RESUMEN
Objective:To investigate the correlation between the expression of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and systemic immunoinflammatory index (SII) in patients with radical hepatectomy.Methods:A total of 78 patients with radical hepatectomy from March 2016 to January 2018 were enrolled in the observation group. All patients were treated with radical hepatectomy. 58 patients with liver benign disease treated at the same time were selected as the control group. The patient′s neutrophil, lymphocyte and platelet levels were calculated by automatic biochemical analyzer, and the NLR and PLR values were calculated. The SII was calculated using the formula platelet × neutrophil/lymphocyte; The patients′ gender, age, preoperative alanine aminotransferase (ALT), tumor diameter, preoperative alpha-fetoprotein (AFP), liver function classification and other indicators were recorded, and univariate and multivariate logistic analysis was performed; the patients were followed up for 18 months after treatment, and were divided into death group and survival group according to the prognosis. The levels of NLR, PLR and SII in the two groups were recorded and analyzed. Pearson correlation analysis was used to analyze the correlation between NLR, PLR, SII and prognosis.Results:The levels of NLR (7.48±1.21), PLR (25.31±4.23) and SII (452.98±43.69) in the observation group were higher than those in the control group [NLR(2.35±0.96), PLR (10.49±2.44) and SII (253.23±25.31)] ( t=6.391, 5.328, 8.562, P<0.05). The results of univariate and multivariate logistic analysis showed that the levels of NLR, PLR and SII in the observation group were related to preoperative ALT, tumor diameter, preoperative AFP and liver function classification ( P<0.05); 55 patients survived and 23 died in 18 months follow-up. The levels of NLR (4.39±1.46), PLR (15.93±4.39) and SII (275.69±21.53) in survival group were lower than those in death group [NLR (13.59±2.49), PLR (53.29±6.41), SII (574.67±46.39)] ( t=7.398, 4.395, 6.781, P<0.05). The results of Pearson correlation analysis showed that the levels of NLR, PLR and SII were negatively correlated with the prognosis of patients ( r=-0.693, -0.771, -0.709, P<0.05). Conclusions:NLR, PLR and SII are highly expressed in patients with radical hepatectomy. The expression level of NLR, PLR and SII is correlated with the prognosis of patients, monitoring their expression level can evaluate the prognosis and guide clinical treatment.
RESUMEN
Objective To investigate the effect of the peritoneal lymphatic stomata on intra-abdominal infection and the regulatory mechanism of angiotensin Ⅱ receptor specific inhibitor PD123319 on peritoneal lymphatic stomata.Methods The experimental study was adopted.Forty rats were divided into the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group by the random number table,every group had 10 rats.The classic appendix perforation (CLP) intraabdominal infection model was established in the abdominal infection group.After establishing the model of abdominal infection,PD123319 solution was injected intraperitoneally immediately (0.2 g/kg) in the abdominal infection drug intervention group.Abdominal cavity of the rats in the sham operation group was opened,and then was shut after flipping the intestine.The rats in the control group,sham operation group and intra-abdominal infection group were treated with intraperitoneal injection of 1ml stroke-physiological saline solution.After 2 hours,the rats were sacrificed,and peritoneal tissue was taken for the following tests.(1) The aperture size and distribution density of peritoneal lymphatic stomata were observed by scanning electron microscope (SEM).(2) The nitric oxide (NO) concentration in the peritoneal tissues was detected using nitric oxide nitric acid reduction method.(3) The expressions of endothelial nitric oxide synthase (eNOS) and Phospho-eNOS (P-eNOS) were detected by the Western blot.(4) The intracellular Ca2+ concentration were detect by flow cytometry.Measurement data with normal distribution were presented as-x ± s.The comparison among groups was analyzed using the ANOVA and pairwise comparison was analyzed by the LSD test.Results (1) The aperture size and distribution density of the peritoneal lymphatic stomata in the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group were respectively (2.3 ± 0.4) μm,(2.5 ± 0.5)μm,(4.7 ±0.5)pm,(3.8 ±0.5)pm and (2.0 ±0.8) × 108/m2,(2.1 ±0.7) × 108/m2,(6.2 ± 1.3) × 108/m2,(4.6 ± 1.4) × 108/m2,with statistically significant differences among the 4 groups (F =98.130,56.780,P ＜ 0.05).There were statistically significant differences in the aperture size and distribution density of the peritoneal lymphatic stomata between the intra-abdominal infection group and control group or intra-abdominal infection drug intervention group (t =11.586,8.573,3.854,3.098,P ＜ 0.05) and no statistically significant differences between the control group and sham operation group (t =1.281,0.514,P ＞0.05).