Diagnostic value of a combined serology-based model for minimal hepatic encephalopathy in patients with compensated cirrhosis / 中华检验医学杂志

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

Efficacy of acupuncture-moxibustion on peripheral facial paralysis at different time points: a Meta-analysis / 中国针灸

OBJECTIVE@#To systematically evaluate the efficacy and safety differences between acupuncture-moxibustion at acute stage and non-acute stage for peripheral facial paralysis.@*METHODS@#The clinical trials regarding acupuncture- moxibustion for peripheral facial paralysis published before May 31st 2019 were searched in databases of CNKI, WF, VIP, SinoMed, PubMed, Cochrane Library and Google Scholar. The information of included studies was extracted and the quality was assessed by two independent researchers. The Meta-analysis was performed by using RevMan 5.3 software.@*RESULTS@#A total of 11 trials were included, involving 1741 patients. The Meta-analysis results showed that: (1) the curative rate of acupuncture-moxibustion at acute stage was higher than that at non-acute stage (=2.45, 95%: 1.91-3.14, =7.06, <0.01); (2) the average curative time of acupuncture-moxibustion at acute stage were shorter than that of non-acute stage (=5.26, 95%: 3.44, 7.08, =5.67, <0.01); (3) the incidence rate of sequelae in 6-month follow up of acupuncture-moxibustion at acute stage were lower than that of non-acute stage (=2.71, 95%: 1.26, 5.84, =2.56, <0.05); (4) one study reported that there were no adverse reactions during treatment in both treatment group and control group.@*CONCLUSION@#Based on current evidence, the efficacy of acupuncture-moxibustion at acute stage is superior to non-acute stage, which could promote the recovery of the disease and shorten the course of treatment, and reduce the occurrence of sequelae. More high-quality, large-sample randomized controlled trials are needed for further verification.

Effect of Kouyanqing granule combined with ornidazole on the expression of HMGB1, TNF-α, IL-17 and IL-23 in patients with chronic periodontitis / 中国基层医药

Objective:To investigate the effect of Kouyanqing granule combined with ornidazole on the expression of high mobility group protein B1 (HMGB1), tumor necrosis factor-α (TNF-α), interleukin-17 (IL-17) and interleukin-23 (IL-23) in patients with chronic periodontitis.Methods:From October 2018 to October 2019, 162 patients with chronic periodontitis admitted to the First People's Hospital of Xiaoshan District were divided into observation group (81 cases) and control group (81 cases) according to the random digital table method.The control group was treated with ornidazole, and the observation group was treated with Kouyanqing granules on the basis of the control group.The course of treatment in both two groups was 4 weeks.The changes of plaque index (PLI), probing depth of periodontal pocket (PD), bleeding index (BI), HMGB1, TNF-α, IL-17 and IL-23 and adverse reactions were compared before and after treatment.Results:The total effective rate of the observation group (91.36%) was higher than that of the control group (77.78%) (χ 2=5.723, P<0.05). The PLI(0.93±0.16), PD[(3.15±0.37)mm] and BI(1.35±0.24) in the observation group were lower than those in the control group [(1.42±0.24), (4.28±0.45)mm and (2.18±0.28)] ( t=15.289, 17.457, 20.256, all P<0.05). The levels of HMGB1 [(0.78±0.13)μg/L], TNF-α[(3.10±0.32)μg/L], IL-17[(368.19±24.31)ng/L] and IL-23[(7.63±0.89)ng/L] in the observation group were lower than those in the control group [(0.96±0.10)μg/L, (4.34±0.46)μg/L, (457.32±21.35)ng/L and (10.32±1.25)ng/L] ( t=9.877, 19.916, 24.793, 15.777, all P<0.05). The incidence of adverse reactions in the observation group (6.17%) was lower than that in the control group (17.28%) (χ 2=4.830, P<0.05). Conclusion:Kouyanqing granule combined with ornidazole is effective in the treatment of chronic periodontitis.It can reduce the levels of HMGB1, TNF-α, IL-17 and IL-23, and has few adverse reactions.

