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Extracellular matrix metalloproteinase inducer CD147 is a glycoprotein on the cell surface. There is minimal expression of CD147 in normal epithelial and fetal tissues, but it is highly expressed in a number of aggressive tumors. CD147 has been implicated in pan-cancer immunity and progression. With the development of CD147-targeting therapeutic strategy, accurate detection of CD147 expression in tumors and its changes during the therapy is necessary. In this study we constructed a novel radiotracer by labeling the anti-CD147 mAb with radionuclide 124/125I (124/125I-anti-CD147) for noninvasive detection of CD147 expression in pan-cancers, and characterized its physicochemical properties, affinity, metabolic characteristics, biodistribution and immunoPET imaging with 124I-IgG and 18F-FDG as controls. By examining the expression of CD147 in cancer cell lines, we found high CD147 expression in colon cancer cells LS174T, FADU human pharyngeal squamous cancer cells and 22RV1 human prostate cancer cells, and low expression of CD147 in human pancreatic cancer cells ASPC1 and human gastric cancer cells BGC823. 124/125I-anti-CD147 was prepared using N-bromine succinimide (NBS) as oxidant and purified by PD-10 column. Its radiochemical purity (RCP) was over 99% and maintained over 85% in saline or 5% human serum albumin (HSA) for more than 7 d; the RCP of 125I-anti-CD147 in blood was over 90% at 3 h post injection (p.i.) in healthy mice. The Kd value of 125I-anti-CD147 to CD147 protein was 6.344 nM, while that of 125I-IgG was over 100 nM. 125I-anti-CD147 showed much greater uptake in CD147 high-expression cancer cells compared to CD147 low-expression cancer cells. After intravenous injection in healthy mice, 125I-anti-CD147 showed high initial uptake in blood pool and liver, the uptake was decreased with time. The biological half-life of distribution and clearance phases in healthy mice were 0.63 h and 19.60 h, respectively. The effective dose of 124I-anti-CD147 was estimated as 0.104 mSv/MBq. We conducted immunoPET imaging in tumor-bearing mice, and demonstrated a significantly higher tumor-to-muscle ratio of 124I-anti-CD147 compared to that of 124I-IgG and 18F-FDG in CD147 (+) tumors. The expression levels of CD147 in cells and tumors were positively correlated with the maximum standardized uptake value (SUVmax) (P < 0.01). In conclusion, 124/125I-anti-CD147 displays high affinity to CD147, and represents potential for the imaging of CD147-positive tumors. The development of 124I-anti-CD147 may provide new insights into the regulation of tumor microenvironment and formulation of precision diagnosis and treatment programs for tumors.
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Fluorodesoxiglucosa F18 , Neoplasias de la Próstata , Masculino , Humanos , Ratones , Animales , Distribución Tisular , Radiofármacos , Radioisótopos de Yodo , Inmunoglobulina G , Línea Celular Tumoral , Microambiente TumoralRESUMEN
Objective: To investigate the detection rate of clinically significant PCa (CSPCa) in lesions of prostate imaging-reporting and data system (version 2) (PI-RADS v2) score 3 in different histological zones of the prostate, the value range of clinical parameters, and the possibility of improving the detection rate by MRI/TRUS fusion prostate biopsy. METHODS: This retrospective study included 297 patients with prostatic lesions of PI-RADS v2 score 3 undergoing transperineal prostate biopsy in Nanjing Drum Tower Hospital from January to December 2019. We analyzed their clinical data, the detection rate of CSPCa in the four histological zones of the prostate and the value range of the clinical parameters. RESULTS: The detection rates of CSPCa in the peripheral zone, transitional zone, central zone and anterior fibromuscular stroma were 23.8%, 11.2%, 40.0% and 50.0%, respectively. In comparison with conventional biopsy, additional MRI/TRUS image fusion biopsy improved the detection rate of CSPCa in the four zones, though with no statistically significant difference. The patients with CSPCa, compared with those in the non-CSPCa group, showed a lower value of free PSA/total PSA (fPSA/tPSA) (0.12 ± 0.05 vs 0.18 ± 0.07) but a higher tPSA level (ï¼»13.06 ± 10.07ï¼½ vs ï¼»8.61 ± 5.86ï¼½ µg/L) and PSA density (PSAD) (ï¼»0.35 ± 0.34ï¼½ vs ï¼»0.16 ± 0.11ï¼½ µg/L2). CONCLUSIONS: In prostate lesions of PI-RADS v2 score 3, the detection rate of CSPCa was higher in the peripheral zone, even higher in the central zone and anterior fibromuscular stroma, than in the transitional zone. Prostatic biopsy is strongly recommended for patients with fPSA/tPSA < 0.12 or PSAD > 0.35 µg/L2, and additional MRI/TRUS image fusion biopsy is preferable for the lesions in the transitional or central zone.
