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1.
Acta Pharmaceutica Sinica ; (12): 98-108, 2022.
Article in Chinese | WPRIM | ID: wpr-913172

ABSTRACT

Tumor microenvironment (TME) is composed of abnormal tumor vasculature, extracellular matrix components, endothelial cells, pericytes, tumor associated fibroblasts, smooth muscle cells and immune cells, which is characterized by hypoxia, acidosis and high interstitial fluid pressure. Hypoxia and acidosis within the TME trigger an adjustment of the extracellular matrix (ECM), a response from neighbor stromal cells (e.g., fibroblasts) and immune cells (lymphocytes and macrophages), inducing tumor growth, angiogenesis, and ultimately, resulting in metastasis. What's more, the components of TME including abnormal tumor vasculature, rich composition of the ECM, and abundant stroma cells impair tumoral distribution and penetration of the drugs. At the same time, this stromal microenvironment plays a vital role in creating an immunosuppressive environment.Over the past years, more and more researches focus on targeting and remolding TME to improve therapeutic effects against tumors. Herein, we reviewed current strategies developed to target and remodel TME, including modulating tumor hypoxia, tumor vasculature, tumor associated fibroblasts, extracellular matrix components, tumor associated macrophage phenotypes and dendritic cells. Also, potential problems and future directions are pointed out in this review.

2.
Article in Chinese | WPRIM | ID: wpr-911251

ABSTRACT

Objective:To evaluate the effect of hydrogen on lung injury induced by extremity ischemia-reperfusion (I/R) in elderly patients.Methods:Sixty American Society of Anesthesiologists physical status Ⅱ or Ⅲ elderly patients, aged 65-75 yr, with height 155-180 cm, weighing 50-75 kg, undergoing lower limb surgery under spinal anesthesia, were divided into 2 groups ( n=30 each) using a random number table method: hydrogen inhalation group (H group) and control group (C group). In H group, 67% hydrogen-33% oxygen was inhaled through the nasal catheter until the end of surgery starting from the completion of anesthesia.In group C, 33% oxygen was inhaled through the nasal catheter until the end of surgery after the completion of anesthesia.Blood samples from the radial artery were collected before anesthesia and at 60 min after tourniquet deflation.Blood gas analysis was performed to determine and record arterial oxygen partial pressure (PaO 2) and arterial carbon dioxide partial pressure (PaCO 2), and alveolar-arterial partial pressure of oxygen difference (A-aDO 2), oxygenation index (OI) and respiratory index (RI) were calculated.Pulmonary surfactant protein D (SP-D) and interleukin-6 (IL-6) concentrations in serum were measured by enzyme-linked immuno sorbent assay.ICU stay time and incidence of pulmonary complications within 7 days after operation were recorded. Results:Compared with group C, PaO 2 and OI were significantly increased, RI and A-aDO 2 were decreased, SP-D and IL-6 concentrations in serum were decreased at 60 min after tourniquet deflation, and ICU stay time was shortened ( P<0.05), and no significant change was found in the incidence of pulmonary complications within 7 days after surgery in group H ( P>0.05). Conclusion:Hydrogen can reduce the lung injury induced by extremity I/R, and the mechanism may be related to the reduction of inflammatory response in elderly patients.

3.
Chinese Journal of Urology ; (12): 867-868, 2021.
Article in Chinese | WPRIM | ID: wpr-911136

ABSTRACT

Co-occurrence of renal cell carcinoma with two different histology is very rare. Here we present a 61-year-old gentleman with right renal mass in clinics. The diagnosis was right renal cell carcinoma by two different enhanced mass showing on CT scan. Right laparoscopic nephrectomy was performed. Pathology showed that one mass was papillary renal cell carcinoma, the other was clear cell renal cell carcinoma. No recurrence or metastasis was found during 36 months of follow up.

