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Objective:To investigate the regulatory effect of dehydroepiandrosterone (DHEA) on the microglial activation after subarachnoid hemorrhage (SAH) in vivo and in vitro.Methods:C57BL/6 mice were used for in vivo experiments. A SAH model was induced by intravascular puncture. They were randomly divided into solvent group, model group, and DHEA pretreatment group. TUNEL staining was used to detect neuronal apoptosis level at 24 h after modeling. Iba-1/CD86 fluorescence double staining was used to detect the activation of microglia. Quantitative fluorescent polymerase chain reaction and Western blot analysis were used to detect the expression of inflammatory factors, including interleukin (IL) -1β, IL-6, tumor necrosis factor (TNF) -α, and inducible nitric oxide synthase (iNOS). The primary cultured microglia was used for in vitro experiments and it was simulated SAH by hemoglobin stimulation. They were randomly divided into control group, model group, and DHEA pretreatment group. Iba-1/CD86 fluorescence double staining was used to detect the microglial activation, and fluorescence quantitative polymerase chain reaction and Western blot analysis were used to detect the expression of inflammatory factors.Results:In vivo model experiments showed that DHEA significantly reduced neuronal apoptosis ( P<0.01) and microglial activation ( P<0.01) after SAH modeling, and IL-6 expression level significantly decreased ( P<0.01), while IL-1β, TNF-α and iNOS showed a downward trend, but there were no statistical differences. In vitro model experiments showed that DHEA could significantly inhibit microglial activation ( P<0.001) and the expression levels of various inflammatory factors ( P<0.001). Conclusions:DHEA pretreatment can reduce neuronal apoptosis and microglia activation after SAH, and it has neuroprotective effect.
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Objective: To compare the mutation status of epidermal growth factor receptor (EGFR) between different lesions and clini-cal characteristics of synchronous multiple ground-glass nodules (SMGGNs). Methods: A retrospective analysis was conducted using clinical data from 35 patients with SMGGNs who were admitted to and received surgery at The Fourth Hospital of Hebei Medical Uni-versity Hospital from January 2017 to December 2018. Next generation sequencing (NGS) was performed for all surgical specimens to detect the mutation status of exons 18, 19, 20, and 21 of the EGFR gene to analyze the relationship between the EGFR mutation sta-tus of the lesions and patient gender, age, lesion location, imaging manifestation of nodules, and adenocarcinoma pathological type . Results: The EGFR mutation rate was 65.7% (23/35 patients). Non-smoking patients and females had higher EGFR mutation rates (P=0.015, P<0.001). The EGFR mutation rate of invasive adenocarcinoma nodules was higher than those of atypical adenomatous hyper-plasia, adenocarcinoma in situ, and minimally invasive adenocarcinoma ( P<0.001). Exon 19 deletion and L858R mutation were the most common mutations of the EGFR gene. There was no significant difference between the pathological subtypes of adenocarcino-ma and the EGFR mutant subtype (P=0.707). Among the 27 patients with multiple nodules with detectable EGFR mutations, the EGFR mutation rate was 85.2% (23/27 patients). Conclusions: The EGFR gene mutation status is different in patients with multiple pulmo-nary ground-glass nodules, suggesting that the occurrence and development of each nodule are independent events. EGFR gene muta-tion is closely related to the development of ground-glass nodules, especially in the invasion of tumors.
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Objective To analyze the application of intraoperative neurophysiological monitoring combined with neuronavigation multi-modal fusion technology in the brainstem glioma resection. Methods One hundred twenty patients with brainstem glioma were divided into observation group and control group. The control group was treated by traditional operation, while the observation group was treated by intraoperative nerve electrophysiological monitoring combined with neuronavigation multimodal fusion technology. The general condition, clinical efficacy, KPS score, complications and survival rate of the two groups were compared. Results The effect was significantly better in the observation group(76.66%)than in control group(53.33%)( x2=11.962,P=0.001).KPS scores were significantly higher in the observation group (27.91 ±1.98) than in the control group (12.11 ±2.13)(t=32.669, P<0.001). Conclusions Intraoperative nerve electrophysiological monitoring plus neuronavigation multimodality fusion technology can improve clinical efficacy and quality of life in patients with brainstem glioma.
