Glutamine synthetase-negative hepatocellular carcinoma has better prognosis and response to sorafenib treatment after hepatectomy / 中华医学杂志(英文版)

BACKGROUND@#Glutamine synthetase (GS) and arginase 1 (Arg1) are widely used pathological markers that discriminate hepatocellular carcinoma (HCC) from intrahepatic cholangiocarcinoma; however, their clinical significance in HCC remains unclear.@*METHODS@#We retrospectively analyzed 431 HCC patients: 251 received hepatectomy alone, and the other 180 received sorafenib as adjuvant treatment after hepatectomy. Expression of GS and Arg1 in tumor specimens was evaluated using immunostaining. mRNA sequencing and immunostaining to detect progenitor markers (cytokeratin 19 [CK19] and epithelial cell adhesion molecule [EpCAM]) and mutant TP53 were also conducted.@*RESULTS@#Up to 72.4% (312/431) of HCC tumors were GS positive (GS+). Of the patients receiving hepatectomy alone, GS negative (GS-) patients had significantly better overall survival (OS) and recurrence-free survival (RFS) than GS+ patients; negative expression of Arg1, which is exclusively expressed in GS- hepatocytes in the healthy liver, had a negative effect on prognosis. Of the patients with a high risk of recurrence who received additional sorafenib treatment, GS- patients tended to have better RFS than GS+ patients, regardless of the expression status of Arg1. GS+ HCC tumors exhibit many features of the established proliferation molecular stratification subtype, including poor differentiation, high alpha-fetoprotein levels, increased progenitor tumor cells, TP53 mutation, and upregulation of multiple tumor-related signaling pathways.@*CONCLUSIONS@#GS- HCC patients have a better prognosis and are more likely to benefit from sorafenib treatment after hepatectomy. Immunostaining of GS may provide a simple and applicable approach for HCC molecular stratification to predict prognosis and guide targeted therapy.

Progress of phosphatidylinositol 3-kinase signaling pathway and its inhibitors in lymphoma / 白血病·淋巴瘤

The over-activation of phosphatidylinositol 3-kinase (PI3K) signaling pathway is closely related to the occurrence and development of malignant tumors. The abnormal expression of this pathway is involved in the regulation of cell growth, malignant transformation, apoptosis and metastasis. The targeted therapy for specific sites of PI3K signaling pathway is a new research hotspot. A variety of different types of PI3K inhibitors have been marketed or entered clinical trials and have shown considerable efficacy in the treatment of malignant lymphomas. In this view, the recent advances in activation patterns of PI3K signaling pathway in lymphoma and PI3K inhibitors are summarized.

Progress of phosphatidylinositol 3-kinase signaling pathway and its inhibitors in lymphoma / 白血病·淋巴瘤

The over-activation of phosphatidylinositol 3-kinase (PI3K) signaling pathway is closely related to the occurrence and development of malignant tumors. The abnormal expression of this pathway is involved in the regulation of cell growth, malignant transformation, apoptosis and metastasis. The targeted therapy for specific sites of PI3K signaling pathway is a new research hotspot. A variety of different types of PI3K inhibitors have been marketed or entered clinical trials and have shown considerable efficacy in the treatment of malignant lymphomas. In this view, the recent advances in activation patterns of PI3K signaling pathway in lymphoma and PI3K inhibitors are summarized.

The effectiveness of modified radical mastectomy combined with radioactive particle implantation in the treatment of patients with advanced breast cancer / 中华老年医学杂志

Objective To explore the effectiveness of modified radical mastectomy combined with radioactive particle implantation in treating advanced breast cancer.Methods A total of 106 patients diagnosed with advanced breast cancer at our hospital from January 2012 to July 2014 were included in this study and were randomly divided into an intervention group (n=53),in which patients were treated with modified radical mastectomy combined with radioactive particle implantation,and a control group (n=53).in which patients received modified radical mastectomy alone.Rates of 1-and 3-year survival,over 1 year local control,disease recurrence,and post treatment complications were recorded and compared between the two groups.Results There was no difference in 1-and 3 year survival rates between the two groups (both P＞0.05).The over 1-year local control rate of cancer in the intervention group (92.5％) was higher than in the control group (77.4％) (x2=4.7111,P=0.030).The disease recurrence rate within 1 year in the intervention group (9.4％) was lower than that in the control group (24.5％) (x2 =4.2828,P =0.0385).The rate of post-treatment complications in the intervention group (11.3 ％) was significantly lower than in the control group (26.4 ％) (x2 =3.9442,P =0.0470).Conclusions Radical mastectomy combined with radioactive particle implantation not only helps to improve the local control rate of patients with advanced breast cancer,but also significantly reduces the recurrence rate of disease and the incidence of complications.

