ABSTRACT
Objective:To investigate the efficacy of concentrated growth factor (CGF) in the reduction of pain and swelling after bone augmentation during surgery for odontogenic maxillary cyst.Methods:Sixteen patients with odontogenic maxillary cysts who underwent bone augmentation during surgery between June 2018 and December 2019 were included in this study. They were randomly divided into two groups ( n = 8/group). In the observation group, CGF and bone substitutes were mixed and covered with biofilm. In the control group, bone powder was used to fill the bone cavity, and artificial biofilm was applied. Postoperative swelling, pain, and scar hyperplasia were compared between the two groups. Pain was rated according to visual analogue score. Swelling was divided into three grades according to the level of swelling. Scar was compared according to vancouver scar scale. Statistical analysis was performed using SPSS 20.0 software. Results:The percentage of grade 1-3 swelling in the observation group were 62.5% (5/8), 37.5% (3/8) and 0.0% (0/8), respectively, and they were 50.0% (4/8), 37.5% (3/8), 12.5%(1/8), respectively ( Z = -1.71, P > 0.05). There was significant difference in the duration of swelling between observation and control groups [(3.8 ± 0.9) days vs. (5.8 ± 1.4) days, t = 6.88, P < 0.05]. At 3, 7 and 14 days after surgery, visual analogue score was (2.21 ± 0.25) points, (3.75 ± 0.22) points and (0.57 ± 0.13) points in the observation group and it was (3.76 ± 0.18) points, (2.38 ± 0.26) points, and (2.38 ± 0.26) points in the control group ( t = 14.23, t = 11.29, t = 17.61, all P < 0.001). At 1, 2 and 4 weeks after surgery, vancouver scar scale score was (4.26 ± 0.26) points, (1.22 ± 0.13) points and (2.47 ± 0.11) points in the observation group, and it was (6.35 ± 0.27) points, (4.47 ± 0.73) points and (2.77 ± 0.21) points in the control group ( t = 15.77, t = 2.67, t = 3.58, P < 0.001). Conclusion:CGF can promote postoperative bone defect repair and wound healing and reduce postoperative swelling, pain and scar.
ABSTRACT
Objective: To evaluate the consistency on the determination of target heart rate by simple calculation method based on resting heart rate and by anaerobic threshold method in cardiopulmonary exercise test (CPET) for patients with coronary artery disease after percutaneous coronary intervention (PCI). Methods: This study was a diagnostic test. Patients with coronary artery disease who underwent the first PCI in the Department of Cardiology of Peking University People's Hospital from October 2011 to April 2021 were enrolled. Patients were further divided into subgroups according to gender, age (<60 years group and ≥60 years group), with or without myocardial infarction history (myocardial infarction group and angina pectoris group) and whether β blockers were applied. The general clinical data of patients, resting heart rate (RHR) and anaerobic threshold heart rate in CPET were collected through the electronic medical record system. The simple target rate (RHR plus 20 or 30 bpm) and the target rate calculated by anaerobic threshold (anaerobic threshold heart rate minus 10 bpm) were both calculated in each patient. Consistency test of target heart rate derived by above the two methods was shown by intra-class correlation (ICC) and Bland-Altman plots. Results: A total of 439 patients were included, age was (56.2±8.8) years, body mass index was (25.77±2.34) kg/m2, there were 382 males (87.0%). The target heart rate determined by anaerobic threshold method was (90.0±11.8)bpm, and the simple target heart rate determined by RHR plus 20 bpm was (91.0±8.4)bpm. There was no significant difference on the target heart rate derived from the two calculation methods (P=0.091). The simple target heart rate determined by RHR plus 30 bpm was (101.0±8.4)bpm, which was significant higher than that determined by anaerobic threshold method (P<0.001). In the following analysis, RHR plus 20 bpm was defined as the simple target heart rate. The ICC value of target heart rate determined by anaerobic threshold and resting rate plus 20 bpm was 0.529(95%CI 0.458-0.593, P<0.001). Bland-Altman plots analysis showed that the ratio of the simple target heart rate and the target heart rate determined by anaerobic threshold method was 1.03±0.11 and the 95% limits of agreement (LOA) were 0.812-1.245. In the subgroup of patients aged<60 years (n=247), the ICC value was 0.492, the ratio by Bland-Altman plots analysis was 1.02±0.11 and LOA was 0.814-1.234; in the subgroup of patients aged ≥60 years (n=192), the ICC value was 0.566, the ratio by Bland-Altman plots analysis was 1.03±0.11 and LOA was 0.810-1.260. In male subgroup(n=382), the ICC value was 0.540, the ratio by Bland-Altman plots analysis was 1.03±0.11 and LOA was 0.813-1.246; in female subgroup(n=57), the ICC value was 0.445, the ratio by Bland-Altman plots analysis was 1.03±0.11 and LOA was 0.810-1.240.In myocardial infarction subgroup (n=186), the ICC value was 0.568, the ratio by Bland-Altman plots analysis was 1.02±0.11 and LOA was 0.810-1.227; in angina pectoris subgroup (n=253), the ICC value was 0.495, the ratio by Bland-Altman plots analysis was 1.04±0.11 and LOA was 0.813-1.260. In the subgroup of patients with β blockers (n=353), the ICC value was 0.520, the ratio by Bland-Altman plots analysis was 1.03±0.11 and LOA was 0.810-1.252; in the subgroup of patients without β blockers (n=86), the ICC value was 0.570, the ratio by Bland-Altman plots analysis was 1.02±0.10 and LOA was 0.821-1.219. Conclusions: The simple target heart rate determined by RHR plus 20 bpm is consistent with the target heart rate determined by anaerobic threshold in patients with coronary artery disease after PCI. But the simple target heart rate determined by RHR plus 20 bpm can't replace the target heart rate determined by anaerobic threshold in this patient cohort.
