.69)％ vs (6.23± 0.44)％,P＜0.05].(3) Expression of miR-155 at mRNA level in the LPS group was increased as compared with that of the control group (1.65 0.07 vs 0.79±0.12,P＜0.05).Compared with the LPS group,pretreatment with 12.50,25.00,50.00 and 100.00 μ g/ml of pravastatin decreased the expression of miR-155 at mRNA level [(1.14±0.10),(1.02±0.10),(0.74±0.15) and (1.140.02)],especially at the concentration of 50 μμ g/ml (all P＜0.05).(4) Expression ofp-JunB and p-FosB proteins in the control,LPS and pravastatin (50 μ g/ml)+LPS groups were (0.33 ±0.06) vs (0.37±0.07),(1.22±0.20) vs (0.80±-0.13),and (0.31 ±0.02) vs (0.21 ±0.05),respectively,showing higher expression level in both p-JunB and p-FosB proteins in the LPS group compared with that of the other two groups (all P＜0.05).(5) Compared with the LPS group,the pravastatin (50 μμ g/ml)+LPS group showed increased migration distance [(166.30±5.07) vs (246.80± 13.42) μ m,P＜0.05],increased numbers of transmembrane cells [(71.67 ± 6.12) vs (95.33 ± 2.73),P＜0.05] and decreased cell apoptosis [(14.40± 1.69) vs (6.05 ± 0.35)％,P＜0.05].(6) Compared with the pEGFP-miR-155 group,the pravastatin (50.00.00 μμ g/mL)+pEGFP-miR-155 group showed longer migration distance [(197.50± 13.86) vs (275.80± 13.63) μ m,P＜0.05],more transmembrane cells [(52.67±5.49) vs (125.00±6.66),P＜0.05] and lower rate of cell apoptosis [(8.90± 1.00) vs (5.05±0.35)％,P＜0.05].Conclusions Pretreatment of extravillous trophoblast cells with pravastatin can protect them from apoptosis and loss of migratory and invasive abilities through inhibiting the activation of AP-1 and down-regulating the expression of miR-155,which may be a mechanism that inhibits the development of preeclampsia.
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OBJECTIVE:To explore the effects of alendronate sodium on bone mineral density (BMD) and bone marker in prostate cancer elderly patients after medical castration therapy. METHODS:In perspective study,84 elderly patients undergoing medical castration therapy were selected and divided into treatment group(45 cases)and control group(39 cases)according to ran-dom number table. Control group received medical castration therapy+Calcium carbonate D3 tablets,1 tablet,po,qn;treatment group was additionally given Alendronate sodium tablets 70 mg,po,once a week,1 week after routine treatment,on the basis of control group. Treatment course of 2 groups lasted for 12 months. The levels of 25-OH-D,testosterone,BMD and bone marker were observed in 2 groups,and the occurrence of ADR was recorded. RESULTS:3 cases of treatment group and 1 case of control group dropped out of the study. Before treatment,there was no statistical significance in above indexes between 2 groups (P>0.05). After treatment,25-OH-D levels of 2 groups were increased slightly,but there was no statistical significance(P>0.05);tes-tosterone level of 2 groups were decreased significantly compared to before treatment,with statistical significance (P0.05). CONCLUSIONS:Alendronate sodium can prevent bone loss and reduce the rate of bone turnover in elderly patients with prostate cancer receiving medical castration therapy.
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BACKGROUND:Bone marrow mesenchymal stem cel s have a close relationship with tumor occurrence and development, which are not only involved in tumor recruitment but impact the biological behavior of tumor cel s. OBJECTIVE:To investigate the effect of bone marrow mesenchymal stem cel s on the biological behavior prostate cancer cel line. METHODS:Human bone marrow mesenchymal stem cel s from healthy adults were col ected and cultured in vitro. Cel morphology and cel markers were observed. Using the Transwel technique, human dermal fibroblasts HDF-a were co-cultured with human prostate carcinoma DU145 cel s in positive control group, wild-type prostate carcinoma DU145 cel s cultured alone in negative control group, and bone marrow mesenchymal stem cel s co-cultured with human prostate carcinoma DU145 cel s in experimental group. Flow cytometry assay was used to detect the cel cycle of prostate carcinoma DU145 cel s, soft agar colony formation assay performed to detect cel proliferative ability, and crystal violet staining used to observe DU145 cel migration at 3 days after culture. RESULTS AND CONCLUSION:Compared with the negative control group, cel proportion at G 2/M+S phase, number of transmembrane cel s and colony counting were significantly decreased in the experimental group. These findings indicate that bone marrow mesenchymal stem cel s may inhibit the proliferation and invasion of prostate carcinoma DU145 cel s by shortening the G 2/M+S phase, thereby providing a new insight into the treatment of human prostate cancer.
