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ObjectiveTo investigate the inhibitory effects and mechanism of the compound Phyllanthus urinaria Ⅱ （CPU Ⅱ）on the growth of transplanted hepatocellular carcinoma Hep3B2.1-7 （Short for Hep3R） cells in nude mice. MethodAfter the establishment of a xenograft model of hepatocellular carcinoma Hep3B cells in mice， the model mice were randomly divided into a model group， a high-dose CPU Ⅱ group （57.5 g·kg-1）， a low-dose CPU Ⅱ group （28.75 g·kg-1）， and a 5-fluorouracil （5-FU） group （0.025 g·kg-1）， with eight mice in each group. The mice in the high- and low-dose CPU Ⅱ groups were treated with drugs by gavage， once per day， and those in the model group were treated with the same volume of normal saline. The mice in the 5-FU group were treated by 5-FU by intraperitoneal injection， once every other day. After 28 days of administration， mice were sacrificed， and transplanted tumors were collected. Immunohistochemistry （IHC） was used to detect the expression of proliferating cell nuclear antigen （PCNA） of tumor tissues. Terminal-deoxynucleotidyl transferase-mediated nick end labeling （TUNEL） was used to detect cell apoptosis of tumor tissues. The mRNA expression of miR-122 and insulin-like growth factor 1 receptor （IGF-1R） in tumor tissues was detected by Real-time quantitative PCR （Real-time PCR）. The protein expression of CCAAT/enhancer-binding protein α （C/EBPα）， hepatocyte nuclear factor-4α （HNF-4α）， and IGF-1R in tumor tissues was detected by Western blot. ResultThe tumor suppression rates of the high- and low-dose CPU Ⅱ groups and the 5-FU group were 74.90%， 63.62%， and 64.15%， respectively. Compared with the model group， the CPU Ⅱ groups and the 5-FU group showed reduced weight （P<0.01） and volume of tumors （P<0.01）， decreased PCNA positive cells， shallow staining， increased apoptosis cells of transplanted tumor tissues （P<0.05， P<0.01）， increased expression of mRNA expression of miR-122 （P<0.01）， down-regulated mRNA expression of IGF-1R （P<0.01）， and up-regulated protein expression of C/EBPα and HNF-4α in nude mouse transplanted tumor tissues （P<0.01）. The expression of IGF-1R protein in the high-dose CPU Ⅱ group was down-regulated （P<0.05）. Compared with the low-dose CPU Ⅱ group， the high-dose CPU Ⅱ group showed increased apoptotic cells （P<0.01）， up-regulated mRNA expression of miR-122 （P<0.01）， and increased expression of C/EBPα and HNF-4α proteins （P<0.01）. ConclusionCPU Ⅱ has an obvious inhibitory effect on the growth of transplanted hepatocellular carcinoma Hep3B cells in nude mice. The mechanism of action is related to enhancing the expression of transcription factors HNF-4α and C/EBPα， thereby promoting the expression of miR-122 and inhibiting the expression of its target gene IGF-1R.
