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Abstract: The aim of this study was to analyze and compare the immunohistochemical expression of plasminogen activator system (PAS) proteins (uPA, uPAR, and PAI-1) in ameloblastomas (AMBs), odontogenic keratocysts (OKCs), and dental follicles (DFs) representing normal odontogenic tissue, as well as to investigate possible correlations between these proteins. Twenty AMBs, 20 OKCs, and 10 DFs were selected for immunohistochemical analysis. In each case, the immunoexpression of uPA, uPAR, and PAI-1 was evaluated semiquantitatively based on the percentage of positivity in odontogenic epithelial and connective tissue cells. The epithelial immunoexpression of uPA was significantly lower in AMBs when compared to OKCs (p = 0.001) and DFs (p = 0.029). Significantly higher epithelial immunostaining for uPAR was observed in AMBs when compared to OKCs (p < 0.001). There were no significant differences in the epithelial immunoexpression of PAI-1 between AMBs and OKCs (p = 1.000). The correlations found for the expression of the studied proteins were not statistically significant (p > 0.05). However, the epithelial and connective tissue expressions of uPAR have a strong positive and statistically significant correlation in AMBs. The present results suggest that uPA is involved in the pathogenesis of OKCs and that uPAR may participate in tumorigenesis in AMBs. The high percentage of PAI-1-positive cells suggests a possible role for this protein in the development of AMBs and OKCs. Furthermore, the studied proteins do not seem to act synergistically in AMBs, OKCs, and DFs.
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Epidermal growth factor receptor (EGFR) signaling and components of the fibrinolytic system, including urokinase-type plasminogen activator (uPA) and thrombomodulin (TM), have been implicated in tumor progression. In the present study, we employed cBioPortal platform (http://www.cbioportal.org/), cancer cell lines, and an in vivo model of immunocompromised mice to evaluate a possible cooperation between EGFR signaling, uPA, and TM expression/function in the context of cervical cancer. cBioPortal analysis revealed that EGFR, uPA, and TM are positively correlated in tumor samples of cervical cancer patients, showing a negative prognostic impact. Aggressive human cervical cancer cells (CASKI) presented higher gene expression levels of EGFR, uPA, and TM compared to its less aggressive counterpart (C-33A cells). EGFR induces uPA expression in CASKI cells through both PI3K-Akt and MEK1/2-ERK1/2 downstream effectors, whereas TM expression induced by EGFR was dependent on PI3K/Akt signaling alone. uPA induced cell-morphology modifications and cell migration in an EGFR-dependent and -independent manner, respectively. Finally, treatment with cetuximab reduced in vivo CASKI xenografted-tumor growth in nude mice, and decreased intratumoral uPA expression, while TM expression was unaltered. In conclusion, we showed that EGFR signaling regulated expression of the fibrinolytic system component uPA in both in vitro and in vivo settings, while uPA also participated in cell-morphology modifications and migration in a human cervical cancer model.
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Humans , Animals , Female , Rats , Uterine Cervical Neoplasms/drug therapy , Phosphatidylinositol 3-Kinases , Prognosis , Cell Movement , Cell Line, Tumor , ErbB Receptors , Mice, NudeABSTRACT
Objective To investigate the efficacy of neuroendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage.Methods From August 2014 to August 2017,91 spontaneous thalamic hemorrhage ruptured into ventricles patients in Affiliated Hospital of the Yangzhou University were enrolled,who were underwent surgical treatment in this retrospective study.The patients were divided into the study group(n =41) and control group(n =50) based on different methods of treatment.The patients in the study group were given with remove visible intraventricular hematoma by neuroendoscopy,followed by External Ventricular Drainage (EVD) combined with urokinase fibrinolysis.The patients in control group were given with EVD combined with urokinase fibrinolysis.The time of postoperative drainage,ICU stay,duration of onset of fever,the number of intracranial infections,and the proportion of Glasgow outcome scale (GOS) (1 to 5) at 6 months postsurgery were compared between two groups.Measurement data were expressed as (Mean ± SD),and t test was used for measurement data.The count data were analyzed by x2 test or nonparametric rank sum test.Results The time of postoperative drainage,the number of intracranial infections,ICU stay in study group were (6.19 ± 1.1) d,5 cases,(2.8 ± 1.6) d,the indexes in control group were (7.06 ± 1.3) d,15 cases,(5.2 ± 2.0) d.The time of postoperative drainage,ICU stay,the number of intracranial infections were superior to those of the control group,and the difference was statistically significant.The proportion of GOS (1 to 5) at 6 months after surgery was 5 cases (12.2％),5 cases (12.2％),10 cases (24.4％),14 cases (34.1％),7 cases (17.1％) in study group,the indexes in control group were 10 cases(20.0％),13 cases (26.0％),11 cases(22.0％),10 cases(20.0％),6 cases(12.0％).The 6-month postoperative GOS of the study group were superior to those of the control group,and the difference was statistically significant (P ＜ 0.05).Conclusion Neruendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage can reduce the time of postoperative drainage and the incidence of intracranial infection,shorten the time of ICU stay and improve the functional prognosis of the patients.
