ABSTRACT
@#Abstract: To investigate the in vitro release, in vivo pharmacokinetics, and the in vitro-in vivo correlation of progesterone suspension injection, self-made progesterone suspension injection was taken as an example. The in vitro release curves of three different particle sizes of progesterone suspension injections were measured using paddle method and dialysis bag method. The in vivo pharmacokinetic characteristics of self-made progesterone suspension injection was studied on SD rats. The plasma concentration of self-made progesterone preparation was detected after intramuscular injection, and correlated with the in vitro release profiles obtained by the dialysis bag method after processing by Wagner-Nelson method. The results showed that when the in vitro release of three different particle sizes of progesterone suspension injections was measured by the paddle method, more than 85% was rapidly released within 20 min, while 85% cumulative release was reached at 40 h, 84 h and 120 h by dialysis bag method, respectively. The release rate obtained by the dialysis bag method was basically consistent with the in vivo release trend, with a correlation coefficient of >0.95, indicating a strong in vivo and in vitro correlation. This study provides some reference for the establishment of the in vitro and in vivo correlation of long-acting suspension injection.
ABSTRACT
Crigler-Najjar syndrome (CNS) is an autosomal recessive disorder in which the content of plasma unconjugated bilirubin is increased due to the reduction or complete deficiency of the activity of bilirubin uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1), classified as CNS type Ⅰ and Ⅱ. CNS type Ⅰ is the most severe, which will develop into kernicterus, damage the brain nervous system, and even threaten the life of patients. This article introduces six CNS treatment techniques, including phototherapy, plasma exchange, drug therapy, liver transplantation, hepatocyte transplantation and gene therapy. The applicable patient types, treatment effects and existing deficiencies of each technique were summarized. Phototherapy, plasma exchange, drug therapy and hepatocyte transplantation can temporarily control serum levels and reduce the risk of jaundice, but cannot completely restore UGT1A1 enzyme activity; liver transplantation is currently the only treatment option for CNS type Ⅰ patients, but is limited by suitable liver donors and post-operative immune rejection. Gene therapy has the most promising application in the treatment of genetic disorders such as CNS, which can provide more viable therapeutic techniques for CNS patients.
ABSTRACT
The purpose of this paper is to review the research status on non-suicidal self-injury (NSSI) in children and adolescents, so as to provide references for the cognition and intervention of NSSI behavior in children and adolescents. NSSI behavior is an independent risk factor for suicide, which not only poses a serious threat to the mental health of children and adolescents, but also brings a great burden on families and society. This paper focuses on the epidemiology, etiology, relationship with other psychiatric disorders, and treatment of NSSI behaviors in children and adolescents.
ABSTRACT
Objective:To translate the Stressor Scale for Emergency Nurse (SSEN), and to test the reliability and validity of the Chinese version.Methods:According to the Brislin model to translate and back-translate the orginal English version, the Chinese version of the scale was determined after cross-cultural adaptation and pretesting. From October 2021 to January 2022, 401 emergency nurses in the Affiliated Hospital of Qingdao University were selected for a questionnaire survey to evaluate the reliability and validity of the translated Chinese scale.Results:The Chinese version of the SSEN retains 27 items, 4 common factors were extracted by exploratory factor analysis, and the factor cumulative variance contribution rate was 78.463%. Confirmatory factor analysis showed that χ2/ df=2.280, comparative fitness index=0.933, Tucker-Lewis index=0.924, incremental fit index=0.933, root mean square of approximate residual=0.079, all within the acceptable range. The item-level content validity index of the Chinese SSEN was 0.80-1.00; the scale-level content validity index was 0.97; it was positively correlated with the Maslach Burnout Inventory manual, and the correlation coefficient was 0.456 ( P<0.001); the Cronbach α coefficient of the total table was 0.971, the split-half reliability was 0.877, and the test-retest reliability was 0.958. Conclusions:The Chinese version of the SSEN has good reliability and validity, and it can be used to investgate the occupattional stressors for emergency nurses in the context of Chinese culture.