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Objective:To develop a nomogram to predict the probability of prostate cancer after transeperineal prostate biopsy, and verify the diagnostic efficacy and clinical applicable value of the model.Methods:The clinicopathologic data of 475 patients who underwent prostate biopsy at Yijishan Hospital of Wannan Medical College between January 2019 to August 2021 were retrospectively reviewed. Of all the patients, 367 patients from January 2019 to December 2020 were in the development cohort and 108 patients from January 2021 to August 2021 were in the validation cohort. Patients in the development cohort were (68.86±9.00) years old. The tPSA level was 13.6(8.6, 23.3)ng/ml, and Prostate Imaging Reporting and Data System (PI-RADS) score was 4(3, 4) points. Patients in the validation cohort were (68.89±8.67) years old. The tPSA was 13.1(8.7, 25.6)ng/ml, and PI-RADS score was 4 (3, 5) points. Univariate and multivariate logistic regression were used to analyze prostate cancer risk factors in the development cohort. Then the nomogram prediction model was established by the risk factors. The prediction model's performance was evaluated using receiver operating characteristic (ROC) curves, calibration maps, and decision curve (DCA) analysis in the development cohort. The performance of the model was verified in the validation cohort.Results:The pathological results showed 180 patients with prostate cancer and 187 patients without prostate cancer in the development cohort. The validation cohort included 53 patients with and 55 without prostate cancer. Based on the results of the univariate and multivariate logistic regression analysis, this model incorporates factors including age ( OR=1.059, P=0.003), platelet-to-monocyte ratio (PMR) ( OR=0.002, P=0.011), f/tPSA ( OR=0.009, P=0.020), and PI-RADS score ( OR= 3.076, P<0.001). The calibration curve revealed a great agreement. Internal validation of the nomogram showed that the area under the ROC curve was 0.845 (95% CI 0.794-0.895). The Hosmer-Lemeshow test was also performed( χ2=1.476, P=0.224). The validation group with an area under the ROC curve was 0.869 (95% CI 0.797-0.941). The results of the decision curve analysis indicated that the decision curve was located above the positive and negative lines in the threshold range of 10% to 90%, within which the model has clinical application. Conclusions:The nomogram, which combines patient age, PMR, f/t PSA, and PI-RADS scores, has high predictive efficacy for prostate cancer and has clinical application value.
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Objective:To summarize and analyze the current application status of oral mucosal graft (OMG) technique in the repair of ureteral strictures in China, and clarify the feasibility, safety and effectiveness of this technique.Methods:The 175 patients who underwent repair of ureteral stricture using oral mucosal patches from June 2015 to February 2022 were etrospectively analyzed in 14 medical centers in China, including 49 cases in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 32 cases in Affiliated Seventh Medical Center of PLA General Hospital, 3 cases in The Second Hospital of Anhui Medical University, 6 cases in The First Affiliated Hospital of Zhengzhou University, 56 cases in Peking University First Hospital, 3 cases in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 cases in Shanghai Sixth People' s Hospital, 4 cases in General Hospital of Estern Theater Command, 4 cases in Lanzhou University Second Hospital, 2 cases in Guizhou Province People 's Hospital, 2 cases in Peking University People' s Hospital, 5 cases in Jinzhou First People's Hospital, 5 cases in The First Affiliated Hospital of Wannan Medical College, 1 case in Shandong Provincial Hospital. In this study, 127 patients (72.6%) used lingual mucosal patches, 32(18.3%) labial mucosa, and 16(9.1%) buccal mucosa. The surgical approach for OMG ureteral reconstruction was mainly minimally invasive, with robot-assisted laparoscopy in 84 patients (48.0%), traditional laparoscopic surgery in 87 patients (49.7%), and open surgery in only 4 patients (2.3%). There were 133 males and 42 females with an average age of (35.0±17.2) years. The mean body mass index (BMI) and stenosis length were (23.1±4.1) kg/m 2 and (4.7±1.8) cm, respectively. The stricture was located in the left ureter in 116 patients, right ureter in 58 case and bilateral ureter in 1 case. The most common causes of ureteral stricture were endoscopic surgery in 88(50.3%)patients, congenital stricture in 55(31.4%)patients, failed ureteroplasty in 29(16.6%)patients, history of extracorporeal shock wave lithotripsy in 13(7.4%)patients, radiotherapy history in 3(1.7%)patients and other causes in 6(3.4%)patients. Strictures were mainly located in the upper ureter, accounting for 61.7% (108/175 cases), followed by 36.0% (63/175) at the ureteropelvic junction and 2.3%(4/175)in the middle ureter. According to the surgical methods, the patients were divided into robot-assisted laparoscopic surgery group ( n=84), traditional laparoscopic surgery group ( n=87)and open surgery group ( n=4). Subgroup analysis of patients in robot-assisted laparoscopic and traditional laparoscopic surgery groups was performed. There were no significant difference in preoperative data between the two groups except for age (32.0±18.3) years vs.