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Objective: To investigate the clinical characteristics of patients with hypertrophic cardiomyopathy (HCM) and restrictive cardiomyopathy (RCM) complicating with intracardiac thrombosis. Methods: This is a retrospective observational study. Consecutive patients diagnosed with HCM or RCM and complicated with intracardiac thrombosis (including left and right atrium or ventricular thrombosis), who were admitted to the Heart Failure Care Unit of Fuwai Hospital, Chinese Academy of Medical Sciences, from September 2008 to September 2018, were enrolled in this study. Patients with myocardial infarction were excluded. The general clinical data of the enrolled patients, including demographic data, major complications, laboratory indicators, echocardiographic indicators, drug application and distribution of intracardiac thrombosis, were collected from electronic medical record system and analyzed. Results: A total of 98 patients were enrolled in this study, including 52 patients (53.1%) with HCM and 46 patients (46.9%) with RCM. The most common comorbidity was atrial fibrillation/flutter: 40 patients (76.9%) in HCM group and 36 patients (78.3%) in RCM group. Majority of patients received oral anticoagulants treatment: 43 patients (82.7%) in HCM group and 35 patients (76.1%) in RCM group. Intracardiac thrombosis was mainly located in the left atrium in both HCM group (39 cases (75.0%)) and RCM group (32 cases (69.6%)). Thrombosis was found in ≥ 2 chambers in 7 patients (7.1%). Rate of left atrial thrombosis was the highest (81.6% (62/76)) in HCM and RCM patients complicating with atrial fibrillation/flutter. Intra-aneurysmal thrombosis occurred in 4 out of 5 patients complicated with apical left ventricular aneurysm. The rate of left ventricular thrombosis in patients with left ventricular ejection fraction≥50% was 7.4% (4/54), which was significantly lower than that in patients with left ventricular ejection fraction<50% (34.5%(10/29)) (P<0.01). Conclusion: There are certain distribution characteristics of HCM and RCM patients with intracardiac thrombosis, and the left atrium is the most common site of thrombosis, more attention should be paid in HCM and RCM patients on the diagnosis and treatment of intracardiac thrombosis.
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BACKGROUND AND OBJECTIVES: The exosomes released by mesenchymal stromal cells (MSCs) in classical FBS-containing media have been demonstrated as an alternative, cell-free therapy in various diseases including inflammatory bowel disease (IBD). It has been found that the function of exosomes is affected by culture condition. We previously developed a serum-free, xeno-free and chemically defined medium, and umbilical cord-derived MSCs in this medium retained the immunosuppressive capability.METHODS: In this study, we evaluated the immunosuppressive function of exosomes from MSCs (MSC-Exo) in defined medium and their therapeutic effect on treating colitis.RESULTS AND CONCLUSIONS: In vitro studies indicated that MSC-Exo reduced the concentration of pro-inflammatory cytokines IFN-γ, TNF-α and IL-1β, and increased the secretion of anti-inflammatory cytokines TGF-β1 and IL-10, but no significant change of inhibitory effect on peripheral blood mononuclear cells proliferation was shown. In vivo experimental colitis showed that administration of MSC-Exo was able to significantly ameliorate the disease activity index score, weight loss, colon shortening, and the histological colitis score through up-regulation anti-inflammatory responses and down-regulation of inflammatory responses. Moreover, the use of MSC-Exo (200 μg) led to an improved therapeutic efficacy when compared with MSCs at a dose of 1×10⁶ cells. Our findings indicate that the exosomes from MSCs in defined medium possess a certain degree of immunosuppressive effect in vitro and exhibit a therapeutic capability in a mouse model of DSS-induced colitis through suppressing inflammation mechanism.
