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Radiotherapy is a primary method for treating tumors. However, since surrounding healthy tissues may also receive a certain dose of irradiation during the radiotherapy, they may suffer from radiation-induced damage, which is even serious for certain patients. Injectable hydrogels are expected to achieve the spacing between target areas and their surrounding tissues during radiotherapy, thus increasing the dose to the target areas while reducing the risk of radiation-induced damage to surrounding healthy tissues and organs. Accordingly, the quality of life of the patients can be improved. Therefore, applying injectable hydrogels serves as a potential strategy for reducing the adverse reactions associated with radiotherapy. This paper reviews the latest research progress in the spacing and protection of hydrogels in radiotherapy for different tumors.
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Late-onset circulatory collapse(LCC)in preterm infants is characterized by sudden onset of hypotension and/or oliguria after the first week of life, which is resistant to volume expanders and inotropes but responds rapidly to timely glucocorticoids treatment.LCC should be managed promptly and properly, or it may cause respiratory, digestive complications and life-long neurological problems.Relative adrenal insufficiency is considered the most likely cause of LCC, but its pathophysiology remains unclear.This review summarizes the current reserch about LCC regarding its pathophysiology, clinical features, diagnosis, treatment, and prognosis.
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Objective:To study the early effects of intact-umbilical cord milking (I-UCM) and cut-umbilical cord milking (C-UCM) for the prevention of anemia of prematurity in preterm infants.Method:From January 2019 to October 2019, C-section delivered infants with gestational age <34 weeks were randomly assigned into I-UCM group and C-UCM group. Hematological parameters at different timepoints after birth, iron status, incidence of anemia within 7 d after birth, blood transfusions, transcutaneous bilirubin levels and the total duration of phototherapy were collected and analyzed.Result:A total of 60 cases were enrolled, including 30 in I-UCM group and 30 in C-UCM group. I-UCM group had significant higher levels of hemoglobin (Hb), hematocrit (Hct) and serum iron on admission ( P<0.05). Comparing with C-UCM group, Hb and Hct were significantly higher in I-UCM group at 7 d and 14 d after birth ( P<0.05). Lower prevalence of anemia within 1 week [3.3% (1/30) vs. 33.3% (10/30), P<0.05] and less blood transfusions during hospitalization [13.3% (4/30) vs. 56.7% (17/30)] were noted in I-UCM group. No statistically significant differences existed between the two groups in phototherapy duration and the peak bilirubin levels ( P>0.05). Conclusion:I-UCM can provide more placental transfusion at birth to increase Hb levels and iron storage to prevent and reduce anemia in preterm infants.
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Objective:To assess the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis of children with biliary atresia.Methods:A prospective survey of infants with hepatitis syndrome and hyperbi-lirubinemia in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2017 to December 2018 was performed.The children with hepatitis syndrome were divided into the biliary atresia group( n=45) and non- biliary atresia group( n=30). Thirty children with hyperbilirubinemia were selected as the control group.Shear wave speed (SWS) of all infants was collected by ARFI ultrasound and compared among 3 groups.Receiver ope-rating characteristic curve(ROC curve) was used to analyze the optimal threshold value for SWS in the diagnosis of biliary atresia. Results:The mean SWS values in the biliary atresia group, non-biliary atresia group and the control group were (1.79±0.29) m/s, (1.26±0.12) m/s and (1.08±0.06) m/s, respectively.Compared with the control group, the mean SWS values in the biliary atresia group and non-biliary atresia group were significantly higher ( t=165.43, 15.75, all P<0.05). The mean SWS value in the non-biliary atresia group was significantly lower than that in the biliary atresia group ( t=90.27, P<0.05). With the non-biliary atresia group as reference, the area under the ROC curve of SWS for diagnosis of biliary atresia was 0.98(95% CI: 0.95-1.00), the optimal threshold was 1.45 m/s, and the sensitivity and specificity were 88.9% and 96.7%, respectively. Conclusions:Rapid non-invasive ARFI elastography is effective in the diagnosis of biliary atresia, and thus has important value for early diagnosis and treatment in clinical practice.
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Delayed umbilical cord clamping and umbilical cord milking could promote blood flowing from the placenta to the newborn, which would increase neonatal blood volume, avoid suddenly cardiac preload changes caused by the interruption of placental transfusion at birth, and make the neonatal cardiovascular system transition more stable and physiological.Although there have been cases of neonatal jaundice and polycythemia caused by placental transfusion in clinical, studies have shown that placental transfusion does not increase the incidence.At present, umbilical cord clamping immediately after birth is the commonly clinical practice in most countries, including China.The method of umbilical cord clamping, the factors effecting placental transfusion and the pros and cons of placental transfusion still need further research.
