ABSTRACT
Objective:To observe the expression of deleted in malignant brain tumor protein 1 (DMBT1) in rat acute respiratory distress syndrome (ARDS) model induced by sepsis and its relationship with ARDS related biomarkers.Methods:Forty-eight healthy male rats were randomly divided into sham operation group (Sham group) and ARDS model group, and the rats in each group were further divided into three subgroups at 6, 12 and 24 hours after operation, with 8 rats in each subgroup. The rats in the Sham group were exposed to the cecum only, and sepsis induced ARDS model was reproduced by cecal ligation and puncture (CLP) in the ARDS model group. The general performance was observed at 6, 12, 24 hours after operation. Abdominal aortic blood of rats was collected, and the levels of DMBT1, surfactant-associated protein D (SP-D), vascular endothelial growth factor (VEGF), interleukins (IL-6, IL-10) in serum were determined by enzyme-linked immunosorbent assay (ELISA). The lung tissues were collected, and the lung wet/dry weight (W/D) ratio was determined. The lung tissue pathological changes were observed under light microscope after hematoxylin-eosin (HE) staining, and the lung tissue injury score was evaluated. The expression of DMBT1 protein in lung tissue was determined by Western blotting. The relationship between the serum DMBT1 and SP-D, VEGF, IL-6, IL-10, lung tissue injury score were analyzed by Pearson correlation analysis.Results:Rats in the ARDS model group showed obvious pathological manifestations after operation. The alveolar structure destruction, inflammatory cell infiltration, and alveolar hemorrhage were observed under microscope. Compared with the Sham group, the lung tissue injury score and the lung W/D ratio at 12 hours after operation in the ARDS model group were significantly increased (lung tissue injury score: 3.35±0.13 vs. 1.16±0.07, lung W/D ratio: 5.36±0.44 vs. 4.38±0.35, both P < 0.05), and pulmonary edema was present, which suggested that the ARDS model caused by CLP was successfully reproduced. The results of ELISA and Western blotting showed that the levels of serum DMBT1, SP-D, VEGF and IL-6 in the ARDS model group increased gradually with time, while the level of IL-10 increased first and then decreased. Compared with the Sham group, the levels of DMBT1 in serum and the expressions of DMBT1 protein in lung tissue in the ARDS model group were significantly increased from 6 hours after operation [serum (ng/L) : 231.96±19.17 vs. 187.44±10.19, lung tissue (DMBT1/β-actin): 2.05±0.19 vs. 0.93±0.25, both P < 0.05], and the levels of SP-D, VEGF, IL-6 and IL-10 in serum were significantly increased from 12 hours after operation [SP-D (ng/L): 73.35±8.05 vs. 43.28±5.77, VEGF (ng/L): 89.85±8.47 vs. 43.19±5.11, IL-6 (ng/L): 36.01±2.48 vs. 17.49±1.77, IL-10 (ng/L): 84.55±8.41 vs. 39.83±5.02, all P < 0.05]. Pearson correlation analysis showed that serum DMBT1 was positively correlated with serum SP-D, VEGF, IL-6, IL-10 and lung injury score at 12 hours and 24 hours in the ARDS model group (12 hours: r values were 0.946, 0.942, 0.931, 0.936, 0.748, respectively; 24 hours: r values were 0.892, 0.945, 0.951, 0.918, 0.973, respectively; all P < 0.05). Conclusion:DMBT1 is a novel early biomarker of ARDS by affecting alveolar epithelial cell, alveolar capillary permeability and inflammatory response.
ABSTRACT
OBJECTIVE To compare the safety of high-dose methotrexate （HD-MTX） via peripherally inserted central catheter （PICC） and totally implantable venous access port （TIVAP） in pediatric patients with malignant brain tumors. METHODS Patients with malignant brain tumors who received HD-MTX via PICCs or TIVAPs in our hospital from July 2018 to April 2022 were retrospectively analyzed. Clinical data were collected to compare differences in blood concentration of methotrexate （MTX），the incidence of adverse events （including adverse drug reactions and catheter-related complications） and length of stay in hospital. Multivariate linear regression was applied to analyze the factors that influenced the blood concentration of MTX. RESULTS A total of 107 patients were included in the study，with 65 patients in the PICC group and 42 patients in the TIVAP group. Blood concentration of MTX at 24 h （C24 h） in TIVAP group was significantly higher than PICC group （[ 126.87±61.99） μmol/L vs. （102.45±48.77） μmol/L，P＜0.05）. There was no significant difference in blood concentration of MTX at 42 h （C42 h），compared with PICC group （P＞0.05）. Results of multivariate linear regression analysis showed that TIVAP was associated with the increase of C24 h（P＜0.05）. No significant differences were observed in the incidence of adverse events and the length of stay in the hospital between 2 groups （P＞0.05）. CONCLUSIONS Risk of adverse events is not increased，although the MTX C24 h level is elevated after administration of TIVAP. TIVAP is a safe choice for HD-MTX therapy with implementing therapeutic drug monitoring.
ABSTRACT
Recently, the importance of terminal care has been emphasized in studies of patients with malignant brain tumors. Healthcare professionals should have knowledge of symptoms caused by brain tumors when treating patients in the terminal phase. This study aimed to investigate the data collection method, evaluation time, and symptoms of patients with brain tumor in the terminal phase through literature search. Seven papers were extracted by a literature search. Data collection methods included collecting information from medical records (4 papers), questionnaire (2 papers), and telephone survey (1 paper). Evaluation times ranged from 46 days to 1 week before death. Symptoms presented by patients with malignant brain tumors in the terminal phase could be classified according to disease-specific symptoms and general symptoms presented by patients with other types of terminal cancer. The most commonly reported disease-specific symptoms were disturbance of consciousness (4 papers), seizures (7 papers), dysphagia (6 papers), and headache (6 papers). The proportion of patients with dysphagia increased as they approached the end of life. These results suggest that the data collection method and evaluation time differ depending on the previous studies and that patients with brain tumors in the terminal phase are likely to present disease-specific symptoms.