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Glomerular disease refers to a class of diseases in which the lesions are mainly located in the glomerulus,and the clinical manifestations are mainly hematuria,proteinuria,edema,hypertension and renal dysfunction.In recent years,it has been found that the urokinase-type plasminogen activator (uPA) of the plasminogen activator family,urokinase-type plasminogen activator receptor (uPAR) and its soluble form have been up-regulated in the pathogenesis of certain glomerular diseases.The combination with integrin affects signaling pathways and changes the morphology and function of podocytes to promote disease progression.In this paper,the relevant research progress is summarized as follows.
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Soluble urokinase-type plasminogen activator receptor(suPAR) , a new injury biomarker, is widely used in research of infectious diseases, cancer, cardiovascular diseases, autoimmune diseases, etc. In recent years, suPAR has been suggested to play an important role in various renal diseases. This review focuses on studies of suPAR in renal diseases and update, which will provide new clues for the diagnosis and treatment of renal diseases.
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Objective To observe the clinical effect of single urokinase and urokinase pump combined with low-molecular-weight Heparin in the treatment of autogenous arteriovenous fistula thrombolysis,and the influence on inflammatory factors [interleukin (IL)-1,IL-6,tumor necrosis factor-α (TNF-α)] and CD62p.Methods 20 hemodialysis patients hospitalized in our hospital for the treatment of thrombosis in fistula were selected.They were randomly divided into group A (n =10) and group B (n =10).The group A was treated by urokinase infusion,and the group B was treated with urokinase pump combined with low-molecular heparin respectively.Results Compared with that before thrombolysis,the blood flow rate was increased significantly while the IL-1,TNF-oα and CD62p decreased significantly in the two groups after thrombolytic treatment,with statistically significant difference (P ＜ 0.05).Compared with the group A,the IL-1,IL-6 and CD62p in group B were decreased after thrombolytic therapy,with statistically significant difference (P ＜ 0.05).Conclusions Urokinase combined with low-molecular-weight heparin is better than single urokinase in the treatment of arteriovenous fistula thrombolysis,providing a theoretical basis for clinical fistula thrombolysis treatment.
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Objective To investigate the expression changes of soluble urokinase-type plasminogen activator receptor(suPAR)and soluble triggering receptors expressed by myeloid cell-1(sTREM-1)in serum of children with primary nephrotic syndrome(PNS)and their clinical significance.Methods A total of 92 cases of newly diag-nosed PNS children were selected in Central Hospital of Yidu Affiliated to Weifang Medical College from June 2014 to September 2016.According to presence or absence of acute tubular necrosis,they were divided into acute renal injury group(27 cases)and non-acute renal injury group(65 cases).According to pathology type,they were divided into mesangial proliferative glomerulonephritis(30 cases),focal segmental glomerulosclerosis(23 cases),membranous ne-phropathy(18 cases),minimal change disease(14 cases)and membrane proliferative glomerulonephritis(7 cases).In the same period,45 healthy children were selected as the healthy control group.The clinical data were collected.The serum levels of suPAR and sTREM-1 were measured by adopting enzyme-linked immunosorbent assay(ELISA). Results The levels of total cholesterol(TC),triglycerides(TG),uric acid(UA),urinary protein/creatinine,24 h urinary protein,urinary N-acetyl-β-glucosaminidase(NAG)and β2-microglobulin(MG)in children with PNS were higher than those in the healthy control group,while serum albumin(ALB)was lower than that in the healthy con-trol group,and the differences were statistically significant(all P<0.05).The serum levels of suPAR and sTREM-1 in PNS patients were(133.09 ± 62.48)ng/L and(79.29 ± 34.68),respectively,which