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OBJECTIVE: To compare the accuracy of different methods of measuring the prostate volume (PV) based on the manifestations of prostatic ultrasonography and MRI. METHODS: Using the drainage method, we measured the volumes of 101 prostatic specimens collected from radical prostatectomy. And with the measures obtained as reference standards, we calculated the PV of the patients with the maximum width (W), height (H) and length (L) of the prostates obtained preoperatively by transabdominal ultrasonography (TAUS), transrectal ultrasonography (TRUS) and MRI using the ellipsoidal formula (PV = W × H × L × 0.52), bullet formula (PV = W × H × L × 0.65) and 3D reconstruction technology. We evaluated the accuracy of the above methods using the Mann-Whitney U test, intraclass correlation coefficient (ICC), and Bland-Altman scatterplot. RESULTS: No statistically significant differences were observed between the specimen and preoperative PVs. The ICCs of the specimen PVs obtained by MRI 3D reconstruction, TRUS bullet formula, MRI ellipsoidal formula and TAUS ellipsoidal formula were 0.978, 0.862, 0.857 and 0.745, respectively. The Bland-Altman scatterplot exhibited that the preoperative PV calculated by MRI 3D reconstruction had the highest consistency with that of the specimen PV, followed by that measured by TRUS bullet formula and that obtained by MRI ellipsoidal formula, while that determined by TAUS ellipsoidal formula had a low consistency. CONCLUSION: The MRI 3D reconstruction technology is the most reliable method for the measurement of PV, followed by TRUS bullet formula, but the latter is recommended for its high applicability in clinical practice.
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Próstata , Neoplasias de la Próstata , Masculino , Humanos , Próstata/diagnóstico por imagen , Próstata/cirugía , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/cirugía , Ultrasonografía , Prostatectomía , Imagen por Resonancia Magnética/métodosRESUMEN
Immunotherapy is considered the fourth major treatment mode for cancer following surgery, chemotherapy, and radiotherapy. In recent years, tumor immunotherapy has achieved breakthrough progress; therefore, it is important to screen patients to identify those who will respond to tumor immunotherapy. Here, we report the construction of a novel heavy chain-only antibody (HCAb) and its corresponding 124I-labeled probe. Using phage display technology, we generated a novel anti-hPD-L1-specific HCAb named Nb6 (selected from 95 monoclones) with high affinity for hPD-L1. The positron-emitting 124I-labeled hPD-L1-targeted HCAb probe was prepared for further evaluation, and nonradioactive natural iodine (natI)-labeled anti-hPD-L1 Nb6 was synthesized as a reference compound. 125I-anti-hPD-L1 Nb6 uptake in OS-732 cells in vitro can be blocked by the precursor. The binding affinity of 125I-anti-hPD-L1 Nb6 to OS-732 cell lines was 2.19 nM. For in vivo studies, an osteosarcoma OS-732 tumor-bearing mouse model was successfully constructed. Polymerase chain reaction (PCR) and Western blot analyses were performed to confirm the presence of the hPD-L1 gene and antigen in the tumor tissue of the OS-732 mouse model. Biodistribution showed that uptake of 124I-anti-hPD-L1 Nb6 probes at 24 h was 4.43 ± 0.33% ID/g in OS-732 tumor tissues. Tumor lesions can be clearly delineated on micro-PET (positron emission tomography)/CT (computed tomography) imaging 24 h after injection of 124I-anti-hPD-L1 Nb6, while the blocking group shows substantially decreased uptake on imaging. Pathological staining validated hPD-L1 expression on the surface of the tumor cell membrane; thus, 124I-anti-hPD-L1 Nb6 can be used for in vivo noninvasive PET imaging. When administered in tandem, Nb6 and 124I-anti-hPD-L1 Nb6 may provide a novel strategy to clinically screen patients for hPD-L1 to identify those who would benefit from immunotherapy of malignant tumors such as osteosarcoma.
