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Objective:To evaluate the effectiveness and feasibility of 3D ResSE-Unet-based intelligent delineation of clinical target volume (CTV) in postoperative adjuvant radiotherapy for breast cancer.Methods:A total of 974 cases of breast cancer treated in the Cancer Diagnosis and Treatment Center of the Fourth Affiliated Hospital of Guangxi Medical University from September 2018 to June 2022 were enrolled in this study, including 614 cases receiving total mastectomy and 360 cases treated with breast-conserving surgery. They were divided into a training set, a validation set, and a testing set. The training set consisted of 874 cases and was used to build a model of 3D ResSE-Unet-based intelligent CTV delineation. The validation set comprised 40 cases and was used to evaluate the feasibility and effectiveness of the clinical application of AI-based CTV design in the radiotherapy for breast cancer. The testing set was composed of 60 cases and was used to test the accuracy of intelligent CTV. The Wilcoxon rank test was used to compare the Dice similarity coefficient (DSC), 95% Hausdorff distance (HD95), and average surface distance (ASD) obtained using the intelligent delineation model.Results:The intelligent delineation model showed high precision. The CTV of cases treated with total mastectomy (CTV cw) and the CTV of cases treated with breast-conserving surgery (CTV b) had DSCs greater than 0.80 and greater than 0.88, respectively. Therefore, compared with CTV cw, CTV b had a higher DSC (0.91 ± 0.03 vs.0.83 ± 0.05, t = 7.11, P < 0.05). Both CTV cw and CTV b had lower HD 95 [(7.56 ± 3.42) mm vs.(8.77 ± 5.89) mm] and ASD [(1.85 ± 0.71) mm vs.(1.86 ± 0.83)mm], without statistically significant difference ( P > 0.05). The left/right supraclavicular and infraclavicular CTV (CTV2) had DSCs greater than 0.8. CTV2 also had low average HD95 and ASD, without statistically significant difference ( P > 0.05). Conclusions:The 3D ResSE-Unet-based intelligent CTV delineation has better consistency and feasibility in postoperative adjuvant radiotherapy for breast cancer, especially the CTVs after breast-conserving surgery.
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@#<b>Objective</b> To investigate the quality control and protection level of medical electron linear accelerators in Shanghai, China. <b>Methods</b> The startified random sampling method was used to cover tertiary, secondary and ungraded hospitals, and a total of 30 medical electron linear accelerators in 15 hospitals were tested for quality control and protection level according to relevant standards. <b>Results</b> Five medical electron linear accelerators failed the quality control test, with an overall inspection pass rate of 83.3% and a re-inspection pass rate of 100%. The pass rate of flatness of square X-ray irradiation field (5 cm × 5 cm)-(30 cm × 30 cm) was 83.3%, the pass rate of symmetry of square X-ray irradiation field was 96.7%, and other indices were qualified. All medical electron linear accelerator rooms passed the protection test. <b>Conclusion</b> The protection of medical electron linear accelerator rooms in Shanghai meets the requirements of national standards, and some indices do not meet the requirements of national standards in the preliminary inspection. The quality control of medical electron linear accelerators should be further strengthened to ensure the treatment effect of patients.
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Background Individual monitoring of occupational external exposure is an essential part of the occupational health management of radiation workers, and is an important basis for the evaluation of individual absorbed dose and the diagnosis of occupational radiation diseases. Continuous participation of monitoring service providers in intercomparison is a fundamental quality assurance for routine monitoring, which can identify problems and improve them in time. Objective Taking the Laboratory of Radiation Protection in Shanghai Institute of Preventive Medicine as an example, to evaluate the performance of an individual occupational external dose monitoring system in the laboratory, identify influencing factors of the monitoring results, and provide a basis for improving the quality of daily monitoring by analyzing the process and results of a national intercomparison of individual dose monitoring. Methods According to the Testing criteria of personnel dosimetry performance for external exposure (GBZ 207-2016), and the relevant requirements of Class II (photon) inspection, a total of 20 groups of blind sample dosimeters were measured for four consecutive years from 2018 to 2021. The radiation energy source of each group was identified, and related personal dose equivalent Hp(10), the uncertainty of measurement results, and the deviation between the reported value and the reference value were calculated. The national intercomparison process and results of individual dose monitoring were also analyzed. Results The energy sources of the blind samples in the tested laboratory for four years were N100 or Cs-137. The reported dose values of the blind samples were 0.57-4.61 mSv, the combined uncertainties were 0.043-0.365 mSv, the expanded uncertainties (k=2) were 0.09-0.73 mSv, and the relative expanded uncertainties (k=2) were 13.8%-16.4%. The single-group performance ∣Pi∣ of 20 sets of blind samples in the four years was ≤0.10, the yearly comprehensive performance of 5 sets of blind samples was ≤0.10, and the yearly Q score of the test report was >15 points. The laboratory achieved excellent results in the national intercomparison of individual dose monitoring in four consecutive years, except the Q value not reaching full score. Conclusion The laboratory exhibits standardized data processing of individual dose monitoring, generates accurate and reliable results, and meets the requirements of relevant national standards; but it should continue to participate in the national intercomparison of individual dose monitoring, strengthen the angular response research of energy identified dosimeter, improve the monitoring ability of low-dose X-rays, analyze the key points of reducing the uncertainty of measurement results, and continuously improve the monitoring ability.
