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The introduction of vitrectomy has solved a difficult and intractable problem in the ophthalmology community for the treatment of fundus oculi diseases. To date, minimally invasive vitrectomy(MIV)is the main surgery for the treatment of fundus oculi diseases. Clinically, patients develop dry eye symptoms after MIV, including lacrimation, foreign body sensation, and visual disturbances. We speculates that MIV may damage the conjunctival and corneal epithelium as well as related sensory nerves, disrupting the tear film and causing a local inflammation response, thereby further affecting the ocular surface microenvironment and inducing or aggravating dry eye symptoms. At present, there are few studies on the changes of ocular surface after MIV. This article aims to analyze the effects of different factors on the microenvironment of the ocular surface before, during and after MIV, and to provide preventive and curative measures that can be taken to guide the clinic to make good preparations for the operation, to choose the appropriate surgical procedure, and to reduce the risk of dry eye in the postoperative period.
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Objective:To investigate the mechanism of IL-6 affecting the expression of CD73 on human placenta-derived mesenchymal stem cells (hPMSCs) and regulating their migration, adhesion and proliferation.Methods:Flow cytometry (FCM) and Western blot were used to analyze the effects of exogenous IL-6 or IL-6 secreted by hPMSCs on the expression of CD73 on hPMSCs. The influence of IL-6 on the phosphorylation of signal transducer and activator of transcription 3 (p-STAT3) in hPMSCs was detected by monoclonal antibody blocking test and Western blot. Real-time cellular analysis (RTCA) was used to analyze the changes in the migration, adhesion and proliferation of hPMSCs after knockdown of CD73 expression or APCP pretreatment.Results:FCM and Western blot showed that both exogenous and autocrine IL-6 from hPMSCs promoted the expression of CD73 on hPMSCs ( P<0.001, P<0.01). Moreover, CD73 expression decreased significantly with the presence of IL-6R inhibitor ( P<0.01). IL-6 could up-regulate the levels of both p-STAT3 and CD73 in hPMSCs ( P<0.05, P<0.01), while CD73 expression decreased after adding STAT3 inhibitor ( P<0.01). RTCA showed that knockdown of CD73 expression on hPMSCs significantly inhibited the adhesion and proliferation ability of hPMSCs( P<0.01, P<0.05), but promoted the migration ability of hPMSCs ( P<0.05). Similarly, inhibiting the hydrolase activity of CD73 on hPMSCs by APCP also resulted in a significant decrease in the adhesion and proliferation capacities of hPMSCs, and an increase in the migration capacity of hPMSCs ( P<0.05). Conclusions:IL-6 enhanced the expression of CD73 on hPMSCs via the JAK/STAT3 pathway, thus affecting the migration, adhesion and proliferation of hPMSCs.
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Objective:To detect the level of long non-coding RNA LINP1 (lncRNA-LINP1) in endometrial carcinoma and to explore the prognostic value of the expression leve.Methods:From January 2015 to December 2016, the tissue samples of 82 patients with endometrial carcinoma in North China University of Science and Technology Affiliated Hospital were used as endometrial carcinoma group, and the normal adjacent tissues were selected as the paracancerous control group.The expression of LINP1 mRNA was measured by real-time fluorescence quantitative PCR (qRT-PCR). The clinicopathological data of the patients were collected, and the relationship between the expression of LINP1 mRNA and clinicopathological parameters was analyzed.Kaplan-Meier method was used to analyze the relationship between the expression of LINP1 mRNA and the survival rate of endometrial patients; and COX multivariate analysis was used to identify the risk factors of death in patients with endometrial cancer.Results:The expression of LINP1 mRNA in endometrial carcinoma group and paracancerous control group were (2.38±0.43) and (1.00±0.24). There was significant difference between the two groups ( t=25.376, P<0.001). The results of clinicopathological parameters showed that the expression of LINP1 mRNA was not related to the age and histological type of endometrial carcinoma (all P>0.05). It was related to lymph node metastasis, FIGO stage, tumor differentiation and vascular invasion (all P<0.05). the three-year total survival rate of the group with high expression of LINP1 mRNA (48.78%) was lower than that of the group with low expression of LINP1 mRNA (80.49%), and the differences were statistically significant (χ 2=6.306, P<0.05). COX Regression analysis showed that, high expression of LINP1 mRNA and FIGO Stage III, IV and lymph node metastasis were the risk factors for death in endometrial cancer patients (HR(95% CI) were 2.898(2.031-4.136), 1.831(1.448-2.316), 1.708(1.364-2.138), P values were 0.002, 0.004 and 0.008, respectively. Conclusion:The high expression of LINP1 mRNA in endometrial carcinoma is closely related to lymph node metastasis, FIGO stage, tumor differentiation, vascular invasion and prognosis.It is a risk factor for the death of patients with endometrial cancer and may be used as an index to evaluate the prognosis of patients with endometrial cancer.