were significantly higher than those in the healthy control group[(31.11 ± 11.61)ng/L and(25.08 ± 8.10)ng/L](t=51.714,49.435;all P=0.000).The serum levels of suPAR and sTREM-1 in acute renal injury group were(188.82 ± 32.21)ng/L and (109.11 ± 24.78)ng/L,respectively,which were significantly higher than those in non -acute renal injury group [(75.96 ± 28.69)ng/L and(52.23 ± 14.07)ng/L]and healthy control group[(31.11 ± 11.61)ng/L and (25.08 ± 8.10)ng/L](F=16 739.607,10 487.256,all P=0.000).The serum levels of suPAR and sTREM-1 in children with focal segmental glomerulosclerosis and membrane proliferative glomerulonephritis were higher than those with minimal change disease,membranous nephropathy and mesangial proliferative glomerulonephritis,and the differences were statistically significant(all P<0.05).Pearson correlation analysis results showed that the serum levels of suPAR and sTREM -1 were positively correlated with TC,TG,urinary protein/creatinine,24 h urinary protein, urinary NAG and β2-MG(all P <0.05),while negatively correlated with ALB(P <0.05). Conclusions The serum levels of suPAR and sTREM-1 are elevated in children with PNS,and which are related with acute renal injury and pathological type,which can reflect the degree of renal tubular disease and kidney function to a certain extent.
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Objective: To explore influence of urokinase on expression of soluble CD40 ligand (sCD40L) in patients with acute coronary syndrome (ACS).Methods: A total of 94 ACS patients diagnosed and treated in our hospital from Aug 2013 to Aug 2015 were selected.According to random number table, they were randomly and equally divided into routine treatment group and urokinase group (received small dose urokinase intravenous drip based on routine treatment group).Levels of sCD40L and cardiac troponin T (cTnT) before and after treatment, therapeutic effect and incidence rate of major adverse cardiovascular events (MACE) were measured and compared between two groups.Results: Compared with before treatment, there were significant reductions in levels of sCD40L and cTnT in both groups after treatment, P<0.01 all;compared with routine treatment group after treatment, there were significant reductions in levels of sCD40L [(2.92±0.36) ng/ml vs.(2.58±0.18) ng/ml] and cTnT [(0.10±0.02) μg/L vs.(0.04±0.01) μg/L] in urokinase group, P=0.013, 0.001 successively.Compared with routine treatment group, there was significant rise in total effective rate (76.6% vs.95.7%),and significant reduction in incidence rate of MACE (34.0% vs.4.3%) within six months in urokinase group (P<0.01 both).Conclusion: Urokinase can significantly inhibit expression of sCD40L and reduce release of cTnT, and improve therapeutic effect, and prevent major adverse cardiovascular events in patients with acute coronary syndrome.
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Objective To study the different curative effect between r-tPA application and urokinase in the interventional therapy for acute and severe pulmonary embolism.Methods Analyzed the clinical date of 22 cases acute and severe pulmonary embolism patients,and classified them into two groups according to the application of r-tPA and urokinase to compare the changes of their blood pressure,heart rate,arterial partial pressure of oxygen,hemachrome and pulmonary arterial pressure before and after therapy,meanwhile,record the thrombolysis time that the two groups took.Results The thrombolysis effect time adopting urokinase was remarkably longer than that thrombolysis adopting r-tPA(P<0.05); The blood pressure,heart rate,arterial partial pressure of oxygen of the two groups gained remarkable improvement after therapy(P<0.05).The pulmonary arterial pressure of the urokinase group dropped obviously after operation(P<0.05),while the r-tPA group dropped not so significantly after operation.The hemachrome of the two groups did not dropped significantly after operation.Conclusion The r-tPA and urokinase are both effective to interventional therapy for acute and severe pulmonary embolism,while r-tPA can clearly shorten the time in thrombolysis and could reduce any bleeding risk.