ABSTRACT
ObjectiveTo investigate the impact of antipsychotics on serum uric acid level in patients with schizophrenia, and to clarify the antioxidant properties of antipsychotics, so as to provide evidence-based guidelines for the treatment of schizophrenia. MethodsKeywords combined with free-text search strategies were used to retrieve English and Chinese databases including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Database, VIP database and Chinese Biomedical Literature Database. Randomized controlled trials related to the effects of antipsychotics on serum uric acid level in patients with schizophrenia were included. Meta-analysis was performed using RevMan 5.3. ResultsA total of 9 kinds of antipsychotics and 1 434 schizophrenia patients in 15 Chinese and English literatures were included. Meta-analysis showed that olanzapine (MD=14.01, 95% CI: 2.39~21.62, P<0.05) and chlorpromazine (MD=51.36, 95% CI: 42.15~60.57, P<0.05) increased the serum uric acid level in schizophrenia patients, while risperidone, aripiprazole, clozapine, haloperidol, quetiapine and ziprasidone had no significant effect on serum uric acid (P>0.05). ConclusionThe effect of different kinds of antipsychotics on serum uric acid level in schizophrenia patients varies, among which olanzapine and chlorpromazine can elevate serum uric acid level in patients with schizophrenia, whereas no other antipsychotics have been found to have any effect on serum uric acid level.
ABSTRACT
Objective:To research the application of deliberated Teach-back combined with Internet+nursing clinical pathway on Gartland type Ⅲ supracondylar fractures.Methods:A total of 51 children with Gartland type III supracondylar fractures who were hospitalized from March 2018 to May 2018 were selected as the control group, and 46 children with Gartlnd type III supracondylar fractures who were hospitalized from June 2018 to August 2018 were selected as the experimental group. The control group was given the traditional perioperative care routines, and the experimental group was given the Internet + perioperative clinical pathway combined with Teach-back for perioperative period.The execute accuracy of fasting and banned drinking was checked between the two groups, the incidence of postoperative needle infection was compared between the two groups, the function of the elbow joint was evaluated according to the Flynn score, the hospitalization days and hospitalization expenses were compared between the two groups.Results:The execute accuracy of fasting and banned drinking was 64.71%(33/51), 58.82%(30/51) in the control group and 86.96%(40/46), 84.78%(39/46)in the experimental group, and there were statistically significant differences between the two groups( χ2 values were 6.431, 7.937, P<0.05 or 0.01). The incidence of postoperative needle infection was 35.29%(18/51) in the control group and 2.17%(1/46) in the experimental group, and there were statistically significant differences between the two groups( χ2 value was 16.844, P<0.01). The difference of Flynn scores after 4 weeks operation between the two groups was statistically significant( P<0.01), but there was no significant difference after 6 weeks operation between the two groups( P>0.05). The hospitalization days and hospitalization expenses were(2.03±0.04) d, (10 135.403±94.384) yuan RMB in the experimental group, and (4.94±0.14) d, (12 577.646±192.604) yuan RMB in the control group, and there were statistically significant differences between the two groups( t values were 21.256, 11.386, P<0.01 or 0.05). Conclusions:The use of Teach-back combined with Internet + nursing clinical pathway on the Gartland type III supracondylar fracture of the humerus can improve the accuracy of preoperative fasting and banned drinking execut and reduce postoperative needle infection. The elbow function of the affected limb is significantly improved 4 weeks after operation. The hospitalization days and hospitalization expenses are reduced and the effect is significantly better than regular care, Which has the value of further clinical research and promotion and application.