Subject(s)
Adrenergic beta-Antagonists , Anaerobic Threshold , Angina Pectoris , Coronary Artery Disease , Female , Heart Rate/physiology , Humans , Male , Myocardial Infarction , Percutaneous Coronary InterventionABSTRACT
Objective:To analyze the difference in immune microenvironment between primary tumor tissues and metastatic tumor tissues of metastatic colorectal cancer, and to screen specific immune-related differentially expressed genes (DEG) related to prognosis of metastatic colorectal cancer via bioinformatics methods.Methods:The GSE131418 microarray dataset of colorectal cancer and metastases was downloaded from gene expression omnibus (GEO) database, including 517 samples from the MCC cohort and 618 samples from the Consortium cohort in Moffitt Cancer Center. Immune-related gene sets were downloaded from immunology database and analysis portal IMMPORT, including 2 483 immune-related genes. A total of 695 cases of RNA sequencing data and 627 cases of clinical information of colorectal cancer tumors and adjacent tissues were downloaded from Cancer Genome Atlas (TCGA) data. The stroma cell score, immune cell score and stromal immune total score of metastatic tumor tissues and primary tumor tissues were calculated by using ESTIMATE algorithm, and 22 kinds of immune cell infiltration in primary tumor and metastatic tumor tissues of colorectal cancer were compared and analyzed by using CIBERSORT deconvolution algorithm. Immune-related DEG were screened to make Kyoto Encyclopedia of Genes and Gnomes (KEGG) signaling pathway enrichment analysis. The patients were divided into high and low expression groups according to the median expression levels of immune-related DEG. The Kaplan-Meier method and Cox regression risk model were used to analyze immune-related DEG, and the genes significantly related to prognosis in the results of the two methods were screened (all P < 0.01), and multivariate analysis was performed by using Cox regression method. The expression differences of each gene in tumor tissues, adjacent tissues, primary tumor tissues and metastatic tissues in GSE131418 data sets of TCGA database and GEO database were compared, and survival analysis was also performed. Results:The stroma cell score, immune cell score and stromal immune total score of colorectal cancer metastatic tissues were lower than those of primary tumor tissues (all P < 0.001). Compared with primary tumor tissues, the proportion of activated natural killer (NK) cells, monocytes, CD8 + T cells, T cells, activated dendritic cells in metastatic colorectal cancer tissues was increased, while the proportion of inactive mast cells, inactive dendritic cells, inactive NK cells, activated memory CD4 + T cells, M1 macrophages, and neutrophils was decreased. There were 289 immune-related DEG in metastatic tissues and primary tumor tissues of metastatic colorectal cancer, including 101 up-regulated genes and 188 down-regulated genes. KEGG signaling pathway enrichment analysis showed that in the immune microenvironment of metastatic tissues in metastatic colorectal cancer, vascular endothelial growth factor (VEGF) signaling pathway, programmed death ligand 1 (PD-L1) expression and programmed death 1 (PD-1) checkpoint pathway, T helper cell (Th) 1, Th2 and Th17 cell differentiation, NF-kappa B signaling pathway, interleukin 17 (IL-17) signaling pathway, chemokine signaling pathway, T cell receptor signaling pathway, MAPK signaling pathway, and NK cell-mediated cytotoxicity pathways enrichment were detected. Immune-related DEG related to prognosis including ANGPTL5, FPR1, HSPA8, NR2E3, PSMD2, PSMD8 and SBDS were screened out. Cox regression multivariate analysis showed that immune-related DEG ANGPTL5 ( HR = 2.69, 95% CI 1.22-5.92, P < 0.05), HSPA8 ( HR = 0.57, 95% CI 0.33-0.97, P < 0.05), and SBDS ( HR = 2.23, 95% CI 1.18-4.21, P < 0.05) were independent prognostic factors for metastatic colorectal cancer. The expression of ANGPTL5 in tumor tissues was lower than that in normal tissues, and the expression of ANGPTL5 in metastatic tissues was higher than that in primary tumor tissues. Patients with high expression of ANGPTL5 in tumor tissues had worse prognosis. The expression of HSPA8 in tumor tissues was higher than that in normal tissues, and the expression of HSPA8 in metastatic tissues was lower than that in primary tumor tissues. Patients with high expression of HSPA8 in tumor tissues had a better prognosis. The expression of SBDS in tumor tissues was lower than that in normal tissues, and the expression of SBDS in metastatic tissues was lower than that in primary tumor tissues. Patients with high expression of SBDS in tumor tissues had worse prognosis. Conclusions:Immune microenvironment of metastatic colorectal cancer is quite different from that of primary tumor. The degree of immune cell infiltration is reduced and the whole is immunosuppressed. The specific immune-related DEG related to prognosis of metastatic colorectal cancer may be new therapeutic targets of metastatic colorectal cancer.