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Objective To explore the operating skills of finding and dissecting renal pedicle in retroperitoneosocpic radical nephrectomy.Methods From April 2011 to April 2015,224 patients with renal tumors were treated by retroperitoneosocpic radical nephrectomy.Along the ureteral ascending methodis used to find renal pedicle for 126 cases(the research group):First found ureter in the iliac crest,the ureter was nearest psoas major here and waseasy to find.Along the ureteral upward until to the renal pelvis and the superior border of renal pelvis is the renal pedicle.77 male and 49 female cases,Age 42 to 84 years,(56.6 ± 9.0) years old on average.Sixty-nine tumors were located in left kidney,and 59 in the right kidney.The mean diameter of renal tumor was(5.3 ± 1.1)cm.There were 25 cases of T1a N0 M0,75 T1b N0 M0,23 of T2 N0 M0,3 of T1bN1M0.Over the same period uplift in he kidney central method is used to find renal pedicle for 98 cases.64 male and 34 female cases,Age 27 to 81 years,(57.9 ± 8.3)years old on average.52 tumors were located in left kidney,and 46 in the right kidney.The mean diameter of renal tumor was (5.5 ± 1.4)cm.There were 19 cases of T1aN0M0,61 T1bN0M0,16 of T2N0M0,2 of T1bN1 M0.Results The differences were significant for Looking for renal pedicle time(2.2 ± 1.1 vs.4.5 ±2.0) min,operation time (73.7 ±67.3 vs.90.1 ±87.5)min,hemorrhage volume(69.8 ±42.7 vs.89.7 ±89.2) ml,the incidence of complications (3 vs.9) between the study group and the control group (P ＜ 0.05).The difference were not significant in postoperative hospital stay (7.5 ± 0.8 vs.7.3 ± 0.8) d,exhaust time (2.1 ± 0.6 vs.2.2 ± 0.6) d between two group.All the operations were performed successfully in the research group,with no conversion to open and transfusion.Major complications included 3 cases of vessel injury.Hemostasis was performed with metal clips and suture.In the control group,ena cava rupture in 3 cases,left lumbar veins rupture in 3 cases,retroperitoneal hematoma in 2 case,mild pulmonary embolism in 1 case.two case performed open operation owing to vena cava rupture.The vena cava rupture transit open surgery in 2 cases,and Hemostasis was performed with metal clips in 1 case of vena cava rupture and on the left side of the lumbar veins rupture was managed by suture,titanium clips and bipolar electrocautery;Retroperitoneal hematoma improved by conservative treatment;Pulmonary embolism improved by medical consultation after thrombolysis.Conclusions Retroperitoneosocpic radical nephrectomy with the method of along the ureteral ascending was safe and could quickly locate and ligate the renal pedicle,and shorten operation time,reduce postoperative complications.
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Objective To investigate the reliability and validity of Simple Facial Grading System (SFGS) in patients with idiopathic fa-cial palsy. Methods 80 patients with idiopathic facial palsy were evaluated with the House-Brackmann (H-B) scale and SFGS before and ev-ery 2 weeks after treatment until 12 weeks or recovery. They were assessed by 2 testers before and 2 weeks after treatment. The results were analyzed and compared. Results The Cronbach'sαcoefficient was 0.93 of SFGS, and 0.74 of H-B scale. The intraclass correlation coeffi-cient (ICC) between testers was 0.84 or higher of SFGS, and 0.77 or higher of H-B scale. The Spearman's rank correlation coefficient be-tween SFGS and H-B scale was 0.73, Kappa coefficients was 0.81 for grade II, 0.74 for grade III, 0.49 for grade IV, 0.66 for grade V, and 0.92 for grade VI. The scores of SFGS and H-B scale positively correlated with the recovery time. Conclusion SFGS is a kind of evaluation for peripheral facial paralysis with satisified reliability and validity, which can be applied to evaluate the severity and outcome during acute stage.