(2) The concentrations of NO in the peritoneal tissues in the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group were respectively (0.380 ± 0.024) μmol/gprot,(0.450 ±0.020) μmol/gprot,(1.253 ±0.033) μmol/gprot and (0.579 ±0.035) μmol/gprot,with a statistically significant difference among the 4 groups (F =52.725,P ＜ 0.05).There were statistically significant differences in the concentration of NO between the intra-abdominal infection group and control group or intra-abdominal infection drug intervention group (t =10.536,67.798,P ＜ 0.05) and no statistically significant difference in the concentration of NO between the control group and sham operation group (t =2.007,P ＞ 0.05).(3) The results of Western blot showed that the expressions of eNOS and P-eNOS in the control group,sham operation group,intra-abdominal infection group and intra-abdominal infection drug intervention group were respectively (0.591 ± 0.028)U/mg,(0.603 ± 0.007) U/mg,(0.615 ± 0.027) U/mg,(0.626 ±0.026) U/mg and (0.578 ±0.003)U/mg,(0.603 ± 0.071) U/mg,(0.773 ± 0.033) U/mg,(0.710 ± 0.012) U/mg,with no statistically significant difference in the expression of eNOS among the 4 groups (F =0.902,P ＞ 0.05) and with a statistically significant difference in the expression of P-eNOS among the 4 groups (F =205.062,P ＜ 0.05).There were statistically significant differences in the expression of P-eNOS between the control group and sham operation group or intra-abdominal infection group (t =7.678,13.322,P ＜ 0.05) and between the intra-abdominal infection group and intraabdominal infection drug intervention group (t =4.035,P ＜0.05).(4) The results of flow cytometry showed that Ca2+ concentration in the control group,sham operation group,intra-abdominal infection group and intraabdominal infection drug intervention group were respectively 82.200％ ± 0.060％,81.730％ ± 0.052％,21.980％ ± 0.010％,29.500％ ± 0.004％,showing a statistically significant difference between the 4 groups (F =21 271.030,P ＜ 0.05).There were statistically significant differences in the Ca2+ concentration between the intra-abdominal infection group and control group (t =164.750,P ＜ 0.05) and between the intra-abdominal infection group and intra-abdominal infection drug intervention group (t =21.338,P ＜ 0.05),and no statistically significant difference between the control group and sham operation group (t =1.861,P ＞ 0.05).Conclusion The intra-abdominal infection could increase aperture size and distribution density of peritoneal lymphatic stomata,and PD123319 may be through inhibiting the activation of NO synthase to decrease the concentration of NO,enhance the concentration of Ca2+ in peritoneal mesothelial cells and reduce the opening of peritoneal lymphatic stomata.
RESUMEN
Objective To observe the short-term and long-term effect of microvascular decompression in patients with trigeminal neuralgia (TN).Methods The chnical data of 180 patients with TN treated with microvascular decompression were retrospectively analyzed.The pain improvement of patients in 2 years was observed,combined with age and course of disease,as well as the type of pressure vessels,whether obvious impression and so on,to analysis the recurrence factors of TN.Results All patients were found with vascular compression,including 93 cases with apparent pressure pressing mark,85 cases with arterial compression,15 cases with venous compression,and 8 cases with arteriovenous compression,among of them 74 patients with artery compression had pressure pressing mark,and 11 patients with vascular compression had pressure pressing mark,all of 8 patients with arteriovenous compression had pressure pressing mark.One week postoperatively,the patients with vascular compression gained significant improvement,of which 79 cases achieved optimal,6 cases achieved good;9 patients with vascular compression achieved optimal,6 cases achieved good,and 5 patients with arteriovenous compression achieved optimal,3 cases achieved good.Follow-up for 1 year after surgery,artery compression recurred in 5 cases,of which 3 cases of part recurrence,2 cases of recurrence completely ;vascular compression recurred in 6 cases;arteriovenous compression recurred in 2 cases.Univariate analysis showed that the vascular compression type,bascular compression notch and duration were the risk factors of postoperative recurrence (P ＜ 0.01).Multiple analysis showed that the vascular compression type,bascular compression degree and duration were the independent risk factors of postoperative recurrence (P ＜ 0.05).Conclusions TN patients treatd with microvascular decompression have effective improvement.History of diease,vascular compression type and compression degree are the important influence factors of postoperative recurrence.