4.
Article in Chinese | WPRIM | ID: wpr-881389

ABSTRACT

@#In this study, ivabradine hydrochloride (IVB) was prepared as elementary osmotic pump tablets whose administration frequency was reduced to once daily. The dissolution method was developed, and effects on drug release profiles were evaluated by single factor analysis involving suspending agents, osmotic active agents and aging process. Orthogonal test was carried out at 3 levels on 3 factors including the amount of polyoxyethylene (PEO) in the core, polyethylene glycol (PEG) percentage and weight increase of controlled-release film coatings. The final formulation consisted of IVB (16.25 mg), PEO N80 (60 mg), hypromellose E5 (10 mg), lactose (111.75 mg), magnesium stearate (2 mg); and the film coatings consisted of PEG (15%), cellulose acetate (85%), with a weight increase of 7.5%. In vitro drug release behaviors were investigated. Prepared tablets exhibited similar release profiles in different pH dissolution media, with no risk of dose dumping in 40% ethanol solutions. The osmotic pressure differences inside and outside the membrane drove drug release. IVB osmotic pump tablets could reduce the frequency of administration and improve patients'' compliance, thus with better application values.

5.
Article in Chinese | WPRIM | ID: wpr-906473

ABSTRACT

Objective:To investigate the effect of Huayu Jiedu prescription (HYJDP) on gut microbiota and fecal metabolites in mice with endometriosis. Method:Normal female C57BL/6J mice were divided into normal control group (CO), endometriosis group (EM) and Chinese medicine Huayu Jiedu decocotion group (CM). CO and EM groups received normal saline and CM group received HYJDP by intragastric administration. Untargeted metabolomics method was used to detect metabolites in fecal supernatant of mice, and receiver operating characteristic (ROC) analysis was used to screen the differential metabolites, 16S rRNA high-throughput sequencing was used to detect the gut microbiota, and Spearman correlation coefficient was used to represent the degree of correlation between differential metabolites and intestinal flora. Lipopolysaccharides (LPSs) in intestinal wall tissue, serum and peritoneal lavage fluid were detected by enzyme-linked immunosorbent assay (ELISA). The expression of Vimentin and E-cadherin in ectopic lesions was detected by immunohistochemistry. Result:HYJDP alleviated the disorders of fecal metabolites and gut microbiota in EMS mice, especially with the recovered levels of homoveratric acid, melilotoside C and physapubescin in fecal supernatant. In the comparison of these three factors between EM group and CO group as well as between EM group and CM group, the variable important in projection (VIP) value was both above 2, and AUC in ROC analysis was both >0.9. As compared with EM group, HYJDP restored the abundance of species such as <italic>Lachnospiraceae_NK4A136_group</italic>, <italic>Lactobacillus</italic> and <italic>Blautia </italic>(<italic>P</italic><0.05). In addition, the level of LPS in peritoneal fluid supernatant of EM group was significantly higher than that of CO group (<italic>P</italic><0.05) and CM group (<italic>P</italic><0.05). The protein expression of vimentin and E-cadherin in endometriosis decreased significantly (<italic>P</italic><0.05). Conclusion:HYJDP which can improve the intestinal environment and reduce the level of LPS in mice with endometriosis, is an effective drug for the treatment of endometriosis.

6.
Article in Chinese | WPRIM | ID: wpr-904327

ABSTRACT

@#Remdesivir-loaded liposomes for inhalation were prepared and the in vitro properties were evaluated. Firstly, preparation methods of remdesivir-loaded liposomes were screened, and single-factor experiments were conducted to optimize the prescription and preparation process. Then the physical property, deposition ratio and aerodynamic particle size distribution of remdesivir-loaded liposomes suspension for inhalation were comprehensively evaluated. As a result, the optimal liposomes were prepared by the thin-film dispersion method with pH 6.5 phosphate-buffered saline as the hydration medium. In the prescription, the ratio of drug to DPPC was 1∶20; the cholesterol accounted for 10% of total lipids; and 20% DSPE-mPEG 2000 was added as stabilizer.4% trehalose was added as lyoprotectant when lyophilizing to obtain ideal appearance, good stability and a small particle size change after reconstitution. Remdesivir-loaded liposomes were spherical with smooth surface and uniform particle size distribution under transmission electron microscope. In vitro release tests showed no significant change for release curves of remdesivir-loaded liposomes suspension before and after nebulization. Deposition experiments indicated that the fine particles fraction of liposomes was 51.4%, and the mass median aerodynamic diameter was less than 5 μm measured by next generation impactor. To sum up, remdesivir-loaded liposomes for inhalation with high encapsulation efficiency and stability can achieve a suitable particle size distribution to effectively deposit in the lung after nebulization, which provides a new approach for the treatment of COVID-19.

