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Objective:To prospectively guide the change of chemotherapy regimen in mouse 5-fluorouracil (5-FU) resistance subcutaneous xenograft tumor model derived from gastric cancer patients by the early changes of MRI apparent diffusion coefficient (ADC), and to compare the difference of tumor load between ADC guided dressing change group and volume guided dressing change group.Methods:From January to June 2020, thirty patient-derived xenografts mouse models were established using 5-FU resistant gastric cancer cells coming from patients, and were randomly divided into experimental group and control group by AdaBoost algorithm, with 15 mice in each group. On the 26th day after transplantation, all mice began chemotherapy with 5-FU as the first-line chemotherapy drug, and underwent MR examination once every two days, including T 2WI and diffusion weighted imaging (DWI). Volumes of tumors were measured using an open-source software ITK-SNAP and values of ADC were measured on ADC maps. According to the change rate of tumor ADC value in the experimental group and the tumor volume growth rate in the control group, the replacement time of chemotherapy drugs was determined, and 5-FU was replaced by paclitaxel. The end point of the experiment was the day that the mice entered the cachexia state. Independent-sample t test was used to compare the difference of tumor load between the two groups. Results:After 5-FU treatment, the ADC value of the two groups both increased. The ADC value began to decline on the 4th day after chemotherapy, and the experimental group continued chemotherapy with paclitaxel instead of 5-FU at this time point. The tumor volume growth rate of the control group increased significantly on the 6th day after chemotherapy (from 8.6% to 16.1%), and the control group used paclitaxel instead of 5-FU chemotherapy at this time point. The observed end point was on the 18th day after chemotherapy. The tumor load of the experimental group [(1.82±0.09) cm 3] was lower than that of the control group [(2.01±0.09) cm 3], and the difference was statistically significant ( t=2.25, P=0.033). On the 16th day after chemotherapy in the experimental group and the 18th day after chemotherapy in the control group, the time of paclitaxel administration in both groups was 12 days. The tumor load in the experimental group [(1.61±0.12) cm 3] was also lower than that in the control group [(2.01±0.09) cm 3], and the difference was statistically significant ( t=2.03, P=0.040). Conclusions:For the subcutaneous transplantation model of 5-FU resistant gastric cancer mice, according to the early changes of tumor ADC value after chemotherapy, the replacement of chemotherapy drugs can obtain a lower tumor load, suggesting that it is a feasible method to optimize the chemotherapy regimen.
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Chronic hepatitis B virus (HBV) infection remains a global health burden. Timely and effective antiviral therapy is beneficial for patients with HBV infection. With existing antiviral drugs, including nucleos(t)ide analogs and interferon-alfa, patients can achieve viral suppression with improved prognosis. However, the rate of hepatitis B surface antigen loss is low. To achieve a functional cure and even complete cure in chronic hepatitis B patients, new antivirals need to be developed. In this review, we summarized the advantages and disadvantages of existing antiviral drugs and focused on new antivirals including direct-acting antiviral drugs and immunotherapeutic approaches.
Subject(s)
Humans , Antiviral Agents/therapeutic use , Hepatitis B/drug therapy , Hepatitis B Surface Antigens , Hepatitis B virus , Hepatitis B, Chronic/drug therapy , Hepatitis C, Chronic/drug therapyABSTRACT
Objective:By improving the lacrimal passage irrigation equipment for infants and young children, a new type of irrigation technology system was established during the nursing process of infantile dacryocystitis washing, and the effect was evaluated.Methods:A total of 3 000 children with dacryocystitis from January 2017 to September 2019 in ophthalmology clinic were collected, and they were randomly divided into the observation group and the control group by the random number table method with 1 500 cases in each group. The observation group used a new lacrimal passage flushing system, and the control group used the traditional lacrimal passage flushing system. The nursing effect, the incidence of complications, the satisfaction of the family members of the children and the operator satisfaction were compared between the two groups.Results:The cure rate after re-rinsing and secondary irrigation was 96.93%(1 201/1 527), 78.95%(30/38) in the observation group, and 84.36%(1 009/1 196), 50.80%(95/187) in the control group, the difference was statistically significant( P<0.01). The incidence of dacryocystitis in infants and young children was 0.27% (4/1 500)in the observation group, and 5.00% (75/1 500)in the control group, the difference was statistically significant( χ2 value was 11.536, P<0.01). The total satisfaction rate of children in the observation group was 98.14% (1 472/1 500), which was higher than the control group′s total satisfaction rate of 91.93% (1 397/1 500), and the difference was statistically significant ( χ2 value was 12.018, P<0.01). The total satisfaction rate of operators in the observation group was 98.00% (1 470/1 500), which was higher than the total satisfaction rate of operators in the control group by 90.87% (1 363/1 500), and the difference was statistically significant ( χ2 value was 12.598, P< 0.01). Conclusions:The application of the improved new lacrimal irrigation system for infants and young children can effectively improve the cure rate of infantile dacryocystitis, reduce the occurrence of complications, and improve the satisfaction of family members and operators. It is worthy of clinical promotion.