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Antígeno B7-H1/metabolismo , Neoplasias Óseas/metabolismo , Regulación Neoplásica de la Expresión Génica , Inmunoconjugados/química , Cadenas Pesadas de Inmunoglobulina/inmunología , Radioisótopos de Yodo , Osteosarcoma/metabolismo , Animales , Antígeno B7-H1/inmunología , Transporte Biológico , Neoplasias Óseas/patología , Línea Celular Tumoral , Humanos , Inmunoconjugados/metabolismo , Inmunoconjugados/farmacocinética , Marcaje Isotópico , Ratones , Osteosarcoma/patología , Biblioteca de Péptidos , Distribución TisularRESUMEN
PURPOSE: Knee arthroscopy, with its unique advantages, has become a routine surgery and is widely carried out around the world. Venous thromboembolism (VTE) after knee arthroscopy is a potentially serious complication. This article analyzes the effects of anticoagulant therapy after knee arthroscopy. METHODS: We used key words or entry terms without any limitations to search the PubMed, Embase, and Cochrane Library databases. Randomized controlled trials (RCTs) of drug prophylaxis for VTE after knee arthroscopy until November 2017 were included in our review. RESULTS: This systematic review identified nine RCTs, consisting of 4290 patients, investigating drug prophylaxis in knee arthroscopy. There are three main drugs for preventing thrombosis after arthroscopic knee surgery: low-molecular-weight heparin (LMWH), rivaroxaban, and aspirin. Our study concluded that there is no difference in symptomatic VTE (excluding symptomatic distal DVT) risk during anticoagulant prophylaxis (RR, 0.98; 95% CI, 0.44-2.19; I2 value = 0%; P = 0.97). Moreover, there was a lower incidence of symptomatic distal DVT (RR, 0.16; 95% CI, 0.06-0.45; I2 value = 0%; P = 0.0005) in the anticoagulant group than in the control group. CONCLUSIONS: In our study, anticoagulant therapy after knee arthroscopy was ineffective. We recommend that anticoagulants not be provided routinely after knee arthroscopy.
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Anticoagulantes/uso terapéutico , Artroscopía/efectos adversos , Heparina de Bajo-Peso-Molecular/uso terapéutico , Articulación de la Rodilla/cirugía , Tromboembolia Venosa/prevención & control , Trombosis de la Vena/prevención & control , Humanos , Tromboembolia Venosa/etiología , Trombosis de la Vena/etiologíaRESUMEN
OBJECTIVE: To investigate the exact prevalence of PCa among males in Nanjing and search for a mode of PCa screening suitable for the specific conditions. METHODS: From January to December 2018, we collected serum samples and clinical information from 6 903 men aged ≥50 years taking physical examination in 16 community health service centers in Nanjing. We proposed multi-parametric MRI (mpMRI) for those with serum PSA ≥4 µg/L, transperineal systematic biopsy and MRI/ultrasound fusion targeted prostate biopsy for those who scored ≥3 points on the Prostate Imaging-Reporting and Data System Version 2 (PI-RADS v2), transperineal systematic biopsy only for those with a PI-RADS v2 score of <3 and serum PSA ≥10 µg/L, and follow-up examinations every 6 months for those with a PI-RADS v2 score of <3 and serum PSA <4 µg/L. RESULTS: Among the 6 903 male subjects, 835 (12.1%) were found with serum PSA≥4 µg/L; 229 (77.4%) of the 296 men that received mpMRI scored ≥3 points on PI-RADS v2; and 79 (53.4%) of the 148 males that underwent prostate biopsy were diagnosed with PCa, with a total detection rate of 1.14% in all the subjects. Of the 77 patients with complete pathological data, 73 (94.8%) were found with clinically significant PCa, 30 (39.0%) with localized, 41 (53.2%) with locally advanced and 6 (7.8%) with metastatic malignancy, 6 (7.8%) in stage â , 21 (27.3%) in stage â ¡, 34 (44.2%) in stage â ¢ and 16 (20.8%) in stage â £. There were 47 (66.2%) high-risk, 18 (25.4%) moderate-risk and 6 (8.5%) low-risk cases among those with localized or locally advanced PCa. CONCLUSIONS: The prevalence of PCa in Nanjing deserves considerable attention, and PCa screening is highly necessary in the high-risk population, for which the combination of serum PSA assay, mpMRI and targeted prostate biopsy may be an ideal method.