Subject(s)
Animals , Mice , Colitis , Colon , Cytokines , Down-Regulation , Exosomes , In Vitro Techniques , Inflammation , Inflammatory Bowel Diseases , Interleukin-10 , Mesenchymal Stem Cells , Up-Regulation , Weight LossABSTRACT
Objectives:To compare the structural and functional features between dilated phenotype and restrictive phenotype of hypertrophic cardiomyopathy patients with severe heart failure. Methods:We retrospectively enrolled the hypertrophic cardiomyopathy patients with severe heart failure (NYHA classⅢ/Ⅳ) who were admitted in our hospital during January 2010 to June 2017. The structural and functional characteristics between dilated phenotype and restrictive phenotype of hypertrophic cardiomyopathy patients with severe heart failure were compared. Results:One hundred and seventy-six hypertrophic cardiomyopathy patients with heart failure were enrolled, including 112 patients with dilated phenotype (dilated group) and 64 patients with restrictive phenotype (restrictive group). Echocardiographic examination showed that LVEDd was larger[(66.9±12.6) mm vs (44.6±10.1) mm,P＜0.001],the maximum left ventricular wall thickness (MLVWT) was thinner(13.1±3.1)mm vs (16.3±3.9)mm, P＜0.001], the proportion of patients with a thinner MLVWT was higher[26.8%(30/112) vs 6.3%(4/64),P=0.003], LVEF was lower ([29.7±10.1]% vs [53.0±18.2]%, P=0.006),the proportion of patients with a LVEF＜50% was higher(96.4%[108/112] vs 14.1%[9/64], P＜0.001),the proportion of patients with both left and right atrium enlarged was lower (42.9%[48/112] vs 100%[64/64], P＜0.001), and the proportion of patients with tricuspid insufficiency was also lower in the dilated group (55.4%[62/112] vs 71.9%[46/64], P=0.031) compared with the restrictive group. Cardiovascular magnetic resonance imaging examination evidenced that the proportion of patients with local ventricular septum hypertrophy was higher[78.7%(48/61) vs 9.4%(3/32), P＜0.001], the proportion of patients with extensive areas of transmural post-contrast delayed hyper-enhancement within septal and left ventricular free wall myocardium was higher(90.2%[55/61] vs 65.6%[21/32], P=0.013)in dilated group compared with the restrictive group. However, the proportion of patients with limited areas of transmural post-contrast delayed hyper-enhancement within interventricular septum or apex is less than that in the restricted group (9.8% [6/61] vs 34.4% [11/32], P=0.026). The maximum ventricular wall thickness was also less than that of the restrictive group ([15.8 ± 3.1] mm vs [19.8±3.4] mm, P=0.001). Conclusions:There are many differences in characteristics of cardiac structure and function between dilated phenotype and restrictive phenotype in hypertrophic cardiomyopathy patients with severe heart failure, such as the size of ventricular and atrium, the ventricular wall thickness, location and area of ventricular hypertrophy, LVEF, prevalence of mitral valve insufficiency and tricuspid insufficiency, myocardial fibrosis. The difference in location and area of ventricular hypertrophy and myocardial fibrosis may be the fundamental changes leading to these two phenotypes of hypertrophic cardiomyopathy.
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Objective To explore the effect of lidocaine with intravenous infusion on the postoperative inflammatory factors and cognitive dysfumction for elderly patients undergoing spinal operation.Method 80 elderly patients undergoing spinal operation in Central hospital of Baoji were enrolled from Janua-y 2015 to January 2016,of which patients divided into two groups randomly,control group (n =40) accepted routine general anesthesia,and study group (n =40) adopted intravenous lidocaine based on the patiems in control group,comparing the MMSE score and the incidence of postoperative cognitive dysfunction (POCD) with before operation,detecting and analyzing the difference of inflammatory and immunity factors.Results The MMSE score of the study group after three days of operation was significantly lower than that of the control group,the difference was statistically significant (P ＜ 0.05).The incidence of POCD in the study group was significantly lower than that in the control group,the difference was statistically significant (P ＜ 0.05).The serum levels of IgA,IgM and IgG in the study group after seven days of operation were significantly higher than those in the control group,the difference was statistically significant (P ＜ 0.05).After three days and seven days postoperatively,the serum levels of interleukin-6 (IL-6) in the study group were significantly lower than those in the control group,the difference was statistically significant (P ＜ 0.05).And there was no significance of TNF-α between two groups at any time point.Conclusions Intravenous lidocaine for patients undergoing spinal operation could inhibit the inflammatory response,improve the function of immunity,and decrease the incidence of POCD,which deserved popularization in clinic.