(37.0±15.9)years, P=0.040], BMI[(22.5±4.3)kg/m 2 vs. (23.7±3.6)kg/m 2, P=0.028], and etiology of stenosis [endoscopic injury, 34(40.5%) vs. 53(60.9%), P=0.012]. Preoperative hydronephrosis and stricture length were assessed by CTU and ureterography. Ureterography 7-9 weeks after surgery showed patency of the reconstructed segment, or no recurrence of hydronephrosis was judged as success. Evaluate the operation method, operation time, success rate, length of OMG in repairing ureteral stricture between laparoscopic and robot-assisted groups. Results:The overall success rate of oral mucosal graft repair surgery reached 97.7%(171/175). The success rate of ureteral reconstruction in the two groups were 96.4%(81/84)and 98.9%(86/87), respectively ( P=0.351), and the difference was not statistically significant. There was no significant difference for operation time, intraoperative blood loss, and mean oral mucosal length between the robotic and laparoscopic groups[(244.7±85.8) min and (222.7±83.5)min ( P=0.116), (58.9±38.6) ml and (68.4±45.5) ml ( P=0.217), (5.0±2.0) cm and (4.6±1.5) cm ( P=0.350)], respectively.Postoperative complications were reported in 23 (13.1%) patients, such as fever, urinary leakage, lymphatic leakage, infection, but only 2 (1.4%) cases patients had complications of Clavien-Dindo score ≥ Ⅲ. The two patients developed urinary stricture after surgery with failed conservative treatment, and no urinary stricture occurred following endoscopic treatment.The short-term (three months after surgery)incidence of complications in the site where the oral mucosa was taken, such as difficulty in opening mouth, pain, and swelling, was 12.0% (21/175), and there was no significant difference for oral complications between patients harvesting different length of mucosal graft. Conclusions:Ureteroplasty with oral mucosal graft is a safe, feasible and reliable technique for ureteral reconstruction. At present, minimally invasive technology is the main surgical approach for ureteroplasty, and there is no significant difference in operation time and success rate between robotic surgery and laparoscopic surgery.
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Bladder clear cell carcinoma is a rare variant of epithelial carcinoma of the lower urinary tract. This manuscript reported a case of 71-year-old female patient with the main complaint of gross hematuria. Transurethral resection of baldder tumor(TURBT) was performed after Gynecological consultation, and postoperative pathology results revealed clear cell carcinoma in bladder. Four months after surgery, the pelvic CT showed tumor recurrence in bladder. Another TURBT was performed followed with gemcitabine infusion chemotherapy. At 5 months after the second surgery, the tumor recurred again, and also resected by TURBT. No relapse or metastasis occurred during the 5-month follow-up after the third operation.
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Objective:To construct of comprehensive quality of evaluation index system about palliative care in general hospitals, so as to provide reference for promoting the scientific and standardized development of palliative care.Methods:Based on the structure-process-outcome quality model, literature research and Delphi method were used to determine the quality of palliative care evalution index system and index weight for general hospitals.Results:A total of 12 experts were consulted for two rounds,the rates of questionnaire retrieve were 12/15 and 12/12 respectively. The authoritative coefficients were 0.909 and 0.879, the Kendall′s W values were 0.27, 0.32 and 0.26 respectively with good coordination degree ( χ2=6.50, 106.62, 494.64, all P<0.05). Finally, the quality of palliative care indicator system in general hospitals was constructed, which included 3 first-level indicators, 30 second-level indicators and 157 third-level indicators. Conclusions:The establishment process of the construction of quality of palliative care indicator system in general hospitals was scientific and reasonable, focusing on the development characteristics of palliative care and can make significant contributions to improve the quality of palliative care.
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Objective:To investigate the clinical features of IgD multiple myeloma (MM) and the effect and prognosis of daratumumab-based combination therapy.Methods:The clinicopathological data of a IgD MM patient with disease progression and extramedullary infiltration treated with daratumumab in the Affiliated Hospital of Qingdao University in December 2019 were retrospectively analyzed.Results:The 74-year-old woman was diagnosed as IgD MM by bone marrow aspiration and immunofixation electrophoresis. The patient was given VD (bortezomib, dexamethasone), RD (lenalidomide, dexamethasone) and ID (ixazomib, dexamethasone) regimens. In June 2020, the patient developed multiple subcutaneous nodules, and she was assessed as progressive disease with extensive extramedullary infiltration. After treated with daratumumab-PAD (liposomal doxorubicin, bortezomib, dexamethasone) regimen, the patient's subcutaneous nodules were significantly reduced and partially disappeared, and the general condition was significantly improved. But the patient was in a cachexia state and finally died of the irregular treatment and disease progression.Conclusions:IgD MM has a low incidence and a short survival period, and there is no uniform standard treatment. The early application of daratumumab combined with proteasome inhibitors, immunomodulators, cytotoxic drugs and hematopoietic stem cell transplantation may improve the overall survival of patients.