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Objective To estimate the gene mutation and the protein expression of v-Raf murine sarcoma viral oncogene homolog B1 (BRAF) in esophageal cancer.Methods From February 2014 to September 2015,75 patients with esophageal cancer who received operation were enrolled.Tissues of cancer,adjacent to cancer and far from cancer were taken.The mutation and protein expression of BRAF were detected.The relationship between BRAF protein positive expression and clinical characteristics of patients with esophageal cancer was analyzed.The enumeration data was compared by chi-square test.Results The mutation of exon 11 and exon 15 of gene BRAF was not found in the tissues of esophageal cancer.Among 75 esophageal cancer,a base C or T inserted in the exon 11 was found in five Ⅲb TNM stage cases,and the expression of BRAF at protein level was positive in 46 cases (61.3％).Among 57 tissues adjacent to cancer,nine cases (15.8 ％) was BRAF positive at protein level.Among 75 tissues far from cancer,five(6.7％) was BRAF positive at protein level.The difference among three groups was statistically significant (x2 =61.098,P＜0.05).The positive rates of BRAF expression at protein level in patients with esophageal cancer at Ⅰ,Ⅱ and Ⅲ TNM stage were 21.7％ (5/23),70.8％ (17/24) and 85.7 ％ (24/28),respectively.The positive rates of BRAF expression at protein level in patients with and without lymph node metastasis were 81.6％ (31/38) and 40.5％ (15/37).The positive expression of BRAF at protein level was related with TNM stage and lymph node metastasis (x2 =23.136 and 13.313,both P＜0.01),however it was not related with gender,age and the degree of tumor differentiation (all P＞0.05).Conclusions There is base insertion in the exon 11 of gene BRAF in esophageal cancer,but gene mutation is not found.BRAF is highly expressed in esophageal cancer,which is related with TNM stage and lymph node metastasis,and BRAF could be an indicator of assessment of degree of malignancy and prognosis of esophageal cancer.
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Objective To investigate the parameters of nutrition status in the patients with COPD and study the difference nutrition status among COPD GOLD classification including A, B,C and D.Methods According to the global initiative for chronic obstructive lung disease ( GOLD) criteria, we classified the COPD outpatients into A, B, C, D group, with 10 cases in each group, 20 cases healthy people as control group as well as 20 patients with chronic bronchitis.Body mass index ( BMI) , triceps skin-fold thickness( TSF) ,ser-um albumin ( ALB ) were measured in each person.Results BMI was significantly lower in COPD group than health control group (21.3 ±4.0kg/m2 vs 24.7 ±3.7kg/m2, P<0.01) ; TSF was significantly reduced in COPD group than the control group (10.3 ± 4.4mm vs 13.0 ±4.4mm, P<0.05);ALB in COPD group was significant decreased than the control group (34.4 ±5.3g/L vs 39.5 ± 6.7g/L, P<0.01).Moreover, there were significantly differences in the nutrition status among COPD groups.BMI in the group of(C+D) was significantly lower compared with the group of (A+B) (19.9 ±4.3kg/m2 vs 22.1 ±3.5kg/m2, P<0.05).TSF was significant-ly decreased in the group of (C+D) than the group of (A+B)(7.7 ±2.4mm vs 12.9 ±4.4mm, P<0.01).Compared with the group of (A+B), ALB was also significantly reduced in the group of (C+D)(32.3 ±4.5g/L vs 36.5 ±5.4g/L, P<0.01).Conclusion The parameters of BMI, TSF, ALB are significantly reduced in the patients with COPD.Severe COPD easily develops malnutrition.Ac-cording to COPD GOLD classification, the nutrition status is worse in the group of ( C+D) than in the group of ( A+B) .It is worthy to pay attention to the nutrition status of COPD patients, and give appreciate therapy for patients with COPD.
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Objective Esophageal spindle cell carcinoma is a rare type of esophageal squamous cell carcinoma , which was usually named esophageal carcinosarcoma .This article was to discuss the clinical characteristics , treatment and prognostic factors of e-sophageal spindle cell carcinoma . Methods The clinical and pathological data of 28 cases of esophageal spindle cell carcinoma were retrospectively analyzed .The prognostic factors was analyzed for various factors including gender , age, smoking history , tumor loca-tion, tumor size, lymph node metastasis, histological type, pathological staging and adjuvant treatment regimen .Kaplan-Meier method was applied to calculate the survival rate , log rank method for single prognostic factor analysis and Cox proportional hazard regression model for multivariate analysis of prognosis . Results One-year, three-year, and five-year survival rates were 89.3%(25/28), 67.1%(19/28), 38.5%(10/28)respectively.Single factor analysis showed that the pathological type , N stage, T stage, pTNM stage were the factors influencing the prognosis(P﹤0.05), while gender, age, smoking and drinking history, tumor location, tumor size, operation incision selection , adjuvant treatment regimen were not .Multivariate analysis showed pTNM stage were the independent fac-tors affecting the prognosis of esophageal spindle cell carcinoma (χ2 =13.104, P=0.000). Conclusion Esophageal spindle cell carcinoma is a rare kind of esophageal squamous cell carcinoma with less invasiveness , low rate of lymph node metastasis and good progno-sis.Radical operation is the preferred treatment .