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Objective:To study the clinical features and risk factors of pulmonary hemorrhage in extremely preterm (EPT) infants.Methods:From February 2018 to January 2022, EPT infants admitted to NICU of our hospital and diagnosed with pulmonary hemorrhage were retrospectively assigned into the observation group and those without pulmonary hemorrhage were assigned into the control group. Univariate analysis and multivariate logistic regression analysis were used to compare the clinical features and determine risk factors of pulmonary hemorrhage in EPT infants.Results:A total of 114 EPT infants were included, including 28 cases (24.6%) in the observation group with pulmonary hemorrhage and 86 cases in the control group. Pulmonary hemorrhage mainly occurred within the first week after birth. Univariate analysis showed that the observation group had higher incidences of following events than the control group: birth asphyxia, delivery room intubation, severe respiratory distress syndrome, hyperglycemia, thrombocytopenia, severe acidosis, shock, score for neonatal acute physiology with perinatal extension-Ⅱ (SNAPPE-Ⅱ) ≥37 and the highest lactate level. Birth weight was lower in the observation group than the control group ( P<0.05). Logistic regression analysis showed that SNAPPE-Ⅱ≥37, shock and hyperglycemia were risk factors of pulmonary hemorrhage ( OR=4.081, 4.610 and 3.355, respectively, all P<0.05). The incidences of mortality and intracranial hemorrhage in the observation group were higher than the control group. The duration of mechanical ventilation in the observation group was longer than the control group ( P<0.05). No significant differences existed in the duration of nasal continuous positive airway pressure, assist mechanical ventilation and total oxygen use, the incidences of grade Ⅱ-Ⅲ bronchopulmonary dysplasia, retinopathy of prematurity and the length of hospital stay ( P>0.05). Conclusions:SNAPPE-Ⅱ≥37, shock and hyperglycemia are early risk factors for pulmonary hemorrhage in EPT infants. EPT infants with pulmonary hemorrhage have higher incidences of mortality and intracranial hemorrhage, requiring longer periods of mechanical ventilation.
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Objective:To investigate the changes in procalcitonin (PCT) and C-reactive protein (CRP) levels in married women with genital ureaplasma urealyticum infection and analyze the risk factors of genital ureaplasma urealyticum infection.Methods:A total of 116 married women with genital ureaplasma urealyticum infection who received treatment in the First Affiliated Hospital of Wenzhou Medical University from January 2019 to December 2019 were included in the observation group. An additional 50 healthy married women who concurrently received physical examination in the same hospital were included in the control group. Serum levels of PCT and CRP were compared between the two groups. Questionnaire outcomes and the risk factors for genital ureaplasma urealyticum infection were subjected to univariate analysis and logistic regression analysis.Results:Serum levels of PCT and CRP in the observation group were (3.71 ± 0.64) μg/L and (34.26 ± 4.23) mg/L, respectively, which were significantly higher than those in the control group [(0.49 ± 0.16) μg/L, (4.84 ± 0.75) mg/L, t = 35.05, 48.76, both P < 0.001]. In the observation group, the proportions of women who used condom each time, who had no abortion, who had one sexual partner, who had first sexual intercourse at the age of ≥ 20 years, who had sexual intercourse ≤ 3 times/week, who had no history of unclean sexual contact, and who knew knowledge of genital ureaplasma urealyticum infection were 54.55%, 24.24%, 65.15%, 54.55%, 42.42%, 69.70%, 34.85%, respectively, which were significantly lower than those in the control group [80.00%, 48.00%, 88.00%, 76.00%, 66.00%, 94.00%, 60.00%, χ2 = 9.79, 9.33, 8.81, 6.89, 7.89, 11.56, 9.32, P = 0.002, 0.009, 0.003, 0.008, 0.005, 0.001, 0.002). Multivariate analysis showed that abortion frequency, number of sexual partners, age at first sexual intercourse < 20 years, frequency of sexual intercourse and history of unclean sexual contact were independent risk factors for genital ureaplasma urealyticum infection ( OR = 2.12, 3.58, 2.34, 2.84, 4.24). Frequent condom use and knowledge of genital ureaplasma urealyticum infection were protective factors for genital ureaplasma urealyticum infection ( OR = 4.03, 3.03). Conclusion:Abnormal increases in serum PCT and CRP levels in married women can be used as sensitive indicators for early diagnosis of genital ureaplasma urealyticum infection. Frequency of sexual intercourse, number of sexual partners, more times of abortion, premature sexual activity, and history of unclean sexual contact are the risk factors of genital ureaplasma urealyticum infection.