ABSTRACT
Objective:To learn the application of nosocomial infection prevention and control measures as stipulated in COVID-19 emergency plans by medical institutions at all levels in the region, for the purpose of strengthening epidemic prevention and control.Methods:During March 12-13, 2020, customized questionnaires were used to learn from 186 hospitals and medical institutions regarding the basics of their nosocomial prevention management departments, emergency plan application and revisions made. Comparison of the ratios or constituent ratios were tested with χ2 test, while the continuous variables analysis between groups was verified with one-way ANOVA. Results:77.53% of the medical institutions had set up independent nosocomial infection management departments, and 87.30% of the institutions were qualified. 80% of the medical institutions had in place emergency plans for respiratory infectious diseases, but 98.05% of them had revised their plans during the pandemic, with an average of 10.85 newly added and revised provisions. Only 30.11% of emergency planed provide for clearly graded early warning.Conclusions:Efforts should be upgraded to develop an emergency prevention and control system for infection prevention and control in epidemics, and improve technical support for infection prevention and control in the system; to strengthen the clearly-graded early warning and graded responses in a scientific manner; and conduct regular drills, revise plan to ensure its applicability.
ABSTRACT
Long non-coding RNAs (lncRNAs) play important roles in several cellular biogenic activities, including the virus-host interaction as well. Virus infection could induce aberrant expression of multiple lncRNAs, and some of these lncRNAs could facilitate or suppress the virus infection via diverse mechanisms. In this paper, we enumerate the differentially expressed lncRNAs induced by different types of viruses and summarize the potential mechanism of interaction between viruses and these lncRNAs.
ABSTRACT
Serine incorporator (SERINC) is a multi-transmembrane family of carrier proteins that is highly conserved among species and helps to integrate serine into lipid bilayers to efficiently synthesize phospholipids Phosphatidylserine and sphingolipids. Recent studies have found that SERINC protein family, especially SERINC3 and SERINC5, act on many different viruses, such as human immunodeficiency virus (HIV) which causes AIDS, inhibit the replication and proliferation of the virus to achieve antiviral effects. The study on the mechanism of virus-host cell interaction has been a hot spot in the field and has important scientific significance. In this article, the structural features of SERINC protein family, the major biological functions, and the interaction with the virus in the anti-virus process are summarized in order to provide important information for the research on the host-virus interaction.
ABSTRACT
Objective@#To investigate the feasibility and value of interphase fluorescence in situ hybridization (FISH) in the pathological diagnosis, differential diagnosis and therapeutic assessment of B-cell lymphomas.@*Methods@#The cohort included 604 cases of B-cell lymphoma which were collected at West China Hospital from May 2010 to December 2016.And all were subjected to interphase FISH using 11 break apart or fusion probes (MYC, bcl-2, bcl-6, IRF4, MYC/IgH, bcl-2/IgH, CCND1/IgH, IgH, API2/MALT1, p53/ATM, and D13S319/CEP12).@*Results@#The median age of the 604 B-cell lymphoma patients was 47.7 (aged 2-90) years including 372 men and 232 women. All the cases was divided into 463 large B cell lymphomas(LBL) and 141 small B cell lymphomas, and the total interphase FISH positive rate was 59.8% (361/604). Among the 463 LBL, 12.5% (58/463), 9.5% (44/463) and 2.2% (10/463) of cases showed MYC, bcl-6 and bcl-2 gene rearrangements respectively; and 363 diffuse large B cell lymphoma (DLBCLs) were reclassified as germinal center B-cell (GCB) subtype (38.6%, 140/363) and non-GCB subtype (61.4%, 223/363) by Hans algorithm. The rearrangement rates in GCB and non-GCB DLBCL were 45.7%(64/140)and 21.5%(48/223; P=0.001), respectively. Compared to the non-GCB DLBCL, GCB DLBCL showed higher MYC and bcl-2 gene rearrangements (P=0.001). Eleven (2.4%, 11/463) cases had MYC and bcl-6 or bcl-2 gene rearrangement (double-hit lymphoma); one (0.2%, 1/463) case had MYC, bcl-6 and bcl-2 gene rearrangements (triple-hit lymphoma); two (0.4%, 2/463) cases had bcl-2 and bcl-6 gene rearrangements. MYC translocation and MYC/IgH fusion were detected in 94.2%(81/86) and 83.7%(72/86) cases of Burkitt lymphomas. IRF4 rearrangement was detected in two cases of IRF4+ LBCL. Genetic abnormalities were detected in 9/19, 100%(29/29), 30.8%(12/39) and 68.5%(37/54) cases of follicular lymphoma, mantle cell lymphoma, MALT lymphoma and chronic lymphocytic leukemia, respectively.@*Conclusions@#Interphase FISH can rapidly and accurately detect the genetic changes in B-cell lymphomas. Different genetic changes are specifically valuable to the diagnosis, differential diagnosis, prognosis evaluation and treatment guidance of various B-cell lymphomas.