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Focal segmental glomerulosclerosis (FSGS) in children, which is a kind of nephrotic syndrome showing steroid resistance, usually progresses to a substantial number of end stage renal disease (ESRD). Although the pathogenesis of primary FSGS is unclear, several recent studies have reported that FSGS is associated with circulating immune factors such as soluble urokinase-type plasminogen activator receptor (suPAR) or anti-CD40 autoantibody. We report a successfully treated case of a 19-year-old female patient who experienced a recurrence of primary FSGS. After the diagnosis of FSGS, the patient progressed to ESRD and received a kidney transplantation (KT). Three days later, recurrence was suspected through proteinuria and hypoalbuminemia. She has been performed plasmapheresis and high dose methylprednisolone pulse therapy and shown remission status without increasing proteinuria for four years after KT. In conclusion, strong immunosuppressive therapy may be helpful for a good prognosis of recurrent FSGS, suppressing several immunologic circulating factors related disease pathogenesis.
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Child , Female , Humans , Young Adult , Diagnosis , Glomerulosclerosis, Focal Segmental , Hypoalbuminemia , Immunologic Factors , Kidney Failure, Chronic , Kidney Transplantation , Methylprednisolone , Nephrotic Syndrome , Plasmapheresis , Prognosis , Proteinuria , Recurrence , Urokinase-Type Plasminogen ActivatorABSTRACT
Simvastatin is a hypolipidemic drug that inhibits hydroxymethylglutaryl coenzyme A (HMGCoA) reductase to control elevated cholesterol,or hypercholesterolemia.Previous studies have shown that simvastatin may attenuate inflammation in ischemia-reperfusion injury and sepsis.Herein,we hypothesized that simvastatin may prevent rats from lipopolysaccharide (LPS)-induced septic shock.In our study,rats were divided into a saline group,an LPS group and an LPS plus simvastatin group.Male Sprague-Dawley (SD) rats were pretreated with simvastatin (1 mg/kg) for 30 min before the addition of LPS (8 mg/kg),with variations in left ventricular pressure recorded throughout.Ninety min after LPS injection,whole blood was collected from the inferior vena cava,and neutrophils were separated from the whole blood using separating medium.The neutrophils were then lysed for Western blotting to detect the levels of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitor-1 (PAI-1).In addition,mesentery microcirculations of inlet diameter,outlet diameter and blood flow rate were measured in all three groups.The results indicated that simvastatin significantly promoted heart systolic function and increased the level ofuPA while simultaneously inhibited the expression of PAI-1 as compared with LPS group.Moreover,simvastatin reversed the LPS-induced inhibition of mesentery microcirculation.Taken together,it was suggested that simvastatin can effectively protect the rats from LPS-induced septic shock.
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Objective To evaluated the effect of Total Glucosides of Paeony (TGP)combined with urokinase for the patients with acute cerebral ischemic stroke.MethodsA total of 152 patients with ACIS were divided into the control group (77 patients) and the observation group (75 patients) by completely randomized grouping method. Patients in the control group were treated with Urokinase by intravenous, and the observation group were treated with TGP combined with Urokinase. All patients were treated with thrombolysis treatment with in the 24 h after the exclusion of cerebral hemorrhage by brain CT and coagulation mechanism disorder. In the following 14 days, they were given the treatment of anti platelet aggregation, lowering blood lipid, trophic nerve and improving circulation. The National Institutes of Health Stroke Scale(NIHSS), the modified Rankin scale(mRS) and the daily life ability index(Barthel) were measured.ResultsThere were 28 (37.3%) patients with the NIHSS scores decreasing 4 points in observation group and 12 (15.6%) in control group after treatment of 7 days,and there was significant difference between two groups (χ2=8.181,P=0.004). There were 68 (90.7%) patients with mRS score less than 4 points in observation group and 51 (15.6%) in control group after treatment of 14 days,and there was significant difference between two groups (χ2=11.945,P=0.001). The NIHSS scores in the observation group was lower than control group (8.3 ± 2.2vs. 9.9 ± 2.5;t=4.192,P<0.05). The mRS score in the observation group was lower than control group (2.3 ± 0.9vs. 2.9 ± 1.1;t=3.684,P<0.01), and the Barthel index in the observation group was higher than the control group (88.7 ± 16.2vs. 77.5 ± 15.2;t=4.401,P<0.01). ConclusionsThe TGP capsules combined with Urokinase intravenous thrombolysis could improve the neurological deficit, and the ability of daily life of ACIS patients.