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Objective To study the clinical features and risk factors of acute pulmonary reperfusion injury after operation in neonates with severe pulmonary stenosis or pulmonary atresia.Method From February 2014 to February 2018,a retrospective analysis was performed in patients with critical pulmonary stenosis or pulmonary atresia who received percutaneous balloon pulmonary valvuloplasty (PBPV) in the neonatal intensive care unit of our hospital.Clinical characteristics,perioperative cardiac structure,hemodynamic data and biochemical results were collected.The neonates were assigned into injury group if they had acute lung reperfusion injury,and non-injury group if not.The risk factors of acute lung reperfusion injury were analyzed using multi-variate Logistic regression model.Result A total of 32 patients (24 prenatal diagnosis and 8 postnatal diagnosis) with severe pulmonary stenosis or pulmonary atresia with intact ventricular septum were enrolled.The main manifestations were dyspnea and cyanosis.Intravenous prostaglandin E was administered to keep the ductus arteriosus open.The age of operation ranged from 1 to 52 days and the median age was 7.5 days.Postoperative acute lung reperfusion injury occurred in 7 cases (21.9％).Preoperative and intraoperative pulmonary valve annulus diameter,balloon diameter,preoperative hemoglobin,hematocrit and blood albumin were significantly lower in the injury group.The operation duration,total length of hospital stay and postoperative duration were longer than in the non-injury group,the differences were statistically significant (P ＜ 0.05).Multi-variate Logistic regression analysis showed that the diameter of pulmonary valve annulus (OR =5.814,95％CI 1.106 ～30.568),preoperative blood albumin (OR =1.361,95％ CI 1.063 ～ 1.742),and hematocrit (OR =1.173,95％ CI 1.010 ～ 1.363) were risk factors of acute lung reperfusion injury,with statistically significant differences (P ＜ 0.05).Conclusion Acute lung reperfusion injury is one of the common complications after the operation of severe pulmonary stenosis or pulmonary atresia.The severity of pulmonary valve annulus stenosis,preoperative hematocrit and blood albumin level may be the risk factors of postoperative acute lung reperfusion injury.
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Objectives To explore the influence of standardized treatment and technical flow improvement on the diagnosis and treatment of congenital diaphragmatic hernia (CDH) after prenatal diagnosis. Methods The clinical data of neonates diagnosed with CDH who were hospitalized in neonatal intensive care unit from January 2005 to August 2016 was analyzed retrospectively. Based on the start time of standardized treatment implementation, 93 cases of CDH hospitalized from January 2010 to August 2016 were divided into the intervention group while 15 cases of CDH hospitalized from January 2005 to December 2009 were divided into the control group. The survival rate and complications of clinical outcomes between two groups were compared. Results There was no significant difference in sex, gestational age, birth weight, Apgar score, and CDH position between two groups (P >0.05). The total survival rate was 81.7％ in the intervention group and 53.3％ in the control group, and there was statistical difference (P0.05). The median operation time in the control group was 4.5 h and the intervention group was 49.5 h. The postoperative survival rate was 61.5％ in the control group and 90.5％ in the intervention group, and the differences between two groups were significant (P >0.05). The first blood gas analysis of deaths cases in both groups showed that there were significant differences in pH and PCO2 values (P >0.05). Conclusions Optimization of the clinical management during perioperative period can improve the survival rate of CDH and reduce complications. However, the dead cases in the intervention group had more severe pulmonary hypoplasia.
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Objective To explore the effects of the multidisciplinary cooperative continue nursing on the quality of life of patients with chronic obstructive pulmonary disease (COPD). Methods From December 2012 to December 2014, hospitalized COPD patients who were in the stable stage of disease and would soon be discharged and met the criteria standards were chosen. Convenient extraction of 64 patients were set as the experimental group in one ward and 50 patients as the control group in the other ward. The conventional discharge guidance was employed in the control group. While the continuation of care before discharge and 1, 3, 6 months after discharge was employed in the experimental group. The indexes such as the quality of life and 6 min walking test distance (6MWD) were observed and compared. Results The total scores and symptoms, activities, influence scores of the quality of life were 48.53±15.78, 35.38± 18.61, 57.95 ±23.69, 52.28 ±15.27 after 6 months intervention in the experimental group and 60.24 ±10.14, 52.76 ±12.36, 68.34 ±15.59, 58.55 ±11.79 in the control group, and there were significant differences (t=-5.69--2.38, P<0.05). 6MWD was (267.46 ±64.64) m after 6 months intervention in the experimental group,which was more than that before intervention (169.42±48.46) m, and there was significant difference (t=-9.71, P<0.01). 6MWD was (201.32±53.93) m after 6 months intervention in the control group, which was not significantly better than that in the experimental group (t=5.82, P<0.01). Conclusions The quality of life of patients with COPD can be significantly improved by the multidisciplinary cooperative continue nursing education after discharge.