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ObjectiveTo observe the effects of Fuzitang （FZT） on the proliferation of MH7A cells， the human rheumatoid arthritis synovial fibroblasts， and the expression of miR-155 and explore its anti-rheumatoid arthritis mechanism. MethodMH7A cells were cultured in vitro and divided into a blank group， high- （25 g·L-1） and low-dose （12.5 g·L-1） FZT groups， and a positive drug group （hydroxychloroquine， 0.006 25 g·L-1）. The cell proliferation was detected by cell counting kit-8（CCK-8） method， and the change in the MH7A cell cycle was detected by flow cytometry. The mRNA expression of miR-155 and its downstream genes， including SH2 domain-containing inositol 5-phosphatase-1（SHIP-1）， protein kinase B 3（Akt3）， and mammalian target of rapamycin（mTOR）， was detected by Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）， and the protein expression of phosphatidylinositol 3-kinase （PI3K）， Akt3， and mTOR was detected by Western blot. ResultFZT in vitro in a concentration of 6.25 g·L-1 above could inhibit the proliferation of MH7A cells in the significant dose- and time-effect manner. Compared with the blank group， the FZT groups showed increased proportions of cells in the G2/M phase （P<0.05）， and the high-dose FZT group showed a decreased proportion of cells in the G0/G1 phase （P<0.05）. The arresting effect of FZT on the cell cycle was in a significant dose-effect manner. Compared with the blank group， the FZT groups showed down-regulated miR-155 and mTOR mRNA expression （P<0.05）， and the high-dose FZT group showed up-regulated SHIP1 mRNA expression and down-regulated Akt3 mRNA expression （P<0.05）. Compared with the blank group， the FZT groups showed reduced protein expression of PI3K， Akt3， and mTOR （P<0.05）. ConclusionFZT can significantly inhibit the proliferation of MH7A cells， and the mechanism is related to the promotion of the expression of SHIP-1 and down-regulation of the gene expression of the PI3K/Akt3/mTOR signaling pathway by down-regulating the expression of miR-155.
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Enhanced recovery after surgery(ERAS)is not only an evidence-based set of perioperative interventions, but also a highly innovative multidisciplinary collaboration model and organizational system. The authors reviewed the research status of the organizational structure and service process of ERAS at home and abroad, elaborated the establishment mode and management operation system of ERAS-multidisciplinary team(ERAS-MDT), discussed the communication mechanism between the teams to strengthen the communication and cooperation of ERAS-MDT, and emphasized the reasonable allocation of human resources of ERAS-MDT to reduce the workload of members. At the same time, the authors reviewed the standardized clinical pathway to facilitate the connection of all aspects during the perioperative period, and through the quality control and quality improvement measures of ERAS mode, the authors hope to further standardize the ERAS service process and escort the efficient operation of ERAS.
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Nowadays, more attentions have been paid on brown adipose tissue (BAT) because BAT plays a great role in individuals with obesity and metabolic diseases. 18F-fluorodeoxyglucose (FDG) PET/CT is noninvasive and sensitive to detect the location, volume, and metabolic activity of BAT. 18F-FDG PET/CT for BAT provides new insight for the prevention and clinical management of obesity and diabetes. The review summarizes the methods to activate BAT, the preparation of patients, 18F-FDG PET/CT imaging techniques and clinical application.
