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ObjectiveTo investigate the expression of lysophosphatidic acid （LPA） in patients with liver cancer， as well as its influence on malignant biological behavior of liver cancer and related regulatory mechanism. MethodsFrom January 2016 to December 2022， 26 patients with liver cancer， 28 patients with liver cirrhosis， and 28 individuals undergoing physical examination were enrolled. ELISIA was used to measure the content of LPA in plasma and peritoneal effusion of the patients with liver cancer or liver cirrhosis accompanied by peritoneal effusion， and the content of LPA was measured in plasma of the normal population at the same time， so as to clarify the difference in the expression of LPA in different populations， such as the patients with liver cancer and those with liver cirrhosis. MTT cell proliferation assay and cell migration assay were used to observe the influence of LPA and its inhibitor pertussis toxin （PTX） on the proliferation， migration， and invasion of SMMC7721 cells. In order to investigate the effect of LPA on the expression of RhoA and its upstream and downstream molecules FAK and P53 after binding to its receptor， qPCR and Western blot were used to observe the effect of LPA on the mRNA and protein expression levels of P53， FAK， and RhoA in SMMC7721 cells. A one-way analysis of variance was used for comparison of the means of continuous data between multiple groups， and the SNK-q test was used for comparison between two groups. ResultsCompared with the patients with liver cirrhosis， the patients with liver cancer had a significantly higher concentration of LPA in plasma （4.99±0.55 μmol/L vs 2.63±0.43 μmol/L， P<0.05） and peritoneal effusion （5.19±0.63 μmol/L vs 2.91±0.46 μmol/L， P<0.05）， and the patients with liver cancer also had a significantly higher level of plasma LPA than the normal population （4.99±0.55 μmol/L vs 1.61±0.39 μmol/L， P<0.05）. The cell proliferation assay showed that LPA significantly promoted the proliferation of SMMC7721 cells， and cell proliferation rate increased with the increase in dose and time； in particular， the middle-and high-dose groups had a significantly higher proliferation rate than the control group （P<0.05）. PTX inhibited the proliferative capacity of SMMC7721 cells in a time-dependent manner， and there was a significant difference between the groups （P<0.05）. The proliferation rate of the 72-hour high-dose LPA group was 3.6 times that of the control group， while the proliferation rate of the PTX group was 0.6 times that of the control group； the proliferation rate of the 72-hour high-dose LPA+PTX group was 1.2 times that of the control group. In addition， LPA increased the migration ability of hepatoma cells， while PTX inhibited their migration， in a time-dependent manner， and there was a significant difference between the groups （P<0.05）. The migration rate of the 72-hour high-dose LPA group was 3.09 times that of the control group， while the migration rate of the PTX group was 0.4 times that of the control group； the migration rate of the 72-hour high-dose LPA+PTX group was 0.99 times that of the control group. qPCR and Western blot showed that there were significant reductions in the mRNA and protein expression levels of P53 in SMMC7721 cells after LPA treatment， while there were significant increases in the mRNA and protein expression levels of FAK and RhoA； there was a significant difference between the LPA group and the control group （P<0.05）. ConclusionThere is an abnormal increase in the expression of LPA in patients with liver cancer， and LPA can promote the proliferation of liver cancer cells and increase their migration ability. At the same time， LPA changes the expression levels of P53， FAK， and RhoA， which may be associated with the promotion of tumor development and progression by LPA.