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Based on the analysis of comprehensive scientific research capability of technology talents,the paper constructs the evalu ation model of comprehensive scientific research capability of technology talents,designs the evaluating indicator system based on big data of scientific and technological information,including the 5 dimensions like basic literacy,influence of scientific research output,scientific research management capability,academic potential and academic status,and studies on its application in talent introduction.
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AIM To study the chemical constituents from Curculigo orchioides Gaertn..METHODS The n-butanol fraction of 95％ ethanol extract from C.orchioides was isolated and purified by silica,macroporous resin and Sephadex LH-20,then the structures of obtained compounds were identified by spectral data.RESULTS Seven compounds were isolated and identified as anacardoside (1),ocinol glucoside (2),3-(4-hydroxyl-3-methoxyphenyl)-propan-1,2-diol (3),benzyl-O-β3-D-glucopyranoside (4),icariside F2 (5),glucosyringic acid (6),calleryanin (7).CONCLUSION Compounds 3-7 are isolated from genus Curculigo for the first time.
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Objective To explore the effect of lidocaine with intravenous infusion on the postoperative inflammatory factors and cognitive dysfumction for elderly patients undergoing spinal operation.Method 80 elderly patients undergoing spinal operation in Central hospital of Baoji were enrolled from Janua-y 2015 to January 2016,of which patients divided into two groups randomly,control group (n =40) accepted routine general anesthesia,and study group (n =40) adopted intravenous lidocaine based on the patiems in control group,comparing the MMSE score and the incidence of postoperative cognitive dysfunction (POCD) with before operation,detecting and analyzing the difference of inflammatory and immunity factors.Results The MMSE score of the study group after three days of operation was significantly lower than that of the control group,the difference was statistically significant (P ＜ 0.05).The incidence of POCD in the study group was significantly lower than that in the control group,the difference was statistically significant (P ＜ 0.05).The serum levels of IgA,IgM and IgG in the study group after seven days of operation were significantly higher than those in the control group,the difference was statistically significant (P ＜ 0.05).After three days and seven days postoperatively,the serum levels of interleukin-6 (IL-6) in the study group were significantly lower than those in the control group,the difference was statistically significant (P ＜ 0.05).And there was no significance of TNF-α between two groups at any time point.Conclusions Intravenous lidocaine for patients undergoing spinal operation could inhibit the inflammatory response,improve the function of immunity,and decrease the incidence of POCD,which deserved popularization in clinic.
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AIM To study the chemical constituents from Curculigo orchioides Gaertn..METHODS The n-butanol fraction of 95％ ethanol extract from C.orchioides was isolated and purified by silica,macroporous resin and Sephadex LH-20,then the structures of obtained compounds were identified by spectral data.RESULTS Seven compounds were isolated and identified as anacardoside (1),ocinol glucoside (2),3-(4-hydroxyl-3-methoxyphenyl)-propan-1,2-diol (3),benzyl-O-β3-D-glucopyranoside (4),icariside F2 (5),glucosyringic acid (6),calleryanin (7).CONCLUSION Compounds 3-7 are isolated from genus Curculigo for the first time.