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Objective To evaluate the value of plasma soluble urokinase?type plasminogen activator receptor (suPAR)and D?dimer for assessing disease severity and prognosis in patients with traumatic brain injury(TBI). Methods A serial of 112 patients with traumatic brain injury admired to our hospital were divided into mild TBI (GCS score 13~15),moderate TBI(GCS score 9~12)and severe TBI(GCS score 3~8). The levels of plasma suPAR and D?dimer were monitored within 24 h after patient admission. Results The levels of suPAR and D?di?mer in TBI group were obviously higher than those in the control group(15.86±7.33 vs 2.79 ± 0.69,P<0.01;3.50 ± 2.78 vs 24 ± 0.15,P<0.01). The levels of suPAR and D?dimer in the severe TBI group were also obviously high?er than those in the moderate TBI group(P<0.05). Plasma suPAR levels and GCS score had significant negative correlation(r =- 0.854,P < 0.01). D?dimer levels and GCS score showed a negative correlation(r =- 0.738, P < 0.01). Plasma suPAR and D ? dimer was positively correlated(r = 0.753,P < 0.01). The area under the curve of D?dimer(AUC)was larger,0.854,95%CI 0.763~0.945;the AUC of suPAR was 0.801,95%CI 0.698~0.903. Conclusion Higher levels of suPAR and D?dimer in TBI patients is not only relevant to the injury sever?ity ,but also closely to the prognosis.
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PURPOSE: In the present study, we evaluated the levels of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitor 1 (PAI-1) by performing immunohistochemical staining to determine whether they were reliable prognostic markers in patients with breast cancer. METHODS: Demographic and clinicopathological parameters of 214 patients with invasive ductal carcinoma (IDC) and 80 patients with ductal carcinoma in situ (DCIS) who were diagnosed and treated from 2006 to 2010 were analyzed. Tissue microarray was constructed and immunohistochemical staining was performed for each specimen. RESULTS: Univariate analyses showed that age at diagnosis, history of hormone replacement therapy, radiation therapy, skin and chest wall invasion, Paget disease, lymphovascular invasion, estrogen receptor positivity, and triple-negative subtype were significantly associated with patient prognosis (p<0.005). Patients with DCIS showed higher PAI-1 expression than patients with IDC (82.5% and 36.2%, respectively; p=0.012). Lymph node metastasis was more frequent in patients with high uPA levels than in patients with low uPA levels (p=0.001). CONCLUSION: Our results suggested that PAI-1 was involved in tumor progression in the early stages of breast cancer, such as DCIS. In addition, our results suggested that high uPA levels were associated with the lymph node metastasis of IDC.
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Humans , Breast Neoplasms , Breast , Carcinoma, Ductal , Carcinoma, Intraductal, Noninfiltrating , Diagnosis , Estrogens , Hormone Replacement Therapy , Lymph Nodes , Neoplasm Metastasis , Plasminogen Activator Inhibitor 1 , Prognosis , Skin , Thoracic Wall , Urokinase-Type Plasminogen ActivatorABSTRACT
Traumatic basal ganglia hemorrhage (TBGH) is a rare presentation of head injuries. Bilateral lesions are extremely rare. The pathophysiologic mechanism of bilateral TBGH seems to be the same as diffuse axonal injury. However, limited information about childhood bilateral TBGH is available in the literature. We report the case of a child with bilateral TBGH treated with stereotactic aspiration of hemorrhage and periodic urokinase irrigation.