ABSTRACT
Objective:To investigate the capability of 18F-FDG PET/CT imaging in monitoring combined immunotherapy response and detecting immune related adverse events (irAEs) in patients with advanced hepatobiliary carcinoma. Methods:From August 2018 to July 2019, 21 patients (14 males, 7 females, age (58.5±10.0) years) with advanced hepatobiliary carcinoma routinely underwent 66 18F-FDG PET/CT examinations in Peking Union Medical College Hospital. SUV max, the occurrence time and symptoms of irAEs were obtained and analyzed. Therapy response (complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), progressive metabolic disease (PMD)) was evaluated according to PET response criteria in solid tumors (PERCIST). Results:(1) Clinical results. Twenty-two irAEs occurred in 16 patients, while were not found in 5 patients. Six organs were involved, including thyroiditis(8), colitis(5), pneumonitis(4), rash(2), hepatitis(2), myositis and fasciitis(1). The appearance time of each irAEs were (103.0±58.0), (141.6±103.5), 34.0(6.0, 308.8), 9 and 117, 62 and 67, and 87 d after therapy, respectively. PET/CT detected all pneumonitis and myositis and fasciitis, but no rash and hepatitis were found. For colitis and thyroiditis, PET/CT detected 4 and 6 times respectively. (2) PET/CT signs of irAEs. Except thyroiditis, all irAEs lesions exhibited exudative changes in CT and high-avidity in PET. SUV max of the lesions were 9.0(7.9, 17.6) (colitis), 7.1±3.2 (thyroiditis), 5.3 and 8.6 (pneumonitis), 4.1 (myositis and fasciitis), respectively. (3) Therapy assessment. Among 21 patients, there were 7 for PMR, 9 for SMD, 5 for PMD, which were 7, 8, 1 in patients with irAEs and 0, 1, 4 in patients without irAEs. Conclusions:Patients with advanced hepatobiliary carcinoma can benefit from combined immunotherapy. 18F-FDG PET/CT can be used to evaluate the efficacy of immunotherapy by detecting the changes of tumor lesions and the occurrence of irAEs simultaneously. However, it is necessary to use CT to distinguish tumor progression from irAEs.
ABSTRACT
Objective:To investigate the application of different imaging methods of 99Tc m-pyrophosphate (PYP) in the diagnosis and pathological classification of cardiac amyloidosis (CA). Methods:A total of 31 patients (22 males, 9 females, age 21-81(57.2±13.4) years) with suspected CA who underwent 99Tc m-PYP dual-phase scintigraphy (early-phase: 1 h, delay-phase: 2-3 h) and SPECT/CT (1 h) between December 2018 and December 2019 in Peking Union Medical College Hospital were retrospectively included. Taking clinical diagnosis as the standard, the results of visual score (≥2, positive) and semi-quantitative values (heart to contralateral lung (H/CL)≥1.5, positive) of 99Tc m-PYP uptake in dual-phase scintigraphy and SPECT/CT imaging were analyzed. One-way analysis of variance and Bonferroni test were used to analyze the data. Results:Among 31 patients with suspected CA, 15 were clinically diagnosed as CA (5 patients with transthyretin-related CA (ATTR-CA) and 10 patients with light chain CA (AL-CA)) and 16 were diagnosed as non-CA. All 5 patients with ATTR-CA had positive dual-phase scintigraphy and SPECT/CT imaging results. Three out of 10 patients with AL-CA had positive early-phase scintigraphy whereas negative delay-phase scintigraphy and SPECT/CT imaging results. Sixteen patients who were clinically diagnosed as non-CA had negative dual-phase scintigraphy and SPECT/CT imaging results. The sensitivity (5/5), specificity (10/10), positive predictive value (5/5), negative predictive value (10/10) and accuracy (15/15) of delay-phase scintigraphy and SPECT/CT imaging were the same. Among 31 patients, 16 patients carried transthyretin-related (TTR) gene mutation, and 4 of them who clinically diagnosed as variant ATTR (ATTRv) had positive image findings while 12 of them who not clinically diagnosed as CA had negative image findings. There were significant differences in H/CL between ATTR-CA group and AL-CA group in early-phase (2.11±0.24 vs 1.31±0.07) and delay-phase (2.02±0.19 vs 1.30±0.05; F values: 75.41 and 87.15, Bonferroni test, both P<0.01). Conclusions:99Tc m-PYP delay-phase scintigraphy and SPECT/CT have high diagnostic efficiencies in ATTR-CA, helping to determine the pathological classification of CA; while early-phase scintigraphy has false positive results. Moreover, 99Tc m-PYP imaging is helpful to detect CA in patients with TTR gene mutation.