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Detección Precoz del Cáncer/métodos , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/diagnóstico , Biopsia , China , Humanos , Biopsia Guiada por Imagen , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Prevalencia , Neoplasias de la Próstata/epidemiologíaRESUMEN
The pH-sensitive peptides drug delivery systems, which target to acidic extracellular environment of tumor tissue, have many advantages in drug delivery. They exhibit a high specificity to tumor and low cytotoxicity, which significantly increase the efficacy of traditional anti-cancer drugs. In recent years the systems have received a great attention. The pH-sensitive peptides drug delivery systems can be divided into five types according to the difference in pH-responsive mechanism,type of peptides and carrier materials. This paper summarizes the recent progresses in the field with a focus on the five types of pH-sensitive peptides in drug delivery systems. This may provide a guideline to design and application of tumor targeting drugs.
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Portadores de Fármacos/química , Sistemas de Liberación de Medicamentos , Neoplasias/tratamiento farmacológico , Péptidos/química , Concentración de Iones de Hidrógeno , MicelasRESUMEN
Microbial electrosynthesis (MES) is a novel CO2 utilization technology. Biocatalysts in this process may use electrons obtained from a photovoltaic system to reduce CO2 to chemicals and realize energy conversion from solar energy to chemical energy. The photoelectric material CuO/g-C3N4 was directly introduced into the MES system using mixed culture as biocatalyst in this study. CuO/g-C3N4 can effectively absorb light and presents satisfactory electron and hole separation ability. Photogenerated electrons from CuO/g-C3N4 enhanced the electron transfer rate and reduced cathodic charge transfer resistance. CuO/g-C3N4 mainly improved the electron supply of electroautotrophic microorganisms through direct electron transfer rather than indirect electron transfer via hydrogen. Photogenerated holes can combine electrons from anode and provide extra driving force to improve the MES performance. Furthermore, the CuO/g-C3N4 photocathode also improved the biocatalytic activity by increasing the total amount of biocatalyst and regulating cathodic microbial community composition. Acetate production rate in MES with the CuO/g-C3N4 photocathode was 2.6 times higher than that of the control group. This study provides a new strategy for semiconductor photocathodes to improve the MES performance with mixed culture.
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Dióxido de Carbono , Cobre , Acetatos , Dióxido de Carbono/química , ElectrodosRESUMEN
Gadolinium (Gd) and its complexes are utilized widely in industrial and clinical diagnoses. As a rare earth metal ion, free gadolinium (Gd(3+)) in the human body poses neurotoxic risks during its in vivo release and retention. In the central nervous system, astrocytes play a pivotal role in processing toxic metal ions. The present study evaluates the effects of Gd on cellular calcium homeostasis, a common mechanism that causes cell death, and on unfolded protein responses (UPRs), a mechanism for cell survival in response to toxic stimuli in mammalian cells. The experimental results indicate that the influx of extracellular Ca(2+) increases greatly after the exposure of astrocytes to Gd; however, no cell deaths were observed. Further evidence suggests the up-regulated expression of the endoplasmic reticulum (ER)-resident chaperone protein GRP78 by ER stress-mediated signal transductions, specifically the activation of ATF6, eIF2a, and IRE1. These results suggest that Gd promotes Ca(2+) influx, thus triggering UPRs, which can be closely associated to the resistance of astrocytes to Gd-induced cytotoxicity.
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Astrocitos/efectos de los fármacos , Calcio/metabolismo , Gadolinio/toxicidad , Respuesta de Proteína Desplegada/efectos de los fármacos , Animales , Astrocitos/metabolismo , Células Cultivadas , Corteza Cerebral/citología , Chaperón BiP del Retículo Endoplásmico , Líquido Extracelular/metabolismo , Homeostasis , Ratas , Ratas Sprague-DawleyRESUMEN
Trastuzumab is a monoclonal antibody targeting human epidermal growth factor 2 (HER2), which has been successfully used in the treatment of patients with breast cancer and gastric cancer; however, problems concerning its cardiotoxicity, drug resistance, and unpredictable efficacy still remain. Herein, we constructed novel organic dopamine-melanin nanoparticles (dMNs) as a carrier and then surface-loaded them with trastuzumab to construct a multifunctional nanoprobe named Her-PEG-dMNPs. We used micro-PET/CT and PET/MRI multimodality imaging to evaluate the retention effect of the nanoprobe in HER2 expression in gastric cancer patient-derived xenograft (PDX) mice models after labeling of the radionuclides 64Cu or 124I and MRI contrast agent Mn2+. The nanoprobes can specifically target the HER2-expressing SKOV-3 cells in vitro (3.61 ± 0.74 vs. 1.24 ± 0.43 for 2 h, P = 0.002). In vivo, micro-PET/CT and PET/MRI showed that the 124I-labeled nanoprobe had greater contrast and retention effect in PDX models than unloaded dMNPs as carrier (1.63 ± 0.07 vs. 0.90 ± 0.04 at 24 h, P = 0.002), a similarity found in 64Cu-labeled Her-PEG-dMNPs. Because 124I has a longer half-life and matches the pharmacokinetics of the nanoparticles, we focused on the further evaluation of 124I-Her-PEG-dMNPs. Furthermore, immunohistochemistry staining confirmed the overexpression of HER2 in the animal model. This study developed and validated novel HER2-specific multimodality imaging nanoprobes for quantifying HER2 expression in mice. Through the strong retention effect of the tumor site, it can be used for the promotion of monoclonal antibody treatment effect and process monitoring.
