RESUMEN
Objective:To compare the survival outcomes in patients of small cell lung cancer (SCLC) with brain-single metastasis and brain with organs-multiple metastasis.Methods:Using the US surveillance, epidemiology and final results database, 5 520 SCLC patients with complete clinical information from 2004 to 2015 were selected. SCLC patients were adjusted, stratified or matched according to the metastasis site after the stratification or matching of the propensity scores, and the lung cancer-specific survival (CSS) rate and overall survival (OS) rate were compared between brain-single metastasis group and brain with organs-multiple metastasis group. In addition, the effects of chemotherapy and radiotherapy in CSS between brain-single metastasis group and brain with organs-multiple metastasis group were compared.Results:Of the 5 520 SCLC patients, 2 658 cases was in the brain-single metastasis group, and 2 862 cases was in brain with organs-multiple metastasis group. After the stratification or matching of the propensity scores, the median survival time in brain-single metastasis group was significantly longer than that in brain with organs-multiple metastasis group (6 months vs. 4 months), and there was statistical difference ( P<0.05). The fatality rate in brain-single metastasis group was significantly lower than that in brain with organs-multiple metastasis group (80.66% vs. 85.96%), and there was statistical difference ( P<0.01). Kaplan-Meier survival curve analysis result showed that the OS rate and CSS rate in brain-single metastasis group were significantly higher than those in brain with organs-multiple metastasis group (14.72% vs. 9.50% and 19.34% vs. 14.04%), and there were statistical differences ( P<0.05). Cox analysis result showed that age, race, T stage, gender, N stage, radiotherapy, chemotherapy, tumor diameter, marriage and metastasis were the influencing factors of CSS rate in SCLC patients with brain metastasis ( P<0.01 or <0.05). Multivariate Logistic regression analysis result showed that radiotherapy and chemotherapy can significantly improve the CSS rate ( HR = 0.668 and 0.671, 95% CI 0.570 to 0.783 and 0.573 to 0.786, P < 0.01). Conclusions:The survival rate in SCLC patients with brain-single metastasis is higher than that of SCLC patients with brain with organs-multiple metastasis; chemotherapy and radiotherapy can improve the survival rate in SCLC patients with brain metastasis.
RESUMEN
Hyperglycemia is common in patients with acute ischemic stroke and is associated with poor outcomes.International guidelines recommend that patients with acute ischemic stroke should maintain their blood glucose level within an appropriate range using the loose treatment.However,specific hypoglycemic measures are still inconclusive.This article reviews the research progress of hyperglycemia after acute ischemic stroke.
RESUMEN
Hyperglycemia is common in patients with acute ischemic stroke and is associated with poor outcomes. International guidelines recommend that patients with acute ischemic stroke should maintain their blood glucose level within an appropriate range using the loose treatment. However, specific hypoglycemic measures are still inconclusive. This article reviews the research progress of hyperglycemia after acute ischemic stroke.
RESUMEN
Bilirubin is a metabolic end product degraded under the action of heme oxygenase.It is an endogenous antioxidant and has the function of anti-atherosclerosis, clearing free radicals and protecting the tissues and organs of the body.This article reviews the metabolism and biological characteristics of bilirubin, and the correlations between bilirubin and vascular risk factors, as well as between bilirubin and ischemic stroke.