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Objective:To investigate the role of IL-1β in regulating human placenta-derived mesenchymal stem cells (hPMSCs) to induce the differentiation of activated peripheral blood mononuclear cells (PBMCs) into CD8 + IL-10 + T cell subset in patients with rheumatoid arthritis (RA). Methods:Serum IL-1β levels in RA patients were detected by CBA kit. hPMSCs were isolated from healthy subjects by enzyme digestion. PBMCs that were isolated from RA patients and healthy subjects by Ficoll density gradient centrifugation were activated with PHA and CD3/CD28 monoclonal antibody (McAb) and then co-cultured with hPMSCs. Flow cytometry (FCM) was used to analyze the ability of hPMSCs to induce the differentiation of activated PBMCs into CD8 + IL-10 + T cell subset with the presence of programmed death ligand 1 (PD-L1) and/or PD-L2 McAb and IL-1β. Expression of PD-L1 and PD-L2 on hPMSCs under IL-1β stimulation was analyzed by RT-PCR and FCM. Results:Serum IL-1β levels were significantly higher in RA patients than in healthy subjects. After the activation by PHA and CD3/CD28 McAb, the proportion of CD8 + IL-10 + T cells in PBMCs of RA patients was significantly lower than that of healthy subjects. Moreover, the proportion of CD8 + IL-10 + T cells significantly increased after co-cultured with hPMSCs. The ability of IL-1β-treated hPMSCs to induce activated PBMCs to differentiate into CD8 + IL-10 + T cells was significantly enhanced compared to untreated hPMSCs. IL-1β could up-regulate the expression of PD-L1 and PD-L2 on hPMSCs. Blocking the expression of PD-L1 and/or PD-L2 on hPMSCs significantly reduced the ability of hPMSCs to induce activated PBMCs to differentiate into CD8 + IL-10 + T cells. Conclusions:IL-1β enhanced the capacity of hPMSCs to induce activated PBMCs to differentiate into CD8 + IL-10 + T cells in RA patients by up-regulating the expression of PD-L1 and PD-L2.
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Objective:To evaluate the accuracy of point-of-care ultrasound in diagnosis of guidewire tip misplacement during central venous catheterization.Methods:Ninety patients of both sexes, aged 18-90 yr, with body mass index of 15.5-44.8 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ-Ⅳ, scheduled for elective surgery with general anesthesia requiring central venous catheter (CVC) insertion through bilateral internal jugular veins or subclavian veins, were enrolled.The ultrasound probe was used, and the target vessel was selected.Anesthesia was induced with propofol, sufentanil and cisatracurium, and positive pressure ventilation was applied after endotracheal intubation.After central venous puncture was successfully performed under ultrasound guidance, the guidewire was inserted to a predetermined length, and the tips of the guidewire were confirmed with X-ray film and with point-of-care ultrasound including a phased array probe and linear array probe, and the results were recorded.The CVC was inserted after confirming the guidewire tip position.Agreement between the guidewire tip misplacement confirmed with point-of-care ultrasound and with bedside X-ray film was analyzed using Kappa statistics.The sensitivity, specificity, and total coincidence rate, rate of misdiagnosis, rate of missed diagnosis, Youden index, odds product, positive predictive value and negative predictive value of the guidewire tip misplacement were calculated during central venous catheterization confirmed using point-of-care ultrasound. Results:Among the 90 patients, 17 cases had guidewire tip misplacement, and the incidence of guidewire tip misplacement was 19%.Point-of-care ultrasound and bedside X-ray film were consistent in the diagnosis of guidewire tip misplacement during CVC insertion (Kappa value 0.945, P<0.05). The sensitivity of point-of-care ultrasound in diagnosing guidewire tip misplacement during CVC insertion was 97.44 %, specificity 97.78%, total coincidence rate 97.67%, rate of misdiagnosis 2.22%, rate of missed diagnosis 2.56%, Youden index 95.22%, odds product 1 672, positive predictive value 95.00%, and negative predictive value 98.88%. Conclusion:Point-of-care ultrasound can be used to diagnose guidewire tip malposition during central venous catheterization.