Prospective cohort study on association between peri-conceptional air pollution exposure and gestational diabetes mellitus / 中华预防医学杂志

Objective@#To explore the association between the exposure to major air pollutants in pre-pregnancy and early pregnancy (peri-conceptional period) and gestational diabetes mellitus (GDM).@*Methods@#From March 2015 to April 2018, 4 817 pregnancies were recruited at three prenatal check-ups hospital in Hefei (Hefei First People′s Hospital, Hefei. Maternal and Child Care Hospital and the First Affiliated Hospital of Anhui Medical University), China. Questionnaire was used to collect the demographic data, the health status and lifestyle of pregnant women. GDM was diagnosed according to the Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes (2017 Edition). Logistic regression was used to investigate the association of exposure to major air pollutants (PM2.5, PM10, SO2, CO and NO2) during different periods of pre-pregnancy (12 weeks before pregnancy) and first trimester (12 weeks after last menstruation) and duration of exposure to high levels of pollutants with GDM.@*Results@#The mean±SD of the age of subjects was (29.14±4.19) years old and the prevalence of GDM was 21.4% (n=1 030). The results of multivariate logistic regression analysis showed that after adjusting for confounding factors, the risk of GDM increased gradually with the prolonged exposure time of high-concentration pollutants compared with pregnant women who were not exposed to high pollution during the pre-pregnancy (χ2=61.28, Ptrend<0.001) with the OR (95%CI) values for exposure time of 1, 2, and 3 months about 1.42 (1.10-1.84), 1.73 (1.29-2.33), and 2.51 (1.75-3.59), respectively. In the pre-pregnancy period, in every 10 μg/m3 increase of PM2.5 and PM10, the OR (95%CI) values of GDM were 1.14 (1.08-1.20) and 1.13 (1.08-1.19), respectively; for each increase of 1 μg/m3 and 0.10 mg/m3 of SO2 and CO, the OR (95% CI) values of GDM were 1.03 (1.01-1.05) and 1.07 (1.01-1.13), respectively. For every 1 μg/m3 increase in the average concentration of SO2 in the first trimester, the OR (95%CI) value of GDM was 1.02 (1.01-1.05).@*Conclusion@#PM2.5, PM10, SO2 and CO exposure during the pre-pregnancy and SO2 exposure in first trimester were positively correlated with the risk of GDM.

Association between vitamin D level and lipid metabolism during second trimester / 中华流行病学杂志

Objective@#To explore the relationship between the vitamin D levels and lipid metabolism during second trimester.@*Methods@#A total of 1 875 pregnant women who were in the second trimester and had antenatal care in 3 hospitals in Hefei of Anhui province from March 2015 to February 2018 were included. Baseline questionnaire survey was performed, and fasting venous blood samples were collected from the pregnant women to detect serum 25(OH)D, cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) levels. Cubic non-linear model and linear regression model were used to analyze the linear relationship between vitamin D levels and lipid metabolism indicators in the second trimester.@*Results@#The vitamin D deficiency rate was 75.3% (1 412/1 875) in the pregnant women. The mean levels of lipid metabolism indicators TC, TG, HDL-C and LDL-C were (233.22±38.87), (226.24±83.88), (79.04±12.77), and (109.54±25.95) mg/dl respectively. Multivariate linear regression model results showed, compared with Q5 of the 25(OH)D, the TC and TG levels of Q1-Q4 groups significantly increased, and the LDL-C of Q1 and Q2 groups significantly increased. The highest difference between TC, TG and LDL-C was observed in Q1 group. (TC: β=16.88, 95%CI: 10.50-23.26; TG: β=34.92, 95%CI: 21.32-48.53; LDL-C: β=9.06, 95%CI: 4.77-13.35). No significant differences in HDL-C level among the 5 groups were observed. When stratified with vitamin D deficiency the results showed that, when 25(OH)D was <50 nmol/L, TC, TG and LDL-C levels decreased by 3.53 (95%CI: 1.30-5.75), 7.42 (95%CI: 2.41 to 12.44) and 2.08 mg/dl (95%CI: 0.60-3.57) along with a 10 nmol/L increase of 25(OH)D, the difference was statistically significant, and when 25(OH)D was ≥50 nmol/L, no significant correlation was found between 25(OH)D level and TC, TG and LDL-C levels. No significant relationship between 25(OH)D level and HDL-C level was observed regardless of vitamin D deficiency.@*Conclusions@#There was a nonlinear relationship between vitamin D levels and lipid metabolism indicators in the second trimester. There was a significant negative correlation between 25(OH)D level and lipid metabolism indicators only in the deficiency of vitamin D.