RESUMEN
Objective To explore the effect of preeclampsia on the expression of hypothalamic-pituitary-adrenal (HPA) axis related genesin the hippocampus of adolescent offspring rats.Methods The pregnant Sprague-Dawley rats were randomly divided into two groups to be given 125 mg · kg-1 ·d-1 L-NAME or 1 mL pure saline by daily injection from day 14 to delivery.Serum corticosterone (CORT) levels in neonatal offspring rats were detected by ELISA.The mRNA and protein levels of glucocorticoid receptor (GR),corticotropin releasing hormone (CRH),CRH receptor 1 (CRHR1) and IL-6 in the hippocampus of 8-week offspring rats were determined by real-time PCR and Western blot,respectively.Results Compared with normal neonatal rats,the serum CORT concentration of neonatal rats with preeclampsia was increased (P＜0.05).Compared with normal adolescent offspring,the levels of GR,CRH and CRHR1 mRNA and protein were increased in the hippocampus of adolescent rats with preeclampsia (P＜0.05),accompanied by increased IL-6 mRNA and protein (P＜0.05),as a downstream inflammatory gene of the GR.Conclusions We found that adolescent SD rats exposed to preeclampsia showed alteration in the expression of HPA related genes in the hippocampus,which played a role in the impairment of learning and memory in children.
RESUMEN
[Abstract ] Objective As an important metal element, iron is involved in a variety of life activities.This study was to inves-tigate the effect of iron deposition on the apoptosis of PC12 cells and the expression of glyceraldehyde de-3-phosphate dehydrogenase (GAPDH). Methods PC12 cells were incubated with FeCl3 at 50, 100, and 500 μmol/L for the establishment of an iron deposi-tion cell model.The proliferation of the PC12 cells was measured with the CCK-8 method, their apoptosis determined by TUNEL, the expressions of GAPDH mRNA and protein detected by quantitative real-time PCR and Western blot respectively, and the level of GAP-DH in the nuclei measured by immunofluorescence assay. Results Compared with the normal control group, the proliferation rate of the PC12 cells was decreased in the 50μmol/L FeCl3 group (100%vs [77.13 ±3.9]%, P>0.05) and significantly in the 100 and 500 μmol/L groups ([66.19 ±3.37]% and [13.84 ±0.43]%) (P0.05) and remarkably in the 100 and 500μmol/L groups (1.93 ±0.07 and 2.33 ±0.15) (P0.05) and markedly elevated in the 100 and 500 μmol/L groups ( 1.45 ±0.13 and 1.79 ±0.07 ) ( P<0.05) .After iron deposition, GAPDH transferred from the cytoplasm to the nuclei of the PC12 cells and nuclear accumulation was observed. Conclusion Iron deposition increases the apoptosis of PC12 cells, which may be related to the up-regulated expression of GAPDH in the nuclei.
RESUMEN
ObjectiveTo compare the predictive value of anatomic scoring system, physiological scoring system, and the combination of two systems in death prediction of patients with severe trauma in intensive care unit (ICU). Methods A retrospective analysis of patients with severe trauma admitted to department of critical care medicine of Daping Hospital, the Third Military Medical University, and Zunyi Medical University from January 2011 to December 2014 was conducted. The patients meeting the following criteria were enrolled: over 16 years old, admitted to hospital shorter than 24 hours after trauma, length of ICU stay≥48 hours, and injury severity score (ISS)≥16. Patients were divided into two groups: survivors and non-survivors. The data of anatomic scoring system, including ISS and new injury severity score (NISS), and physiological scoring system, including acute physiology and chronic health evaluationⅡ(APACHEⅡ) score were collected. The predictive power for death of the scoring system alone or combination in patients with severe trauma was evaluated.Results A total of 614 patients with severe trauma were enrolled, and there were 153 deaths with a mortality rate of 24.9%. ISS, NISS, APACHEⅡ, ISS+ APACHEⅡ, NISS+ APACHEⅡ of non-survivors were significantly higher than those of survivors (ISS: 29.15±7.75 vs. 24.31±6.50, NISS: 41.96±12.01 vs. 29.64±8.19, APACHEⅡ: 23.71±6.58 vs. 17.02±5.49, ISS+ APACHEⅡ: 52.86±10.00 vs. 41.33±8.70, NISS+ APACHEⅡ: 65.67±13.46 vs. 46.66±10.43, allP< 0.01). The area under receiver operating characteristic curve (AUC) of ISS, NISS, APACHEⅡ, ISS+ APACHEⅡ, NISS+ APACHEⅡ was 0.687, 0.792, 0.782, 0.809, and 0.860, respectively. Both of ISS+ APACHEⅡ and NISS+ APACHEⅡ had higher AUC than that of ISS, NISS or APACHEⅡ alone; and the AUC of NISS+ APACHEⅡ was significantly larger than that of ISS+ APACHEⅡ(allP< 0.05). NISS+ APACHEⅡ showed the largest AUC in death prediction of severe trauma patients. The cut-off value, sensitivity, specificity, positive predict value (+PV), negative predict value (-PV), positive likelihood ratio (+LR), negative likelihood ratio (-LR), and Youden index of NISS+ APACHEⅡ, which had the greatest AUC, were 56, 75.2%, 82.0%, 58.1%, 90.9%, 4.17, 0.30, and 0.572, respectively.Conclusion The combination of anatomic scoring system and physiological scoring system is better than single scoring system for death prediction in patients with severe trauma in ICU, and it may be considered to be a new method for early identification of death risk in patients with severe trauma.