ABSTRACT
Objective:To analyze clinical data of 3 children with LMX1B-associated disease characterized by asymptomatic glomerular proteinuria, thus improving the recognition of asymptomatic proteinuria with genetic causes. Methods:Three patients with LMX1B-associated disease presented with prominent asymptomatic proteinuria diagnosed by the next-generation sequencing in Department of Pediatrics, Peking University First Hospital from April 2014 to October 2017 were included in this study.Clinical data, including renal and extrarenal manifestations, renal biopsy, and family history, were collected and retrospectively analyzed. Results:All 3 children were girls, the age of onset were 2 years, 1 year, and 4 years, respectively, and the diagnosis age were 11 years, 5 years and 6 years, respectively.All of them had glomerular proteinuria, and nephrotic-level proteinuria occurred in one patient.Microscopic hematuria was found in 2 patients.All of them had normal renal function.Only one patient underwent renal biopsy.Electron microscopy of the first time of biopsy revealed segmental thinning of the glomerular basement membrane.Re-biopsy 4 years later showed irregular thickening of the glomerular basement membrane, moth-eaten appearance and collagen fibrillar material deposition.No abnormalities of nails, limbs and joints were observed by physical examination.Two patients had a family history of renal disease.Conclusions:Genetic factors should be considered in children with obscure onset asymptomatic proteinuria without definite clinical causes.Genetic testing can help diagnose and guide treatment as early as possible.
ABSTRACT
OBJECTIVE@#To identify the key genes and explore mechanisms in the development of myelodysplastic syndrome (MDS) by bioinformatics analysis.@*METHODS@#Two cohorts profile datasets of MDS were downloaded from Gene Expression Omnibus (GEO) database. Differentially expressed gene (DEG) was screened by GEO2R, functional annotation of DEG was gained from GO database, gene ontology (GO) enrichment analysis was performed via Kyoto Encyclopedia of Genes and Genomes (KEGG) database, and key genes were screened by Matthews correlation coefficient (MCC) based on STRING database.@*RESULTS@#There were 112 DEGs identified, including 85 up-regulated genes and 27 down-regulated genes. GO enrichment analysis showed that biological processes were mainly enriched in immune response, etc, cellular component in cell membrane, etc, and molecular function in protein binding, etc. KEGG signaling pathway analysis showed that main gene enrichment pathways were primary immunodeficiency, hematopoietic cell lineage, B cell receptor signaling pathway, Hippo signaling pathway, and asthma. Three significant modules were screened by Cytoscape software MCODE plug-in, while 10 key node genes (CD19, CD79A, CD79B, EBF1, VPREB1, IRF4, BLNK, RAG1, POU2AF1, IRF8) in protein-protein interaction (PPI) network were screened based on STRING database.@*CONCLUSION@#These screened key genes and signaling pathways are helpful to better understand molecular mechanism of MDS, and provide theoretical basis for clinical targeted therapy.
Subject(s)
Computational Biology , Gene Expression , Gene Expression Profiling , Humans , Microarray Analysis , Myelodysplastic Syndromes/genetics , Protein Interaction MapsABSTRACT
Objective: To evaluate the mid-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using the Cai tube in the treatment of left colorectal cancer. Methods: A prospective randomized control trial (China Clinical Trials Registration Number: ChiCTR-OOR-15007060) was performed. Sixty patients with left colorectal cancer at Department of Gastrointestinal Surgery of Zhongshan Hospital from September 2015 to August 2017 were prospectively enrolled. Case inclusion criteria: (1) left colorectal adenocarcinoma (rectal cancer with distance ≥ 8 cm from tumor low margin to anal edge, sigmoid colon cancer, descending colon cancer and left transverse colon cancer) confirmed by preoperative pathology; (2) satisfactory conditions of conventional laparoscopic surgery; (3) maximum diameter of the tumor < 4.5 cm confirmed by preoperative abdominal and pelvic CT or MRI; (4) BMI < 30 kg/m2. Case exclusion criteria: (1) benign lesions, mucinous adenocarcinoma, signet-ring cell carcinoma and other special pathological types of tumors confirmed by preoperative pathological examination; (2) multiple or recurrent cancers; (3) with a history of neoadjuvant chemoradiotherapy; (4) obvious regional infiltration or distant metastasis indicated by preoperative imaging examination; (5) intestinal obstruction, intestinal perforation, etc. Participants were randomly assigned to NOSES group (using the Cai tube) and conventional laparoscopy (CL) group by random number table method. Clinical data between two groups were compared and analyzed, including perioperative conditions, tumor exfoliation cell detection and bacterial culture results of intraperitoneal lavage fluid, postoperative complications (Clavien-Dindo grading), postoperative pain [visual simulation scoring (VAS) assessment], anal function (Kirwan anal function grading assessment), and postoperative 3-year disease-free survival (DFS), overall survival (OS), overall recurrence rate, and local recurrence rate. Results: A total of 60 patients were enrolled, with 30 in the NOSES group and 30 in the CL group. All the patients in the NOSES group successfully completed operation with Cai tube. Baseline data between the two groups were not significantly different (all P>0.05). There were no statistically significant differences between two groups in conversion rate to open surgery, number of lymph node harivested, proximal and distal resection margin of tumor, negative rate of