ABSTRACT
Objective@#To study the clinicopathologic features of lymphoproliferative disease by lymph node core needle biopsy(CNB)and to evaluate the diagnostic significance of CNB for lymphoproliferative disease.@*Methods@#The annual distribution, entity constitute, clinical finding, gross feature, morphologic change, affiliate study and repeat biopsy diagnosis of 1 013 cases of lymph node CNB diagnosed at West China Hospital of Sichuan University from January 2009 to December 2015 were investigated.@*Results@#(1) Proportion of lymph node CNB in total amount of biopsy specimens increased from 0.2% in 2009 to 0.8% in 2015.(2) The study cohort included 471 lymphomas, 12 atypical lymphoid hyperplasia (ALH), 136 suspected lymphomas, 372 benign lesions, and 22 cases of descriptive diagnoses. The most common types were diffuse large B cell lymphoma and T-lymphoblastic lymphoma. (3) Majority of patients were adolescents and children younger than 20 years or the elderly older than 60 years. 53.1% CNB tumor specimen consisted of ≥4 tissue cores and 40.5% were >2 cm in length. (4) 104 CNB cases with previous history of excision biopsy was included 45 carcinomas(no metastatic carcinoma was found), 32 lymphomas for treatment observation.1/14 suspicious lymphomas, 1/1 ALH and 3/22 cases benign lesions were diagnosed as lymphoma by repeat biopsy respectively. (5) 217 CNB cases were diagnosed as lymphoma by subsequent CNB (70), or subsequent excision biopsy (147) including 78.5%(73/93) suspected lymphomas, 5/7 ALH and 32.3%(20/62)benign lesions.@*Conclusions@#Lymph node CNB has certain clinical indications, although limited for the diagnosis of lymphoproliferative disorders. Suspected lymphomas and ALH diagnosed by CNB should be followed by repeat tissue biopsy. For the benign lesions by CNB it does not rule out additional biopsy to further investigate the lesion.
ABSTRACT
Phenylketonuria (PKU) is a newborn inherited metabolic disorder caused by the genetic deficiency of hepatic enzyme phenylalanine hydroxylase (PAH) which thus in metabolic disorder of phenylalanine. In this study, ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was used to analyze the accurate amount of coenzyme Q10 (CoQ10) and the relative amount of CoQ9 in newborn dried blood spot (DBS) collected from 5 PKU newborns (3 and 30 days after birth, respectively) and 20 healthy newborns. The content of CoQ10 was (122.1±24.9 ng/mL) and (59.0±12.0 ng/mL) in DBS from healthy newborns and PKU newborns, respectively. The relative contents of cholesterol and glucose in the DBS were determined by gas chromatography-mass spectrometry (GC-MS). In comparison with healthy newborn group, the levels of CoQ10, CoQ9, cholesterol and glucose were all significantly decreased in PKU newborns. The increased content of Phe and the decreased content of CoQ10 showed significant inverse correlation in the DBS from PKU. This study provides references for diet therapy of PKU newborns.