RESUMEN
To investigate cognitive dysfunction of type 2 diabetes patients accompanied with obstructive sleep apnea syndrome [OSAS], and to analyze its relevant characteristics. Total 115 type 2 diabetes patients were divided into OSAS group [O group, n=83] and non-OSAS group [N group, n=32]; Physical examination patients [C1 group, n=64] and OSAS patients without diabetes [C2 group, n=47] served as the control group. Apnea-hypopnea index [AHI], nocturnal lowest saturation of pulse oxygen [LSPO2] and simple mental state examination scale [MMSE] were evaluated. Among diabetes patients, patients with OSAS have lower glycated hemoglobin, platelet count, thrombocytocrit, MMSE score and lowest mean arterial oxygen than non-OSAS patients; cognitive dysfunction state and glycemic control of patients are related to their diabetic duration, and then along with increase of diabetic duration, glycemic control becomes poor, so that cognitive dysfunction becomes more and more obvious. Along with increased diabetic duration in type 2 diabetes accompanied with OSAS, glycemic control becomes poor, so that cognitive dysfunction more easily occurs. Meanwhile, coagulation function of blood system in OSAS patients with diabetes is impacted to some extent
Asunto(s)
Humanos , Masculino , Femenino , Trastornos del Conocimiento , Apnea Obstructiva del Sueño , Hemoglobina Glucada , Recuento de PlaquetasRESUMEN
Objective To investigate the efficacy of CT guided radioactive 125I seed implantation on elderly patients with advanced malignancies.Methods 78 cases of elderly patients with malignant were collected and divided into two groups.41 cases of the treatment group were treated with CT guided radioactive 125I seed implantation.Particle activity was 29.6 MBq.The prescription dose was 90-110 Gy.37 cases of the control group were treated with optimized supportive care.Data from all of patients were to review and followup observation in short term efficacy,quality of life and side efforts.Results The total effective rate was 92.7 ％(38/41)and the disease control rate was 97.6 ％(40/41)in the treatment group.The control group was in the effective rate and 16.2 ％(16/37)in the disease control rate.The quality of life of the treatment group was higher than those in the control group(P＜0.05).And there is no obviously side efforts.Conclusion The treatment of elderly patients with advanced malignant tumors by 125I seed implantation was a safe and effective method.It can improve the quality of patients' life.
RESUMEN
OBJECTIVE To investigate and control the risk factors about nosocomial infection in cerebral hemorrhage patients.METHODS Totally 986 hospitalized patients with cerebral hemorrhage in our hospital from Jan 2002 to Dec 2005 were studied retrospectively.RESULTS It showed that the incidence of nosocomial infection rate was 32.05%,case infection rate was 44.62%.The nosocomial respiratory tract infection was the highest(66.36%),the second one was the urinary tract(20.68%).We also found that the risk factors prone to nosocomial infection were aging,long hospitalization,respiratory machine application,respiratory tract inicison,indwelling catheter and coma.CONCLUSIONS Nosocomial infection is still a high frequent complication in cerebral hemorrhage.It is suggested that there be urgent need for treating the underlying disease and reducing the risk factors,then can reduce the development of infection in patients with cerebral hemorrhage.