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OBJECTIVE：To screen the components with better anti-inflammatory effect from Codonopsis Radix polysaccharide and explore the anti-inflammatory mechanism. METHODS ：Using Codonopsis Radix as sample ，the crude polysaccharide （CP） was obtained by water extraction and alcohol precipitation. After CP was separated and purified by Fast Flow DEAE Sepharose ， SephadexG-150 gel column and so on ，the components CP 1-2-1 and CP 3-1-1 were obtained and then characterized. The survival rate of RAW 264.7 cell was determined by MTT method after cultured with CP ，CP1-2-1 and CP 3-1-1（0.01，0.1，1，10，100 μg/mL）for 24 and 48 h respectively. The cells were divided into blank group （blank culture medium ），model group （1 μg/mL LPS）and low-，medium- and high-concentration groups of 3 kinds of Codonopsis Radix polysaccharide （1 μg/mL LPS+25，50， 100 μg/mL CP，CP1-2-1，CP3-1-1 solution）. After cultured for 24 h，NO content in cell culture solution ，mRNA expressions of TLR4，IL-6，NF-κB and TNF-α in cells were determined. RESULTS：The sugar content of CP reached （92.20±0.73）％. CP 1-2-1 was a single neutral polysaccharide composed of fructose with a relative molecular weight of 25.8 kDa. CP 3-1-1 was an acidic heteropolysaccharide composed of arabinose ，rhamnose，galactose and galacturonic acid and so on ，with a relative molecular weight of 49.5 kDa. Cell survival rates were higher than 99％，after cultured with 3 kinds of polysaccharide for 24 and 48 h. Compared with blank group ，NO content in cell culture solution and mRNA expressions of TLR 4，IL-6，NF-κB and TNF-α in cells were increased significantly in model group （P＜0.05 or P＜ . Compared with model group ， NO content in cell 2016CFB412） culture solution of each administration group was significantly reduced，mRNA expressions of TLR 4，NF-κB，TNF-α，IL-6 in cells in 50，100 μg/mL CP group were significantly decreased ong1991@163.com （P＜0.05 or P＜0.01）；mRNA expressi ons of TLR 4，NF-κB in cells in 25 µg/mL CP 1-2-1 group and mRNA expressions of TLR 4，NF-κB，TNF-α，IL-6 in cells in 50，100 µg/mL CP 1-2-1 group were significantly decreased （P＜0.05 or P＜0.01）；mRNA expressionsof IL- 6 in cells in 25 µg/mL CP 3-1-1 group，mRNA expressions of NF-κB，TNF-α，IL-6 in cells in 50 µg/mL CP 3-1-1 group and mRNA expressions of TLR 4，NF-κB，TNF-α，IL-6 in cells in 100 µg/mL CP 3-1-1 group were significantly decreased （P＜0.05 or P＜0.01）. CONCLUSIONS ：CP，CP 1-2-1 and CP 3-1-1 all have certain anti-inflammatory activities. The mechanism may be related to inhibiting the generation and releasing of inflammatory cytokines such as TNF-α，IL-6 by inhibiting the activation of TLR 4/NF-κB pathway.