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Background:Faecalibacterium prausnitzii( Fp) is one of the most abundant bacterium in human intestinal microbiota,and is closely correlated with the process of colitis-associated colorectal cancer(CAC). Aims:To observe the effect of Fp on CAC,and investigate the possible mechanism. Methods:The model of CAC was induced by azoxymethane (AOM)and dextran sodium sulfate( DSS). Fifty-two C57BL/ 6J mice were randomly divided into 4 groups:group A (AOM + DSS),group B(AOM + DSS + Fp),group C(AOM + DSS + Fp supernatant)and group D(control group). All the mice were sacrificed on day 92. DAI was assessed,serum levels of TNF-α and IL-10 were determined by ELISA. HE staining was used to examine the grade of tumor. Expressions of VEGF,COX-2,NF-κB in tumor tissue were measured by immunohistochemistry. Results:The tumorigenesis rates of group A,B,C were 100% ,100% and 77. 8% ,respectively;mainly were high-grade intraepithelial neoplasia. The tumor load in group A was significantly higher than that in group B (P < 0. 01),and the spleen index in group B was significantly higher than that in group C(P < 0. 01). Serum level of TNF-α was significantly lower(P < 0. 05)and IL-10 was significantly higher(P < 0. 05)in group A than that in group B. No significant differences in expressions of VEGF,COX-2,NF-κB were found among group A,B and C. Conclusions:Fp had no obvious effect on the occurrence rate of CAC,and Fp supernatant could decrease the incidence of CAC in mice. Fp and its supernatant could reduce the tumor load via regulating the expressions of TNF-α,IL-10.
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Background:Faecalibacterium prausnitzii(Fp)is a commensal intestinal bacterium that exhibits anti-inflammatory and immunomodulatory capacity in vivo and in vitro. It has been reported that Fp in intestinal lumen was reduced in patients with colorectal cancer,which might be a factor associated with cancer development. Aims:To investigate the effect and immunological mechanism of Fp and its genomic DNA(fDNA)on the killing activity of peripheral blood mononuclear cells (PBMCs)against human colon cancer LoVo cells. Methods:PBMCs derived from healthy adults were co-cultured in vitro with Fp,fDNA,or the digested fDNA(d-fDNA),respectively. Killing activity of PBMCs against LoVo cells was measured by MTT assay;concentrations of interferon-gamma(INF-γ),a Th1-type cytokine and interleukin-4(IL-4),a Th2-type cytokine in culture supernatant of PBMCs were determined by ELISA;and expressions of T-bet and GATA3,the transcription factors specific for Th1 and Th2 cells,were measured by real-time PCR. Results:Compared with the PBMCs not treated,fDNA could significantly enhance the killing activity of PBMCs against LoVo cells(P < 0. 05);meanwhile,it promoted IFN-γ secretion,up-regulated T-bet mRNA expression and inhibited IL-4 secretion and GATA3 mRNA expression in PBMCs(P < 0. 05). Similar effects were not observed in PBMCs treated with Fp and d-fDNA. Conclusions:fDNA enhances the killing activity of PBMCs against human colon cancer cells by up-regulating Th1 immune response.