RESUMEN
Objective To explore the relationship between the dynamic change of plasma tissue-type plasminogen activator(t-PA)and its inhibitor-1(PAI-1)levels and infarct size in patients with acute cerebral infarction.Methods There were 100 patients with acute cerebral infarction,22 cases of large area infarction,36 cases of small area infarction,42 cases of lacunar infarction.The levels of plasma t-PA or PAI-1 in 24 h,2 d,14 d,21 d after cerebral infarction were detected by chromogenic substrate method,compared with normal control and the level of blood plasma t-PA or PAI-1 in patients with different size of cerebral infarction.Results Compared with normal control,levels of plasma t-PA at 24 h,2 d,14 d after acute cerebral infarction decreased significantly,and plasma PAI-1 level increased significantly(all P0.05).The plasma t-PA level in patients with large size of infarction was lower obviously than that in patients with small area infarction and lacunar infarction,small size of infarction was lower than that in lacunar infarction(all P0.05).Conclusion The plasma t-PA level decreased and PAI level increased in patients with acute cerebral infarction.The the size of infarction area is larger,the plasma t-PA level is lower,but there is no relationship between the plasma PAI-1 level and infarction area.
RESUMEN
Objective To investigate the effect and significance of batroxobin on the levels of neuron-specific enolase(NSE) and endothelin(ET) in plasm of patients with transient ischemic attacks(TIAs).Methods 120 cases of carotid territory TIAs(
RESUMEN
Objective To determine the dynamic changes of plasma endothelin (ET), calcitonin gene related peptide (CGRP) and atial natriuretic peptide (ANP) in elderly patients with acute cerebral infarction and explore the pathological role of ET, CGRP and ANP in the development of acute cerebral infarction.Methods The concentrations of ET, CGRP and ANP in plasma were determined with radioimmunoassay in 78 elderly patients with acute cerebral infarction and 60 normal controls.Results (1)The levels of ET and ANP in patient group were significantly higher than those in control group ( P3 cm) and small area infarct group (1.5～3.0 cm) were significantly higher (all P
RESUMEN
Object To investigate the effects of Heart-benefitting Recipe (HBR) on the histopathological changes of Alzheimer's disease (AD) rats after unilateral amyloid-?_ 25-35 protein (A?_ 25-35 ) injection into the amygdala. Methods The experimental rat models with dementia,spatial learning,and memory impairment were induced by unilateral amyloid ?_ 25-35 protein (A?_ 25-35 ) injection into the amygdala of rats. The spatial learning and memory ability and the function of cholinergic system were observed by the means of Morris water maze and radioligand binding assay. The protein expression of A?_ 1-40 ,AT_8 was estimated with immunohistochemistry. The expression of mRNA related to APP was observed by RT-PCR. Results HBR significantly alleviated the spatial learning and memory impairment induced by A?_ 25-35 and remarkably increased the activity of ChAT and Rt of M-receptor binding sites of these models. The expressions of A?_ 1-40 protein and APP mRNA in cortex and hippocampus of AD rats were decreased remarkably by HBR. The results of immunohistochemistry showed that the expression of hyperphosphorilated tau AT_ 8 in cortex and hippocampus of AD rats was inhibited significantly by HBR. Conclusion HBR can effectively improve the spatial learning and memory impairment,decrease the deposition of A?_ 1-40 ,and alleviate the hyperphos-phorylation of tau of AD rats induced by A?_ 25-35 .
RESUMEN
0.05).The scores of MMSE increased significantly(all P