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Objective:To investigate the characteristics of diagnostic radiology and the situation of repeated examinations at medical institutions of Jinshan district, and put forward strategies and suggestions for the correct guidance on and reasonable applications of various medical exposures.Methods:The cases data on radiological examinations at medical institutions in Jinshan district, obtained in 2017 from Shanghai Municipal Health Commission Information Center Platform, was used to describe the characteristics of population distribution of patients, examination types, examination areas, diagnosed diseases, number of repeated examinations and the result of radiological examinations.Results:The main types of radiological examinations in Jinshan district were the CT scans and the conventional X-ray diagnosis, accounted respectively for 53.2% and 44.7% of the total radiological examinations. The radiological examinations were mainly performed on household registration (77.3%). The number of radiological examinations on males was close to on females, with examination frequency of 49.4% for males and 50.1% for females. The greatest frequency of radiological examinations was found in the age group older than 41 years, accounting for 77.1% of CT scans and 65.2% of the conventional X-ray diagnosis. The main examination sites of the CT scans at Jinshan medical institutions were chest (32.8%), abdomen (19.4%), brain (16.1%) and spine (11.4%), and for the conventional X-ray diagnosis were chest (43.2%) and limbs (39.6%). The main departments applying for radiological examinations are surgery (39.7%) and medicine (27.1%). The numbers of radiological examinations are, respectively, diseases of the respiratory system (19.8%), the injury, poisoning and some other consequences of external causes (15.8%), and the diseases of musculoskeletal system and connective tissue (15.8%). The positive rate of the conventional X-ray diagnosis was 53.1%, and the positive rate of CT scans was 73.5%. The conventional X-ray diagnosis and CT scans contributed higher specific rates of repeated examinations, accounting for 9.3% and 7.9% of the total of such type examination, respectively.Conclusions:CT scans in Jinshan district accounted for more than half of the total frequency of radiological examinations, therefore, interventions should be imposed on certain types of phycians and patients types.
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Objective:To construct back propagation (BP) neural network model to predict the dose required for 131I therapy for hyperthyroidism and to calculate the personalized dose plan for patients. Methods:A complete set of data of patients treated for hyperthyroidism radioaiodine was collected from the nuclear medicine departments of several medical colleges in Shanghai, including history, examination result, treatment course, etc. As a result, a prediction model was established. The predicated result for BP neural network, radial basis function (RBF) neural network and Support Vector Machine (SVM) were compared by means of small sample data. The optimal model was selected to predict administrated dose and to finally test the accuracy of the model.Results:The average errors in BP neural network, RBF neural network and SVM model based on small samples were 5.53%, 7.09% and 9.64%, respectively. After comparison, BP neural network was selected to build the prediction model. 30 cases of data were selected by random sampling to verify the BP neural network. The mean error, mean square error, minimum error and maximum error of the prediction result were 7.22%, 0.053, 0.57% and 13.78%, respectively.Conclusions:In this study, a neural network prediction method was proposed to provide a more accurate dose for patients in need of radioiodine therap for hyperthyroidism, and to reduce the possibility of radiation damage or the unsatisfactory therapeutic effect caused by insufficient dose. It has clinical practical significance in providing the reference for clinicians to evaluate the administrated dose.