Application value of non-flapping technique in immediate implant prosthesis in aesthetic area of anterior teeth / 中国基层医药

Objective@#To explore the application value of non-flapping technique in immediate implant prosthesis in aesthetic area of anterior teeth.@*Methods@#From March 2016 to September 2017, 104 patients who received immediate implant restoration of anterior teeth in the First Hospital of Jiaxing were divided into observation group (53 cases) and control group (51 cases) according to random number table method.The control group was treated with conventional flap immediate implantation, while the observation group was treated with non-flap immediate implantation.The red aesthetic index (EPS), alveolar bone resorption and patients' satisfaction were compared between the two groups.@*Results@#The PES scores of the observation group were (6.17±1.21)points, (5.94±1.03)points and (5.12±0.85)points, respectively after repair 3 months, 6 months and 12 months, which were significantly higher than those of the control group [(5.38±0.96)points, (4.79±0.76)points, (4.05±0.70)points] (t=3.679, 6.459, 6.993, all P<0.05). At 3 months, 6 months and 12 months after restoration, the alveolar bone resorption in the observation group was(0.29±0.04)mm, (0.63±0.12)mm, (1.07±0.17)mm, respectively, which was significantly lower than that in the control group [(0.36±0.07)mm, (0.95±0.24)mm, (1.28±0.26)mm] (t=6.291, 8.649, 4.893, all P<0.05). At 12 months after repair, the satisfaction rate of patients in the observation group was 98.11% (52/53), which was significantly higher than 84.31% (43/51) in the control group (χ2=4.637, P<0.05).@*Conclusion@#The application of non-flapping technique in immediate implant prostheses in aesthetic area of anterior teeth has good effect, which can obtain better aesthetic effect, reduce alveolar bone absorption and improve patients'satisfaction with prostheses.However, in clinical work, it is necessary to strengthen preoperative examination and measurement of patients, accurately grasp the direction of implants and avoid the occurrence of bone wall perforation during operation.

Construction and practice of multi-disciplinary team information management system in the hospital / 中华医院管理杂志

Multi-disciplinary team(MDT) is a new mode of medical diagnosis and treatment service. Multidisciplinary discussion could provide patients with a scientific, standardized and effective individualized diagnosis and treatment plan to avoid over-treatment. This article is based on the application experience of the MDT information management platform designed by the First Affiliated Hospital of Zhejiang University during the past five years. It discussed how to build a MDT management system which could fit the medical environment of large general hospitals in China. The MDT management system simplifies the MDT process, improves the efficiency of MDT work, and enhances the overall medical quality of hospitals. Meanwhile, it also contributes to strengthen the disciplinary collaboration in such aspects as disease diagnosis and treatment, personnel training, and scientific research innovation, ultimately forming a new multi-disciplinary collaboration system in hospitals.

Trends analysis of vitamin D status among pregnant women in Hefei during 2015-2017 / 中华预防医学杂志

From March 2015 to February 2018, 4 728 women aged 18 to 45 years old with single-pregnancy at the gestational age of 13 to 27 weeks in Hefei were recruited to analyze the trend of vitamin D status. The average levels of serum 25(OH)D in 2015, 2016 and 2017 were (43.22±18.41) nmol/L, (39.3±15.1) nmol/L and (36.6±17.0) nmol/L, and the prevalence of vitamin D deficiency were 69.5%, 77.6% and 81.4%, respectively. Compared with 2015, the levels of serum 25(OH)D in pregnant women in 2016 and 2017 decreased by 5.23 (95%CI: 4.10-6.35) nmol/L and 7.98 (95%CI: 6.77-9.19) nmol/L. The OR (95%CI) values for the risk of vitamin D deficiency were 1.88 (95%CI: 1.57-2.24) and 2.41 (95%CI: 1.98-2.93).