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Since mid-December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has outbroken in Wuhan, Hubei Province, China, and spread rapidly to other provinces in China and dozens of countries and regions around the world, becoming the Public Health Emergency of International Concern (Public Health Emergency of International Concern). SARS-CoV-2 can mainly transmit by droplets or close contact, and is generally susceptible in the crowd. Tumor patients are at high risk of this pathogen because of their impaired immune function. Identifying tumor patients with 2019 novel coronavirus disease (COVID-19) early, and understanding its distribution characteristics can help to improve the cure rate of patients, and better control the epidemic and development of SARS-CoV-2 much better. With comprehensive analysis of relevant literature, this paper reviews the clinical characteristics of neoplastic patients with COVID-19, and puts forward some suggestions on how to deal with this epidemic.
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Humanos , Betacoronavirus , Infecções por Coronavirus , Epidemiologia , Epidemias , Neoplasias , Pandemias , Pneumonia Viral , EpidemiologiaRESUMO
Objective The aim of this study was to investigate the relative expression of zinc finger protein ZNF436 in hu-man gastric cancer cells and tissues and its mechanism of ZNF436 on migration and invasion of gastric cancer MKN -28 cells. Methods RT-qPCR and immunohistochemistry were used to determine the expression of ZNF436 at the levels of mRNA and pro-tein in human gastric cancer cells,gastric cancer and matched paracancerous tissues,and normal human gastric tissues. ZNF436 ex-pression and prognostics were analyzed through online data. The ZNF436 -siRNA ( experimental group) and NC -siRNA( control group)plasmids were transfected into MKN028 cells. RT-qPCR was used to confirm the knockout efficiency of ZNF436 after trans-fection for 48 hours. The transwell assay was used to analyze the effect of ZNF436 on cell migration and invasion after knockout ZNF436. The effect of ZNF436 on cell metastasis was verified by nude mice metastasis experiments. The effect of ZNF436 on WNT/β-catenin signaling pathway was verified by immunoblotting. Results Compared with normal gastric epithelial cells,ZNF436 was highly expressed in human gastric cancer cells(P<0. 001). ZNF436 was highly expressed in gastric cancer tissues compared with ad-jacent normal tissues and normal human gastric tissues(P<0. 001). The expression of ZNF436 was associated with the prognosis of gastric cancer from online data(P=0. 0028);the high expression of ZNF436 gene,the worse prognosis of patients(P<0. 001);When compared with the control group,the migration and invasion ability in the experimental group was significantly inhibited(P<0. 001);the size and volume of metastasis in nude mice in the experimental group were significantly lower than those in the experimental group ( P<0. 001). After the low expression of ZNF436,the WNT/β-catenin signaling pathway and its downstream cytokines were signifi-cantly inhibited. Conclusion ZNF436 is up-regulated as a potential oncogene in human gastric cancer and participates in the pro-gression of gastric cancer by promoting WNT/β-catenin signaling pathway.