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Objective@#To evaluate the quality of life after Altemeier and Delorme procedures for rectal prolapse patients.@*Methods@#A retrospective cohort study was performed. Clinical data of patients with full-thickness rectal prolapse undergoing surgical treatment in the Sixth Affiliated Hospital, Sun Yat-sen University from February 2013 to January 2018 were retrospectively analyzed. Patients who had no preoperative imaging data, who suffered from internal rectal intussusception, or who did not undergo Altemeier and Delorme operations were excluded. Sixty-seven patients were enrolled, including 32 males with median age of 20.5 (13, 34) years and 35 females with median age of 65.0 (50, 77) years. According to different procedures, patients were divided into the Altemeier group (48 cases) and the Delorme group (19 cases), who received standard Altemeier and Delorme operations respectively. The maximal prolapse length of preoperative squat position, the Longo constipation score, Wexner incontinence score, EQ-5D-5L score, postoperative complications and recurrence rate were analyzed and compared between two groups.@*Results@#The maximal prolapse length of preoperative squat position in Altemeier group and Delorme group was (7.3±3.3) cm and (4.9±2.1) cm respectively with significant difference (t=2.907, P=0.005). The operations in both groups were successfully completed. The operation time and postoperative hospital stay of Altemeier group were longer than those of Delorme group [(112.3±47.0) minutes vs. (80.7±35.4) minutes, t=2.637, P=0.010; (11.3±5.0) days vs. (8.6±3.0) days, t=2.177, P=0.033]. The median follow-up period was 26 (13, 45) months. In the last follow-up, compared to pre-operation, the Longo constipation score [9.0 (6.0, 14.0) vs 4.0 (1.0, 6.5), Z=-4.989, P<0.001], Wexner incontinence score [0 (0, 5.5) vs. 0 (0, 2.0), Z=-3.325, P<0.001] and EQ-5D-5L score [45.0 (40.0, 57.5) vs. 80.0 (70.0, 87.5), Z=-5.587, P<0.001] were all improved obviously in the Altemeier group, meanwhile Longo constipation score [6.0 (5.0, 14.0) vs. 3.0 (1.0, 7.0), Z=-2.186, P=0.029], Wexner incontinence score [0 (0, 12.0) vs. 0 (0, 4.0), Z=-2.325, P=0.020] and EQ-5D-5L score [50.0 (35.0, 60.0) vs. 75.0 (65.0, 90.0), Z=-3.360, P=0.001] in the Delorme group were all improved obviously as well. The postoperative morbidity of complication between the two groups was not significantly different [10/48 (20.8%) vs. 4/19 (21.1%), χ2=0.049, P=0.826]. Sixteen patients (28.0%) relapsed after operation, including 10 patients in the Altemeier group and 6 patients in the Delorme group, without statistically significant difference (P=0.134).@*Conclusions@#Both the Altemeier and Delorme procedures are effective treatments for rectal prolapse, which can improve the postoperative quality of life. Delorme procedure has the advantages of shorter operation time and faster postoperative recovery in patients with mild prolapse.
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Objective To determine the relationship between end-tidal carbon dioxide tension (PET CO 2 )obtained from the distal ends of the tracheal tube and arterial pressure of carbon dioxide (PaCO 2 ) compared with the sidestream capnometer in infants with congenital heart disease. Methods Twenty infants undergoing congenital heart disease surgery,12 males and 8 females,aged 3-48 months,ASA physical statusⅠ-Ⅲ were enrolled.Measurements of PET CO 2 were obtained from the distal ends of the tracheal tube using a sterile 22 G catheter that was inserted into the tube and from the proximal end with a sidestream capnometer in 20 intubated infants with congenital heart dis-ease.The data including PET CO 2 and the arterial PaCO 2 were obtained both after the anesthesia induc-tion and the CPB.Results The data of PET CO 2 obtained from the distal ends of the tracheal tube after the anesthesia induction [(36.8 ±2.7)mm Hg vs.(32.5 ± 1.4)mm Hg,P <0.05 ]and the CPB [(40.8±2.5)mm Hg vs.(36.5±1.6)mm Hg,P <0.05]were both higher than those from the proximal end with a sidestream capnometer.The difference between PaCO 2 and PET CO 2 obtained from the distal ends of the tracheal tube after the induction [(7.1 ±0.7)mm Hg vs.(1 1.4 ± 1.5 ) mm Hg,P <0.01]and the CPB [(9.3±1.2)mm Hg vs.(13.5±2.3)mm Hg,P <0.01]were sig-nificantly lower than that between PaCO 2 and PET CO 2 obtained from the proximal end.Distal side-stream PET CO 2 correlated with the PaCO 2 (R 2 =0.94 after induction and R 2 =0.93 after the CPB,P<0.05).However,the proximal PET CO 2 with the sidestream capnometer correlated very poorly with PaCO 2 whether after the induction (R 2 = 0.68,P < 0.05 )nor the CPB (R 2 = 0.66,P < 0.05 ). Conclusion We conclude that the PET CO 2 obtained from the distal ends of the tracheal tube provides accurate estimates of the PaCO 2 in critically ill infants with congenital heart disease.