7.
Chinese Medical Journal ; (24): 1952-1958, 2021.
Article in English | WPRIM | ID: wpr-887625

ABSTRACT

BACKGROUND@#Early detection of gastric cancer (GC) has been the topic of major efforts in China. This study aimed to explore the risk factors associated with GC and to provide evidence for the selection of a high-risk population of GC.@*METHODS@#Based on the cancer screening cohort of the National Cancer Screening Program in Urban China, GC patients diagnosed by endoscopy and pathological examinations constituted the case group, and controls were 1:3 matched by sex and age (±5 years) individually. The variables were selected by univariable analysis of factors such as body mass index (BMI), dietary habits, lifestyle, stomach disease history, and family history of GC; and multivariable logistic regression was used to analyze the influencing factors of GC and to calculate the odds ratio (OR) of related factors and its 95% confidence interval (CI).@*RESULTS@#A total of 215 GC cases and 645 matched healthy controls were included in the final analysis, with a median age of 61 years for the case and control groups. Overall analysis showed that high educational level (above primary school) (OR = 0.362, 95% CI = 0.219-0.599, P < 0.001), overweight/obesity (BMI ≥24 kg/m2; OR = 0.489, 95% CI = 0.329-0.726, P < 0.001), cigarette smoking (OR = 3.069, 95% CI = 1.700-5.540, P < 0.001), alcohol consumption (OR = 1.661, 95% CI = 1.028-2.683, P = 0.038), history of stomach disease (OR = 6.917, 95% CI = 4.594-10.416, P < 0.001), and family history of GC in first-degree relatives (OR = 4.291, 95% CI = 1.661-11.084, P = 0.003) were significantly correlated with the occurrence of GC. Subgroup analyses by age and gender indicated that GC risk was still increased in the presence of a history of stomach disease. A history of chronic gastritis, gastric ulcer, or gastric polyposis was positively associated with GC, with adjusted ORs of 4.155 (95% CI = 2.711-6.368), 1.839 (95% CI = 1.028-3.288), and 2.752 (95% CI = 1.197-6.326).@*CONCLUSIONS@#Subjects who smoke, drink, with history of stomach disease and family history of GC in first-degree relatives are the high-risk populations for GC. Therefore, attention should be paid to these subjects for GC screening.


Subject(s)
Case-Control Studies , Humans , Middle Aged , Overweight , Risk Factors , Stomach Neoplasms/etiology
8.
Chinese Journal of Neurology ; (12): 814-818, 2020.
Article in Chinese | WPRIM | ID: wpr-870888

ABSTRACT

Subarachnoid hemorrhage (SAH) is a common hemorrhagic cerebrovascular disease with high mortality and disability rate. Intracranial aneurysm is the major cause of SAH,severe and unbearable headache with meningeal irritation is the typical clinical manifestation of it,and the diagnosis is mainly confirmed by neuroimaging. The purpose of SAH treatment is to eradicate bleeding causes such as aneurysms and brain arteriovenous malformation (bAVM), eliminate brain edema and control intracranial pressure, prevent cerebral vasospasm and secondary cerebral ischemia, and deal with complications such as hydrocephalus actively. Two international multicenter randomized controlled trials, ISAT (International Subarachnoid Aneurysm Trial) and BRAT (Barrow Ruptured Aneurysm Trial), have provided new evidences for the treatment of aneurysmal subarachnoid hemorrhage. Multidisciplinary collaboration,consisting of neurosurgery, intervention and neurology departments, is an important guarantee for good clinical outcomes.