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@#Objective To investigate the reliability and validity of Simple Facial Grading System (SFGS) in patients with idiopathic facial palsy. Methods 80 patients with idiopathic facial palsy were evaluated with the House-Brackmann (H-B) scale and SFGS before and every 2 weeks after treatment until 12 weeks or recovery. They were assessed by 2 testers before and 2 weeks after treatment. The results were analyzed and compared. Results The Cronbach's α coefficient was 0.93 of SFGS, and 0.74 of H-B scale. The intraclass correlation coefficient (ICC) between testers was 0.84 or higher of SFGS, and 0.77 or higher of H-B scale. The Spearman's rank correlation coefficient between SFGS and H-B scale was 0.73, Kappa coefficients was 0.81 for grade II, 0.74 for grade III, 0.49 for grade IV, 0.66 for grade V, and 0.92 for grade VI. The scores of SFGS and H-B scale positively correlated with the recovery time. Conclusion SFGS is a kind of evaluation for peripheral facial paralysis with satisified reliability and validity, which can be applied to evaluate the severity and outcome during acute stage.
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@#Objective To investigate the reliability and validity of Simple Facial Grading System (SFGS) in patients with idiopathic facial palsy. Methods 80 patients with idiopathic facial palsy were evaluated with the House-Brackmann (H-B) scale and SFGS before and every 2 weeks after treatment until 12 weeks or recovery. They were assessed by 2 testers before and 2 weeks after treatment. The results were analyzed and compared. Results The Cronbach's α coefficient was 0.93 of SFGS, and 0.74 of H-B scale. The intraclass correlation coefficient (ICC) between testers was 0.84 or higher of SFGS, and 0.77 or higher of H-B scale. The Spearman's rank correlation coefficient between SFGS and H-B scale was 0.73, Kappa coefficients was 0.81 for grade II, 0.74 for grade III, 0.49 for grade IV, 0.66 for grade V, and 0.92 for grade VI. The scores of SFGS and H-B scale positively correlated with the recovery time. Conclusion SFGS is a kind of evaluation for peripheral facial paralysis with satisified reliability and validity, which can be applied to evaluate the severity and outcome during acute stage.
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Objective To observe the clinical efficacy of beraprost sodium on early stage of diabetic nephropathy(DN).Methods We measured serum levels of serum soluble intercelluhar adhesion molecule (sICAM)-1 in 27 cases with diabetes without nephropathy and 48 cases with early DN.Patients with early DN were randomly assigned into two treatment groups:the conventional treatment group and the beraprost sodium treatment group.Changes of sICAM-1 and C-reactive protein (CRP) levels and urinary albumin excretion rate (UAER) were measured in the two groups before and after treatment.Results The serum sICAM-1 levels in early DN patients was significantly higher than that of the diabetes without nephropathy group((1385 ± 171) g/ Lvs.(943 ± 167) g/L;t =1.034,P =0.002).There were no significant difference observed on levels of sICAM-1,CRP and UAER between the two treatment groups (P ＞ 0.05).The level of sICAM-1 and CRP in the beraprost sodium treatment group was significantly lower than those before treatment (P ＜ 0.05 or P ＜ 0.01).The symptoms were significantly alleviated in both groups (P ＜ 0.05 or P ＜ 0.01),especially for the beraprost sodium treatment group(P ＜ 0.05 or P ＜ 0.01).Conclusion Patients with early DN have elevated serum sICAM-1 levels.Treatment of beraprost sodium has protective effect on early DN as it significantly decreases the serum levels of sICAM-1 and CRP in patients with early DN.