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Lung cancer is a highly vascular tumors, over the past ten years, anti-angiogenes is has been proved to be an effective and highly promising combinational treatment. The data of the combination of anti-angiogenesis with chemotherapy, targeted therapy, immunotherapy has been constantly updating. Advanced lung cancer patients, no matter different groups or different stages of the disease, are benefited from anti-angiogenes. In this paper, based on the clinical status and unsolved problems, combined with the latest clinical and translational research data, we reviewed the current anti-angiogenesis treatment of lung cancer. .
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Humans , Angiogenesis Inhibitors/therapeutic use , Immunotherapy , Lung Neoplasms/pathology , Molecular Targeted Therapy , Neovascularization, Pathologic/drug therapyABSTRACT
@#<b>Objective</b> To investigate dose parameters in computed tomography (CT) scanning of common body parts inall public medical institutions in Shanghai, China, and analyze the dose distribution of CT scanning among adult subjects in Shanghai, and to provide a basis for establishing the diagnostic reference levels of CT scanning in Shanghai. <b>Methods</b> We selected at least one medical institution with CT services each from all 16 districts of Shanghai. In each medical institution, a piece of CT equipment with qualified annual inspection was sampled to investigate the doses to subjects in head, chest, abdomen, and lumbar spine scanning. We collected the basic information of the subjects, CT scanning parameters, volumetric CT dose index (CTDI<sub>vol</sub>), and dose length product (DLP). <b>Results</b> The scanning data of 1475 subjects were obtained. The 75th percentiles of the CTDI<sub>vol</sub> of the head, chest, abdomen, and lumbar spine were 57 mGy, 11 mGy, 16 mGy, and 23 mGy, respectively. The 75th percentiles of the DLP were 862 mGy·cm, 361 mGy·cm, 593 mGy·cm, and 550 mGy·cm, respectively. <b>Conclusion</b> CTDI<sub>vol</sub> and DLP differed significantly at different body parts, and also differed greatly at the same body parts. The DLP of men was slightly higher than that of women.
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Triptolide (TP), an active component of Tripterygium wilfordiiHook. f. (TWHF), has been widely used for centuries as a traditional Chinese medicine. However, the clinical application of TP has been restricted due to multitarget toxicity, such as hepatotoxicity. In this study, 28 days of oral TP administration (100, 200, or 400 μg·kg
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Neck dissection for oral squamous-cell carcinoma (OSCC) is a clinically controversial issue and has therefore been the subject of abundant research. However, no one has performed a bibliometric study on this topic to date. The aim of this study was to assess the development of research on neck dissection for OSCC in terms of the historical evolution, current hotspots and future directions, particularly including research trends and frontiers from 2010 to 2019. Literature records related to research on neck dissection for OSCC were retrieved from the Web of Science Core Collection (WoSCC). CiteSpace was used as a tool to perform a bibliometric analysis of this topic. The survey included 2 096 papers. "Otorhinolaryngology" was the most popular research area. The most active institutions and countries were Memorial Sloan Kettering Cancer Center and the USA, respectively. Shah J.P. was the most cited author. Among the six identified "core journals", Head & Neck ranked first. The top three trending keywords were 'invasion', 'upper aerodigestive' and 'negative neck'. 'D'Cruz AK (2015)' was the most cited and the strongest burst reference in the last decade. The study evaluated the effect on survival of elective versus therapeutic neck dissection in patients with lateralized early-stage OSCC. The depth of invasion and the management of N0 OSCC were research frontiers in this field. The present study provides a comprehensive bibliometric analysis of research on neck dissection for OSCC, which will assist investigators in exploring potential research directions.