Effect of acupoint stimulation on the quality of recovery in patients with radical thyroidectomy under the concept of enhanced recovery after surgery: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of acupoint stimulation on the quality of recovery in patients with radical thyroidectomy under the concept of enhanced recovery after surgery (ERAS).@*METHODS@#A total of 62 patients with radical thyroidectomy were randomized into an observation group and a control group, 31 cases in each one. In both of the two groups, general anesthesia with tracheal intubation was applied, the same anesthesia induction and maintenance medication were given. In the observation group, auricular point pressing with magnetic beads was adopted at bilateral shenmen (TF) and transcutaneous electrical acupoint stimulation (dilatational wave, 2 Hz/100 Hz in frequency, 6 to 12 mA) was performed at bilateral Hegu (LI 4) and Neiguan (PC 6) from 30 min before anesthesia induction to the end of the anesthesia. In the control group, medical adhesive plaster was pasted at bilateral shenmen (TF) and the electrodes were plastered at bilateral Hegu (LI 4) and Neiguan (PC 6) with no corresponding stimulation. In both of the two groups, visual analogue scale for anxiety (VAS-A) score was observed to evaluate the anxiety severity before anesthesia induction; the total intraoperative dosages of sufentanil, remifentanil and propofol were recorded; the numerical rating scale (NRS) score was used to assess the pain severity of instant time (T0) and 30 min (T1) of entering post-anesthesia recovery room (PACU), motor and static mode at 2 h (T2), 6 h (T3), 12 h (T4), 24 h (T5) after surgery; time of first anal exhaust, time of getting out of bed after surgery, total hospitalization time and the incidences of postoperative nausea and vomiting were observed; the quality of recovery was assessed by the 40-item quality of recovery score (QoR-40).@*RESULTS@#The VAS-A score and the total intraoperative dosage of remifentanil in the observation group were reduced compared with the control group (0.05). The time of first anal exhaust and getting out of bed after surgery in the observation group were advanced than those in the control group (0.05). Compared with the control group, the QoR-40 score was increased in the observation group (<0.05).@*CONCLUSION@#Acupoint stimulation can improve the preoperative anxiety in patients with radical thyroidectomy, reduce the intraoperative anesthetic dosage and postoperative pain, advance the time of anal exhaust and getting out of bed, improve the quality of postoperative recovery and enhance the recovery process.

The association of Vitamin D levels with lipid metabolism during pregnancy / 中华预防医学杂志

Vitamin D deficiency is common in pregnant women, and it is associated with multiple gestational complications, fetal intrauterine dysplasia, and maternal and infant health in postpartum period. Vitamin D involved in lipid metabolism may affect maternal-fetal health during pregnancy through this biological pathway. This review provides an overview of three main aspects, including, the effect of vitamin D on the mechanism of lipid metabolism, the relationship between vitamin D and lipid metabolites in pregnant women and women with pregnancy complications. An association between vitamin D status and lipid metabolism at different stages of pregnancy has been justified in most current studies, and the underlying mechanism has also been partly elucidated. Given some gestational complications, such as gestational diabetes and pre-eclampsia, pregnant women with these conditions are often associated with abnormal lipid metabolism and vitamin D deficiency. There is no doubt that the studies on the vitamin D supplementation and lipid metabolism improvement could have crucial clinical significance for this population. More randomized controlled trials with multi-center, large sample and multi-dose interventions are needed in the future to provide scientific evidence for clinical practice.

Expression and clinical significance of receptor for activated C kinase 1 and β-catenin in cervical cancer tissues / 临床与实验病理学杂志

Purpose To investigate the expression and clinical significance of receptor for activated C kinase 1 (RACK1) and β-catenin in cervical cancer tissues. Methods The expression of RACK1 mRNA and β-catenin mRNA in 126 cases of cervical cancer and adjacent normal tissues was detected by RT-PCR, and the expression of RACK1 and β-catenin protein was detected by SP immunohistochemistry. The correlation between the expression of RACK1 and β-catenin protein and clinicopathological data and prognosis was analyzed. Results The relative expression of RACK1 mRNA in cervical cancer tissues was lower than that in adjacent normal tissues, while the relative expression of β-catenin mRNA in cervical cancer tissue was higher than that in adjacent normal tissues. There was a significant difference between the two groups (P < 0.05) . The positive expression rate of RACK1 in cancer tissue group was lower than that in adjacent tissue group (19.0％ vs 63.5％) , while the positive expression rate of β-catenin was higher than that in adjacent tissue group (69.0％ vs 31.0％) (P < 0.05) . The higher the TNM stage, the lower the differentiation and the lower the RACK1 positive expression rate with lymph node metastasis, the higher the positive expression rate of β-catenin (P < 0.05) .There was a negative correlation between RACK1 and β-catenin protein expression (r = 0.404, P < 0.05) . The survival rates of the patients with strong positive expression of RACK1 protein and weak positive expression of β-catenin protein were higher (42.8％ vs 33.3％, 42.8％ vs 36.4％) , but the difference was not statistically significant (P> 0.05) . There was a significantly difference in the median survival time between the two groups (57.2 vs 34.0, 44.2 vs 29.8, P < 0.05) . Weak positive expression of RACK1 protein and strong positive expression of β-catenin were risk factors for poor prognosis in patients with cervical cancer (HR were 9.654 and 8.882 respectively, P < 0.05) .Conclusion The abnormal expression of RACK1 and β-catenin may be related to the occurrence, development and prognosis of cervical cancer, and affect the lymph node metastasis of cervical cancer.