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The gut microbiota is very important in the initiation, progression, and dissemination of cancer, and the regulation of microbiota has been employed as a novel strategy to enhance the effect of immunotherapy. Adiponectin (APN), an adipocyte-derived hormone, plays a vital role in regulating the immune response of innate immune cells. The deficiency of APN inhibits rhabdomyosarcoma growth. However, whether this function is associated with regulating gut microbiota remains unknown. To investigate, we performed 16S ribosomal RNA (rRNA) gene sequencing on the fecal microbiome of APN gene knockout mice to determine whether APN deletion affects the gut microbiota. We found APN deficiency alters gut microbial functions involved in metabolism, genetic information processing, and cellular processes. In addition, a decreased abundance of Bacteroides and an increased abundance of Prevotella and Helicobacter were observed in rhabdomyosarcoma-bearing APN knockout mice; these bacteria were associated with the inhibition of rhabdomyosarcoma growth. These findings suggest that gut microbiota may be a potential target of APN deficiency against rhabdomyosarcoma.
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Adiponectina/deficiencia , Adiponectina/genética , Microbioma Gastrointestinal/genética , Errores Innatos del Metabolismo/genética , Rabdomiosarcoma/genética , Animales , Bacterias/clasificación , Bacterias/genética , Bacteroides/genética , Heces/microbiología , Humanos , Errores Innatos del Metabolismo/complicaciones , Errores Innatos del Metabolismo/microbiología , Ratones , Ratones Noqueados , ARN Ribosómico 16S/genética , Rabdomiosarcoma/complicaciones , Rabdomiosarcoma/microbiologíaRESUMEN
OBJECTIVE: Laparoscopic techniques for placement of peritoneal dialysis catheters are becoming increasingly popular. This study describes an one-port laparoscopic technique for insertion of peritoneal dialysis catheters. MATERIAL AND METHODS: Eighteen consecutive chronic renal failure patients underwent laparoscopic placement of Swan-neck catheters. All patients were eligible to receive local infiltration anaesthesia and none had had a previous peritoneal catheter placed. Videoscopic monitoring was performed via a peel-away sheath through an incision near the umbilicus; a 16 Fr peel-away sheath was then inserted towards the bladder and rectum. A Swan-neck catheter was passed through the peel-away sheath into the true pelvis. A subcutaneous tunnel was created and a point in left lower quadrant was selected as the exit site of the catheter. RESULTS: All the catheters were successfully placed and the mean time of operation was 26.5 min (range 14-35 min). The patients were discharged 2-4 days following the operation. During a mean follow-up period of 10.6 months (range 6-18 months), there were no catheter-related complications, such as catheter migration, dialysate leakage, exit-site infection and bacterial peritonitis. CONCLUSIONS: One-port laparoscopic technique is a simple, safe and effective method for placement of peritoneal dialysis catheters.