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Humans , Bibliometrics , Carcinoma, Squamous Cell/surgery , Head and Neck Neoplasms , Mouth Neoplasms/surgery , Neck DissectionABSTRACT
Polygonum multiflorum is a traditional Chinese herbal medicine and has many biological activities such as hair-blacking, anti-atherosclerosis, anti-inflammatory and anti-aging. However, the liver injury induced by P. multiflorum has aroused wide attention in recent years. 2,3,5,4'-tetrahydroxystibane-2-O-β-D-glucoside(TSG) is a main component of P. multiflorum, but the role of TSG in inducing liver injury is unclear. The aim of present study was to evaluate TSG's potential liver injury and effects on bile acid homeostasis and phospholipids efflux. C57 BL/6 J mice received intraperitoneal administration of 400 mg·kg~(-1) of TSG daily for 15 days, and then biochemical indexes of liver injury and changes of phospholipid content were detected. The changes of bile acid compositions were detected by LC-MS/MS. The results showed TSG 400 mg·kg~(-1) significantly increased the content of serum total bile acid(TBA) and alkaline phosphatase(ALP). Elevated free bile acid levels were observed in TSG-treated groups, including β-muricholic acid(β-MCA), ursodeoxycholic acid(UDCA), hyodeoxycholic acid(HDCA), chenodeoxycholic acid(CDCA), deoxcholic acid(DCA) in serum and β-MCA, CDCA in liver. TSG inhibited the protein expression of farnesoid X receptor(FXR) and down stream bile salt export pump(BSEP), which may result in the accumulation of bile acid. TSG also inhibited the expression of 25-hydroxycholesterol-7 alpha-hydroxylase(CYP7 B1), which may disturb the alternative pathway for bile acid synthesis. In addition, intraperitoneal injection of TSG 400 mg·kg~(-1) significantly decreased the content of phospholipids in bile. The research showed that TSG significantly inhibited the expression of multidrug resistance protein 2(MDR2) and destroyed the regular distribution of MDR2 on the bile duct membrane of liver. In vitro results showed that the IC_(50) of TSG on HepG2 cells was about 1 500 μmol·L~(-1) and TSG at 500 μmol·L~(-1)(for 24 h) could destroy the distribution of MDR2 on the bile duct membrane of liver. In conclusion, TSG induced liver injury by disrupting bile acid homeostasis and phospholipids efflux.
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Animals , Mice , Bile Acids and Salts , Chromatography, Liquid , Glucosides , Homeostasis , Liver , Phospholipids , Tandem Mass SpectrometryABSTRACT
OBJECTIVE@#To analyze the screening results of glucose-6-phosphate dehydrogenase (G6PD) deficiency and gene mutation distribution of G6PD deficiency in preterm infants in Chengdu, China, in order to provide a basis for the improvement of G6PD screening process in preterm infants.@*METHODS@#Fluorescent spot test for G6PD deficiency using dried blood spots was used for G6PD screening of 54 025 preterm infants born from January 1, 2015 to December 31, 2019 in Chengdu, and G6PD enzymology and gene detection were used for the diagnosis of 213 infants with positive screening results.@*RESULTS@#Among the 54 025 preterm infants, 192 were diagnosed with G6PD deficiency, with an incidence rate of 3.55‰. The incidence rate of G6PD deficiency in preterm infants was higher than that in full-term infants in the same period of time and tended to increase year by year. Birth in summer, gestational age T mutation tend to have mild conditions.
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Female , Humans , Infant , Infant, Newborn , China/epidemiology , Genetic Testing , Glucosephosphate Dehydrogenase/genetics , Glucosephosphate Dehydrogenase Deficiency/genetics , Infant, Premature , MutationABSTRACT
Glioma-associated microglial cells, a key component of the tumor microenvironment, play an important role in glioma progression. In this study, the mouse glioma cell line GL261 and the mouse microglia cell line BV2 were chosen. First, circadian gene expression in glioma cells co-cultured with either M1 or M2 microglia was assessed and the exosomes of M2-polarized and unpolarized BV-2 microglia were extracted. Subsequently, we labeled the exosomes with PKH67 and treated GL261 cells with them to investigate the exosome distribution. GL261 cell phenotypes and related protein expression were used to explore the role of M2 microglial exosomes in gliomas. Then a specific miR-7239-3p inhibitor was added to verify miR-7239-3p functions. Finally, the mouse subcutaneous tumorigenic model was used to verify the tumorigenic effect of M2 microglial exosomes in vivo. Our results showed that in gliomas co-cultured with M2 microglia, the expression of the BMAL1 protein was decreased (P < 0.01), while the expression of the CLOCK protein was increased (P < 0.05); opposite results were obtained in gliomas co-cultured with M1 microglia. After treatment with M2 microglial exosomes, the apoptosis of GL261 cells decreased (P < 0.001), while the viability, proliferation, and migration of GL261 cells increased. Increased expression of N-cadherin and Vimentin, and decreased E-cadherin expression occurred upon treatment with M2 microglial exosomes. Addition of an miR-7239-3p inhibitor to M2 microglial exosomes reversed these results. In summary, we found that miR-7239-3p in the glioma microenvironment is recruited to glioma cells by exosomes and inhibits Bmal1 expression. M2 microglial exosomes promote the proliferation and migration of gliomas by regulating tumor-related protein expression and reducing apoptosis.