circumferential margin, operation time, blood loss, inflammatory indexes, postoperative anal function, postoperative hospital stay, hospitalization cost, morbidity of postoperative complications (Clavien-Dindo grade II or above) (all P>0.05). Compared to the CL group, the NOSES group had lower maximum postoperative VAS score (2.5±0.3 vs. 5.1±0.4, t=3.187, P<0.01), and fewer use of additional postoperative analgesia [6.7% (2/30) vs. 33.3% (10/30),χ2=6.670, P=0.02]. The postoperative time to gas passage was shorter in the NOSES group [(2.2±1.4) days vs. (3.1±1.2) days,P=0.026]. No tumor cells and bacterial contamination were found in abdominal lavage fluid before and after operation in either group. The anal function at postoperative 3-month of all the patients in the NOSES group was Kirwan grade I to II, while in the CL group, anal function of 2 cases (6.7%) was Kirwan grade III, and of 28 cases was also Kirwan grade I to II, whose difference was not statistically significant (P>0.05). In the NOSES group and the CL group, 3-year DFS was 96.7% and 83.3% (P=0.090), OS was 100% and 90% (P=0.096), overall recurrence rate was 3.3% and 10.0% (P=0.166), and local recurrence rate was 3.3% and 3.3% (P=0.999), respectively, whose differences were not statistically significant (all P>0.05). Conclusions: In the treatment of left colorectal cancer, compared with conventional laparoscopic colectomy, NOSES colectomy using Cai tube exhibits less scar, less postoperative pain, shorter recovery of gastrointestinal function, and similar mid-term outcomes. Given proper surgical indications, the surgical procedure is safe and feasible.
Subject(s)
Follow-Up Studies , Humans , Laparoscopy , Pain, Postoperative , Postoperative Complications/surgery , Prospective Studies , Rectal Neoplasms/surgery , Retrospective Studies , Sigmoid Neoplasms/surgery , Treatment OutcomeABSTRACT
Chronic unpredicted mild stress(CUMS) combined with isolated feeding was used to induce depressed rat model. The anti-depressant effects of Zhizichi Decoction(ZZCD) and its solid fermented product(ZZC) were analyzed by behavioral test and comparison of pathological tissues of hippocampus and liver, metabolic characteristics of intestinal flora, and relative abundance of species. The results showed that ZZC could increase sucrose preference, shorten the immobility time in the forced swim test and tail suspension test(P<0.05), and repair damaged hippocampus and liver tissues, and the effect was superior to that of ZZCD. The results of Biolog ECO plates showed that the average well color development(AWCD) of intestinal flora in the model group significantly decreased and the metabolic levels of sugar and amino acids were reduced, while the AWCD of the treatment groups increased. The metabolic levels of the two carbon sources were improved in the ZZC group, while only sugar metabolic level was elevated in the ZZCD group. Metagenomic analysis of intestinal flora showed that the ratio of Firmicutes/Bacteroidetes was 3.87 in the control group, 21.77 in the model group, 5.91 in the ZZC group, and 18.48 in the ZZCD group. Lactobacillus increased by 3.28 times, and Prevotella and Bacteroidetes decreased by 75.59% and 76.39%, respectively in the model group as compared with that in the control group. Lactobacillus decreased by 31.13%, and Prevotella and Bacteroidetes increased by more than three times in the ZZC group as compared with that in the model group, while the corresponding changes in the ZZCD group were not significant. ZZC could improve depression-like beha-viors by regulating the structure of intestinal flora and metabolic functions and repairing damaged hippocampus and liver tissues in depressed rats, showing an anti-depressant effect superior to that of ZZCD. This study is expected to provide a basis for the development of new anti-depressant food products.
Subject(s)
Animals , Depression/drug therapy , Disease Models, Animal , Fermentation , Gastrointestinal Microbiome , Hippocampus , Rats , Stress, PsychologicalABSTRACT
Objective:This study by using the method of network pharmacology to screen the active constituent and related targets of Epimedii Folium aims to explore the mechanisms of the reinforcing effect of Epimedii Folium on kidney in the treatment of PCOS. Methods:By retrieving data from TCMSP datebase, screened out the active constituent of Epimedii Folium and the information of the targets corresponding to each active constituent; by using the gene database of NCBI, translated the information of the targets into gene names; by retrieving data from GeneCards datebase, extracted the genes related to PCOS; related targets of Epimedii Folium in the treatment of PCOS were obtained by Venn tool; by using Cytoscape 3.7.2 software, constructed a network diagram of Epimedii Folium-active constituents-targets-PCOS; by using STRING database, constructed the protein interaction network; then carried out GO enrichment analysis of related targets by Geneontology database and carried out pathway enrichment analysis of related targets by KEGG database. Results:There were 23 active constituents of Epimedii Folium and 132 related targets treating PCOS. The Epimedii Folium could play the reinforcing effect on kidney mainly by regulating the biological processes like steroid hormone receptor activity, as well as KEGG pathways such as Estrogen signaling pathway, GnRH signaling pathway, GnRH secretion, HIF-1 signaling pathway and VEGF signaling pathway in treating PCOS. Conclusion:From the perspective of network pharmacology, this study preliminarily analyzed the related targets and pathways of reinforcing effect on kidney of Epimedii folium in the treatment of PCOS, providing reference for further experiments and application inclinics.