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Objection]To study the clinical effect of self-prescribed jianpihuazhuoxiaoyu decoction in treating the patients with non-alcoholic liver of fat. [Methods]45 patients were treated with self-prescribed Jianpihuazhuoxiaoyu decoction in treatment group and other 45 patients with Polyene Phosphatidylcholine Capsules and Ursodeoxycholic Acid. Observe the patients'body mass index(BMI),radiological changes,liver function(AST/ALT) and lipids(TG/TC/HDL/LDL). [Results] The total effective rates were 91.3%,82.6% respectively, compared with the control group,the treatment group significantly improved liver function,lipid content decreased,obesity weight was effectively controlled and reduced,sonogram also showed improvement in the texture of the liver,compared with control group there were significant differences(P<0.05),difference was statistically significant.
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Purpose] This paper aims to summarize the clinical practice of using Buzhong Yiqi Decoction to treat the obstructed nine orifices. [Approach] After explaining Li Dongyuan’s theory that those obstructed nine orifices reflecting headaches and tinnitus are caused by intestines and stomach diseases,which is in his Suwen On Deficiency and Excess and analyzing several simple cases of using buzhong yiqi decoction to treat the obstructed nine orifices,this paper tries to trace the theoretical origin of Prof. Lian’s practice and present the practical experience of flexible usage of Buzhong Yiqi Decoction. [Result] The outcome of several patients under treatment shows that the short-and-mid-term treatment is very effective. [Conclusion] Prof. Lian’s philosophy of traditional Chinese medicine reflects his attitude that “those patients suffering from insufficiency of primordial Qi and clear Yang failing to distribute”or“clear Yang coming out of stomach”ask for strengthening the spleen and stomach so their stomach recovers to the healthy state. As a result,their Yang Qi has been greatly improved,the spleen and stomach in the middle energizer have returned to their original place,reaching the autonomous regulation of the nine orifices,which has shed some light on the usefulness of Buzhong Yiqi on treatment diseases other than those of spleen and stomach.
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Objective To compare test results of antinuclear antibodies (ANA ) using different brands kit and methodology . Methods 180 cases who accepted serum ANA detection in hospital from April to December 2012 were choosen ,in which 145 cases of positive serum and 35 cases of healthy control .The 180 cases were tested for ANAs by YHLO ANA-17S ,EUROIMMUN ANA profile 3 and ANA IIFA kits at the same time ,and all parameters about ANA decetion were compared such as sensitivity ,specifici-ty ,positive predictive value ,negative predictive value and the coincidence rate between the two kinds of kits .Results The sensitivi-ty of YHLO ANA-17S ,EUROIMMUN ANA profile 3 and EUROIMMUN ANA IIFA was 94 .8% ,90 .4% ,95 .6% ;specificity was 88 .9% ,91 .1% ,93 .3% ;positive predictive value was 96 .2% ,96 .8% ,97 .7% ;negative predictive value was 85 .1% ,75 .9% , 87 .5% ;the coincidence rate between the EUROIMMUN ANA profile 3 and EUROIMMUN ANA IIFA was 84 .0% (P>0 .05) ,be-tween the YHLO ANA-17S and EUROIMMUN ANA IIFA was 80 .0% (P>0 .05) ,between theYHLO ANA-17S and EUROIM-MUN ANA profile 3 was 93 .0% (P> 0 .05) .Conclusion Three kits for detecting ANAs have good sensitivity and specificity , which can be used for autoimmune disease detection .Laboratory tests result should be combined with clinical symptoms according to the diagnostic criteria to make the final diagnosis .