9.
Article in Chinese | WPRIM | ID: wpr-869963

ABSTRACT

Objective:To evaluate the effect of hydrogen on the occurrence of pulmonary complications after thoracoscopic radical resection of lung cancer.Methods:One hundred and ten patients of both sexes, aged 45-75 yr, with body mass index of 18-23 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, scheduled for elective thoracoscopic radical resection of lung cancer, were divided into 2 groups ( n=55 each) using the random number table method: hydrogen group (group H) and control group (group C). Patients inhaled 66.7% hydrogen for 60 min before anesthesia in group H, while 33% oxygen was inhaled for 60 min in group C. Blood samples were collected from the radial artery at 5 min before one-lung ventilation (T 0) and 1 h of one-lung ventilation (T 1) for blood gas analysis and for determination of peak airway pressure, airway plateau pressure, driving pressure and dynamic lung compliance.Oxygenation index was calculated.Bronchoalveolar lavage fluid on the ventilated side was collected at T 0 and T 1 for measurment of interleukin-6 concentrations by enzyme-linked immunosorbent assay.The incidence of pulmonary complications within 7 days after surgery was recorded. Results:Compared with group C, the oxygenation index and dynamic lung compliance were significantly increased, and the peak airway pressure, airway plateau pressure, driving pressure, interleukin-6 concentrations in bronchoalveolar lavage fluid, and incidence of pulmonary complications within 7 days after surgery were decreased in group H ( P<0.05). Conclusion:Hydrogen can decrease the occurrence of pulmonary complications, and the mechanism is related to reducing lung inflammatory responses and improving lung compliance in the patients undergoing thoracoscopic radical resection of lung cancer.

10.
Article in Chinese | WPRIM | ID: wpr-869934

ABSTRACT

Objective:To evaluate the effect of dexmedetomidine on intestinal injury in severely burned rats.Methods:One hundred and twenty healthy clean-grade male Sprague-Dawley rats, weighing 240-260 g, were divided into 4 groups ( n=30 each) using a random number table method: sham operation group (group Sham), sham plus dexmedetomidine group (group Sham+ Dex), severe burn group (group Burn), and severe burn plus dexmedetomidine group (group Burn+ Dex). Forty percent total body surface area of III degree burn model was developed in chloral hydrate-anesthetized rats.Dexmedetomidine was intravenously infused for 4 h at a rate of 5 μg·kg -1·h -1 starting from 3 h after establishing the model in Sham+ Dex group and Burn+ Dex group.The small intestinal tissues were removed for examination of the pathological changes which were scored and for determination of tumor necrosis factor-alpha (TNF-α) and high-mobility group box 1 protein (HMGB1) contents (by enzyme-linked immunosorbent assay), and expression of occludin and ZO-1 protein (by Western blot). The serum concentrations of 4-kD-FITC were measured at 90, 180, 360 and 720 min after establishing the model. Results:Compared with Sham group, the pathological scores of intestinal tissues, contents of TNF-α and HMGB1, serum concentrations of 4-kD-FITC at each time point were significantly increased, and the expression of occludin and ZO-1 was down-regulated in Burn group and Burn+ Dex group ( P<0.05), and no significant change was found in the parameters mentioned above in Sham+ Dex group ( P>0.05). Compared with Burn group, the pathological scores of intestinal tissues, contents of TNF-α and HMGB1, serum concentrations of 4-kD-FITC at each time point were significantly decreased, and the expression of occludin and ZO-1 was up-regulated in Burn+ Dex group ( P<0.05). Conclusion:Dexmedetomidine can reduce intestinal injury in severely burned rats, and the mechanism may be related to inhibiting inflammatory responses in the intestine.

11.
Article in Chinese | WPRIM | ID: wpr-829563

ABSTRACT

@#Recently,an increasing number of studies have found that matrix metalloproteinase (MMPs) are closely related to the severity,diagnosis and prognosis of a variety of diseases. MMPs have therefore also gained increasing attention as a potential biomarker. In this paper,the application of MMPs in the diagnosis of tumors,cardiovascular diseases,inflammatory diseases and neurodegenerative diseases was summarized,and three types of detection methods based on RNA level,protein level and hydrolase activity of MMPs were introduced,which aims to provide some theoretical reference for the study of clinical application of MMPs detection.