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Tripterygium wilfordii multiglycoside (GTW) is a commonly used compound for the treatment of rheumatoid arthritis (RA) and immune diseases in clinical practice. However, it can induce liver injury and the mechanism of hepatotoxicity is still not clear. This study was designed to investigate GTW-induced hepatotoxicity in zebrafish larvae and explore the mechanism involved. The 72 hpf (hours post fertilization) zebrafish larvae were administered with different concentrations of GTW for three days and their mortality, malformation rate, morphological changes in the liver, transaminase levels, and histopathological changes in the liver of zebrafish larvae were detected. The reverse transcription-polymerase chain reaction (RT-PCR) was used to examine the levels of microRNA-122 (miR-122) and genes related to inflammation, apoptosis, cell proliferation and liver function. The results showed that GTW increased the mortality of zebrafish larvae, while significant malformations and liver damage occurred. The main manifestations were elevated levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), significant liver atrophy, vacuoles in liver tissue, sparse cytoplasm, and unclear hepatocyte contours. RT-PCR results showed that the expression of miR-122 significantly decreased by GTW; the mRNA levels of inflammation-related genes il1β, il6, tnfα, il10, cox2 and ptges significantly increased; the mRNA level of tgfβ significantly decreased; the mRNA levels of apoptosis-related genes, caspase-8 and caspase-9, significantly increased; the mRNA level of bcl2 significantly decreased; the mRNA levels of cell proliferation-related genes, top2α and uhrf1, significantly reduced; the mRNA levels of liver function-related genes, alr and cyp3c1, significantly increased; and the mRNA level of cyp3a65 significantly decreased. In zebrafish, GTW can cause increased inflammation, enhanced apoptosis, decreased cell proliferation, and abnormal expression of liver function-related genes, leading to abnormal liver structure and function and resulting in hepatotoxicity.
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Animals , Apoptosis , Chemical and Drug Induced Liver Injury/genetics , Inflammation/genetics , Trans-Activators , Tripterygium , Zebrafish/genetics , Zebrafish ProteinsABSTRACT
This study aimed to investigate whether psoralen can aggravate hepatotoxicity induced by carbon tetrachloride(CCl_4) by inducing hepatocyte cycle arrest and delaying liver regeneration. Female C57 BL/6 mice aged 6-8 weeks were randomly divided into control group, model group(CCl_4 group), combined group(CCl_4+PSO group) and psoralen group(PSO group). CCl_4 group and CCl_4+PSO group were given CCl_4 intraperitoneally at a dose of 100 μL·kg~(-1) once; olive oil of the same volume was given to control group and PSO group intraperitoneally; 12 h, 36 h and 60 h after CCl_4 injection, PSO group and CCl_4+PSO group were administrated with PSO intragastrically at a dose of 200 mg·kg~(-1); 0.5% CMC-Na of the same volume was administrated to control group and PSO group intragastrically. The weight of mice was recorded every day. Serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were measured at 36 h, 60 h and 84 h after CCl_4 injection. Mice were sacrificed after collection of the last serum samples. Liver samples were collected, and liver weight was recorded. Histopathological and morphological changes of liver were observed by haematoxylin and eosin staining. The mRNA levels of HGF, TGF-β, TNF-α, p53 and p21 in liver were detected by RT-qPCR. Western blot was used to detect the levels of cell cycle-related proteins. According to the results, significant increase of serum ALT and AST and centrilobular necrosis with massive inflammatory cell infiltration were observed in CCl_4+PSO group. After PSO administration in CCl_4 model, the mRNA levels of HGF(hepatocyte growth factor) and TNF-α were reduced, while the mRNA expressions of TGF-β, p53 and p21 was up-regulated. The expression of PCNA(proliferating cell nuclear antigen) was significantly increased in CCl_4 and CCl_4+PSO group, while the relative protein level in CCl_4+PSO group was slightly lower than that in CCl_4 group. Compared with control and CCl_4 group, the expression of p27(cyclic dependent kinase inhibitor protein p27) was prominently increased in CCl_4+PSO group. These results indicated that hepatotoxicity induced by CCl_4 could be aggravated by intraperitoneal administration with PSO, and the repair process of liver could be delayed. The preliminary mechanism may be related to the inhibition of PCNA and regulation of some cell cycle-associated protein by psoralen, in which the significant up-regulation of p27, p53 and p21 may play important roles.