Norcantharidin enhanced cisplatin sensitivity via YAP pathway in A549 cells / 中国药理学通报

Aim To investigate the effect of cotreat-ment norcantharidin (NCTD) and cisplatin (DDP) on the cisplatin sensitivity and proliferation in A549 cells, and whether YAP molecule involved in this process. Methods A549 cells were used as a model for inves-tigating the function of NCTD and DDP in this study. The expression of caspase-3,Annexin V,YAP,CTGF and Cyr61 were detected using RT-PCR and Western blot assay. The cell growth and proliferation were as-sessed by MTT and CCK-8 assay. Moreover, the tran-scriptional activity of YAP was detected by luciferase reporter gene assays. Results YAP was required for the cell growth and proliferation. NCTD,DDP and co-treatment of NCTD and DDP depressed cell viability, inhibited cell proliferation and promoted the sensitivity of cisplatin in A549 cells. Our results showed that the higher expressed oncogene YAP activated and promoted cell proliferation in lung cancer cells. Moreover, the high concentration of NCTD or DDP significantly re-duced cell proliferation, but cotreatment of NCTD and DDP in low concentration could significantly increase the cisplatin sensitivity via YAP pathway in A549 cells. Conclusions The cotreatment of NCTD and DDP in low concentration significantly reduces the transcriptional activity and protein level of YAP, then inhibits cell proliferation and thus increases the sensi-tivity of DDP in A549 cells.

Effect of miR-424 on migration and invasion of non-small cell lung cancer cells A549 / 中国比较医学杂志

Obejectives To explore the effect of miR-424 on migration and invasion of non-small cell lung cancer A549 cells. Methods Expression of miR-424 in NCI-H460, NCI-H1975, NCI-H446, A549, NCI-H1299, NCI-H157 lung cancer cells and embryonic lung fibroblasts MRC-5 cells was examined by RT-PCR. miR-424 inhibitor and miR-424 NC were transfected into A549 cells with liposome LipofectamineTM2000. Cell viability was measured by MTT assay. Cell migration and invasion was measured by wound scratch assay and transwell migration assay,respectively. The expression of matrix metalloproteinase 2 (MMP2), MMP9, transforming growth factor-β(TGF-β1), p-Smad3 was measured by western blot. Results The expression of miR-424 in NCI-H460, NCI-H1975, NCI-H446, A549, NCI-H1299, NCI-H157 cells (1. 78 ± 0. 13, 1. 69 ± 0. 10, 1. 89 ± 0. 18, 2. 88 ± 0. 27, 2. 52 ± 0. 20, 2. 49 ± 0. 23) was significantly higher than that in MRC-5 cell 0. 58 ± 0. 05(P< 0. 01). Compared with the miR-424 NC group, the cell viability was reduced (P<0. 01), cell migration and invasion ability was decreased (P< 0. 01), and the expression of MMP2, MMP9, TGF-β1, p-Smad3 protein was down-regulated in miR-424 inhibitor group ( P < 0. 01 ) . Conclusions miR-424 inhibitor can inhibit the migration and invasion in lung cancer A549 cells via inhibition of TGF-β1/Smad3 signal pathway.