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Child , Humans , Basal Ganglia Hemorrhage , Basal Ganglia , Craniocerebral Trauma , Diffuse Axonal Injury , Hemorrhage , Intracranial Hemorrhages , Urokinase-Type Plasminogen ActivatorABSTRACT
La trombosis de la vena subclavia reviste especial gravedad por las secuelas funcionales y las posibles complicaciones sistémicas que puede desencadenar cuando no se diagnostica a tiempo. Aunque en muchos casos la presentación clínica puede ser diagnóstica, siempre se requieren pruebas de imagen, ya sean no invasivas, como la ecografía con Doppler color, o invasivas, como la flebografía, que es considerada el patrón de oro, ya que demuestra el trombo y confirma la permeabilidad de la circulación colateral. El objetivo de este estudio es demostrar los resultados de la fibrinólisis por catéter y comprobar que su tratamiento agresivo está justificado para evitar secuelas incapacitantes, especialmente en gente joven. Entre el 1 enero de 2006 y el 31 de diciembre de 2012 se atendieron cinco pacientes diagnosticados con trombosis en la vena subclavia, y fueron tratados con fibrinólisis endovenosa con uroquinasa a 100.000 UI/hora. El criterio para escoger los pacientes a trombolizar, fue el tiempo de evolución menor de 6 días y las características agudas del trombo (trombo hipoecogénico-homogéneo, que ocasiona aumento del calibre venoso), así como las características del paciente, edad y repercusión clínica. En nuestra limitada experiencia hemos tenido un éxito del 80 %, con resolución de la sintomatología en el 100 % en trombólisis con uroquinasa, por lo cual la recomendamos como el manejo inicial de las trombosis subclavias, siempre y cuando cumplan las indicaciones y haya ausencia de contraindicaciones absolutas o relativas para trombólisis.
Subclavian vein thrombosis can be particularly serious due to the functional consequences and possible systemic complications that can be triggered when not diagnosed early. Although in many cases the clinical presentation may be diagnostic, imaging is always required, either non-invasive (Doppler ultrasound) and / or invasive, as is the case with venography which is considered the gold standard because it shows the thrombus and confirms the permeability of the collateral circulation. The purpose of the study is to demonstrate the results of catheter directed fibrinolysis and suggests that aggressive treatment of this condition is justified to prevent the possible disabling sequelae, particularly in young people. During the period between January 1, 2006 to December 31, 2012, 5 patients were treated for thrombosis in the subclavian vein with catheter directed thrombolysis with urokinase at 100,000 UI/hour. The selection criteria for thrombolysis, was the time of evolution (less than 6 days) and acute characteristics of thrombus in ultrasound (hypo echogenic-homogenous thrombus, which causes an increase in venous caliber), as well as the characteristics of the patient, the age, and clinical repercussions. In our limited experience we had a success rate of 80% due to the dissolution of the thrombus, with a 100% resolution of symptoms in thrombolysis with urokinase; so we recommend it as the initial management of the subclavian thrombosis as long as the patients are symptomatic and have not contraindications to thrombolysis.
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Humans , Fibrinolysis , Urokinase-Type Plasminogen Activator , Venous ThrombosisABSTRACT
Objective To investigate the effects of primary percutaneous coronary intervention (PCI) combined with intracoronary low-dose urokinase therapy on myocardial perfusion and clinical outcome in acute STEMI patients. MethodsFrom Oct. 2011 to Jun. 2013, 183 patients suffering from myocardial infarction with acute ST segment elevation, (STEMI) who had undergone emergent PCI in 306 Hospital of PLA conforming to inclusion criteria were enrolled in the present study. They were randomly assigned to urokinase group (n=91) and control group (n=92). For urokinase group, besides routine interventional treatment, patients were given single or multiple intracoronary injection of 0.05-0.1 million U urokinase immediately before primary PCI, while for control group, patients received routine interventional treatment only. The main indices determined and compared between the two groups included the immediate blood flow grading of thrombolysis in myocardial infarction (TIMI), corrected TIMI frame count, falling degree of ST segment elevation in ECG after intervention, and left ventricular function on the 7th and 30th day after intervention, and also major adverse cardiac events (MACE) on the 30th day after intervention. Results The TIMI Ⅲ blood flow and corrected TIMI frame count were obviously better in urokinase group than in control group (83 vs 71, P=0.034; 21.2±10.7 vs 29.6±15.3, P=0.012) immediately after PCI, ant the falling degree >70% of ST segment elevation at 90min after intervention was significantly more marked in urokinase group than that in control group (93.4% vs 82.6%, P=0.025). When compared with urokinase group to control group, although no significant difference was found in left ventricular ejection fraction (LVEF) on the 7th day of follow-up (53.5±9.4 vs 51.6±8.7, P=0.158), the cardiac ultrasound revealed a better outcome of LVEF (56.3±9.8 vs 53.5±8.1, P=0.036) and a lower MACEs (including death, angina, target vessel revascularization, heart failure and stroke, etc.)(4.4% vs 13.0%, P=0.038) on the 30th day of follow-up. Conclusion Emergency PCI combined with single or multiple intracoronary injection of low-dose urokinase before stent implantation may efficiently improve the myocardial perfusion and left ventricular function, and improve the short-term prognosis of acute myocardial infarction patients with due safety.