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Objective To investigate effects of H2 S on myocardial ischemia injury in rats and explore the possible mechanism from oxidative stress.Methods Fourty-eight male SD rats were randomly divided into 6 groups:sham operation group,ischemia group,ischemia + NaHS low,middle and high dose groups and ischemia + PPG group.The acute myocardial ischemia model was established by ligating the left anterior descending coronary artery(LAD) of the rats.Saline was intraperitoneally administrated in ischemia group.LADs were not ligated but only threaded in sham operation group in rats.In ischemia + NaHS low,middle and high dose groups or ischemia + PPG group,sodium hydrosulfide(NaHS) or DL-propargylglycine(PPG) was intraperitoneally injected respectively at 3 hours after ischemia.All rats were killed at 6 hours after the operation.The content of malondialdehyde (M DA),and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in myocardial tissue were respectively measured.The pathological changes of myocardial tissue were observed with electron microscope.Results Compared with those of sham operation group,the myocardial structural damage was increased,the content of MDA was significantly increased,and the activities of SOD and GSH-Px were significantly decreased in ischemia group in rats ((P ＜ 0.01).Compared with those of ischemia group,the myocardial structural damage was alleviated,the content of MDA was significantly decreased,and the activity of SOD was significantly increased in ischemia + NaHS low,middle and high dose groups ; the activity of GSH-Px was significantly increased in ischemia + NaHS middle and high dose groups in rats (P ＜ 0.05).Compared with those of ischemia group,the myocardial structural damage was increased,the content of MDA was increased,the activities of SOD and GSH-Px were decreased in ischemia + PPG group in rats (P ＜ 0.05).Conclusion The administration of H2S could significantly alleviate the myocardial injury by increasing the activities of SOD and GSH-Px,and decreasing the MDA synthesis in acute myocardial ischemia.
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Objective To evaluate the effects of exogenous hydrogen sulfide on inflammatory responses during acute myocardial ischemia in rats.Methods Twenty-four adult male Sprague-Dawley rats,weighing 250-290 g,were randomly divided into 3 groups (n =8 each):sham operation group,acute myocardial ischemia group,and sodium hydrosulfide (NaHS) group.The animals were anesthetized with intraperitoneal chloral hydrate.The model of acute myocardial ischemia was established by ligating the left anterior descending branch of coronary artery.Normal saline 2 ml/kg and NaHS 3.12 mg/kg were intraperitoneally injected at 3 h of ischemia in AMI and NaHS groups,respectively.The rats were sacrificed at 6 h after ligation and hearts were removed for determination of interleukin-1β (IL-1β),IL-6 and tumor necrosis factor-α (TNF-α) contents (by ELISA) and intercellular adhesion molecule-1 (ICAM-1) mRNA expression (by semi-quantitative PCR) in myocardial tissues and for examination of myocardial ultrastructure with transmission electron microscope.Results Compared with S group,IL-1β,IL-6 and TNF-α conte.nts and ICAM-1 mRNA expression in myocardial tissues were significantly increased in AMI group (P ＜ 0.05).Compared with AMI group,IL-1β,IL-6 and TNF-α contents and ICAM-1 mRNA expression in myocardial tissues were significantly decreased in NaHS group (P ＜ 0.05).The damage to myocardial ultrastructure was significantly alleviated in NaHS group when compared with AMI group.Conclusion The mechanism by which exogenous H2S alleviates the acute myocardial ischemia injury is related to inhibition of the inflammatory responses in rats.