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Cateterismo/métodos , Laparoscopía/métodos , Diálisis Peritoneal , Adulto , Anciano , Creatinina/sangre , Humanos , Fallo Renal Crónico/terapia , Persona de Mediana EdadRESUMEN
BACKGROUND: There are three main techniques for the removal of epidermoid cysts: traditional wide excision, minimal excision, and punch biopsy excision. For inflamed cysts, the wall is more friable and, therefore, more difficult to remove completely. The classic surgical excision always leads to a long scar or high rate of recurrence. CO2 laser has been proven to result in minimal incision, less bleeding, no suture, and a smaller or no scar. Photodynamic therapy (PDT) has been proposed as an antimicrobial alternative for common and drug-resistant bacteria in nonspecific and multiple sites. It was also shown to be effective in accelerating healing and inhibiting excessive proliferation of hyperplastic scar. Thus, we combined minimally invasive CO2 laser incision with PDT for epidermoid cysts with infection. METHODS: Thirty-three patients had a total of 39 infectious cysts. Two of the patients withdrew due to the high cost after 1 treatment session. After local injection of anesthesia, a hole measuring 2-3 mm was made at the pore in the upper part of the cyst along skin texture by CO2 laser (power 5 W, surgical pattern). The contents of the cyst were extracted through the hole using a curette and compression with gauze. PDT was then performed immediately. A total of 3 PDT sessions were recommended. The overall clinical effects, recurrence rates, cosmetic outcomes, adverse events, and patient satisfaction were assessed. RESULTS: We achieved a 97% success rate in 31 patients with 34 lesions using a combination of minimally invasive CO2 laser incision with PDT. At the 6- to 12-month follow-up, 30 of the patients had excellent cosmetic outcomes and satisfactory therapeutic effect. Pain during the illumination process, which can be relieved by dynamic cold air, was the primary adverse event. CONCLUSION: Our results demonstrate promise for the combination of minimally invasive CO2 laser incision with PDT as a safe and effective therapy for epidermoid cysts with infection. This treatment can inactivate a wide range of microbes including gram-positive and -negative bacteria, without developing drug resistance. Furthermore, it can promote fast wound healing and reduce scar formation.
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Ácido Aminolevulínico/uso terapéutico , Quiste Epidérmico/tratamiento farmacológico , Quiste Epidérmico/cirugía , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Adulto , Dióxido de Carbono , Terapia Combinada , Quiste Epidérmico/microbiología , Femenino , Humanos , Láseres de Gas , Masculino , Satisfacción del Paciente , Adulto JovenRESUMEN
Carbuncle, a collection of interconnected furuncles with multiple pustular openings, is usually caused by Staphylococcus aureus (S. aureus). In this condition, both skin and subcutaneous tissue of the lesion show severe inflammation. It often occurs in immunocompromized patients such as those with diabetes, nephritis, malnutrition, heart failure, hypogammaglobulinemia, exfoliative dermatitis, or pemphigus or those using corticosteroids for long-term. Antibiotics and aggressive debridement are the primary recommended treatments for carbuncle. We report a case of carbuncle that received satisfactory response, in which the inflammation subsided and the wound healed after the administration of ALA photodynamic therapy for three times.
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Ántrax , Fotoquimioterapia , Ácido Aminolevulínico/uso terapéutico , Ántrax/tratamiento farmacológico , Humanos , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Staphylococcus aureusRESUMEN
OBJECTIVE: To compare the early rehabilitation effects of total hip arthroplasty (THA) with the direct anterior approach (DAA) versus the posterior approach (PA). METHODS: We searched PubMed, Embase, Web of Science, the Cochrane Library, and Google databases from inception to June 2019 to select studies that compared the DAA and PA for THA. Only randomized controlled trials (RCT) were included. Two researchers independently screened studies for inclusion, extracted data, and assessed the methodological quality. A meta-analysis was conducted using RevMan 5.3 software provided by Cochrane Assisted Network. RESULTS: A total of 932 patients underwent THA. There were 467 cases in group DAA and 465 cases in group PA. There was a significant difference in the incidence of lateral femoral cutaneous nerve injury between DAA and PA groups (RR = 38.97, 95% CI: 7.89-192.57, P < 0.05). DAA was associated with less pain compared with PA [WMD = -0.65, 95% CI (-0.91-0.38), P < 0.05]. There was no significant difference in operation time, hospitalization stay, and intraoperative bleeding volume. Moreover, in supplementary data, the number of acetabular prostheses in Lewinnek's safety zones in DAA was more than that in the PA group (RR = 1.20, 95% CI [1.04-1.39], P < 0.05), and the time of discontinuation of walking aids in the DAA group was earlier than that in the PA group (WMD = -11.05, 95% CI [-17.79-4.31], P < 0.05). CONCLUSION: The DAA total hip arthroplasty has comparable results with PA, with earlier postoperative functional recovery, less postoperative pain scores, and higher incidence of lateral femoral cutaneous nerve injury. The results need to be validated by large-sample, high-quality RCT studies, and long-term follow-up of complications.