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A variety of biomarkers have been identified in recent prospective and retrospective reports as being potentially predictive of venous thromboembolis (VTE), particularly idiopathic deep venous thrombosis (IDVT). This study identified a serum tumor biomarker for early screening of IDVT. A total of 128 IDVT patients (54 females and 74 males; average age: 50.9±17.4 years) were included. Carcinoembryonic antigen (CEA), ferritin, β2-microglobulin, cancer antigen (CA) 125, CA 15-3, CA 19-9, squamous cell carcinoma antigen (SCC), alpha-fetoprotein (AFP), prostate specific antigen (PSA), free PSA (f-PSA), and beta-human chorionic gonadotropin (β-HCG) in patients with IDVT were detected. Malignancies were histo- or cytopathologically confirmed. Of the 128 IDVT patients, 16 (12.5%) were found to have malignancies. Serum CEA, CA 125, CA 15-3, and CA 19-9 were found to be helpful for detecting malignancies in IDVT patients. Our study revealed a positive association between these markers and tumors in IDVT patients. On the other hand, SCC and AFP were not sensitive enough to be markers for detecting tumors in patients with IDVT. No significant differences were found in positive rates of ferritin and β2-microglobulin between tumor and non-tumor groups, and no significant difference exists in serum levels of ferritin and β2-microglobulin between the two groups. Carbohydrate antigens, CA 15-3 in particular, may be useful for differential diagnosis and prediction of malignancies in patients with IDVT.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Antigens, Neoplasm , Blood , Antigens, Tumor-Associated, Carbohydrate , Blood , Biomarkers, Tumor , Blood , CA-125 Antigen , Blood , CA-19-9 Antigen , Blood , Carcinoembryonic Antigen , Blood , Chorionic Gonadotropin, beta Subunit, Human , Mucin-1 , Blood , Neoplasms , Blood , Diagnosis , Prostate-Specific Antigen , Blood , Retrospective Studies , Sensitivity and Specificity , Serpins , Blood , Venous Thrombosis , Blood , alpha-Fetoproteins , MetabolismABSTRACT
A variety of biomarkers have been identified in recent prospective and retrospective reports as being potentially predictive of venous thromboembolis (VTE), particularly idiopathic deep venous thrombosis (IDVT). This study identified a serum tumor biomarker for early screening of IDVT. A total of 128 IDVT patients (54 females and 74 males; average age: 50.9±17.4 years) were included. Carcinoembryonic antigen (CEA), ferritin, β2-microglobulin, cancer antigen (CA) 125, CA 15-3, CA 19-9, squamous cell carcinoma antigen (SCC), alpha-fetoprotein (AFP), prostate specific antigen (PSA), free PSA (f-PSA), and beta-human chorionic gonadotropin (β-HCG) in patients with IDVT were detected. Malignancies were histo- or cytopathologically confirmed. Of the 128 IDVT patients, 16 (12.5%) were found to have malignancies. Serum CEA, CA 125, CA 15-3, and CA 19-9 were found to be helpful for detecting malignancies in IDVT patients. Our study revealed a positive association between these markers and tumors in IDVT patients. On the other hand, SCC and AFP were not sensitive enough to be markers for detecting tumors in patients with IDVT. No significant differences were found in positive rates of ferritin and β2-microglobulin between tumor and non-tumor groups, and no significant difference exists in serum levels of ferritin and β2-microglobulin between the two groups. Carbohydrate antigens, CA 15-3 in particular, may be useful for differential diagnosis and prediction of malignancies in patients with IDVT.