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Objective To evaluate the efficacy of dexmedetomidine combined with remifentanil for drug-induced sleep endoscopy (DISE) in the patients with snoring. Methods Sixty patients of both sexes with snoring, aged 18-61 yr, with body mass index of 21. 0-33. 1 kg∕m2 , of American Society of Anesthe-siologists physical statusⅠ or Ⅱ, scheduled for elective DISE, were randomly divided into either dexme-detomidine combined with propofol group (group P) or dexmedetomidine combined with remifentanil group (group R), with 30 patients in each group. Dexmedetomidine was infused within 10 min in a loading dose of 0. 6 μg∕kg, followed by an infusion of 0. 6 μg·kg-1 ·h-1 for 10 min in both groups. Then propofol was given by target-controlled infusion with the initial target effect-site concentration (Ce) of 1. 0 μg∕ml in group P, and remifentanil was given by target-controlled infusion with the initial target Ce of 1. 5 ng∕ml in group R. At 2 min after the target effect-site and plasma concentrations were balanced, the Ces of propofol and remifentanil were adjusted by increments of 0. 2 μg∕ml and 0. 2 ng∕ml, respectively, until satisfactory snoring occurred and then the Ce was maintained at this level in P and R groups. Bispectral index value was re-corded at 5 min after admission to the operating room (T1 ), at 20 min of dexmedetomidine infusion (T2 ), at 2 min after the target effect-site and plasma concentrations were balanced (T3 ), at the beginning of DISE (T4 ), when the nasopharyngolarygnoscope reached the site of oropharynx (T5 ) and at the end of DISE (T6 ). Observer's Assessment of Alertness∕Sedation scale scores were recorded at T1-4 . The time for prepar-ing sedation, recovery time, the lowest value of SpO2 and development of adverse events were recorded. Re-sults Sixty patients completed DISE successfully. Compared with group P, the bispectral index value at T3-6 was significantly increased, the time for preparing sedation was prolonged, the recovery time was short-ened, the lowest value of SpO2 was increased, and the incidence of respiratory depression was decreased in group R (P< 0. 05). There was no significant difference in Observer's Assessment of Alertness∕Sedation scale scores at T1-4 between two groups ( P> 0. 05). Conclusion Combination of dexmedetomidine and remifentanil produces better efficacy for DISE than combination of dexmedetomidine and propofol in the pa-tients with snoring.
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Objective To evaluate the effect of wire-reinforced polyurethane epidural catheters on the success rate of epidural catheterization in the patients undergoing caesarean section.Methods A total of 182 pregnant patients,aged 25-43 yr,with body height of 145-178 cm,weighing 51-100 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective caesarean section under combined spinal-epidural anesthesia,were divided into 2 groups using a random number table:polyvinyl chloride epidural catheter group (group Ⅰ,n =94) and wire-reinfnrced polyurethane epidural catheter group (group 11,n=88).Spinal or epidural puncture was performed at L2,3 or L3,4 interspace,and the corresponding epidural catheter was inserted in each group aficr succcssful puncturc.Thc dcvclopment of difficult insertion,intravascular catheter insertion or paresthesia during puncture or insertion was defined as a failure of epidural catheterization.The occurrence of failed epidural catheterization was recorded.Results The failure rate of epidural catheterization was significantly lower in group 1Ⅱ than in gronp Ⅰ (P＜0.05).Conclusion Wire-reinforced polyurethane epidural catheters can raise the success rate of epidural catheterization in the patients undergoing caesarean section.
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Objective To investigate the effect of Wnt1 on the expression of Cyclin D1 in human corneal epithelial cells and its related molecular mechanisms. Methods 12 T25 cell culture flasks were cultured after hu-man corneal epithelial cells anabiosis ,culture and continuous passage for 2 times. Culture flasks were divided into 3 groups with 4 culture flasks in each group. Twenty-five ng/mL and 50 ng/mL recombinant human Wnt1 protein were added in two of the groups,and one group without T-cell culture medium(Wnt1)was used as control. Cells cultured in T25 flask were taken from three groups at different time(6 h,24 h,48 h and 72 h). The total number of corneal epithelial cells in each group was calculated. Expression of Cyclin D1 in corneal epithelial cells was de-tected by Western blot. Results The expression of Cyclin D1 protein in the control group decreased gradually from 0 h to 48 h,and reached the lowest level at 48 h and increased at 72 h. Cyclin D1 protein expression in 25 ng/mL group at 6 h after Wnt1 was added was not detected,and Cyclin D1 protein expression in 50 ng/mL group in-creased. The expression of Cyclin D1 protein in 25 ng/mL group and 50 ng/mL group was significantly higher than that in control group at 24 h,48 h and 72 h,reaching the peak at 48 h and decreased at 72 h. Compared with the control group,the growth rate of corneal epithelial cells in 25ng/ml group and 50ng/ml group increased after Wnt1 was added. There was significant difference in 72 h,but no significant difference in 6h,24h and 48h. Conclu-sions The stimulation of Wnt1 protein can enhance the expression of Cyclin D1 in a certain time range,and has a positive correlation with Wnt1 protein. As one of the target genes of Wnt1 signaling pathway,Cyclin D1 may play an important role in the repair of corneal epithelial injury and its cell proliferation and differentiation.