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OBJECTIVE:To compare clinical efficacy and safety of budesonide and beclometasone assisting with terbutaline by atomization inhalation in the treatment of acute pediatric asthma attack. METHODS:150 pediatric patients with acute asthma attack were randomly divided into group A and group B,with 75 cases in each group. Both group received symptomatic support treatment as low-flow oxygen inhalation,eliminating phlegm,relieving a cough,dilating bronchus and anti-infection,and atomization inhala-tion of budesonide,1 ml each time,bid. Based on this,group A was given atomization inhalation of budesonide,2 ml each time, bid;group B was given atomization inhalation of beclometasone,2 ml,bid. Treatment course of 2 groups lasted for 7 d. Clini-cal efficacy,asthma control,PEF% and the occurrence of ADR were observed in 2 groups;the time of symptoms and signs dis-appearance and hospitalization time were recorded,and symptoms and signs of children were scored 1 day before treatment and 7 days after treatment. RESULTS:During treatment,2 cases and 3 cases were withdraw from the test in group A and group B, respectively. The total effective rates of group A and B were 91.78% and 94.44%,and the rate of asthma control 95.89% and 94.44%,without statistical significance(P>0.05). The time of breathing difficulties disappearance,cough disappearance time, wheezing disappearance time and hospitalization time of group A were separately (2.11 ± 0.54),(3.28 ± 0.93),(4.38 ± 1.05), (5.83±1.29)d;those of B group were separately(2.07±0.52),(3.30±0.96),(4.45±1.08),(5.90±1.33)d,there was no sig-nificant difference between 2 groups(P>0.05). The clinical symptoms and signs score of group A before and after treatment were separately (4.28 ± 0.94) and (0.15 ± 0.04);those of before and after treatment of group B were separately (4.23 ± 0.91) and(0.11±0.03). There was significant difference before and after treatment(P0.05). The PEF% of group A before and after treatment were separately (51.4 ± 9.8)% and (67.2 ± 11.2)%;those of before and after treatment of group B were separately(52.0±7.1)%and(68.3±8.7)%. There was significant difference before and after treatment (P0.05). No obvi-ous ADR was found in 2 groups. CONCLUSIONS:Budesonide and beclometasone assisting with terbutaline by atomization inha-lation in the treatment for acute pediatric asthma attack possess the same effects and can efficiently relieve symptoms and signs, increase the rate of asthma control and shorten the rehabilita-tion course with good safety.
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Objective To investigate the synergistic efficacy of different antibiotic combinations against KPC-2 carbapenemase producing Klebsiella pneumoniae strains in vitro and search for effective antibiotic combination.Methods During 2008 - 2009,a total of 24 strains of K.pneumoniae producing KPC-2 carbapenemase were collected from 8 hospitals in the First Affiliated Hospital of Medical School of Zhejiang University,Ningbo LiHuiLi Hospital,Zhejiang People's Hospital,Hangzhou Third Hospital,the Second Hospital of Shaoxing,Hangzhou First Hospital,Fudan University Huashan Hospital,General Hospital of Nanjing Military Region.MLST technique was used for epidemiological analysis.The MIC of antibiotics,such as amikacin,minocycline,imipenem,amoxicillin/clavulanic-acid,ceftazidime,meropenem,gentamicin,cefoxitin,cefepime,rifampicin,polymyxinB,ciprofloxacin were determined by an agar dilution method,the MIC of tigecycline and piperacillin/tazobactain were determined by Etest.The antibacterial activities of cefepime in combination with amoxicillin/clavulanic-acid,amikacin,or ciprofloxacin,amikacin with ciprofloxacin,imipenem with amikacin,ciprofloxacin,polymyxinB,or minocycline,polymyxin B with rifampicin,ceftazidime with amoxicillin/clavulanic-acid were assessed by chequerboard synergy agar dilution tests against all the isolates.Results MLST showed 5 STs among 24 strains of KPC-2 carbapenemase producing K.pneumoniae,and the most prevalent clone was ST11 (15 strains).All isolates were susceptible to polymyxin B and tigecycline,and the resistance rate of minocycline was 4.2％.The synergetic effects were observed in cefepime-amoxicillin/clavulanic acid,imipenem-amikacin,ceftazidime-amoxicillin/clavulanic acid combinations as 19 isolates,13 isolates,and 13 isolates,respectively.Conclusions KPC-2 carbapenemase producing K.pneumoniae is sensitive to polymyxin B,tigecycline and minocycline.The synergetic effect is predominant in cefepime-amoxicillin/clavulanic acid,imipenem-amikacin ceftazidime-amoxicillin/clavulanic acid combinations in vitro,their clinical efficacy are worthy of further observation.