12.
Article | WPRIM | ID: wpr-831049

ABSTRACT

Purpose@#The purpose of this study was to investigate the prognostic impact of Epstein-Barr virus(EBV)–microRNA (miRNA, miR)-BHRF1-1 with chronic lymphocytic leukemia (CLL) as wellas role of EBV-miR-BHRF1-1 in p53 gene. @*Materials and Methods@#Quantitative reverse transcription–polymerase chain reaction and western blotting wereused to quantify EBV-miR-BHRF1-1 and p53 expression in cultured CLL. @*Results@#p53 aberration was associated with the higher expression level of EBV-miR-BHRF1-1 (p <0.001) which was also an independent prognostic marker for overall survival (p=0.028;hazard ratio, 5.335; 95% confidence interval, 1.193 to 23.846) in 97 newly-diagnosed CLLpatients after adjusted with International Prognostic Index for patients with CLL. We identifiedEBV-miR-BHRF1-1 as a viral miRNA regulator of p53. EBV-miR-BHRF1-1 repressedluciferase reporter activity by specific interaction with the seed region within the p53 3-untranslated region. Discordance of p53 messenger RNA and protein expression wasassociated with high EBV-miR-BHRF1-1 levels in CLL patients and cell lines. EBV-miR-BHRF1-1 inhibition upregulated p53 protein expression, induced cell cycle arrest and apoptosisand decreased cell proliferation in cell lines. EBV-miR-BHRF1-1 mimics downregulated p53protein expression, decreased cell cycle arrest and apoptosis, and induced cell proliferationin cell lines. @*Conclusion@#This study supported the role of EBV-miR-BHRF1-1 in p53 regulation in vitro. Our resultssupport the potential of EBV-miR-BHRF1-1 as a therapeutic target in EBV-associated CLLwith p53 gene aberration.

13.
Chinese Journal of Urology ; (12): 833-837, 2019.
Article in Chinese | WPRIM | ID: wpr-824597

ABSTRACT

Objective To investigate the assessment and treatment strategy of patients with renal cell carcinoma.Methods The clinical data of 43 patients with renal cell carcinoma and bone metastases admitted to the First Affiliated Hospital of Nanjing Medical University from January 2006 to December 2018 were retrospectively analyzed.The follow-up time was 6 years,with an average age of 55.4 years (21-87 years).There were 29 males,14 females,22 cases of limb bone metastasis,12 cases of spinal metastasis,9 cases of multiple bone metastasis,21 cases of Fuhrman grade 1 and 2,19 cases of T1,and 20 cases of N0.All patients were confirmed by postoperative pathological examination or imaging data suggesting that bone metastasis are from renal cell carcinoma.Forty-three patients underwent primary renal surgery,and molecular targeted therapy was used after the operation.The treatment process was smooth,no obvious discomfort,and postoperative pathology showed clear cell carcinoma.22 patients with limb bones metastasis and 12 patients with spinal metastasis included in the study all met the indications for secondary surgery after the disease assessment.After communicating with the patient,13 patients with limbs metastasis and 6 patients with spinal metastasis received local treatment,including complete resection of the extremities and spinal fixation,the remaining 15 patients and 9 patients with multiple bone metastasis were treated conservatively.There were 19 patients in the local treatment group,13 patients with limbs bone metastasis,6 patients with spinal bone metastasis,the average age was 54.9 years,the average diameter of the primary tumor was 4.7 cm.There were 24 patients in the conservative treatment group,9 patients with limbs metastasis,6 patients with spinal metastases and 9 cases with multiple bone metastasis,with an average age of 56 years and a primary tumor diameter of 5.6 cm.Limb metastatic lesions were evaluated according to the patient's general condition,bone pain,fracture risk,and bone metastasis.Spinal lesions were evaluated according to Tokuhashi score,Harrington score,Tomita score,vertebral stability assessment,and molecular targeted therapy.Aminokinase inhibitors,conservative treatment with local radiotherapy and bisphosphonate treatment.Results During the follow-up period,the 1-year overall survival rate of the local treatment group was 100.0%,the 2-year overall survival rate was 89.4%,and the 5-year overall survival rate was 73.7%.The 1-year overall survival rate of the conservative treatment group was 87.5%,and the 2-year overall survival rate was 62.5%.The 5-year overall survival rate was 16.7%.The 2-year and 5-year survival rates of the local treatment group were statistically different (P =0.044,P =0.000) compared with the conservative treatment group.For patients with limb bone metastasis,the 5-year survival rate was significantly higher in patients receiving topical treatment than in the conservative treatment group (P =0.011).For spinal metastasis,spinal pain in the local treatment group was alleviated to varying degrees.No spinal instability and spasticity were observed after follow-up.In the spine patients who received conservative treatment,3 patients developed paraplegia,which was statistically different from local treatment (P =0.046).Another 9 patients with multiple bone metastases did not undergo local surgery,and all died after multiple organ failure.Conclusions At the same time of molecular targeted therapy,according to the evaluation results,selective treatment of bone metastases with secondary surgical indications,including complete resection of the extremities and spinal fixation,can significantly improve the survival and quality of life of those patients.

