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Objective: To examine the short-term curative effect with minimally invasive right infra-axillary thoracotomy for transaortic modified Morrow procedure. Methods: The clinical data of 60 patients who underwent video-assisted thoracoscopic transaortic modified Morrow procedure from August 2021 to August 2022 at Department of Cardiovascular Surgery, Zhejiang Provincial People's Hospital were retrospectively analyzed. There were 31 males and 29 females, with the age (M (IQR)) of 54.0(22.3) years (range: 15 to 71 years). The echocardiography confirmed the diagnosis of moderate mitral regurgitation in 30 patients, and severe mitral regurgitation in 13 patients. Systolic anterior motion (SAM) was present preoperatively in 54 patients. All 60 patients underwent transaortic modified Morrow procedure through a right infra-axillary thoracotomy using femorofemoral cardiopulmonary bypass. Surgical procedures mainly included transverse aortic incision, exposure of left ventricular outflow tract (LVOT), septal myectomy, and correction of the abnormal mitral valve and subvalvular structures. Results: All 60 patients underwent the programmatic procedures successfully without conversion to full sternotomy. The cardiopulmonary bypass time was (142.0±32.1) minutes (range: 89 to 240 minutes), while the cross-clamp time was (95.0±23.5) minutes (range: 50 to 162 minutes). The patients had a postoperative peak LVOT gradient of 7.0 (5.0) mmHg (range: 0 to 38 mmHg) (1 mmHg=0.133 kPa). A total of 57 patients were extubated on the operating table. The drainage volume in the first 24 h was (175.9±57.0) ml (range: 60 to 327 ml). The length of intensive care unit stay was 21.0 (5.8)h (range: 8 to 120 h) and postoperative hospital stay was 8 (5) days (range: 5 to 19 days). The postoperative septal thickness was 11 (2) mm (range: 8 to 14 mm). All patients had no iatrogenic ventricular septal perforation or postoperative residual SAM. The patients were followed up for 4 (9) months (range: 1 to 15 months), and none of them needed cardiac surgery again due to valve dysfunction or increased peak LVOT gradient during follow-up. Conclusion: Using a video-assisted thoracoscopic transaortic modified Morrow procedure through a right infra-axillary minithoracotomy can provide good visualization of the LVOT and hypertrophic ventricular septum, ensure optimal exposure of the mitral valve in the presence of complex mitral subvalvular structures, so that allows satisfactory short-term surgical results.
Subject(s)
Male , Female , Humans , Mitral Valve Insufficiency/surgery , Thoracotomy , Retrospective Studies , Cardiomyopathy, Hypertrophic/surgery , Ventricular Septum/surgery , Treatment Outcome , Minimally Invasive Surgical Procedures/methodsABSTRACT
The "student-centered" flipped classroom teaching model can improve students' academic achievement, improve cognition, and cultivate innovation ability. However, it has obvious deficiencies in the integrity and systematization of knowledge as well as education. The traditional teaching concept based on " teacher-centered" has the unique advantages of systematization of knowledge learning and education. Therefore, we integrated the merits of these two different teaching models and introduced the semi-flipped classroom teaching model into the Biochemistry teaching of 2020 stomatology, pharmacy and preventive medicine majors in Cheeloo Medical College, Shandong University, compared with the traditional teaching of 2019 same majors. The data on the improvement of students ' academic achievement and self-cognition were analyzed. The results showed that the students' achievements of the semi-flipped classroom teaching model were better than those of the traditional teaching (P<0. 01). The students' self-cognitions were significantly improved after the implementation of semi-flipped classroom teaching (P<0. 01 or P<0. 05). This study provides a reference for the related teaching and research work in medical colleges.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of a weekly schedule of low dose-intensity docetaxel monochemotherapy for patients with anthracycline-resistant metastatic breast cancer (MBC) in poor physical status.</p><p><b>METHODS</b>Thirty MBC patients who were previously exposed to anthracycline treatment received docetaxel alone at a dose of 30 mg/m2 on D1, D8 and D15, repeated every 4 weeks for a maximum of 6 cycles.</p><p><b>RESULTS</b>Of the 30 evaluable patients, 2 (6.7%) achieved a complete response, and 9 (30.0%) a partial response, with an overall objective response rate of 36.7% (95% CI: 20.5%-53.9%). The most common adverse event was hematologic toxicity. After an average follow-up of 15.0 months, the median time to progression (TTP) was 8. 5 months and the median overall survival (OS) had not reached yet at the end of follow-up.</p><p><b>CONCLUSION</b>The weekly low dose-intensity docetaxel monochemotherapy is effective and well-tolerated in patients with anthracycline-resistant metastatic breast cancer in poor physical status.</p>