Effect of metabolites of Clostridium butyricum, butyric acid and hydro-gen, on acute gastric mucosal lesion / 中国病理生理杂志

AIM:To observe the antiulcer effect of butyric acid and hydrogen , the main metabolites of Clos-tridium butyricum (C.butyricum), and to explore the underlying mechanism .METHODS: The mouse model of acute gastric mucosal lesion was prepared by gavage with ethanol .The mice were randomly divided into 4 groups:normal group , model group , butyric acid group and hydrogen group .The mice in butyric acid group and hydrogen group were given buty-rate and hydrogen prior to model establishment , respectively .Macroscopic observation of the pathological changes in gastric tissues was performed to evaluate the effect of the 2 metabolites of C.butyricum.Meanwhile, the mRNA expression levels of inflammatory factors, such as IL-12, RAN1 and MCP-1, were determined by RT-qPCR.The expression levels of apopto-sis-related proteins Bcl-2 and Bax were detected by immunohistochemical staining .RESULTS:The macroscopic observa-tion found that butyrate , not hydrogen , protected gastric mucosa .HE staining also showed that butyrate significantly attenu-ated the pathological damage of the gastric mucosa induced by ethanol .Compared with model group , the mRNA levels of inflammatory factors IL-12, RAN1 and MCP-1 in butyrate group significantly decreased (P<0.01).In butyrate group, the protein level of Bax was obviously decreased compared with model group (P<0.01), while the protein level of Bcl-2 was significantly increased ( P<0.01 ) .CONCLUSION: The gastric mucosa protective metabolite of C.butyricum may be butyric acid , not hydrogen .Butyric acid protects the gastric mucosa against ethanol-induced lesion by inhibiting the inflam- mation and reducing the expression ratio of Bax/Bcl-2.

Effect of miR-424 on migration and invasion of non-small cell lung cancer cells A549 / 中国比较医学杂志

Obejectives To explore the effect of miR-424 on migration and invasion of non-small cell lung cancer A549 cells. Methods Expression of miR-424 in NCI-H460, NCI-H1975, NCI-H446, A549, NCI-H1299, NCI-H157 lung cancer cells and embryonic lung fibroblasts MRC-5 cells was examined by RT-PCR. miR-424 inhibitor and miR-424 NC were transfected into A549 cells with liposome LipofectamineTM2000. Cell viability was measured by MTT assay. Cell migration and invasion was measured by wound scratch assay and transwell migration assay,respectively. The expression of matrix metalloproteinase 2 (MMP2), MMP9, transforming growth factor-β(TGF-β1), p-Smad3 was measured by western blot. Results The expression of miR-424 in NCI-H460, NCI-H1975, NCI-H446, A549, NCI-H1299, NCI-H157 cells (1. 78 ± 0. 13, 1. 69 ± 0. 10, 1. 89 ± 0. 18, 2. 88 ± 0. 27, 2. 52 ± 0. 20, 2. 49 ± 0. 23) was significantly higher than that in MRC-5 cell 0. 58 ± 0. 05(P< 0. 01). Compared with the miR-424 NC group, the cell viability was reduced (P<0. 01), cell migration and invasion ability was decreased (P< 0. 01), and the expression of MMP2, MMP9, TGF-β1, p-Smad3 protein was down-regulated in miR-424 inhibitor group ( P < 0. 01 ) . Conclusions miR-424 inhibitor can inhibit the migration and invasion in lung cancer A549 cells via inhibition of TGF-β1/Smad3 signal pathway.

Effect of metabolites of Clostridium butyricum, butyric acid and hydro-gen, on acute gastric mucosal lesion / 中国病理生理杂志