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Animals , Female , Mice , Alanine Transaminase , Aspartate Aminotransferases , Carbon Tetrachloride , Chemical and Drug Induced Liver Injury , Ficusin , Liver , Liver RegenerationABSTRACT
This study aimed to describe two cathelicidins (cathelicidin-PR1 and cathelicidin-PR2) from the skin of Paa robertingeri (Anura: Ranidae). The deduced mature peptides cathelicidin-PR1 and cathelicidin-PR2 were composed of 29 and 25 residues, respectively. Cathelicidin - PR1 has higher antimicrobial activity it could kill Gram-positive and Gram-negative bacteria and even some fungal species. Cathelicidin-PR1 exhibited more effective than AMP in antimicrobial activity against Pseydomonas maltophilia clinical strain. On the contrary, cathelicidin-PR2 had very weak antimicrobial activity. Furthermore, cathelicidin-PR1 and cathelicidin-PR2 exhibited very low hemolytic activity against human erythrocytes and little hemagglutinating activity. The results suggested that the cathelicidin-PR1 might serve as a template for developing novel antibiotics.
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BACKGROUND@#Portosystemic shunts, including surgical portosystemic shunts and transjugular intra-hepatic portosystemic shunt (TIPS), may have benefit over endoscopic therapy (ET) for treatment of variceal bleeding in patients with cirrhotic portal hypertension; however, whether there being a survival benefit among them remains unclear. This study was to compare the effect of three above-mentioned therapies on the short-term and long-term survival in patient with cirrhosis.@*METHODS@#Using the terms "variceal hemorrhage or variceal bleeding or variceal re-bleeding" OR "esophageal and gastric varices" OR "portal hypertension" and "liver cirrhosis," the Cochrane Central Register of Controlled Trials, PubMed, Embase, and the references of identified trials were searched for human randomized controlled trials (RCTs) published in any language with full texts or abstracts (last search June 2017). Risk ratio (RR) estimates with 95% confidence interval (CI) were calculated using random effects model by Review Manager. The quality of the included studies was evaluated using the Cochrane Collaboration's tool for the assessment of the risk of bias.@*RESULTS@#Twenty-six publications comprising 28 RCTs were included in this analysis. These studies included a total of 2845 patients: 496 (4 RCTs) underwent either surgical portosystemic shunts or TIPS, 1244 (9 RCTs) underwent either surgical portosystemic shunts or ET, and 1105 (15 RCTs) underwent either TIPS or ET. There was no significant difference in overall mortality and 30-day or 6-week survival among three interventions. Compared with TIPS and ET, separately, surgical portosystemic shunts were both associated with a lower bleeding-related mortality (RR = 0.07, 95% CI = 0.01-0.32; P < 0.001; RR = 0.17, 95% CI = 0.06-0.51, P < 0.005) and rate of variceal re-bleeding (RR = 0.23, 95% CI = 0.10-0.51, P < 0.001; RR = 0.10, 95% CI = 0.04-0.24, P < 0.001), without a significant difference in the rate of postoperative hepatic encephalopathy (RR = 0.52, 95% CI = 0.25-1.00, P = 0.14; RR = 1.09, 95% CI = 0.59-2.01, P = 0.78). TIPS showed a trend toward lower variceal re-bleeding (RR = 0.46, 95% CI = 0.36-0.58, P < 0.001), but a higher incidence of hepatic encephalopathy than ET (RR = 1.78, 95% CI = 1.34-2.36, P < 0.001).@*CONCLUSIONS@#The overall analysis revealed that there seem to be no short-term and long-term survival advantage, but surgical portosystemic shunts are with the lowest bleeding-related mortality among the three therapies. Surgical portosystemic shunts may be the most effective without an increased risk of hepatic encephalopathy and TIPS is superior to ET but at the cost of a higher incidence of hepatic encephalopathy. However, some of findings should be interpreted with caution due to the lower level of evidence and the existence of significant heterogeneity.