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Artroplastia de Reemplazo de Cadera/métodos , Humanos , Dimensión del Dolor , Complicaciones Posoperatorias , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del TratamientoRESUMEN
BACKGROUND: Apocynum venetum leaves are used as a kind of phytomedicine and the main ingredient in some traditional Chinese medicine products for the relief of colitis. To understand the bioactive constituents of A. venetum L., we did a phytochemistry study and investigated anti-Inflammatory effects of compounds and explored the underlying mechanisms. METHODS: We isolated compounds from ethanol extract of A. venetum L. leaf and detected the most effective compound by NO inhibition assay. We investigated anti-Inflammatory effects on dextran sulfate sodium (DSS)-induced colitis mice and lipopolysaccharide (LPS)-stimulated RAW264.7 cells. The disease activity index was determined by scores of body weight loss, diarrhea and rectal bleeding; histological damage was analyzed by H&E staining; macrophages change in the colon were analyzed by immunohistochemistry (IHC); myeloperoxidase activity was measured by myeloperoxidase assay kits; levels of proinflammatory cytokines were determined by qPCR and ELISA; protein production such as COX-2, iNOS, STAT3 and ERK1/2 were determined by western blotting. RESULTS: We isolated uvaol from ethanol extract of A. venetum L. leaf and found uvaol has excellent potential of inhibiting NO production. We further found uvaol could attenuate disease activity index (DAI), colon shortening, colon injury, and colonic myeloperoxidase activity in DSS-induced colitis mice. Moreover, uvaol significantly reduces mRNA expression and production of pro-inflammatory cytokines (TNF-α, IL-6, IL-1ß, and MCP-1) and infiltration of macrophages in colonic tissues of colitis mice. Studies on LPS challenged murine macrophage RAW246.7 cells also revealed that uvaol reduces mRNA expression and production of pro-inflammatory cytokines and mediators. Mechanically, uvaol inhibits the pro-inflammatory ERK/STAT3 axis in both inflamed colonic tissues and macrophages. CONCLUSIONS: A. venetum leaf contains uvaol and uvaol has potent anti-inflammatory effects on DSS-induced experimental colitis and LPS-stimulated RAW264.7 macrophage cells. These results suggest uvaol is a prospective anti-inflammatory agent for colonic inflammation.
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Liver cancer is a common malignant disease in China, while the primary hepatic neuroendocrine tumor (PHNET) is extremely rare presented with various manifestations. We herein describe an interesting PHNET case, which was clinically diagnosed as hepatocellular carcinoma (HCC) based on strong clinical evidence and the national guideline, but confirmed to be PHNET by pathology. A42-year-old Chinese male was admitted for persistent upper abdominal pain, and CT scan revealed a huge liver tumor in the left lobe. The tumor presented attributes of tumor rupture, portal vein tumor thrombus, elevated serum AFP level, background hepatitis B virus infection history, and radiological features mimicking typical HCC. After left semi-hepatectomy was performed for curative treatment of the primary "HCC", the pathology demonstrated the correct diagnosis be poorly differentiated neuroendocrine carcinoma (NEC). The immunohistochemistry assays showed positive neuroendocrine markers of CgA and Syn and negative HCC markers of Hep Par 1 and GPC3, ruling out concurrent HCC. This case and literature review suggest that in spite of rare incidence, PHNET should be considered as a possible diagnosis when lacking a confirmative pathology result, even when sufficient evidence of typical presentation exist to establish the clinical diagnosis of HCC.
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OBJECTIVE: This article analyzed the clinical efficacy and tolerability of rivaroxaban and enoxaparin in patients undergoing total knee arthroplasty (TKA) surgery. METHODS: Five randomized, controlled clinical trials on rivaroxaban versus enoxaparin in patients who underwent TKA were identified and included in this meta-analysis. RESULTS: The meta-analysis indicated that rivaroxaban prophylaxis was associated with lower rates of symptomatic venous thromboembolism (VTE) (relative risk[RR]:0.55; 95% confidence interval [CI]: 0.35-0.86; Pâ=â.009), symptomatic deep vein thrombosis (DVT) (RR 0.44, 95% CI 0.25-0.80, Pâ=â.007), asymptomatic DVT (RR: 0.57; 95% CI: 0.37-0.89; Pâ=â.01), distal DVT (RR: 0.62; 95% CI: 0.45-0.85; Pâ=â.003) and proximal DVT (RR: 0.42; 95% CI: 0.24-0.75; Pâ=â.004). Compared with the enoxaparin group, the incidence of symptomatic pulmonary embolism (PE) (RR: 0.48; 95% CI: 0.19-1.24; Pâ=â.13) in the rivaroxaban group was not significantly different. A nonsignificant trend towards all-cause death (RR: 0.38; 95% CI: 0.03-4.92; Pâ=â.46) or major bleeding (RR: 1.59; 95% CI: 0.77-3.27; Pâ=â.21) risk between rivaroxaban and enoxaparin prophylaxis was found. CONCLUSION: Compared with the enoxaparin group, the group using rivaroxaban after TKA had a significantly lower rate of symptomatic VTE, symptomatic DVT, asymptomatic DVT, distal DVT, and proximal DVT. Our study shows that rivaroxaban after TKA is more effective than enoxaparin and did not increase major bleeding or all-cause mortality.