AIM:To observe the antiulcer effect of butyric acid and hydrogen , the main metabolites of Clos-tridium butyricum (C.butyricum), and to explore the underlying mechanism .METHODS: The mouse model of acute gastric mucosal lesion was prepared by gavage with ethanol .The mice were randomly divided into 4 groups:normal group , model group , butyric acid group and hydrogen group .The mice in butyric acid group and hydrogen group were given buty-rate and hydrogen prior to model establishment , respectively .Macroscopic observation of the pathological changes in gastric tissues was performed to evaluate the effect of the 2 metabolites of C.butyricum.Meanwhile, the mRNA expression levels of inflammatory factors, such as IL-12, RAN1 and MCP-1, were determined by RT-qPCR.The expression levels of apopto-sis-related proteins Bcl-2 and Bax were detected by immunohistochemical staining .RESULTS:The macroscopic observa-tion found that butyrate , not hydrogen , protected gastric mucosa .HE staining also showed that butyrate significantly attenu-ated the pathological damage of the gastric mucosa induced by ethanol .Compared with model group , the mRNA levels of inflammatory factors IL-12, RAN1 and MCP-1 in butyrate group significantly decreased (P<0.01).In butyrate group, the protein level of Bax was obviously decreased compared with model group (P<0.01), while the protein level of Bcl-2 was significantly increased ( P<0.01 ) .CONCLUSION: The gastric mucosa protective metabolite of C.butyricum may be butyric acid , not hydrogen .Butyric acid protects the gastric mucosa against ethanol-induced lesion by inhibiting the inflam- mation and reducing the expression ratio of Bax/Bcl-2.

Influence of propofol intravenous anesthesia on T helper cells of patients with primary liver cancer in perioperative period / 局解手术学杂志

Objective To study the effect of propofol intravenous anesthesia on T helper cells of patients with primary liver cancer during perioperative period.Methods A total of 86 patients with primary liver cancer in our hospital from November 2014 to October 2015 were selected,who were divided into observation group and control group according to the method of random numbers,43 cases in each group.The observation group were taken propofol intravenous anesthesia,and the control group were treated with sevoflurane inhalation anesthesia.The Th1 cells percentage,Th2 cells percentage and the ratio changes of the Th1/Th2 cells of two groups before anesthesia and postoperative 1 day were compared.The plasma cortisol levels of two groups before anesthesia,after anesthesia,intraoperative and 1 day after operation were observed.Results The percentage of Th2 cells in observation group and control group 1 day after surgery had no significant difference (P ＞ 0.05).The percentage of Th1 cells and Th1/Th2 cells ratio of the observation group were higher than those of the control group [(16.32 ± 1.76) ％ vs.(14.16 ± 1.03),(8.48 ± 0.92) vs.(7.11 ± 0.72)],the differences were significant (P ＜ 0.05).The plasma cortisol levels of observation group during operation and 1 day after operation were lower than those of the control group[(12.34 ± 1.02) μg/dL vs.(16.13 ± 1.26) μg/dL,(12.01 ± 0.94) μg/dL vs.(15.25 ± 1.08) μg/dL],the differences were significant(P ＜ 0.05).Conclusion The propofol intravenous anesthesia can encourage more Th to differentiate into Th1 cells,which plays a protective role in the patient's immune function.

Effect of combined gastrointestinal internal and external nutritional support in the treatment of elderly patients with lung cancer / 中国基层医药

Objective To explore the effect of combined gastrointestinal internal and external nutritional support in the treatment of elderly patients with lung cancer.Methods According to the random number table method,86 patients with advanced non-small cell lung cancer(NSCLC) were divided into the control group and observation group,43 cases in each group.The observation group was given nutritional intervention on the basis of treatment in the control group.The 12-month survival rate,median progression time and median survival time were evaluated.The clinical efficacy of the two groups was evaluated.The quality of life before and after treatment was evaluated by the KPS score.Results The 12-month survival rate of the observation group was 39.53％,which was significantly higher than 18.60％ of the control group(x2 =4.56,P =0.03).The median survival time and median survival of the observation group were (7.85 ± 1.27) months,(9.98 ± 1.71) months,respectively,which were significantly higher than (6.07 ±0.98)months,(7.99 ± 1.38)months of the control group(t =7.27,5.93,P =0.00,0.00).The total effective rate of the observation group was 88.37％,which was significantly higher than 55.81％ of the control group (x2 =11.32,P =0.00).The KPS scores of the observation group and the control group after treatment were (73.17 ± 2.75)points,(59.68 ±2.52) points,respectively,which were higher than (52.75 ± 2.02) points,(53.01 ± 1.98) points before treatment,and the KPS scores of the observation group were significantly higher than those of the control group (t =39.24,13.64,P =0.00,0.00).The incidence rate of adverse reaction in the observation group was 48.84％,which in the control group was 55.81％,the difference was not statistically significant (x2 =0.41,P =0.51).The CD4+ cells,CD4+/CD8+ and NK cells in the control group were significantly lower than those before treatment (t =6.14,8.44,7.48,P =0.00,0.00,0.00),which in the observation group were significantly higher than before treatment (t =4.89,5.17,6.33,P =0.00,0.00,0.00),the differences were statistically significant compared with the control group after treatment(t =8.11,4.26,5.88,P =0.00,0.00,0.00).The levels of hemoglobin and albumin in the observation group were significantly higher than those in the control group(t =3.88,6.39,P =0.00,0.00).Conclusion The combination of chemotherapy combined with nutritional intervention in the treatment of locally advanced NSCLC is beneficial to improve the immune function and nutritional status of patients,improve clinical efficacy and survival of patients,better improve their quality of life,and will not increase adverse reactions.