"Effect of ""Foot exercises"" on peripheral neuropathy and plantar pressure in patients with diabetic foot" / 现代临床护理

Objective To observe the effectiveness of routine nursing plus foot exercise on the peripheral neuropathy and plantar pressure in patients with diabetic foot.Methods Toally 100 patients with diabetic foot were randomly divided into 2 groups.On the basis of routine nursing care,50 patients in the observation group were given foot exercises for 12 weeks,50 patients in the control group were given routine nursing only.Before and after intervention,the Toronto clinical scoring system (TCSS),left and right foot peak pressure variation were observed.Results Before intervention,there was no statistical difference between the two groups' TCSS sore and the peak pressure of left and right foot (P ＞0.05).After intervention,the observation group's average total score of TCSS was lower,there was significantly different between two groups (P＜ 0.001).The peak pressure of left and right foot is lower in the observation group,the difference was statistically significant (P ＜ 0.05).Conclusion Foot exercises is worthy of clinical promotion,because it can improve the peripheral neuropathy of patients with diabetic foot,so as to reduce the plantar pressure,reduce the pain of patients and improve their life quality.

"Effectiveness evaluation of second class activities based on""specialist nursing clinic""" / 现代临床护理

Objective To explore the effect of extracurricular activities based on specialist nursing clinic. Methods Thirty-four undergraduate nursing students of grade 2013 in the Capital Medical University were enrolled in the study. After learning of nursing theories for senile dementia, the extracurricular activities based onspecialist nursing clinicwere carried out. Before and after the second class activities, the caring ability inventory scale and self scale-rating for self-directed learning (SRSSDL) were used to assess 34 students. Result After the activities, students' caring ability and self-directed learning ability were statistically significantly improved (P<0.01). Conclusion The extracurricular activities based onspecialist nursing cliniccan stimulate the learning interest of nursing students and improve their self-directed learning ability and humanistic care ability.

Effect of two biological immunologic induction therapies on renal transplant recipients / 器官移植

Objective Toevaluateefficacyandsafetyoftwodifferentbiologicalsinimmunologic inductiontherapyonrenaltransplantrecipients.Methods Clinicaldataof78renaltransplantrecipientswho received biological immunologic induction therapy in Department of Urology of the 452nd Hospital of Chinese People's Liberation Army from June 2008 to April 2013,were retrospectively analyzed. According to different biological immunologic induction therapy,the recipients were divided into two groups,monoclonal antibody group (group A,n=35,received treatment of basiliximab)and polyclonal antibody group [group B,n=43, received treatment of antithymocyte globulin (ATG)]. And the other recipients who didn't receive immunologic induction therapy in the hospital during the corresponding period were chosen as control group (group C,n=32). The survival rates of recipient and kidney in 3 groups at 12th weeks after transplantation were analyzed.The levels of serum creatinine (Scr)of recipients in 3 groups were monitored at 7,14,30,60 d after transplantation. The occurrence rates of complications including acute rejection,delayed graft function and infectionwerecomparedamong3groups.Results At12thweeksaftertransplantation,thesurvivalratesof recipient and kidney in 3 groups were 100% and 100% in group A,97.7% and 97.7% in group B,100%and 96.9% in group C. There was no significant difference among 3 groups (all in P>0.05 ). Compared with group C,the Scr levels in group A and B decreased significantly at 7,14 d after transplantation (all in P<0.05 ). Compared with group C,the incidence rates of acute rejection decreased in group A and B(all in P<0.05 ). There was no significant difference in the incidence rates of delayed graft function among 3 groups (all in P>0.05 ). The incidence rate of infection in group B was significantly higher than those in group A and C (allinP<0.05).Conclusions Immunologicinductiontherapyissafeandeffectiveintheapplicationon renal transplant recipients.

Immunologic induction therapy affects immune status of recipients after kidney transplantation / 中国组织工程研究

BACKGROUND:At present, biological agent-involved immunologic induction therapy gradual y became a key component in immunosuppression therapy of kidney transplantation. It can effectively prevent acute rejection and avoid the appearance of complications. OBJECTIVE:To evaluate the effect of different biological agents on immune state and functional status of transplanted kidney in immunologic induction therapy. METHODS:Clinical data of 110 recipients with kidney transplantation were retrospectively analyzed. In accordance with the conditions of immunologic induction therapy, recipients in the monoclonal antibody group (n=35) received basiliximab. Recipients in the polyclonal antibody group (n=43) underwent rabbit anti-human antithymocyteglobulin. Recipients in the control group (n=32) did not receive immunologic induction therapy. Absolute value of lymphocytes and the number of CD4+T lymphocyte subsets in peripheral blood were comparatively analyzed among three groups at 1, 4 and 12 weeks after kidney transplantation. Functional status of the transplanted kidney and complications of infection were evaluated at 12 weeks after transplantation.RESULTS AND CONCLUSION:The incidence of acute rejection was lower in the monoclonal antibody group and polyclonal antibody group than in the control group (P<0.05). The incidence of infectious complications was higher in the polyclonal antibody group than in the monoclonal antibody group and control group (P<0.05). The absolute value of lymphocytes was lower in the monoclonal antibody group and polyclonal antibody group at 1, 4 and 12 weeks after transplantation than in the control group (P<0.05). The number of CD4+T lymphocyte subsets in peripheral blood was lower in the polyclonal antibody group than in the monoclonal antibody group and control group at 1, 4 and 12 weeks after transplantation (P<0.05). These results suggested that biological agents participate in immunologic induction therapy of kidney transplantation, can effectively suppress the functional status of activated T lymphocytes, and decrease the occurrence of early acute rejection of the transplanted kidney. However, the incidence of infectious complications was higher after the use of rabbit anti-human antithymocyteglobulin.