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Objective To investigate the influence of FOXP 3 expression in pancreatic carcinoma cells (PCCs) on the maturation and immunologic function of dendritic cells (DCs).Methods The siRNA sequences targeting FOXP3 gene (siRNA-FOXP3) and negative control siRNA (siRNA-NC) were specifically designed and transfected into PCCs , then the level of IL-10 and TGF-β1 of culture supernatant were detected by ELISA.The supernatants of pancreatic carcinoma cell transfected by FOXP 3-siRNA were collected , then it was mixed with GM-CSF and IL-4 to induce the differentiation of DCs .Flow cytometric analysis were used to measure the expression of surface markers CD 86 , CD80 , HLA DR on DCs which were treated with supernatants . The levels of IL-12p70, IFN-γin supernatants were detected by ELISA .The DCs were co-cultured with T lymphocytes, and then the lymphocytes proliferation and cytoxicity were analyzed by CCK -8 assays.Results Compared with PANC1 with siRNA-NC transfection, PANC1 with siRNA-FOXP3 transfection had a decreased expression of IL-10, TGF-β1 [(8.93 ±3.06)ng/L vs (26.60 ±5.57)ng/L;(2 544 ±78)ng/L vs (2 856 ± 92)ng/L], the positive expression rate of CD86, HLA DR in DCs cultured in the medium containing the supernatants of the pancreatic carcinoma cell transfected by siRNA-FOXP3 was significantly increased [(28.10 ±3.11)%vs (13.90 ±0.42)%;(66.15 ±4.17)%vs (43.15 ±3.32)%], the expression of IL-12p70, IFN-γwas significantly increased [(52.75 ±7.89)ng/L vs (26.14 ±4.50)ng/L, (898.43 ±88.82) ng/L vs (412.76 ±24.68) ng/L], after co-culture with lymphocytes at ratios of 1:5, 1:10, 1:20, the proliferation was significantly increased [(95.27 ±3.80)% vs (71.77 ±5.70)%, (78.97 ±5.73)% vs (52.30 ±8.72)%, (57.60 ±4.36)% vs (43.73 ±6.01)%], and the cytoxicity of CTL to PANC1 cells with 1:20, 1:40 co-culture was significantly increased [(28.44 ±5.20)% vs (8.82 ±2.29)%, (40.85 ± 5.15)% vs (17.38 ±4.86)%], and the difference between the two groups was statistically significant (P<0.05).Conclusions FOXP3 expression in PCCs can inhibit the maturation and immunologic function of DCs.
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Objective: To reasonably allocate the hospital fixed assets, improve the use efficiency of hospital fixed assets and enhance the management level of hospital fixed assets. Methods: Literature method, observation method and expert interview are mainly adopted to launch comprehensive investigation on the current management conditions of the fixed assets of public hospitals in Quzhou from 2009 to 2011. Results: The allocation of assets is not reasonable, the utilization rate of large devices is not high and the return on assets is relatively low. Conclusion: Professional centralized management of large special equipment should be implemented, informatization management is comprehensively implemented, ABC management approach is applied to conduct classified management of fixed hospitals of the hospitals, so as to establish layered assets management accountability system.
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Objective To investigate the expression of placental growth factor (PlGF) protein and mRNA in lungs of neonatal rats exposed to 85%hyperoxia, and to establish the relationship between PlGF and bronchopulmonary dysplasia (BPD). Methods Forty-eight Sprague–Dawley neonatal rats were randomly exposed to air (control group)(n=24) and 85% hyperoxia (hyperoxia group)(n=24)within 12 h after birth. The rats were sacrificed at 3, 5 and 7 days after exposure (eight at each time) and their lungs were sampled. PlGF protein and mRNA expression in the lungs were determined by Western blot and real-time polymerase chain reaction (PCR) at 3, 5 and 7 days. Left lung tissue was used for morphological and histological observation with hematoxylin and eosin staining. Terminal air spaces and the secondary septa were counted manually under microscope. T-test was applied for statistics. Results Compared with the control group, morphological and histological analysis in the hyperoxia group revealed inflammatory cell infiltration, simplified alveolar structure, less alveolar, alveolar cavity expansion and thickened alveolar septum. Morphometric measurements showed that terminal air spaces and secondary septa were significantly fewer in the hyperoxia rats than those in the control group at 5 and 7 days (terminal air spaces:23.6±8.2 vs 33.1±6.2 and 28.5±9.2 vs 38.4±10.1, t=1.91, 2.53, all P<0.05;secondary septa:56.0±12.2 vs 78.3±8.2 and 75.4±12.2 vs 126.1±10.2, t=2.14, 2.72, all P<0.05). Real-time PCR showed that expression of PlGF mRNA increased significantly on day 3, 5 and 7 in the hyperoxia group compared with the control group (1.16±0.17, 1.34±0.15 and 1.65±0.19 vs 0.65±0.21, 0.47±0.11 and 0.46±0.17, respectively, t=1.93, 2.55, 2.79, all P<0.05). Western blot also showed that expression of PlGF protein on day 3, 5 and 7 in the hyperoxia group increased compared with the control group, but only being significant on day 3 (0.24±0.17 vs 0.09±0.01, t=2.44, P<0.05). Conclusions Hyperoxia (85%) exposure could increase PlGF protein and mRNA expression in the lungs of neonatal rats, likely contributing to pathogenesis of BPD, and might lead to pulmonary vascular developmental disorders in BPD.