Clinical efficacy of recombinant human endostatin injection combined with chemotherapy in the treatment of ;patients with advanced gastric cancer and its influence on the quality of life / 中国基层医药

Objective To explore the clinical curative effect of recombinant human endostatin injection combined with chemotherapy in the treatment of patients with advanced gastric cancer and malignant ascites,and its influence on the quality of life.Methods 62 patients with advanced gastric cancer from July 2012 to July 2015,were randomly divided into observation group (31 cases)and control group (31 cases).The control group was treated with FOLFOX6 chemotherapy,the observation group was given recombinant human endostatin injection on the basis of the treatment of the control group.The two groups were treated for 3 weeks.The curative effect,QOL score,Karnofsky score,the change of serum CEA and CA19 -9 levels and drug adverse reaction incidence before and after treatment were compared in the two groups.Results The RR of the observation group was higher than that of the control group (54.84 vs 29.03%,χ2 =4.239 3,P 0.05).Conclusion The clinical efficacy of recombinant human endostatin injec-tion combined with malignant ascites in the treatment of patients with advanced gastric carcinoma is significant,and can significantly improve the quality of life of patients,has the important research value.

Effects of dexmedetomidine used to supplement analgesia with sufentanil on stress response and inflammatory response after cardiac valve replacement with CPB / 中华麻醉学杂志

Objective To evaluate the effects of dexmedetomidine used to supplement analgesia with sufentanil on the stress response and inflammatory response after cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-four patients of both sexes,aged 18-64 yr,with body mass index of 18-30 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ (New York Heart Association Ⅱ or Ⅲ),scheduled for elective cardiac valve replacement with CPB,were randomly divided into sufentanil analgesia group (group S,n =20) and dexmedetomidine supplementing sufentanil analgesia group (group DS,n=24) using a random number table.After induction of general anesthesia,the patients were endotracheally intubated and mechanically ventilated.Combined intravenous-inhalational anesthesia was used to maintain anesthesia.Dexmedetomidine was infused at 0.3 μg · kg-1 · h-1 from closure of the chest to the end of surgery in group DS,while the equal volume of normal saline was given instead in group S.The patient-controlled intravenous analgesia (PCIA) was used for postoperative analgesia.PCIA solution contained sufentanil 2 μg/kg in 100 ml of normal saline in group S,or sufentanil 2 μg/kg plus dexmedetomidine 3 μg/kg in 100 ml of normal saline in group DS.The PCIA pump was set up with a 0.5 ml bolus dose,a 5 min lockout interval and background infusion at a rate of 1.5 ml/h.Visual analogue scale score was maintained ≤ 3.When visual analogue scale score ≥ 4,morphine 0.1 mg/kg was injected intravenously.The occurrence of analgesics-related respiratory depression,bradycardia and hypotension was recorded.At the end of surgery (T0),and 12,24,48 and 72 h after surgery (T1-4),blood samples were collected from the central vein for determination of serum cortisol,β-endorphin,C-reactive protein,interleukin-2 (IL-2),and IL-6 concentrations by enzyme-linked immunosorbent assay.Results No analgesics-related adverse events were detected in the two groups.Compared with group S,the requirement for morphine was significantly decreased,the serum cortisol concentration was decreased at T2-4 and the serum β-endorphin,C-reactive protein concentrations were decreased at T1-4,the serum IL-2 concentrations were increased at T1-4,and the serum IL-6 concentrations were increased at T3 in group DS (P＜0.05).Conclusion Dexmedetomidine used to supplement analgesia with sufentanil can alleviate the stress response and inflammatory response after cardiac valve replacement with CPB.