ABSTRACT
Objective:To investigate the effect of body weight-supported treadmill training on neuropathic pain and expression of glutamate decarboxylase-65/67 (GAD-65/67) in spinal dorsal horn of rats with spinal cord injury (SCI). Methods:A total of 24 Sprague-Dawley rats were randomly divided into sham group, SCI-sedentary (SCI-Sed) group and SCI-Exercise (SCI-Ex) group, with eight rats in each group. Allen's method was used to make T10 incomplete SCI model. Seven days after SCI, SCI-Ex group was given body weight-supported treadmill training. Before SCI, and seven days, 14 days, 21 days, 28 days and 35 days after SCI, the von Frey filaments and thermal stimulation pain tester were used to evaluate the mechanical and thermal pain thresholds. Then, Western blotting and immunohistochemical analysis were performed on the spinal cord of all rats to detect the expression of GAD-65 and GAD-67. Results:The mechanical and thermal pain thresholds were higher in SCI-Ex group than in SCI-Sed group 21 days, 28 days and 35 days after SCI (P < 0.01). Compared with the sham group, the expression of GAD-65 and GAD-67 decreased in SCI and SCI-Ex groups (P < 0.05), and increased in SCI-Ex group compared with that of SCI-Sed group (P < 0.05). Conclusion:Body weight-supported treadmill training could increase the synthesis of GAD-65/67 in the distal spinal cord dorsal horn of incomplete SCI rats, and improve the pain thresholds of hind limbs in rats with SCI.
ABSTRACT
Hepatitis B virus (HBV) infection is still a public problem that seriously threatens human health. Evaluation of liver fibrosis progression with an efficient noninvasive model is of great significance for condition assessment, disease management, and prognostic evaluation in patients with chronic HBV infection. This article reviews the noninvasive models commonly used in the diagnosis of liver fibrosis in recent years, summarizes the research background, methods, related studies, and advantages and disadvantages of these models, and analyzes the current research status and possible development trends of liver fibrosis assessment models. Recent studies have shown that although current models are not perfect for Chinese patients with chronic HBV infection as the main predisposing factor for liver fibrosis, the excellent performance of noninvasive models in liver fibrosis assessment provides a reference for the assessment of liver fibrosis in patients with chronic HBV infection and can replace liver biopsy to a certain extent.
ABSTRACT
Hepatitis B virus (HBV) infection is still a public problem that seriously threatens human health. Evaluation of liver fibrosis progression with an efficient noninvasive model is of great significance for condition assessment, disease management, and prognostic evaluation in patients with chronic HBV infection. This article reviews the noninvasive models commonly used in the diagnosis of liver fibrosis in recent years, summarizes the research background, methods, related studies, and advantages and disadvantages of these models, and analyzes the current research status and possible development trends of liver fibrosis assessment models. Recent studies have shown that although current models are not perfect for Chinese patients with chronic HBV infection as the main predisposing factor for liver fibrosis, the excellent performance of noninvasive models in liver fibrosis assessment provides a reference for the assessment of liver fibrosis in patients with chronic HBV infection and can replace liver biopsy to a certain extent.
ABSTRACT
Objectvie:To investigate the infiltration patterns of immune cells in colorectal cancer, and to explore the correlation of immune cells infiltration with clinical characteristics and overall survival (OS) of patients.Methods:The RNA sequencing data of 615 patients with colorectal cancer were downloaded from The Cancer Genome Atlas (TCGA) database. The data was updated on July 19, 2019, and included 571 colorectal cancer tissues and 44 paracancerous tissues. There were 552 cases with clinical data, such as survival time, survival status, age, gender, clinical stage, grade, tumor location and so on. Using CIBERSORT deconvolution algorithm, the relative amounts of 22 immune cell types were calculated based on standardized gene expression data. According to the results of CIBERSORT algorithm, the samples with high accuracy of deconvolution result were selected ( P < 0.05), and they were used for analysis and graphing. The correlations between the infiltration patterns of immune cells and the clinical characteristics and OS of patients were analyzed. Results:After the CIBERSORT method was used to filter and remove samples with P ≥ 0.05, a total of 282 tumor tissue samples and 16 paracancerous tissue samples were screened. In 293 cases with clinical information, there were 277 tumor tissue samples and 16 paracancerous tissue samples. In 293 samples, M0 macrophages, M1 macrophages, M2 macrophages, CD8 + T cells and unactivated CD4 memory T cells accounted for a higher proportion of total immune cells; in tumor tissue samples, the expressions of M0 macrophages, M1 macrophages, activated CD4 memory T cells, and unactivated natural killer (NK) cells were higher; in paracancerous tissues, the expressions of naive B cells, M2 macrophages, activated NK cells, unactivated dendritic cells, unactivated mast cells and plasma cells were higher; with the increase of clinical stage, the expressions of follicular helper T cells, activated CD4 memory T cells, activated NK cells, M1 macrophages decreased, and the expressions of plasma cells and regulatory T cells increased, and the differences were statistically significant (all P < 0.05). M1 macrophages, unactivated mast cells, activated CD4 memory T cells, CD8 + T cells, and follicular helper T cells were highly expressed in right colon cancer, while M0 macrophages and activated mast cells were highly expressed in left colon and rectal cancer, and the differences were statistically significant (all P < 0.05). The patients were divided into high infiltration group and low infiltration group based on the median expression level of infiltrated immune cells, and the survival analysis was performed. The result of survival analysis showed that patients with high initial B cell infiltration had good OS; however, patients with high infiltration of M2 macrophages, activated mast cells, and neutrophils had poor OS. Conclusions:There are different types of immune cell infiltration patterns in the colorectal cancer samples of different stages and locations, which are closely related to tumor progression and OS of patients. They are expected to be applied to the development of therapeutic targets and prognosis prediction.