14.
Article in Chinese | WPRIM | ID: wpr-804530

ABSTRACT

@#In this study, pregabalin controlled porosity osmotic pump tablets which are taken once a day were prepared. Single-factor tests were carried out to investigate the influence of excipients and manufacturing process. The formulation was optimized through orthogonal experiment on three levels of three significant factors including the amount of sodium citrate, and polyethylene glycol 400 and coating weight gain. On the basis of the results of the single-factor tests and the orthogonal experiment, optimal formulation and manufacturing process were obtained. The final tablet formulation contained pregabalin(82. 5 mg), microcrystalline cellulose(40%), sodium citrate(27. 5%), magnesium stearate(0. 5%)and 5% povidone K30 solution as the tablet binder; the coating formulation consisted of cellulose acetrate and 60% of polyethylene glycol 400 as a porogen; the coating weight gain was 3%. In vitro drug release kinetic study suggested that the drug release from controlled porosity osmotic pump tablets was mainly driven by osmotic pressure, which was barely affected by the pH of the release medium. The drug release behavior of the tablets within 12 hours complied with zero-order release rule and the linear correlation coefficient was 0. 991 6. The obtained porosity osmotic pump tablets could effectively slow the drug release rate, reduce concentration fluctuation and improve the safety and convenience for the patients, hence with broad prospects.

15.
Chinese Journal of Urology ; (12): 833-837, 2019.
Article in Chinese | WPRIM | ID: wpr-801140

ABSTRACT

Objective@#To investigate the assessment and treatment strategy of patients with renal cell carcinoma.@*Methods@#The clinical data of 43 patients with renal cell carcinoma and bone metastases admitted to the First Affiliated Hospital of Nanjing Medical University from January 2006 to December 2018 were retrospectively analyzed. The follow-up time was 6 years, with an average age of 55.4 years (21-87 years). There were 29 males, 14 females, 22 cases of limb bone metastasis, 12 cases of spinal metastasis, 9 cases of multiple bone metastasis, 21 cases of Fuhrman grade 1 and 2, 19 cases of T1, and 20 cases of N0. All patients were confirmed by postoperative pathological examination or imaging data suggesting that bone metastasis are from renal cell carcinoma. Forty-three patients underwent primary renal surgery, and molecular targeted therapy was used after the operation. The treatment process was smooth, no obvious discomfort, and postoperative pathology showed clear cell carcinoma.22 patients with limb bones metastasis and 12 patients with spinal metastasis included in the study all met the indications for secondary surgery after the disease assessment. After communicating with the patient, 13 patients with limbs metastasis and 6 patients with spinal metastasis received local treatment, including complete resection of the extremities and spinal fixation, the remaining 15 patients and 9 patients with multiple bone metastasis were treated conservatively. There were 19 patients in the local treatment group, 13 patients with limbs bone metastasis, 6 patients with spinal bone metastasis, the average age was 54.9 years, the average diameter of the primary tumor was 4.7 cm. There were 24 patients in the conservative treatment group, 9 patients with limbs metastasis, 6 patients with spinal metastases and 9 cases with multiple bone metastasis, with an average age of 56 years and a primary tumor diameter of 5.6 cm. Limb metastatic lesions were evaluated according to the patient's general condition, bone pain, fracture risk, and bone metastasis. Spinal lesions were evaluated according to Tokuhashi score, Harrington score, Tomita score, vertebral stability assessment, and molecular targeted therapy. Aminokinase inhibitors, conservative treatment with local radiotherapy and bisphosphonate treatment.@*Results@#During the follow-up period, the 1-year overall survival rate of the local treatment group was 100.0%, the 2-year overall survival rate was 89.4%, and the 5-year overall survival rate was 73.7%. The 1-year overall survival rate of the conservative treatment group was 87.5%, and the 2-year overall survival rate was 62.5%. The 5-year overall survival rate was 16.7%. The 2-year and 5-year survival rates of the local treatment group were statistically different (P=0.044, P=0.000) compared with the conservative treatment group. For patients with limb bone metastasis, the 5-year survival rate was significantly higher in patients receiving topical treatment than in the conservative treatment group (P=0.011). For spinal metastasis, spinal pain in the local treatment group was alleviated to varying degrees. No spinal instability and spasticity were observed after follow-up. In the spine patients who received conservative treatment, 3 patients developed paraplegia, which was statistically different from local treatment (P=0.046). Another 9 patients with multiple bone metastases did not undergo local surgery, and all died after multiple organ failure.@*Conclusions@#At the same time of molecular targeted therapy, according to the evaluation results, selective treatment of bone metastases with secondary surgical indications, including complete resection of the extremities and spinal fixation, can significantly improve the survival and quality of life of those patients.