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Objective:The tumorigenesis, progression, and metastasis of lung cancer are mostly governed by the immunosuppres-sive profile. This study aimed to explore the levels of various immunosuppressive inhibitory molecules in lung-cancer patients subject-ed to different chemotherapy cycles. Methods:Thirty-three patients with advanced lung cancer (ALC;stages III-IV) without receiving prior chemotherapy and 23 healthy subjects were enrolled in our study. Peripheral blood samples were collected from the patients be-fore each chemotherapy cycle. The inhibitory markers expressed in T cells such as TIM3, PD-1, and CTLA4 were analyzed by flow cy-tometry. Results:The percentages of CD4+TIM3+, CD8+TIM3+, CD4+PD-1+, CD8+PD-1+, CD4+CTLA-4+, and CD8+CTLA-4+T cells in the peripheral blood of the ALC patients were significantly higher compared to the controls. The percentage of CD4+TIM3+, CD8+TIM3+, CD4+PD-1+, and CD8+PD-1+T lymphocytes in the peripheral blood of patients (n=19) who achieved PR or SD significantly de-creased after five cycles of chemotherapy (P<0.05). Similarly, the percentages of CD4+CTLA-4+and CD8+CTLA-4+T cells in the pa-tients also decreased after five cycles of treatment. Conclusion:The immune status of ALC patients was evidently suppressed. Effec-tive chemotherapy successfully potentiated effective immune responses by downregulating inhibitory molecules in T cells.
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[Objective]To sum up pro. Lian Jianwei’s clinical experience in treating acne. [Method] By proved recipe analysis, it shows pro. Lian Jianwei ’s treatment based on differentiation of signs from different angles and the clinical thought of flexibly applying ancient formulae on acne. [Result] Pro. Lian Jianwei is good at revising ancient formulae for treating acne with good effect, according to patients ’pulse signs and mechanism;if the food is stagnated in the gastric-intestine, which wil transform into heat and up along the channel, Baohe Pil shal be used to remove stagnation and heat; if the liver is de-pressed with heat, deficient blood and weak spleen, Xiaoyan Powder shal be used for regulation and stretching the wood; use Wenqing Drink to nourish blood and remove toxin for deficient blood and hot liver, toxic heat implicated in spleen and stomach; apply Zisheng Pil to regulate and tonify middle part of the body for deficient spleen and stomach with turbidness and dyspepsia, etc. [Conclusion] Pro. Lian Jianwei has rich clinical experience, his clinical thought of “treatment based on differentiation of signs, with flexible methods and formulae, coping with shifting diseases by sticking to a fundamental principle”, worthy our deep experiencing and study.
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Objective To study the clinical features of invasive pulmonary aspergillosis (IPA) with chronic obstructive pulmonary diseases (COPD),so as to provide evidence for early diagnosis and treatment.Methods A retrospective analysis was made upon clinical data,diagnosis,treatment and prognosis of 53 patients with IPA and COPD admitted between January 2005 and February 2011 collected in a respiratory unit of the Second Xiangya Hospital Affiliated Central South University.Results There were 53 cases of diagnosed as IPA with COPD,with history of using broad-spectrum antibiotics.And there were 43 cases using steroids more than 2 weeks,51 with obvious breathlessness,and 20 with fever.Early stage didn't present characteristical changes on CT scan.However,after disease progression,32 cases had maculas shadows and nonspecific consolidations in bilateral lung,14 with solitary or multiple nodules,4 with solitary or multiple air crescent sign,and 2 with halo sign.Four patients of COPD with IPA underwent bronchoscopy examination.In fungi pathogeny,sputum positive rate and galactomannan positive rate were 56.6％ and 52.8％,respectively.A total of 53 cases received antifungal treatment.Among 37 cases which underwent mechanical ventilation,24 received noninvasive ventilation and 13 received invasive ventilation.There were 33 cases which were improved and cured,and 20 cases which had no relief after half-a-month treatment or withdrew treatment.Among them,13 cases died because of multiple-organ failure (5/15) or acute renal failure (8/15).Conclusions Early suspected diagnosis,timely examination in allusion to IPA,actively searching for etiological and imaging evidences,early established diagnosis and antifungal treatment would improve prognosis of patients with COPD combined IPA who have history of high doses of cortieosteroids,obvious breathlessness and non-response to antibiotics.
ABSTRACT
IL-8 was radiolabeled with 125I via Bolten-Hunter agent and the distribution of 125I-IL-8 in mice was determined in order to understand IL-8 behaviors in vivo. The percentage of 125I-IL-8 in blood, heart, liver, lung, kidneys, bone and spleen was obtained. The half-clearance of fast phase T1/2 alpha and slow phase T1/2 beta were 0.32 h and 8.01 h respectively. Most of 125I-IL-8 was excluded by kidneys.