RESUMEN
Objective To investigate the clinical characteristics and treatments of patients with long-term oral aspirin treatment combined with craniocerebral injury.Methods A retrospective analysis was made on 24 cases admitted for long-term oral aspirin treatment combined with craniocerebral injury from January 2010 to June 2012.There were 15 males and 9 females at age of 52-78 years (mean,63.5years).Injuries were caused by a traffic accident in 18 cases,a high fall in four and a blow in two.GCS on admission was 13-15 points in six cases,10-12 points in 10 cases and ＜ 8 points in eight cases.Six cases had conventional treatment,nine puncture drainage,six intracerebral hematoma evacuation by small craniotomy and three hematoma evacuation by large craniotomy.Results The patients were followed up for three months.Glasgow outcome score (GOS) was used to assess the prognosis in five categories,i.e.,grade Ⅴ (good recovery),grade Ⅳ (low disability),grade Ⅲ (severe disability),grade Ⅱ (vegetative state) and grade Ⅰ (death).Besides,grades Ⅴ and Ⅳ GOS represented a good outcome.Of these patients 15 (62.5％) had good results and nine (37.5 ％) undesirable results.Conclusions Patients with long-term oral aspirin administration combined with craniocerebral injury are characterized by high incidence of delayed and progressive cerebral hemorrhage,multi-focus intracerebral hemorrhage and postoperative rehemorrhagia.Therefore,aspirin therapy should be discontinued.Instead,enough blood coagulation accelerator,platelet and fresh plasma should be given.An operation is necessary for the patients with critically severe conditions but is not advisable for the patients with milder conditions.
RESUMEN
Objective To observe the expression of interleukin-1β (IL-1β) in blood serum after axonal injury in rats and investigate the effects of ciclosporin A (CsA) on it so as to discuss mechanism of CsA protecting neural function. Methods A total of 75 adult male SD rats were randomly divided into control group (Group A with 5 rats), only optic nerve stretch group (Group B with 35 rats) and stretch plus CsA treatment group (Group C with 35 rats). Stretch injury was induced in the right optic nerves of the rats in Group B and C. CsA at 20 mg/L was intraperitonealy injected in Group C immediately after stretch injury. Five animals from both Group B and Group C were killed at 1,3, 6, 12 hours and at days 1,3 and 7 after stretch injury or injection of CsA respectively. Morphological changes of optic nerves and retinal ganglion cells (RGCs) after stretch injury were examined under light microscope. In the mean- time, expression of IL-1β in the blood serum was observed by means of radioimmunoassay. Results (1) Histopathological observation showed lose of R GCs at day 3 and disarranged nerve fiber at day 7 after stretch injury of optic nerve in Group B, but significant amelioration of corresponding changes in Group C. (2) The expression of IL-1β in blood serum in Group B was significantly higher than that in Group A 3, 6, 12 hours and 1 day after injury. The expression of IL-1β reached peak at the 6th hour, then de- creased gradually and returned to the similar level of Group A after 3 days. The expression pattem of IL- 1 β in blood serum of Group C decreased more significantly at 3, 6, 12 hours and 1 day compared with that in Group B but was still higher than that of Group A at 6, 12 hours and 1 day. Conclusions The long-term and excessive expression of IL-1β may be involved in the secondary pathological changes after axonal injury. CsA exerts neuroprotective effect on injured axons mostly by attenuation of inflammation re- action after axonal injury.