16.
Chinese Journal of Neurology ; (12): 989-993, 2019.
Article in Chinese | WPRIM | ID: wpr-800362

ABSTRACT

Subarachnoid hemorrhage (SAH) is a common hemorrhagic cerebrovascular disease, which not only has devastating impact on the central nervous system but also on many other organs. Due to the differences in the age of onset, etiology, risk factor, original bleeding site and amount of bleeding, complication, and the level of medical center, the clinical outcomes for specific patients are quite different. With the progress of medical science, the further development of neuroimaging, neurointervention and neurological intensive care has significantly improved the overall clinical outcome of SAH and greatly reduced the mortality rate. In particular, the results of some high-quality multicenter randomized controlled trials have been published in recent years, which provide new evidence-based evidence for SAH risk assessment and treatment selection. This article focuses on the etiology, emergency diagnosis and clinical evaluation, treatment of common causes and treatment of severe neurological diseases of SAH, so as to improve the understanding of SAH and guide clinical practice.

17.
Cancer Research and Treatment ; : 1098-1106, 2019.
Article in English | WPRIM | ID: wpr-763170

ABSTRACT

PURPOSE: This study differentiates patient and care delays of breast cancer and explores the related factors as well as the associations with the prognosis in Guangzhou, a southern city of China. METHODS: A cohort of female incident breast cancer patients (n=1,551) was recruited from October 2008 to March 2012 and followed up until January 1, 2016 (n=1,374) in the affiliated hospitals of Sun Yat-sen University. The factors associated with patient and care delays were analyzed with multivariable logistic models. Cox proportional hazards regression models were constructed to estimate the impacts of the delays on the prognosis. RESULTS: There were 40.4% patient delay (≥3 months) and 15.5% care delay (≥1 month). The patient delay, but not the care delay, was significantly related to the clinical stage and consequently worsened the prognosis of breast cancer (hazard ratio, 1.45; 95% confidence interval, 1.09 to 1.91 for progression-free survival). The factors related to an increased patient delay included premenopausal status, history of benign breast disease, and less physical examination. CONCLUSION: Patient delay was the main type of delay in Guangzhou and resulted in higher clinical stage and poor prognosis of breast cancer. Screening for breast cancer among premenopausal women may be an effective way to reduce this delay.


Subject(s)
Breast Diseases , Breast Neoplasms , Breast , China , Cohort Studies , Female , Humans , Logistic Models , Mass Screening , Physical Examination , Prognosis , Solar System
18.
Article in Chinese | WPRIM | ID: wpr-755650

ABSTRACT

Objective To evaluate the role of H1 receptor in inflammatory responses during ventila-tor-induced lung injury ( VILI) in rats. Methods Thirty clean-grade healthy male Sprague-Dawley rats, aged 9-10 weeks, weighing 250-300 g, were divided into 3 groups ( n=10 each) using a random number table method: control group (group C), VILI group (group V) and H1 receptor antagonist clemastine group ( group Cle) . The animals were anesthetized and tracheostomized, and the rats in group C kept spon-taneous breathing. The rats were mechanically ventilated for 4 h with the tidal volume of 40 ml/kg, respira-tory rate 40 breaths/min, inspiratory/expiratory ratio 1 : 1, and inspired oxygen fraction ratio 21% in group V. In group Cle, clemastine 0. 9 mg/kg was intramuscularly injected at 30 min before anesthesia, the ani-mals were tracheostomized after being anesthetized, and then the rats were mechanically ventilated with the same ventilator settings as group V. The animals were sacrificed at 4 h of ventilation, bronchoalveolar lav-age fluid ( BALF) was collected for determination of concentrations of total protein, interleukin-6 ( IL-6) , tumor necrosis factor-alpha ( TNF-α) , and the lung specimens were obtained for microscopic examination of pathologic changes and for determination of wet/dry weight ratio ( W/D ratio ) . Results Compared with group C, the concentrations of total protein, IL-6 and TNF-αin BALF and W/D ratio were significantly in-creased in group V (P<0. 05). Compared with group V, the concentrations of total protein, IL-6 and TNF-αin BALF and W/D ratio were significantly decreased in group Cle ( P<0. 05) . The pathologic chan-ges of lung tissues were significantly attenuated in group Cle as compared with group V. Conclusion H1 receptor is involved in the process of inflammatory responses during VILI in rats.