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Objective To investigate nutrition status and dyspnea in the patients with chronic obstructive pulmonary disease (COPD) between GOLD Ⅱ and GoLD Ⅲ, and test the evaluative validity of disease status by GOLD classification of COPD. Methods Thirty patients with clinically stable COPD were recruited, including 15 patients of GOLD Ⅱ of COPD and 15 patients of GOLD Ⅲ of COPD. Body mass index (BMI), triceps skin-fold thickness (TSF), serum albumin (Alb), and partial pressure of oxygen in arterial blood (PaO2) were measured in each patient. Dyspnea was assessed by the Borg Scale (BS). Exercise stress test was taken by incremental exercise test. Results BMI was significantly lower in the patients of GOLD Ⅲ than that in the patients of GOLD Ⅱ[(19±5 ) kg/m2 vs (23±3) kg/m2,p < 0.05]. TSF was significantly reduced in the patients of GOLD Ⅲ than that in the patients of GOLD Ⅱ[ (8±3) mm vs(13±5) mm, P < 0.01]. Alia in the patients of GOLD Ⅲ was significantly decreased than that in the patients of GOLD Ⅱ [(32±7) g/L vs (36±6) g/L, P <0.05]. The difference of PaO2 between the patients of GOLD Ⅲ and the patients of GOLD Ⅱ was significant [(72±9) nun Hg (1 mm Hg = 0.133 kPa ) vs (78±8) nun Hg, P < 0.01], and the significant difference of BS was found between the patients of GOLD Ⅲ and the patients of GOLD Ⅱ( 5.0±2.0) grades vs (3.0±1.0) grades, P <0.05 ]. In addition, 12 patients in the patients of GOLD Ⅱ took the exercise stress test and 8 patients were found anaerobic threshold (AT), 5 patients in the patients of GOLD Ⅲ took the exercise stress teat and no AT was found. Conclusions The parameters of BMI, TSF, Alb and PaO2 are significantly reduced in the patients of GOLD Ⅲ than those in the patients of GOLD Ⅱ. In the patients of GOLD Ⅲ, BS is higher than that in the patients of GOLD Ⅱ and AT is difficult to obtain, suggesting more severe in degree of impairment. GOLD classification of COPD reflects the disease stares and prognosis in the patients with COPD, as a valuable parameter in clinical practice.
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Objective To evaluate the efficacy of administration of ampicillin/sulbactam and imipenem/cilastatin in treatment of aspiration pneumonia in aged patients. Methods 26 aged patients was treated with aspira-tion pneumonia (2.25～3.00 g) through vessel injection twice perday,and another 26 patients was treated with imi-penem/cilastatin (0.5 g) through vessile injection every 6～8 hours. We evaluated the efficacy through assessing the temperature,the chest radiography,WBC and CRP,incidence of side effects,the time to cure and the clearance of bacteria. Results The cure rate was 84.6% (22/26) and 92.3% (24/26),respectively (χ2=0.19,P=0.66). The time to cure was 8.2±2.8 days and 7.5±1.6 days for the groups (t=1.107,P=0.274). Gastrointestinal side effects were observed in the group of ampicillin/sulbactarn;slight abnormality of liver function occurred in the group of imipenem/cilastatin ;all above adverse effects in two groups were rapidly and completely disappeared after therapy stopped. Conclusion Both ampicillin/sulbactam and imipenem/cilastatin are effective antibiotics to treat aspiration pneumonia in aged patients.
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Plasma viral RNA load is widely accepted as the most relevant parameter to assess the status and progression of Simian immunodeficiency virus (SIV) infections. To accurately measure RNA levels of the virus, a one-step fluorescent quantitative assay was established based on the SYBR green Real-time reverse transcription-polymerase chain reaction (RT-PCR). The lower detection limit of the assay was 10 copies per reaction for the virus. This method was successfully applied to quantify SIVmac251 and SIVmac239 viruses produced in CEM×174 cells. Additionally, the performance of the SYBR green RT-PCR was assessed in a SIVmac251 infected rhesus macaque. The result demonstrated that the method could detect as little as 215 copies per milliliter of plasma and the dynamic pattern of viral load was highly consistent with previous results. With regard to convenience, sensitivity and accuracy our assay represents a realistic alternative to both branched-chain DNA (b-DNA) assays or real-time PCR assays based on TaqMan probes.
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Objective To study the expression of dyspnea and SpO2 with the patients with COPD and silicosis during exercise, further more to provide the reference in clinic treatment.Methods Cycle exercise test was used in 20 patients with COPD and 20 silicosis patients , The oxygen uptake per minute (VO2) ,Borg Scale (BS), SpO2, and other index of exercise test were detected. Results Dyspnea index as Borg scale was closely correlated with oxygen uptake (VO2) during exercise in all the patients. Borg scale slope (BSS) for quantitative evaluation of dyspnea could be derived from the linear regression line,and the BSS in COPD patients was higher than BSS in silicosis patients[(10.9?3.8)BS/(L?min) vs (7.2 ?1.9)BS/(L?min),P
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Objective To study the expression of ILD patients and health men during exercise,furthermore provide the reference of application of exercise test in ILD.Methods Cycle exercise test was used in 36 patients with ILD and 20 normal subjects,The oxygen uptake per minute(VO2),Borg Scale(BS),SpO2,and other index of exercise test were detected.Results Compared with normal subjects,The VO2max in ILD patients was decrease markedly;The BS was increased,SpO2 decreased markedly during exercise.Conclusions The results indicate that the hypoxemia and dyspnea are the limited factors of exercise in the patients with ILD;The capacity of exercise in ILD decrease compare with normal subjects.