Subject(s)
Humans , Confidence Intervals , Esophageal and Gastric Varices , Pathology , Gastrointestinal Hemorrhage , Portasystemic Shunt, Transjugular Intrahepatic , Randomized Controlled Trials as TopicABSTRACT
Background:@#Portosystemic shunts, including surgical portosystemic shunts and transjugular intra-hepatic portosystemic shunt (TIPS), may have benefit over endoscopic therapy (ET) for treatment of variceal bleeding in patients with cirrhotic portal hypertension; however, whether there being a survival benefit among them remains unclear. This study was to compare the effect of three above-mentioned therapies on the short-term and long-term survival in patient with cirrhosis.@*Methods:@#Using the terms "variceal hemorrhage or variceal bleeding or variceal re-bleeding" OR "esophageal and gastric varices" OR "portal hypertension" and "liver cirrhosis," the Cochrane Central Register of Controlled Trials, PubMed, Embase, and the references of identified trials were searched for human randomized controlled trials (RCTs) published in any language with full texts or abstracts (last search June 2017). Risk ratio (RR) estimates with 95% confidence interval (CI) were calculated using random effects model by Review Manager. The quality of the included studies was evaluated using the Cochrane Collaboration’s tool for the assessment of the risk of bias.@*Results:@#Twenty-six publications comprising 28 RCTs were included in this analysis. These studies included a total of 2845 patients: 496 (4 RCTs) underwent either surgical portosystemic shunts or TIPS, 1244 (9 RCTs) underwent either surgical portosystemic shunts or ET, and 1105 (15 RCTs) underwent either TIPS or ET. There was no significant difference in overall mortality and 30-day or 6-week survival among three interventions. Compared with TIPS and ET, separately, surgical portosystemic shunts were both associated with a lower bleeding-related mortality (RR = 0.07, 95% CI = 0.01–0.32; P < 0.001; RR = 0.17, 95% CI = 0.06–0.51, P < 0.005) and rate of variceal re-bleeding (RR = 0.23, 95% CI = 0.10–0.51, P < 0.001; RR = 0.10, 95% CI = 0.04–0.24, P < 0.001), without a significant difference in the rate of postoperative hepatic encephalopathy (RR = 0.52, 95% CI = 0.25–1.00, P = 0.14; RR = 1.09, 95% CI = 0.59–2.01, P = 0.78). TIPS showed a trend toward lower variceal re-bleeding (RR = 0.46, 95% CI = 0.36–0.58, P < 0.001), but a higher incidence of hepatic encephalopathy than ET (RR = 1.78, 95% CI = 1.34–2.36, P < 0.001).@*Conclusions:@#The overall analysis revealed that there seem to be no short-term and long-term survival advantage, but surgical portosystemic shunts are with the lowest bleeding-related mortality among the three therapies. Surgical portosystemic shunts may be the most effective without an increased risk of hepatic encephalopathy and TIPS is superior to ET but at the cost of a higher incidence of hepatic encephalopathy. However, some of findings should be interpreted with caution due to the lower level of evidence and the existence of significant heterogeneity.
ABSTRACT
Objective@#To study the the application characteristics of paediatric CT examination by investigating four main children′s hospital of Shanghai.@*Methods@#All the CT scan cases of paediatric patients in this work were obtained from the radiology information system (RIS) database in four hospitals between 2011 and 2014. The distribution of using CT scans was analysed according to the age, gender, anatomical regions and the duplicated cases of the patient, then estimated the paediatric CT scan rates of four hospitals in Shanghai.@*Results@#Retrospective review of RIS showed 249 350 CT examinations from 175 672 young patients were performed between 2011 and 2014 in the surveyed hospitals. More males (62%) were scanned than females (38%). The majority of children receiving the examinations were 1 to 5 years old, which amounted to 40.3% in all. Cardiac CT accounted for 14.5% among all children of ≤1 year old CTs and accounted for 63.0% among all cardiac CT scans. There were 33 634 (19.1%) individuals who had received 2 or more CT scans during the four years. The estimated paediatric CT scan frequencies of four hospitals in Shanghai from 2011 to 2014 were 37.9 examinations per 1 000 population in 2011, 43.3 examinations per 1 000 population in 2012, 43.3 examinations per 1 000 population in 2013 and 39.0 examinations per 1 000 population in 2014.@*Conclusions@#The CT scan frequencies of four hospitals in children and young adults was almost keeping stable in Shanghai.