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Objective To evaluate the feasibility of ETView visual endotracheal intubation in elderly patients with a potentially difficult airway under general anesthesia.Methods A total of 80 patients scheduled for elective surgery,with at least three characteristics indicative of an increased risk for difficult tracheal intubation and aged 65-86 years with American Society of Anesthesiologists (ASA) grade [Ⅱ or Ⅲ,were selected and randomly assigned into 2 groups:the control group (Group C) and the ETView visual endotracheal intubation group (Group E) (n=40 for each).After induction with propofol 0.5-1.5 mg/kg,sufentanil 0.2 μg/kg,and rocuronium 0.6mg/kg,regular tracheal intubation and ETView visual endotracheal intubation were conducted in Group C and Group E respectively.Blood pressure and heart rate were recorded before induction (T0),before initial intubation (T1),at successful intubation (T2),and 5min after successful intubation (T3).Duration of catheterization,number of intubation attempts,rate of successful intubation at first attempt and complications within 2 days of intubation were also recorded.Results The duration of catheterization and the number of intubation attempts were lower in Group E than in Group C[(34±6) s vs.(48± 22) s,(1.0±0.0) vs.(1.4±0.4),t=2.484 and 2.373,respectively,P=0.017 and 0.023,respectively].The rate of successful intubation at first attempt was higher in Group E than in GroupC (100％ or 40 cases vs.75％ or 30 cases),x2=5.714,P=0.017).There was no significant difference in hemodynamic changes and the rate of postoperative hoarseness between the two groups (P＞0.05 for both).Conclusions ETView visual endotracheal intubation shows excellent safety in elderly patients with a difficult airway under general anesthesia,with shorter catheterization duration and a higher rate of successful intubation at first attempt than regular intubation.
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Objective To study the expression of tight junction factors in human placental tissues derived from assisted reproductive technology (ART) and natural pregnancy and its role in placental barrier.Methods Ten placental samples were collected from the women who had undergone ART treatment and 11 placenta were collected from control group.Transmission electron microscope (TEM) examination was utilized to detect the morphology of placental tight junctions.The mRNA of claudin (CLDN) 1,CLDN4,CLDN5,CLDN8,zonula occudens (ZO) 1 was detected by real-time PCR and the protein of CLDN4,CLDN8 and occludin (OCLN) were measured by western blot.Results TEM microscopy results showed that placenta samples derived both ART and control placenta had normal microscopic histological features of tight junctions,localized in the apical part of the syncytium and also between the cell-cell contacts of fetal blood vessel endothelial.The expression level of CLDN4 mRNA were 0.87 ±0.17 in ART group and 1.18 ± 0.30 in control group,respectively.The expression level of CLDN8 mRNA were 3.25 ± 2.32 in ART group and 1.08±0.41 in control group,respectively.The mRNA level of CLDN4 and CLDN8 were significantly differentially expressed in ART derived placenta when compared with control groups.The expression level of CLDN1,CLDN5,OCLN and ZO1 mRNA were 0.49 ± 0.44,0.80 ± 0.20,0.92 ± 0.18 in ART group and 1.09±0.82,1.21 ±0.78,0.80± 0.27 in control group,respectively,in which there were no significant differences between two groups.Western Blot analysis showed the protein levels of tight junctions CLDN4,CLDN8 and OCLN did not differ between groups.Conclusions Tight junction factors were expressed in human placental tissues.Tight junction derived from ATR platenta might have mild dysfunction.