ABSTRACT
Objective To observe the incidence of critical illness-related corticosteroid insufficiency (CIRCI) after severe traumatic brain injury (sTBI) and investigate the relationship between CIRCI and prognosis.Methods This prospective cohort study enrolled 89 sTBI patients (68 males and 21 females;at age range of 15-80 years) hospitalized within 24 hours after sTBI from June 2014 to December 2015.The Glasgow coma scale (GCS) was ≤8 points.The causes of injury included extensive contusion of brain (44 cases),subdural hematoma (21 cases),epidural hematoma (11 cases),primary brain stem injury (8 cases) and diffuse axonal injury (5 cases).Adrenocorticotropic hormone (ACTH) stimulation tests were done within 36 hours after sTBI to identify CIRCI patients.The patients were divided into CIRCI group (50 cases) and non-CIRCI group (39 cases).Moreover,the patients were categorized into survival group (62 cases) and death group (27 cases) based on survival status.The GCS score,mechanical ventilation time,cerebral hernia,survival time and mortality within 28 days were observed in two groups.Results The incidence of CIRCI in sTBI patients was as high as 56％ (50/89).Compared with the non-CIRCI group,the CIRCI group had lower GCS [(5.3 ± 1.7) points vs.(6.1 ± 1.4) points,P ＜ 0.05],and sTBI patients with CIRCI were mechanically ventilated for a longer period of time [(9.9 ± 2.8) days vs.(7.5 ± 1.6) days,P ＜ 0.05].In comparison with non-CIRCI patients,the incidence of brain herniation in sTBI patients with CIRCI was higher (58％ vs.21％,P ＜0.01).The total fatality rate within 28 days was 30％ (27/89).The survival time of CIRCI group was significantly shorter than that of non-CIRCI group (P ＜ 0.05).The fatality rate in the CIRCI group was significantly higher than that of the non-CIRCI group [40％ (20/50) vs.18％ (7/39),P ＜0.05].The incidence of CIRCI in death group was significantly higher than that of the survival group [74％ (20/27) vs.48％ (30/62),P ＜ 0.05].Conclusions The incidence of CIRCI in STBI patients is high.The sTBI patients with CIRCI has significantly higher incidence of brain hernia,longer mechanical ventilation time,higher 28-day mortality and shorter survival time compared with non-CIRCI patients.
ABSTRACT
Objective To establish CFPAC-1 cell lines deficient in CDC25B2 by recombinant lentivirus, and to investigate the role of this gene. Methods After CFPAC-1 cells were transduced with recombinant lentivirus producing CDC25B2 siRNA, stably transduced cells with green fluorescent protein were selected by flow cytometer. The mRNA and protein expression of CDC25B2 was examined by RT-PCR and Western blot analysis. The effect of the lentivirus on the cell proliferation, cell cycle, clone-forming, migration and invasion ability was analyzed by MTr method, flow cytometer, plate clone-forming assay and Transwell chamber method respectively. Results CDC25B2 siRNA knocked down CDC25B2 expression in CFPAC-1 cells significantly. The silencing efficiency of siRNA transduction by recombinant lentivirns was very high. Proliferation, cloneforming, migration and invasion ability of human pancreatic cancer cell line CFPAC-I were significantly in-creased, while cell cycle was not affected. Conclusion CDC25 B2 plays an important role in cell proliferation, clone-forming, migration and invasion of pancreatic cancer. This research provides experimental evidences for targeting CDC25B2 in gene therapy against pancreatic cancer.