19.
Article in Chinese | WPRIM | ID: wpr-755616

ABSTRACT

Objective To evaluate the effect of hydrogen on the expression of matrix metalloproteinase-9 (MMP-9) in brain tissues of mice with sepsis-associated encephalopathy (SAE).Methods A total of 212 clean-grade healthy male C57BL/6J mice,aged 6-8 weeks,weighing 20-25 g,were divided into 4 groups (n =53 each) using a random number table method:sham operation group (group Sham),sham operation plus hydrogen group (group Sham+H2),group SAE and SAE plus hydrogen group (group SAE+ H2).The sepsis model was established by intraperitoneally injecting human fecal suspension.Sham+H2 and SAE+H2 groups inhaled 2% hydrogen for 1 h at 1 and 6 h after establishing the model,respectively.Postoperative 14-day survival rate was recorded.Evans blue (EB) was injected into the tail vein at 24 h after establishing the model,and the content of EB in brain tissues was calculated.Brain tissues were taken for determination of brain water content.The expression of tumor necrosis factor-alpha (TNF-α),interleukin-6 (IL-6) and high-mobility group box 1 protein (HMGB1) in hippocampal tissues was detected by enzymelinked immunosorbent assay.The expression of MMP-9 and ZO-1 protein and mRNA in hippocampal tissues was determined by Western blot and real-time polymerase chain reaction,respectively,at 6,12 and 24 h after establishing the model.Results Compared with Sham group,the 14-day survival rate was significantly decreased,the EB content in brain tissues,brain water content,and contents of TNF-α,IL-6 and HMGB1 were significantly increased,the expression of MMP-9 protein and mRNA was up-regulated,and the expression of ZO-1 protein and mRNA was down-regulated in SAE and SAE+H2 groups (P<0.05),and no significant change was found in the parameters mentioned above in group Sham+H2 (P>0.05).Compared with group SAE,the 14-day survival rate was significantly increased,the EB content in brain tissues,brain water content,and contents of TNF-α,IL-6 and HMGB1 were significantly decreased,the expression of MMP-9 protein and mRNA was down-regulated,and the expression of ZO-1 protein and mRNA was up-regulated in group SAE+H2 (P<0.05).Conclusion The mechanism by which hydrogen attenuates the blood-brain barrier damage may be related to inhibiting MMP-9 expression and to reducing inflammatory responses in brain tissues of SAE mice.

20.
National Journal of Andrology ; (12): 243-247, 2019.
Article in Chinese | WPRIM | ID: wpr-816803

ABSTRACT

Objective@#To explore the feasibility of glans-preserving surgery (GPS) in the treatment of superficial penile squamous cell carcinoma (PSCC) with the lesion diameter of ≥2 cm.@*METHODS@#We retrospectively analyzed the clinical data on 69 cases of superficial PSCC (≤T1aN0) treated by GPS (n = 36) or radical surgery (total or partial penectomy, n = 33) from July 2007 to July 2017.@*RESULTS@#The mean tumor diameter and depth of invasion were 3.16 (2.0-6.0) cm and 0.89 (0.5-2.0) cm in the GPS group and 3.56 (2.0-6.0) cm and 1.89 (0.6-4.0) cm respectively in the radical surgery group. The patients were followed up for 10-102 (mean 42) months, during which, 5 patients in the GPS group developed local recurrence at 40 days and 2, 4, 7 and 9 months postoperatively, again underwent gansectomy, partial penectomy or GPS, and experienced no more recurrence during the follow-up of 54, 34, 39, 66 and 70 months. No local recurrence was observed in the radical surgery group, and none of the 69 patients experienced lymph node metastasis or died during the follow-up.@*CONCLUSIONS@#GPS is safe and efficient for the treatment of superficial PSCC with the lesion diameter of ≥2 cm.

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