CD4 and CD8 cells in gastric mucosa from AIDS patients with gastritis infected by Helicobacter pylori / 中华微生物学和免疫学杂志

Objective To investigate the relationship among Helicobacter pylori(H.pylori),CD4 positive cells and CD8 positive cells in gastric mucosa of the AIDS patients with gastritis.Methods Fiftyeight AIDS patients with upper abdominal pain were diagnosed with chronic gastritis through gastroscopy.The gastric biopsies from them were used for H.pylori detection with rapid urease test and Giemsa staining,pathology examination with HE staining,and immunohistochemistry analysis for CD4,CD8 positive cells in Gastric mucosa.And the application of flow cytometry was for the detection of peripheral blood CD4 and CD8 lymphocytes from the patients.Results H.pylori was positive in 26 cases,and negative was in 32 cases.CD8 cell expression in gastric mucosa of the AIDS patients with H.pylori positive was significantly higher than H.pylori negative patients(P＜0.05).There is no difference CD4 cell expression in gastric mucosa between the AIDS patients with H.pylori positive and H.pylori negative patients.Moreover,CD8 positive lymphocytes in gastric mucosa of those patients with H.pyloriinfection were significantly stronger than the CD4 positive lymphocytes.However,the peripheral blood CD4 lymphocytes from the patients with H.pylori infection were more than those from H.pylorinegative patients significantly(P＜0.05).Conclusion The expression level of CD8 cells in gastric mucosal tissues of AIDS patients with H.pylori infection were higher than those without H.pylori infection.The CD4 lymphocytes from the peripheral blood of the patients with H.pylori infection were more than those without H.pylori negative patients.

Donor antigenic specificity CD4+CD25+Treg cells prolong the survival of allograft kidney in rats / 中国组织工程研究

BACKGROUND: the development of magnetic separation technique,it is feasibility to in vitro sort and amplify CD4+CD25+Treg cells for transplantation; however,the application dosage and immune tolerance have been less reported yet.OBJECTIVE: To investigate dose-effect relationship of CD4+CD25+Treg cells during allograft transplantation.METHODS: SD rats which were considered as the donors and Wistar rats as receptors were used to establish allograff kidney transplantation models.CD4+CD25+Treg cells were separated from splenic cells of Wistar rats and induced phenotype of donor antigenic specificity in vitro.According to the quantities of CD4+CD25+Treg cells injecting through tail vein during the operation of allograft kidney transplantation,models were rolled into four experiment groups: group 1(2×105),group 2(5×105),group 3(1×106),and group 4(2×106).The models out injection were considered as controls.Survival status of kidney was detected at day 15 postoperatively; creatinine level and pathological changes were detected at days 4,9 and 15 according to Banff Schema diagnostic standard; semi-quantitative scores were measured Watanabe technique.RESULTS AND CONCLUSION: The death rate was the highest in control group(83.3%),and then group 1(66.7%),group 4(58.3%),and group 2(33.3%); but rats in the group 3 were all survival.Creatinine level in experimental groups was significantly less than control group at days 4,9,and 15 postoperatively(P<0.05,P<0.01); the creatinine levels in the group1 and group 2 were significantly greater than in the group 3 and group 4 at days 9 and 15 postoperatively(P<0.05),Semi-quantitative scores demonstrated that there was no significant difference between group 2 and group 1; but the scores in the group 3 and group 4 were significantly greater than control group(P < 0.05).The results indicated that CD4+CD25+Treg cells could improve kidney function following transplantation,and prolong survival time of transplanted kidney.The 1×106 was the best dosaae for application.

Diagnosis and treatment of breast implant rupture / 中华医学美学美容杂志

Objective To study the diagnosis, treatment and prognosis of the rupture of breast implant. Methods Physical examination, X-ray fluoroscopy, high frequency and color the Doppler ultrasonography were helpful to make a clear diagnosis, in exploring and removing the fiber envelope by inframammary or periareolar incision, repairing the anatomy structure of the breasts and performing augmentation mammaplasty again. Results In 32 patients, the breast shape was basically symmetrical, most of the incisions were healed by first intention except 2 cases with complication of subcutaneous fluid collection. A satisfactory therapeautic result could be achieved by taking out the breast implant which was rupture, exploring and removing the fiber envelope, and extending the lacuna. Conclusion A satisfactory therapeautic result can be achieved by extending the lacuna.