ABSTRACT
Objective To study the 18F-FDG PET/CT features of tuberculous and malignant diffuse peritoneal lesions and to discuss the diagnostic value of 18F-FDG PET/CT in diagnosing and differentiating the lesions. Methods The 18F-FDG PET/CT features of 72 patients with tuberculous peritonitis,28 primary serous papillary carcinoma of the peritoneum and 135 peritoneal metastases confirmed by clinic and/or histopathology, were retrospectively reviewed. The peritoneal thickening features of tuberculous and malignant peritoneal lesions were observed. The maximal standardized uptake value (SUVmax) of peritoneal lesions and ascites, ascites SUVmax/liver SUVmax (T/NT) were compared between tuberculous peritonitis and cancerous peritonitis. The ROC curve was used to analyze the diagnostic efficiency of T/NT, SUVmax of peritoneal lesions and ascites. Results The typical 18F-FDG PET/CT features of tuberculous peritonitis were uniformity thickening of parietal peritoneum, mesenteric and omental stain like changes, widely and even distribution of the peritoneal 18F-FDG, while the cancerous peritonitis was obvious uneven thickening of parietal peritoneum, mesenteric and omental nodules and pie-shape changes, uneven distribution of the peritoneal 18F-FDG. The degree of 18F-FDG uptake was increased in all peritoneal lesions, and there was no significant difference between the tuberculous group (SUVmax=10.53±5.44) and the cancerous group (SUVmax=11.45±6.78, t=1.017, P>0.05). The 18F-FDG concentration in malignant ascites (SUVmax=1.88±0.65,T/NT=0.73± 0.18) was obvious higher than that of tuberculous ascites (SUVmax=1.67±0.69,T/NT=0.57±0.27, t=2.243 and 5.045,both P<0.05). The area under the ROC curve of T/NT, SUVmax of ascites, SUVmax of peritoneal lesions were 0.707, 0.593, 0.536, respectively. Conclusion The 18F-FDG PET/CT imaging can reflect the morphology and metabolic changes of peritoneal lesions. It is important to combine the SUVmax of ascites in order to improve the efficiency of diagnosing the diffuse peritoneal diseases.
ABSTRACT
Objective To investigate the clinical characteristics of patients with non-vaIvular atrial fibrillation (NVAF) combined with type 2 diabetes mellitus (T2DM),and explore the effect of T2DM on survival status of patients with NVAF.Methods A total of 646 patients with NVAF in Tianjin Chest Hospital from January 2014 to September 2015 were enrolled in the study,and were divided into T2DM group (n=110) and non-T2DM group (n=536) according to whether these patients were complicated with T2DM.The clinical data,incidence rates of cerebral infarction and cardiovascular death after 1-year follow-up were compared between the two groups.Multivariate Cox regression analysis was performed to determine independent factors for cerebral infarction and cardiovascular death within 1 year.Results The age,body mass index,incidence rates of hypertension,coronary heart disease,transient ischemic attack (TIA) or stroke,and hyperlipidemia,and application rates of aspirin,statins in the T2DM group were higher than those in the non-T2DM group,there were statistically significant differences (P<0.05).After 1-year follow-up,the incidence rate of cardiovascular death in the T2DM group was 14.5 % which was significantly higher than 5.1% in the nonT2DM group (P<0.05).The incidence rate of cerebral infarction within 1 year in the T2DM group and non-T2DM group were 12.7 % and 6.4%,respectively.There was no significant difference in the incidence rate between the two groups (P>0.05).Multivariate Cox regression analysis showed that age,TIA or stroke history and T2DM were the independent risk factors for cerebral infarction (P<0.05).Age,heart failure and T2DM were the independent risk factors for cardiovascular death,and ACEI/ARB was an independent protective factor (P<0.05).Conclusion T2DM could increase the risk for cerebral infarction and cardiovascular death in patients with NVAF.