ABSTRACT
Objective:To investigate the efficacy of bevacizumab on the treatment of serious peritumorous brain edema. Methods:A total of 16 patients with malignant brain tumors and serious peritumorous brain edema, (13 cases of lung cancer, 2 cases of breast can-cer, and 1 case of recurrent glioblastoma) were analyzed. Treatment with glucocorticoids, osmotic dehydration, and other convention-al approaches were not effective for these patients. Bevacizumab was administered at a dose of 5 mg/kg at least once every three or four weeks. The Karnofsky performance score (KPS) and the changes in cerebral edema symptoms, such as cerebral edema volume, tu-mor volume, edema index (EI), and changes in magnetic resonance imaging (MRI) were compared before and after treatment. The t-test and least-significant difference method were used to compare treatment groups. Results:All bevacizumab-treated patients had re-duced symptoms. The KPS after treatment was significantly higher than that before treatment (P<0.001). The cerebral edema vol-umes, tumor volumes, and EI of 16 patients were significantly decreased (P<0.05). Bevacizumab caused mild clinical side effects. Con-clusion:Preliminary results showed that treatment of serious peritumorous brain edema with bevacizumab was safe and effective.
ABSTRACT
Objective: To analyse the Chilean trends in mortality from brain malignancies between 1985 and 1999. Methods: We calculated mortality rates from malignant brain tumors using data obtained from death certificates available at the National Statistics Office. The following International Classification of Diseases categories were selected: 191.0 to 191.9 (ICD-9), and C71.0 to C71.9 (ICD-10). The rates were adjusted using direct standardization. Prais-Winsten methodology was used for time correlation analysis. Results: Sex-specific rates varied from 0.9 to 1.75 per 100.000 in men and from 0.7 to 1.22 in women. The trend was toward a statistically significant increase in mortality from malignant brain tumors in both groups. The analysis by age group showed no statistically significant variation in those below 35 years old, and a statistically significant increase in those between 35 and 39 years old, and in those above 45 years old. Conclusions: The trend in mortality from malignant brain tumors, in Chile, shows a statistically significant increase in those between 35 and 39 years old, and in those above 45 years old.
Existe controversia en el aumento de la incidencia en las tasas de tumores primarios malignos de cerebro. Este incremento podría explicarse por el crecimiento exponencial en el número de Tomografías computarizadas. Objetivo: Evaluar la tendencia de la mortalidad por tumores cerebrales primarios malignos en Chile (TCM). Metodología: Estudio de tasas de mortalidad de datos obtenidos en índices demográficos (años 1985 a 1999). Se utilizó la población de Chile de los años estudiados y se ajustó a la población estimada de 1999. Se usó las categorías 191,0 a 191,9 y C 71-0 a C 71-9 de la Clasificación Internacional, correspondiendo al grupo de tumores malignos del SNC. Se estudiaron tasas específicas por edad y sexo. Se calculó la tendencia utilizando las tasas ajustada por edad y sexo. Se utilizó una prueba de regresión lineal (Prais-Winsten) para mediciones correlacionales en el tiempo (Stata 7). Resultados: Se obtuvo 2.304 TCM. Las tasas específicas por sexo varían entre 0,90 a 1,75 x 100.000 en hombres y de 0,7 a 1,22 en mujeres. La tendencia global de la mortalidad por tumores tiende al ascenso en ambos grupos y es significativamente más alta en hombres (0,47 95 % IC 0,18 a 0,42 p = < 0,005) El estudio por grupos etarios no muestra un aumento significativo en menores de 14 años, ni entre 15 y 34 años. En los grupos de 45 años y más es estadísticamente significativa. Conclusión: La tendencia a la mortalidad por TCM aparece en ascenso en los grupos etarios 35 a 39 años y 45 años y más.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Brain Neoplasms , Mortality , Chile , Epidemiology, DescriptiveABSTRACT
Even though many hypotheses have been derived from the anatomical and functional analysis of in vivo models of brain tumors, it is still impossible to explain the mechanism of peritumoral edema. To determine whether increased permeability in a blood-brain barrier model correlated with the malignancy of a co-cultured brain tumor, the authors established an in vitro brain capillary endothelial monolayer co-culture model. Water-soluble factors which might explain the pathogenetic mechanism of peritumoral edema in brain tumors were expected and observed. The benign cell co-culture model used co-cultured astrocytoma cell lines such as C6 and H683 in the second compartment of a brain capillary endothelial monolayer culture model circumscribed with a 0.4u sized porous membrane which permitted communication of the media but limited cell migration to another compartment, and the malignant cell co-culture model used co-cultured glioblastoma cell lines such as 87MG and 373MG. Permeability at molecular weight 373 increased in the astrocytoma and glioblastoma co-culture models to 150% and 240% respectively, of that in a normal astrocyte co-culture model. Permeability at this molecular weight also increased in the astrocytoma- and glioblastoma-conditioned medium culture models to 38% and 131%, respectively, of that in a normal astrocytoma-conditioned medium culture model. The observed result was that permeability of the endothelial monolayer increased in accordance with the malignancy of co-cultured cells in the system permitting-other than cell migration-media transfer only. The result suggested that some factor soluble in media secreted from co-cultured cells changes the permeability of the endothelial monolayer and could explain the pathogenetic mechanism of peritumoral edema in malignant brain tumors.