ABSTRACT
BACKGROUND: Blood hemoperfusion with resin adsorption can clean larger molecules that exceed the molecular weight cutoff of combined continuous veno-venous hemofiltration (CVVH). Hence blood hemoperfusion with resin adsorption combined CVVH (HP+CVVH) has higher ability of mediator clearance, and can improve clinical outcomes in theory. This study aimed to investigate the effect of blood hemoperfusion with resin adsorption combined continuous veno-venous hemofiltration (HP+CVVH) on plasm cytokines like TNF-α, IL-1β, IL-6, cellular immunity and prognosis in patients with multiple organ dysfunction syndrome (MODS). METHODS: This was a prospective, randomized clinical trial. A total of 30 patients who had been diagnosed with MODS were enrolled in this study. Patients were randomly allocated to routine treatment+HP+CVVH group (treatment group) and routine treatment+only CVVH group (control group). In the treatment group, patients received blood hemoperfusion with resin adsorption for 2 hours, and then received CVVH for 10 hours every day. In the control group, patients received CVVH for 12 hours only every day. The patients in the two groups received blood purification therapy for three days. The plasma of patients in the treatment group was obtained at 0, 2, 12, 24, 26, 36, 48, 50, 60 hours, 5th day, 7th day and 10th day, respectively. The plasma of patients in the control group was obtained at 0, 12, 24, 36, 48, 60 hours, 5th day, 7th day and 10th day, respectively. APACHE II score, T-lymphocytes subpopulations, blood lactate acid concentration, heart rate, breathing rate, and oxygenation index were observed. RESULTS: Plasma cytokines like TNF-α, IL-1β, IL-6 decreased markedly after HP (P<0.01);T-lymphocytes subpopulations CD3+, CD4+, CD8+, CD4+/CD8+ increased after HP+CVVH or only CVVH. The plasma concentrations of TNF-α, IL-1β and IL-6 in the two groups were not markedly different at 12, 36, and 50 hours. But on the 5th day, the plasma concentrations of TNF-α, IL-1β and IL-6 in the treatment group were lower than those in the control group (P<0.05). On the 28th day, 5 patients died in the treatment group, and 6 patients in the control group. CONCLUSIONS: Both HP+CVVH and CVVH can clean plasma cytokines like TNF-α, IL-1β, and IL-6, and improve cellular immunity and clinical symptoms and signs of patients. Compared with only CVVH, the plasma concentrations of TNF-α, IL-1β and IL-6 were lower on the 5th day, and patients have an increased survival rate on the 28 day in the HP+CVVH group.
ABSTRACT
<p><b>BACKGROUND</b>Glioma is the most common type of malignant brain tumor and the prognosis of glioma is still poor. Moreover, the prognosis of patients diagnosed with grade III gliomas varies significantly. In this study, we assessed the factors that contribute to the prognosis of patients with grade III gliomas.</p><p><b>METHODS</b>Data from 97 patients with grade III glioma who received surgery from 2000 to 2005 were included in this study. Kaplan-Meier survival analysis and Cox regression analysis were used to analyze the prognostic effects of 16 different factors selected from clinical characteristics, results from neuroimaging and pathological examinations, as well as different treatment schemes.</p><p><b>RESULTS</b>The results indicated that age, preoperative Karnofsky Performance Scale score, extent of tumor invasion, tumor resection degree, residual tumor shown by postoperative magnetic resonance imaging (MRI), and postoperative radiotherapy and chemotherapy all correlated with patient prognosis. Furthermore, Cox multivariate analysis also showed the age (P < 0.01), extent of tumor invasion (P < 0.01), residual tumor shown by postoperative MRI (P < 0.05), and postoperative radiotherapy (P < 0.05) significantly correlated with patients' prognosis.</p><p><b>CONCLUSIONS</b>Age, postoperative radiotherapy and residual tumor indicated by MRI after surgery correlated significantly with the prognosis of patients with grade III glioma. The extent of tumor invasion may be an independent prognostic factor for patients with grade III glioma.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Brain Neoplasms , Pathology , General Surgery , Glioma , Pathology , General Surgery , Kaplan-Meier Estimate , Karnofsky Performance Status , Multivariate Analysis , Neoplasm, Residual , Radiotherapy , Prognosis , Proportional Hazards ModelsABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of handportable mobiletelephone microwave radiation on rat central nervous system by setting up rat model.</p><p><b>METHODS</b>80 healthy male SD rats (weighed about 200 g) were divided into 4 groups at random: control, radiation, decranium, decranium + radiation. TUNEL method was adopted used to detect the apoptosis of neurons after irradiation, then immunohistochemistry was used to detect Bcl-2, Bax expression in all brain tissue.</p><p><b>RESULTS</b>TUNEL positive rate, Bax and Bcl-2 positive cell numbers could be found in decranium + radiation group [(26.45 +/- 9.27)%, (23.5 +/- 3.58), (11.1 +/- 2.55) respectively]. There were significant differences among control [(9.59 +/- 2.55)%, 14.2 +/- 2.46, 7.0 +/- 1.14 respectively], decranium group [(9.52 +/- 1.93)%, 15.5 +/- 1.77, 7.4 +/- 1.76], radiation group [(10.04 +/- 3.62)%, 15.9 +/- 2.02, 7.2 +/- 1.07] (P < 0.01). But the difference was not found in the ratio of Bax to Bcl-2.</p><p><b>CONCLUSION</b>Microwave radiation did not affect the intact rat, but did promote the occurrence of neuron apoptosis in cranial defect rat. Bax, Bcl-2 gene participated in regulation of apoptosis. The intact cranium may be an important factor to protect the neurons against handportable mobiletelephone microwave radiation to some extent.</p>