ABSTRACT
Objective To investigate the clinical characteristics of patients with non-vaIvular atrial fibrillation (NVAF) combined with type 2 diabetes mellitus (T2DM),and explore the effect of T2DM on survival status of patients with NVAF.Methods A total of 646 patients with NVAF in Tianjin Chest Hospital from January 2014 to September 2015 were enrolled in the study,and were divided into T2DM group (n=110) and non-T2DM group (n=536) according to whether these patients were complicated with T2DM.The clinical data,incidence rates of cerebral infarction and cardiovascular death after 1-year follow-up were compared between the two groups.Multivariate Cox regression analysis was performed to determine independent factors for cerebral infarction and cardiovascular death within 1 year.Results The age,body mass index,incidence rates of hypertension,coronary heart disease,transient ischemic attack (TIA) or stroke,and hyperlipidemia,and application rates of aspirin,statins in the T2DM group were higher than those in the non-T2DM group,there were statistically significant differences (P<0.05).After 1-year follow-up,the incidence rate of cardiovascular death in the T2DM group was 14.5 % which was significantly higher than 5.1% in the nonT2DM group (P<0.05).The incidence rate of cerebral infarction within 1 year in the T2DM group and non-T2DM group were 12.7 % and 6.4%,respectively.There was no significant difference in the incidence rate between the two groups (P>0.05).Multivariate Cox regression analysis showed that age,TIA or stroke history and T2DM were the independent risk factors for cerebral infarction (P<0.05).Age,heart failure and T2DM were the independent risk factors for cardiovascular death,and ACEI/ARB was an independent protective factor (P<0.05).Conclusion T2DM could increase the risk for cerebral infarction and cardiovascular death in patients with NVAF.
ABSTRACT
Objective To investigate the correlation between atlE gene and biofilm formation of Staphylococcus epidermidis . Methods 64 strains of clinically isolated Staphylococcus epidermidis in our hospital from June 2015 to June 2016 were collected . The biofilm formation test was used to detect bacterial biofilm .PCR was use to amplify atlE gene .Then the correlation between the atlE gene with biofilm formation was analyzed .Results 24 strains of biofilm positive bacterium were detected ,the detection rate was 37 .5% ;31 strains of atlE gene was detected ,the detection rate was 48 .4% ;atlE gene was significantly correlated to biofilm formation(P<0 .05) .Conclusion Staphylococcus epidermidis has the ability to form biofilm ;atlE gene has a relation with biofilm formation of Staphylococcus epidermidis .
ABSTRACT
Objective To explore the influencing factors of the collateral circulation formation in patients with acute cerebral infarction.Methods Three hundred and fifty-two patients with acute cerebral infarction were included in this study,the clinical date of their head and neck 256 slice spiral CT angiography (CTA)examination was analyzed.According to the formation of collateral circulation in the head and neck CTA imaging results,it is divided into the collateral circulation group and the non-collateral circulation group.The clinical data of the two groups were compared.The influencing factors of the formation of collateral circulation in patients with acute cerebral infarction were analyzed by single factor analysis and multivariate logistic regression analysis.Results (1)In 352 cases of acute cerebral infarction,197 cases(56.0%)had collaterals,155 cases (44.0%)had none collateral.(2)Single factor analysis showed that age(t=-2.860,P=0.004),hypertension combined with diabetes(χ2 = 10.709,P= 0.001),history of TIA(χ2 = 4.626,P= 0.034),low density lipoprotein(t=-2.176,P=0.030),high homocysteine(t=2.885,P=0.004),cerebral vascular stenosis(Z=-5.936,P=0.000),posterior circular lesions(χ2=8.548,P=0.004)were the influencing factors in the formation of collateral circulation.(3)Multivariate Logistic regression analysis showed that old age(OR=1.031;95%CI=1.008-1.054;P=0.007),hypertension combined with diabetes(OR= 2.009;95%CI=1.159-3.482;P=0.013),high homocysteine(OR=1.023;95%CI,1.005-1.041;P=0.014),circular lesions(OR=1.727;95%CI=1.063-2.804;P=0.027)were relatively independent risk factors in acute cerebral infarction patients with none circulation,the degree of cerebral vascular stenosis(OR=0.507;95%CI=0.389-0.661;P=0.000),low density lipoprotein(OR=0.723;95%CI=0.532-0.982;P=0.038)served as protective factor.Conclusion Old age,hypertension combined with diabetes,high homocysteine and posterior circulation lesions are risk factors for the formation of collateral circulation in patients with acute cerebral infarction,cerebral vascular stenosis degree and low density lipoprotein can promote the formation of collateral circulation.