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<p><b>OBJECTIVE</b>To evaluate the reliability and application of GeneSearch(TM) breast lymph node assay (Genesearch), a real-time fluorescence quatitative PCR method, in intraoperative assay of metastasis in sentinel lymph nodes (SLNs) from breast cancer patients.</p><p><b>METHODS</b>Totally 140 SLNs from 80 patients with breast carcinoma were prospectively studied from May 2010 to August 2010. The 80 patients included 78 women and 2 men who ranged in age from 29 to 85 years, and the median age is 49 years. The expression of CK19 and mammaglobulin in all 140 SLNs were detected by Genesearch, and the results were compared with that of histological evaluation of both frozen and paraffin-embedded sections.</p><p><b>RESULTS</b>Among SLNs, by histological analyses, there were 121 without metastasis, 17 with macrometastasis, 2 with micrometastasis, and none of isolated tumor cell. By Genesearch, there were 119 without metastasis and 21 with metastasis. Genesearch showed sensitivity of 89.4%, positive predictive value of 81.0%, negative predictive value of 98.3% and specificity of 96.7% by comparing to histological analyses. The concordance between Genesearch and histological analysis was 95.7%. The sensitivity of Genesearch was 15/17 for macrometastasis and 2/2 for micrometastasis.</p><p><b>CONCLUSIONS</b>Genesearch detection presents high sensitivity and specificity in evaluating metastasis of sentinel lymph nodes in breast cancer, but strict performance technically is necessary to avoid false positive and false negative results. Inability of further subtyping for the positive cases might be the key limitations for wide application of this method.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Breast Neoplasms , Pathology , General Surgery , Breast Neoplasms, Male , Pathology , General Surgery , Intraoperative Period , Lymph Nodes , Pathology , Lymphatic Metastasis , Diagnosis , Neoplasm Micrometastasis , Diagnosis , Predictive Value of Tests , Sensitivity and Specificity , Sentinel Lymph Node BiopsyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the diagnostic approach and criteria for intraductal papillary neoplasms of breast.</p><p><b>METHODS</b>According to the criteria of 2003 WHO classification, 187 cases of intraductal papillary neoplasm of breast were identified and enrolled into the study. The clinical and histologic features were reviewed and immunohistochemical study for CD10, p63, CK14, CK5/6, CK7, MGB1 and p53 were carried out on 53 cases.</p><p><b>RESULTS</b>Amongst the 187 cases studied, there were 128 cases of intraductal papilloma, 16 cases of atypical intraductal papilloma and 43 cases of intraductal papillary carcinoma. They showed a spectrum of morphologic features including epithelial and stromal hyperplasia and secondary changes. The expression of myoepithelial markers, including CD10 and p63, significantly decreased in ascending order from intraductal papillomas, atypical intraductal papillomas and intraductal papillary carcinomas (P < 0.001). The expression of basal cell markers, including CK5/6 and CK14, showed a mosaic pattern in benign lesions and significantly decreased or was absent in atypical and carcinomatous lesions (P < 0.001). In contrast, the luminal cell marker CK7 expressed in the three groups with no statistically significant difference (P = 0.06). On the other hand, the expression of MGB1 in intraductal papillary carcinomas was much lower than that in the other two groups (P = 0.002 and P = 0.007). The staining for p53 was negative in all of the three groups.</p><p><b>CONCLUSIONS</b>Intraductal papillary neoplasms of breast represent a heterogeneous group of lesions with various morphologic appearances. Correlation with immunostaining results for myoepithelial markers, basal-type cytokeratins and luminal epithelial markers are helpful in arriving at a definitive diagnosis.</p>