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Objective To retrospectively explore the incidence and causes of apnea after operation for retinopathy of prematurity(ROP). Methods The clinical data of 17 premature infants with operation for ROP(ROP group)and the other 23 premature infants without ROP(control group)were collected.The occurrence of apnea(time of onset and remission and original diseases) was recorded after operation in ROP group and at adjusted 37 weeks of gestational age in control group.Follow-up was conducted for 4 weeks,and the prevalences of apnea were compared between these two groups.Results There was significant difference in prevalenees of apnea between ROP group and control group ( 52.9%vs 21.7%,P<0.05).In ROP group,time of occurrence of apnea was (38±40)h after operation,and time of remission was (126±145)h after onset.Among the infants with apnea,there were 3 cases of pneumonia(33.3%),1 case of hypoglycemia(11.1%)and 5 cases with unexplained causes(55.5%). Conclusion Infants after operation for ROP are more prone to apnea,and pediatricians and ophthalmologists are required to collaborate in the perioperative care.
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Objective To expore the mechanism of low-dose interfone-γ(IFN-γ) influences on differentiation of oligodendrocyte precursor cell. Methods The cerebral cortex samples were obtained from one day old SD rats to form mixed single cell suspensions. After culturing in full medium for 7 to 10 days, succession and differential velocity adherent technique were performed to acquire oligodendrocyte precursor cell and cultured in serum-free medium. IFN-γ, AG490 and Fludarabine were added during the culture of oligodendrocyte precursor cell and reverse transcription-polymerase chain reaction, Western blot and flow cytometry were performed to evaluate the expression of intracellular P27kip1 and its influence on the differentiation of oligodendrocyte precursor cell. Results (1)The expression of P27kip1 mRNA and protein was lower in IFN-γ group than in control group (t=85. 535, P<0. 05;t= 12. 481, P<0. 05), while the expression of P27kip1 mRNA and protein in IFN-γ+AG490 group and IFN-γ+Fludarabine group were both higher than those in IFN-γ group (P<0. 05). (2) The phosphorylation levels of JAK2/STAT1 in INF-γ group were higher than that in the other three groups (P<0. 05). (3) The percentage of myelin basic protein positive cells was (68. 42 ± 2. 53)% in IFN-γ group, lower than that in control group [(88.21 ± 1.97)%](t=10.682, P < 0.05). Myelin basic protein positive cells in IFN-γ + AG490 group were (57. 63 ±2. 75) %, lower than those in the IFN-γ group. The same figure in IFN-γ+Fludarabine group were (79. 53±4. 15)% , higher than those in IFN-γ group (t = 3.957, P<0.05). Conclusions Low-dose IFN-γ can regulate the expression of intracellular P27kip1 through JAK2/STAT1 signal transduction pathway and Fludarabine may participate in this process and improve the differentiation and maturation of oligodendrocyte precursor cell.
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Objective To investigate the protective effects and mechanisms of NF-KB inhibitor pyrrolidine dithiocarbamate (PDTC) on infant rabbits with lung injury caused by mechanical ventilation. Methods Twenty healthy infant rabbits were randomly divided into four groups. (1) Mechanical ventilation (MV, with VT = 24 ml/kg);(2) Mechanical ventilation plus PDTC pre-treatment (MVP, VT = 24 ml/kg with PDTC 100 mg/kg injection via ear vein half an hour prior to MV) ; (3) Mechanical ventilation combined with endotoxin (EMV, 0.1 ml/kg of endotoxin dripping into trachea then on MV, VT = 24 ml/kg) ; (4) EMV plus PDTC pretreatment (EMVP, PDTC 100 mg/kg injection via ear vein followed by 0.1 mg/kg of endotoxin dripping into trachea in half an hour then on MV with VT = 24 ml/kg for 4 h continuously. MPO and the activation of NF-κB in lung tissues and the genetic expression and protein quantity of TNF-α and IL-8 in homogenate were measured. The pathological changes in lung tissues were examined. Results Pre-treatment with PDTC had significant minor pathological changes caused by MV and MV plus endotoxin, which were indicated by the fact that MPO, activation of NF-KB and the genetic expression and protein quantity of TNF-α and IL-8 were significantly suppressed. Conclusions PDTC could decrease the expression, synthesis and release of pro-inflammatory cytokines. This may be through suppressing the activation of NF-κB resulting in less infiltration with inflammatory cells and protective effects on lung injury caused by MV and MV plus endotoxin.