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Anticoagulantes/uso terapéutico , Artroplastia de Reemplazo de Rodilla/efectos adversos , Enoxaparina/uso terapéutico , Complicaciones Posoperatorias/prevención & control , Rivaroxabán/uso terapéutico , Tromboembolia Venosa/prevención & control , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Tromboembolia Venosa/etiologíaRESUMEN
BACKGROUND: Venous thromboembolism (VTE) is considered a potentially serious complication of knee arthroscopy and leads to conditions such as deep venous thrombosis (DVT) and pulmonary embolism (PE). Low-molecular-weight heparin (LMWH) is widely employed in knee arthroscopy to reduce perioperative thromboembolic complications. However, the efficacy and safety of LMWH in knee arthroscopy remains unclear. METHODS: Seven randomized controlled clinical trials on LMWH in knee arthroscopy were identified and included in this meta-analysis. The main outcomes of the effectiveness (prevention of DVT and PE) and complications (death, major bleeding, and minor bleeding) of LMWH in knee arthroscopic surgery were assessed using Review Manager 5.3 software. RESULTS: The meta-analysis indicated that LMWH prophylaxis comprised 79% of asymptomatic DVT. No association was found in symptomatic VTE (RR: 0.90; 95% confidence interval [CI]: 0.39-2.08; P = 0.80), symptomatic DVT (RR: 0.79; 95% CI: 0.28-2.23; P = 0.66), symptomatic PE (RR: 1.36; 95% CI: 0.37-4.97; P = 0.64) and major bleeding (RR: 0.70; 95% CI: 0.12-3.95; P = 0.68) risk during LMWH prophylaxis were identified. Death was not reported in these studies. Moreover, there was a lower incidence of minor bleeding (RR: 0.64; 95% CI: 0.49 to 0.83; P = 0.001) in the control group than in the LMWH group. CONCLUSION: Compared with the control group, the group treated with LMWH after knee arthroscopy was no association in reducing the symptomatic VTE rate, symptomatic DVT rate or symptomatic PE rate. The symptomatic VTE rate was 0.5% (11/2,166) in the LMWH group versus 0.6% (10/1,713) in the control group. Although the limitations of this meta-analysis cannot be ignored, the results of our study show that LMWH after knee arthroscopy is ineffective. We recommend that LMWH should not be routinely provided for knee arthroscopy. TRIAL REGISTRATION: ClinicalTrials.gov NCT03164746.
Asunto(s)
Artroscopía/efectos adversos , Heparina de Bajo-Peso-Molecular/efectos adversos , Heparina de Bajo-Peso-Molecular/farmacología , Rodilla/cirugía , Seguridad , Humanos , Tromboembolia Venosa/etiología , Tromboembolia Venosa/prevención & controlRESUMEN
INTRODUCTION: Hemangiomas are common benign tumors of the liver. Spontaneous rupture is a rare complication, occurring most commonly in giant hemangiomas. Rupture of a hemangioma with hemoperitoneum is a serious development and can be fatal if not managed promptly.The present study reports the unique case of a man who experienced rupture and hemorrhage of a hepatic hemangioma (HH) due to perforation of the gallbladder fundus. After en block resection of the hemangioma and gallbladder using the Pringle maneuver, the patient made an uneventful recovery without complications.To our knowledge, spontaneous rupture of HH secondary to gallbladder perforation has not been reported in the literature. This case highlights a unique, rare cause of ruptured HH and the need to consider appropriate treatment for some hemangiomas to avoid this potentially fatal complication. CONCLUSION: The current case may provide additional support for treatment of HH due to the potential for spontaneous rupture. For patients with ruptured HH, enucleation with the Pringle maneuver is recommended.