ABSTRACT
Objective:To report four male COL4A5 mutation mosaicism patients with X-linked Alport syndrome, and to provide evidence for diagnosis, genetic counseling, and reproduction in the respective families and improve our knowledge of mosaicism in Alport syndrome. Methods:Suspected male mosaic patients for COL4A5 who met the following criteria: clinical diagnosis of Alport syndrome, harbored COL4A5 mutations detected using next generation sequencing or Sanger sequencing, heterozygosity for the mutant and normal COL4A5 alleles in the DNA demonstrated by Sanger sequencing, registered in the on-line registry of hereditary kidney diseases, and admitted to Peking University First Hospital during the period of April 2018 to April 2019 were enrolled. Clinical data and karyotypes were retrospectively analyzed. Genetic DNA isolated from multiple tissues was analyzed for COL4A5 gene mutations by using PCR and Sanger sequencing. Related literatures published in PubMed, CNKI and Wanfang databases were reviewed. Results:Four COL4A5 somatic and germline mosaic male patients with Alport syndrome were included in the study. Patient 1 was characterized by hematuria and proteinuria. His karyotype of peripheral blood was normal. COL4A5 c.3455-1G>A mosaicism was detected in multiple tissues (peripheral blood, saliva and urine). Patient 2 presented with hematuria and microalbuminuria. His karyotype of peripheral blood was normal. COL4A5 c.4994+1G>A mosaicism was detected in multiple tissues (peripheral blood, saliva and skin fibroblasts). Patients 3 showed hematuria without proteinuria. COL4A5 c.3535G>A mosaicism was found in genomic DNA of peripheral blood and hair. Laboratory and physical examinations of patient 4 showed hematuria and normal renal function, without proteinuria, megasoma or small testes. COL4A5 c.3106G>A mosaicism was detected in genomic DNA of skin fibroblasts. Although without karyotype analysis due to unavailable specimens, 47,XXY or 46,XY/47,XXY mosaicism was not considered according to the reproductive history and lack of clinical manifestations of megasoma and small testes in patients 3 and 4. Renal disease in 8 published male cases with mosaicism for COL4A5 was affected by mutant allelic fractions and genotype. Conclusions:Compared with hemizygous males with X-linked Alport syndrome, the renal phenotype of mosaic males was milder, and associated with mutant allelic fractions and mutation type.
ABSTRACT
@#Familial exudative vitreoretinopathy(FEVR)is an inherited vitreoretinopathy characterized by vascular dysplasia of periphery retina. Typical fundus findings consist of avascular periphery retina, increasing branching and abnormal anastomosis of retinal vessels. Having diversified clinical phenotypes, FEVR patients can be asymptomatic, which can often be missed, or with severe complications including retinal detachment, retinal folds, vitreous hemorrhage, causing vision loss. While FEVR had been thought to be rare in previous studies, the incidence was found to reach up to 1% in recent studies of fundus screening in the newborn. Diagnosis is usually based on clinical features, fundus fluorescein angiography, and detection of pathogenic genes. Ultra-wide-field imaging is a noninvasive and convenient way for the screening and diagnosis of FEVR. In this review,clinical features and diagnostic approaches of FEVR are concluded, and application value of ultra-wide-field imaging in its screening is discussed.
ABSTRACT
Circulating tumor cells (CTC) are tumor cells that escape from the primary or metastatic tumor into the circulatory system, and closely related to cancer metastasis. Since the samples can be obtained through simple and minimally invasive blood sampling operations, CTCs have a great clinical potential. PCa is one of the most common malignant tumors in men. In recent years, many scholars have conducted studies as to whether CTC technology can be used for the diagnosis and treatment of PCa, as well as for more accurate prediction of the risk of progression. This article summarizes the advances in researches relating CTC technology and the diagnosis and treatment of PCa. CTC detection has been developed from simple counting to phenotypic classification, and even to its combination with the determination of the expressions of specific genes (such as AR, AR-V7, etc.) and single-cell sequencing. Some reports showed that CTC technology has a certain significance in the early diagnosis of PCa, but its main value is demonstrated in drug sensitivity and prognosis evaluation in the late stage of the malignancy. The standardized detection methods and reference values of CTCs in PCa will be important research orientations in the near future.