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Node negative breast cancer is a prevalent form of breast cancer .With the improvement of breast cancer screening and disease awareness ,the rates of node negative breast cancer are gradually increasing . Although node negative breast cancer patients have much lower recurrence rates as compared with node positive patients,node-negative breast cancer is unequal to a low risk disease .Thus,it is important for oncologist to esti-mate the risk factors of node negative disease ,to carry out risk assessment and to guide the best regimen for these patients.In current review ,we discuss the value of traditional prognostic factors and new prognostic factors ,such as the urokinase -type plasminogen activator/plasminogen activator inhibitor 1,oncotype DX,MammaPrint and tumor associated macrophages ,on the predictive and treatment decisions in node negative breast cancer .
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Background and purpose:P38 mitogen-activated protein kinase (P38MAPK) signal transduction pathway is involved in occurrence, development and transfer process in a wide variety of tumors. Urokinase-type plasminogen activator (uPA) plays an important role in tumor invasion and metastasis. This study aimed to explore the clinical signiifcance of the P38MAPK signaling pathway and the expression of uPA in ovarian cancer.Methods:The expressions of uPA, P38MAPK, ERK and AKT were detected in 49 cases of cervical adenocarcinoma by immunohistochemistry. The expressions of uPA and P38MAPK were detected by Western blot in ovarian cancer cell lines HO8910, HO-8910PM, SKOV3 and CAOV3. The changes of uPA and P38MAPK were detected by SB203580, a speciifc inhibitor of P38MAPK signal transduction pathway.Results:The result of immunohistochemical method showed that positive expression rates for uPA, P38MAPK, ERK and AKT were 61.22%, 57.14%, 53.06% and 55.10%, respectively. The expression of the uPA was positively correlated with the P38MAPK (r=0.865,P=0.001), and related with clinicopathologic stage, differentiated degree, lymph node metastasis, but not related with age and histologic type (P>0.05). The expressions of AKT and ERK were related with the lymph node metastasis and greater omentum metastasis(P0.05). The expression of uPA in HO-8910PM was higher than that in ovarian cancer cell lines HO8910, SKOV3 and CAOV3, and the expression of uPA reduced when the P38MAPK signal transduction pathway was cut off by the SB203580. The expressions of P38MAPK and uPA were negatively correlated with the prognosis of ovarian cancer (Log-rank=3.897 and 11.044,P=0.048 and 0.001). Conclusion:The P38MAPK signal transduction pathway was activated in ovarian cancer. The activated P38MAPK signal transduction pathway can raise the expression of uPA, which may contribute to the development of ovarian cancer. The result indicates that the P38MAPK signal transduction pathway and uPA might play an important role in the invasion and metastasis of ovarian cancer. P38MAPK and uPA might be useful markers for evaluating prognosis of ovarian cancer.
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Objective To investigate the clinical efficacy and safety of recombinant tissue type plasminogen activator(rr-PA) and urokinase(UK) in the treatment of acute myocardial infarction (AMI).Methods According to the digital table,128 patients with AMI were randomly divided into two groups,64 cases in each group.The control group adopted UK intravenous thrombolytic therapy,while the observation group adopted rr-PA intravenous thrombolytic therapy.The recanalization condition at different time after thrombolytic therapy,the incidence rate of cardiovascular events and death rate were compared between the two groups.Results The recanalization rate at 30min,60min and 120min after thrombolysis of the observation group were 29.69 ％,59.38 ％ and 93.75 ％,respectively,which were significantly higher than 14.06％,35.94％ and 68.75％ of the control group(x2 =6.34,7.01,7.45,all P ＜ 0.05) ;The incidence rate of cardiovascular events and mortality rate of the observation group after thrombolytic therapy were 17.19％ and 4.64％,respectively,which were significantly lower than 40.63％ and 12.50％ of the control group (x2 =7.83,7.62,all P ＜ 0.05).Conclusion Recombinant tissue type plasminogen activator intravenous thrombolytic therapy has significant effect in the treatment of acute myocardial infarction after thrombolysis,which can reduce the incidence of cardiovascular events and mortality,with good clinical application value.