ABSTRACT
Objective To explore the effect of the flipped classroom model on the training of nursing theory and skills to newly-contracted nurses. Methods A total of 122 newly-contracted nurses in 2013 were selected as the control group, where the traditional training methods were adopted. The 303 newly-contracted nurses recruited into the hospital in 2014 were set as the experimental group, where the training was carried out by using the flipped classroom model for 1 year. After training, the differences between the two groups in the theoretical test and nursing skills assessment were compared. A satisfaction survey about the flipped classroom model was made in the experimental group. Results Both the scores on the nursing theory and skills in the experimental group were higher than those in the control group (all P<0.001).More than 88.9%of the newly-contracted nurses in the experimental group was for the training arrangement, classroom experience and application of the flipped class model. Conclusion The application of the flipped classroom model in the training of nursing for newly-contracted nurses can improve the learning effect of newly-contracted nurses and enhance their nursing theory and skills.
ABSTRACT
Objective@#To investigate the relationship between M2-polarized macrophages and early response in multiple myeloma and its molecular mechanism.@*Methods@#Two hundred and forty bone marrow biopsy tissue were collected and M2-polarized macrophages were stained by anti-CD163 monoclonal antibody. In vitro M2-polarized macrophages were derived from human peripheral blood mononuclear cell or THP-1 cells and identified by flow cytometry. Two myeloma cell lines RPMI 8226 and U266 were co-cultured with M2 macrophages using a transwell system. We measured myeloma cells proliferation through CCK-8 method and the pro-inflammatory cytokines expression (TNF-α and IL-6) by ELISA. Real time PCR was applied to measure chemokines (CCL2 and CCL3) , chemokine receptors (CCR2, CCR5) , VEGF and their receptors. In addition, flow cytometry was used to analyze the apoptosis of myeloma cells induced by dexamethasone.@*Results@#①Patients with high percentage of M2 macrophage involvement in bone marrow showed poorer response (23.9% versus 73.0%, χ2=60.31, P<0.001). ② In vitro the proliferation of RPMI 8226 cells (P=0.005 at 24 h, P=0.020 at 36 h) or U266 myeloma cells (P= 0.030 at 24h, P=0.020 at 36h) co-cultured with M2-polarized macrophages was higher than control group. ③In vitro the apoptotic rate of RPMI 8226 cells (29.0% versus 71.0%, t=4.97, P=0.008) or U266 myeloma cells (24.9% versus 67.7%, t=6.99, P=0.002) co-cultured with M2-polarized macrophages was lower than control group. ④ In vitro M2-polarized macrophages promoted myeloma cells secreting higher level of IL-6, TNF-α and higher expression of CCL2, CCL3, CCR2, CCR5, VEGFA, VEGFR-1,-2 compared with the non-macrophage co-culture system.@*Conclusion@#M2-polarized macrophages promote myeloma cells proliferation and inhibit apoptosis through a very complex mechanism involving pro-inflammatory cytokines IL-6 and TNF-α, chemokines and related receptors such as CCL2, CCL3, CCR2, CCR3, and VEGF as well as related VEGFR.
ABSTRACT
Objective: To evaluate the feasibility and safety of applying enhanced recovery after surgery (ERAS) protocol in patients undergoing laparoscopic distal pancreatectomy. Methods: Data of 36 patients undergoing laparoscopic distal pancreatectomy from May 2016 to May 2017 in the First Affiliated Hospital, Zhejiang University School of Medicine were reviewed. The patients were divided into ERAS group (n=12) and control group (n=24). The patients in ERAS group received a series of enhanced recovery procedures, including multimodal analgesia, early off-bed activity and early oral food-taking, etc. Operation time, intraoperative blood loss, time to first flatus, postoperative complications, and length of postoperative hospital stay were evaluated. Results: There were no statistically significant differences in operation time and intraoperative blood loss between ERAS group and control group (all P0.05). The time to first flatus and length of postoperative hospital stay were significantly shortened in ERAS group (all PP0.05). Conclusion: The ERAS protocol for laparoscopic distal pancreatectomy can significantly promote gastrointestinal function recovery and shorten postoperative hospital stay, and may reduce the incidence of postoperative complications.