Subject(s)
Cell Count , Humans , Male , Neoplasms, Second Primary , Neoplastic Cells, Circulating , Prognosis , Prostatic Neoplasms/therapyABSTRACT
OBJECTIVE@#To systematically evaluate the efficacy and safety of steroid combined with immunosuppressants in the treatment of primary IgA nephropathy in children.@*METHODS@#English and Chinese electronic databases were searched to include the studies on the efficacy and safety of steroid combined with immunosuppressants versus steroid alone in the treatment of primary IgA nephropathy in children. Outcome measures included proteinuria remission rate, urinary protein quantification, incidence of adverse events, estimated glomerular filtration rate, and incidence of renal dysfunction. Review Manager 5.3 software was used for data analysis.@*RESULTS@#A total of 7 studies with 381 children were included. The children had moderate to severe proteinuria. The Meta analysis showed that compared with the steroid alone group, the steroid combined with immunosuppressants group achieved a significantly higher rate of proteinuria remission (RR=1.36, 95%CI: 1.19-1.55, P<0.001) and significantly lower urinary protein quantification (SMD=-0.82, 95%CI: -1.23 to -0.41, P<0.001). There was no significant difference in the incidence rate of adverse events between the two groups (RR=1.28, 95%CI: 0.92-1.77, P=0.14).@*CONCLUSIONS@#The current evidence shows that for children with primary IgA nephropathy who have moderate to severe proteinuria, steroid combined with immunosuppressants has a better effect than steroid alone and does not increase the incidence rate of adverse events.
Subject(s)
Child , Glomerular Filtration Rate , Glomerulonephritis, IGA , Humans , Immunosuppressive Agents , ProteinuriaABSTRACT
Objective:To explore the application value of 3D printing and image inversion in the reduction and fixation of jaw fracture.Methods:A retrospective analysis was conducted in 28 patiens with jaw fracture who had treated by internal fixation of jaw bone in Department of Stomatology, the Second People's Hospital of Lianyungang from January 2018 to Junr 2019.There were 18 males and 10 females.The patients were divided into two groups according to whether they used 3D printing technology to assist surgery.The observation group(15 patients) used 3D printing technology to assist surgery after obtaining 3D CT images.The 13 patients in the control group were operated only with the assistance of three-dimensional reconstruction of CT scan.The operation time, intraoperative bleeding, hospitalization time and postoperative complications were compared between the two groups.Results:All patients were followed-up for 6-12 months, with an average follow-up of 9.8 months.The observation group had significantly shorter operation time[(76.08±5.02)min] and hospital stay[(12.36±1.39)d], less intraoperative blood loss[(81.23±6.12)mL] compared with the control group[(99.12±3.18)min, (16.45±3.27)d, (130.68±3.78)mL]( t=5.324, 3.135, 9.798, all P<0.01). There were no statistically significant differences in the incidences of joint adhesion and incision infection between the two groups (all P>0.05). Conclusion:3D printing technology can achieve preoperative design, surgical simulation and internal fixation of titanium plate precise shape, effectively improve the accuracy and safety of jaw fracture reduction, greatly shorten the operation time.
ABSTRACT
Objective:To observe the mechanism of Buyang-Huanwu Decoction on inflammation mediated by NOD-like receptors (NLRP3) inflammasome. Methods:A total of 48 rats were divided into sham operation group, model group and Buyang-Huanwu Decoction group, 16 in each group according to the random number table method. The model group and the Buyang-Huanwu Decoction group used spinal cord blowers to hit the spinal cord to establish a spinal cord injury model. The Buyang-Huanwu Decoction group was gavaged with Buyang-Huanwu Decoction 12.6 g/(kg?d), and the sham operation group and the model group were gavaged with equal volume of sterile saline once a day for 3 days. Nissl staining was used to observe the neuronal morphology of spinal cord tissues in each group. Immunohistochemical staining was used to detect the expression of NLRP3 in spinal cord tissues. ELISA was used to detect the levels of serum IL-1β and IL-18. Western blot was used to detect the expression of cleaved systeinyl aspartate-specific protease (cleaved-Caspase1). Results:Compared to the model group, the average optical density of NLRP3 positive expression (0.54 ± 0.04 vs. 0.78 ± 0.06) in Buyang-Huanwu decoction group significantly decreased ( P<0.05); the content of IL-1β (43.66 ± 1.21 pg/ml vs. 67.64 ± 2.43 pg/ml) and IL-18 (49.43 ± 3.88 pg/ml vs. 65.87 ± 2.53 pg/ml) in serum of the Buyang-Huanwu decoction group significantly decreased ( P<0.05); the expression of cleaved caspase 1 protein (0.63 ± 0.02 vs. 0.79 ± 0.07) in Buyang-Huanwu decoction group significantly decreased ( P<0.05). Conclusions:The Buyang-Huanwu Decoction can reduce the inflammatory response by inhibiting the expression of NLRP3 inflammasome after spinal cord injury, by reducing the activation of Caspase1.