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Objective To explore diagnostic value of multi-slice spiral CT imaging features with respect to pancreatic neuroendocrine tumors (pNET) of different histological grades. Methods A retrospective analysis of preoperative abdominal plain CT and dual-phased contrast-enhanced CT was performed in 21 patients (median age, 47 years;12 males and 9 females) with pathologically proven pNET. age, gender, endocrine function, location and size of lesion, cystic change or necrosis, completeness of capsule, calcification, dilation of pancreatic duct were evaluated.CT attenuation-related parameters (plain CT value, relative density index, and CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase) of each tumor were measured or calculated. All tumors were pathologically classified into three histological grades (G1, G2 and G3) based on mitotic count and ki-67 index. Kruskal-Wallis test was performed to compare differences of age, gender, endocrine function, morphological features among different grades. CT attenuation-related parameters were evaluated using Kruskal-Wallis or one-way analysis of variance (ANOVA). Results Twenty four pNET foci [grade G1 (n=13), G2 (n=7) and G3 (n=4)] were seen in the 21 patients. The difference of age, gender among different grades demonstrated no statistical significance (P>0.05). Nine lesions of G1 and 1 lesion of G2 demonstrated endocrine function, and the difference of endocrine function among three grades was statistically significant (χ2=8.355,P=0.012). For G1, G2 and G3, 11, 5 and 2 lesions were seen in uncinate process, pancreatic head and neck, respectively while 2, 2 and 2 lesions in pancreatic body and tail, respectively. The median maximum diameter of pNET of G1, G2 and G3 was 1.5, 2.5 and 6.7 cm, respectively;For G1, G2 and G3, 13, 4 and 0 lesions demonstrated intact capsule, respectively while 2, 3, and 3 lesions cystic degeneration and necrosis, respectivel; 0, 2 and 2 lesions calcification,respectively, 0, 1 and 2 lesions dilation of pancreaticobiliary duct, respectively, 0, 1 and 4 lesions sign of malignancy, respectively. The difference of size of lesion, completeness of capsule, calcification, and dilation of pancreatic duct showed statistical significance (P0.05). In addition, pNET of different grades demonstrated similar density and relative density index on plain CT. Regarding CT value, CT value difference, enhanced percentage and enhancement index on arterial and portal phase, the pNET of G2 showed highest value, while pNET of G3 lowest value, however, the difference about CT attenuation-related parameters among three grades showed no significant difference (P>0.05). Conclusion pNET of different histologic grades have some specific CT imaging features, which can facilitate an accurate diagnosis of pNET prior to therapy.
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Objective To discuss the short-term results of tricuspid valve annuloplasty with prosthetic ring.Methods Tricuspid valve annuloplasty with prosthetic ring was performed in 34 patients with organic or functionaltricuspid valve insufficiency. At the same time atrial septal defect and ventrieular septal defect were closed valve re-placement was done. Results There was no in-hospital death. Echocardiography was done about one week after oper-ations,which showed that fight ventricle or pulmonary artery were smaller than that before operation in all patients andresidual tricuspid valve insufficiency was found mild in 11 cases, moderate in 2 cases. Conclusion Tricuspid valveannuloplnsy should be performed in patients with organic or functional tricuspid valve insufficiency. Better short-termresults may be got when prosthetic ring was used to small tricuspid annulus.
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<p><b>OBJECTIVE</b>To explore the synergic effect of heparan sulfate (HS) and cytokines on the growth of human umbilical cord blood (UCB) hematopoietic cells.</p><p><b>METHODS</b>Hematopoietic cells from human UCB were cultured with (1) cytokines (rhIL-3, rhIL-1beta, rhIL-6 and SCF) or (2) SN (supernatant from cultured human marrow stromal cells) and cytokines, or (3) SN, or (4) HS and cytokines. Cellular proliferation, CFU-GM yields and changes of cell immunophenotype were observed.</p><p><b>RESULTS</b>Hematopoietic cell proliferation reached peak at the 14th day. The number of total nucleated cells increased 134.5-, 171.3-, 81.5- and 167.2-fold in (1), (2), (3) and (4) groups, respectively, at the 21th day, the (3) group significantly decreased. CD(34)(+) cells increased at the 7th day and reached peak, at the 14th day with a percentage of 68.4%, 82.5%, 69.8% and 79.3%, and at the 21th day 56.2%, 71.7.%, 12.3% and 73.3%, respectively. CD(33)(+) cells reached peak at the 14th day and increased by 80.2%, 68.6%, 81.6% and 70.3%, respectively, and remained these levels at the 21th day. CD(38)(+) cells increased by 66.6%, 73.8%, 70.4% and 71.9% at the 7th day and remained this level at the 14th and the 21th day. From the first week of culture, the percentage of CFU-GM increased in all of the four groups, at the second week of culture, it increased by 250%, 279%, 217% and 273%, and at the third week still increased by 151%, 240%, 145% and 231%, respectively.</p><p><b>CONCLUSION</b>The combination of SN and cytokines have a synergic effect in promoting proliferation of hematopoietic cell from human UCB. The synergic effect remained the same when SN was replaced by heparan sulfate.</p>