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Adult , Female , Humans , Middle Aged , Breast Neoplasms , Metabolism , Pathology , Carcinoma, Intraductal, Noninfiltrating , Metabolism , Pathology , Carcinoma, Papillary , Metabolism , Pathology , Diagnosis, Differential , Immunohistochemistry , Keratin-14 , Metabolism , Keratin-5 , Metabolism , Keratin-6 , Metabolism , Keratin-7 , Metabolism , Mammaglobin A , Metabolism , Neprilysin , Metabolism , Papilloma, Intraductal , Metabolism , Pathology , Transcription Factors , Metabolism , Tumor Suppressor Proteins , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship between Ki67 expression and tumor response to neoadjuvant chemotherapy with anthracyclines plus taxanes in breast cancer.</p><p><b>METHODS</b>From January 2008 to June 2009, 129 patients with primary breast invasive ductal cancer received neoadjuvant chemotherapy with anthracyclines plus taxanes. The expression of Ki67 in the tumor tissues was determined by using immunohistochemistry with core needle biopsy specimens prior to the chemotherapy. The tumor response to the chemotherapy was evaluated by dynamic enhanced MRI based on RECIST2000 criteria, pathologic response was assessed according to Miller-Payne grading system, and the clinical comprehensive response was evaluated based on MRI combined with pathologic response.</p><p><b>RESULTS</b>Dynamic enhanced MRI classified 87 cases (67.4%) as effective. According to the Miller-Payne grading system, 99 cases (76.7%) were ranged effective. One hundred and ten cases (85.5%) were recognized as clinically comprehensive effective. The effective rates of neoadjuvant chemotherapy in patients with a Ki67 expression >10% evaluated by the above-mentioned three standards were 73.2%, 81.4% and 89.7%, respectively; and those in patients with a Ki67 expression < or = 10% were 50.0%, 62.5% and 71.9%, respectively. Compared with patients with a Ki67 expression < or = 10%, the patients with a Ki67 expression >10% had better response rates determined by all the three standards (P values were 0.020, 0.030 and 0.010, respectively). The Ki67 expression in the tumor tissue was linearly correlated with clinically comprehensive response on the Linear-Linear association analysis.</p><p><b>CONCLUSIONS</b>There is a statistic association between Ki67 expression and tumor response to the neoadjuvant chemotherapy with anthracyclines plus taxanes in breast cancer, and the patients with a higher expression of Ki67 has a better tumor response to the chemotherapy.</p>
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Anthracyclines , Therapeutic Uses , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Breast Neoplasms , Drug Therapy , Metabolism , Chemotherapy, Adjuvant , Ki-67 Antigen , Metabolism , Prospective Studies , Taxoids , Therapeutic Uses , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>The aim of this study is to investigate the changes of expression of estrogen receptors (ER), progesterone receptors (PR), Her-2, Ki-67 and histological grade after neoadjuvant chemotherapy in breast cancer.</p><p><b>METHODS</b>Sixty-seven patients with histopathalogically confirmed breast cancer by core needle biopsy received neoadjuvant chemotherapy. The effect of neoadjuvant chemotherapy was assessed according to the criteria of the Japanese Breast Cancer Society: non-effective (G1), mildly effective (G2), moderately effective (G3), markedly effective (G4) and completely effective (G5). All pathological slides were retrospectively reviewed. Immunohistochemical staining (EnVision method) was used to detect the expression of ER and PR, Her-2 and Ki-67. The pre- and post-neoadjuvant chemotherapy status of tumor histological grade, ER and PR, Her-2 and Ki-67 expression in the 49 cases were compared.</p><p><b>RESULTS</b>The effect of neoadjuvant chemotherapy was assessed in 67 patients. There were 5 cases (7.5%) in G1, 19 in G2 (28.4%), 20 in G3 (29.9%), 17 in G4 (25.4%) and 6 in G5 (9.0%), respectively. PR positive rate was 71.4% after chemotherapy versus 91.8% before chemotherapy, with a statistically significant reduction (P = 0.021). However, the ER and Her-2 expression before and after neoadjuvant chemotherapy was stable. Of the patients with invasive ductal carcinoma, 28.6% had histological grade change after neoadjuvant chemotherapy, and 85.7% of patients decreased one grade. The proportion of histological grade change in the G1, G2, G3, G4 were 0, 5.9%, 41.2% and 54.5%, respectively (P = 0.013). The average rate of Ki-67 expression decreased from 28.3% pre-chemotherapy to 11.0% post-chemotherapy (P = 0.011). After the neoadjuvant chemotherapy, the Ki-67 expression rate decreased by > 10%, > 20%, > 30%, > 40% and > 50% in 3 groups (G1 and G2, group G3, group G4 and G5) showed a tendency to be increased, with a significant difference (P < 0.05).</p><p><b>CONCLUSION</b>PR expression in breast cancer decreases after neoadjuvant chemotherapy, while ER and Her-2 expressions remain stable. After neoadjuvant chemotherapy, the histological grade and proliferation index are decreased and correlated with the response to chemotherapy. Therefore, histological grade and proliferation index may be effective complementary factors in assessment of the effectiveness of neoadjuvant chemotherapy.</p>