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Anthracyclines , Therapeutic Uses , Antineoplastic Agents , Therapeutic Uses , Breast Neoplasms , Drug Therapy , Pathology , Carcinoma, Ductal, Breast , Drug Therapy , Pathology , Carcinoma, Lobular , Drug Therapy , Pathology , Drug Resistance, Neoplasm , Follow-Up Studies , Leukopenia , Lymphatic Metastasis , Nausea , Neoplasm Metastasis , Neoplasm Staging , Remission Induction , Survival Rate , Taxoids , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To investigate the cell cycle changes of hepatoma cells and the effect of antisense oligonucleotide targeting bFGF on apoptosis in the hepatoma cells.</p><p><b>METHODS</b>The oligodeoxynucleotides were transfected with Lipofectin into hepatoma HepG2 cells. Inhibition of bFGF protein expression was assessed by confocal laser scanning microscopy and Western blot under the best condition of transfection of antisense oligonucleotide targeting bFGF, and the apoptosis in those cells was determined by flow cytometry. HepG2 cells were cultured in 24-well culture dish. The cultured cells were divided into 3 groups: group 1, the normal control group without any treatment; group 2, transfected with antisense oligonucleotide targeting bFGF; group 3, transfected with scrambled sequence targeting bFGF.</p><p><b>RESULTS</b>The results from confocal microscopy and Western blot showed an inhibition of expression of bFGF at different levels under the best condition of transfection with antisense oligonucleotide targeting bFGF. The treatment with antisense oligonucleotide of bFGF not only reduced the expression of bFGF revealed by confocal microscopy and Western blotting, but also increased the apoptosis in HepG 2 cells (P < 0. 01).</p><p><b>CONCLUSION</b>Treatment with antisense oligonucleotide of bFGF inhibits expression of bFGF protein and increase apoptosis. bFGF may take part in apoptosis regulation of hepatoma cells and may be used as a target in the treatment of hepatocellular carcinoma.</p>
Subject(s)
Humans , Apoptosis , Carcinoma, Hepatocellular , Metabolism , Pathology , Cell Cycle , Cell Line, Tumor , Fibroblast Growth Factor 2 , Genetics , Metabolism , Liver Neoplasms , Metabolism , Pathology , Oligonucleotides, Antisense , Pharmacology , TransfectionABSTRACT
Objective: To evaluate the clinical efficacy and tolerability of a 3-week regimen of low dosage of paclitaxel (PTX) combined with gemcitabine (GEM) for metastatic breast cancer (MBC) patients who had been pretreated with antracyclines. Methods: Thirty two MBC patients who received antracyclines chemotherapy were recruited in this study. They were infused with PTX (120 mg/m2) for 3 h on d 1, followed by 30-min intravenous infusion with GEM 900 mg/m2) on d 1 and d 8. The combined chemotherapy was repeated every 21 d as one cycle. Maximum 6 cycles were given. Toxicity was evaluated on all the patients. The clinical efficacy was evaluated on those who had received at least 2 cycles of combined chemotherapy. Results: All of the 32 patients completed 156 cycles of chemotherapy with a median number of five cycles per patient. Four patients (12.5% %) achieved a complete response, 15 patients (46.9%) had a partial response, with an overall objective response rate of 59.4% (95% CI: 42.4%-76.4%). Stable disease was documented in 8 patients (25%) while progressive disease occurred in 5 patients (15.6%). There were no differences in response rates between the ER(+) and ER(-) patients, between the patients aged ≥50 years and <50 years, and between the patients with invasive ductal cancer and invasive lobular cancer (P = 0.783, P = 0.328, P = 0.794,respectively). The average follow-up period was 20.2 months, the median time to progression was 10.0 months, and median overall survival time was 20.0 months. Nine patients were alive with no progression at the end of follow-up. Conclusion: The 3-week combined chemotherapy of low dosage of PTX with GEM is effective for breast cancer patients who had been treated with antracyclines. The hematologic and non-hematologic toxicities are well-tolerated.
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<p><b>OBJECTIVE</b>To explore the effect of antisense oligonucleotide targeting endostatin (endostatin-ASON) transfecting bone marrow stromal cells ( BMSC) on hematopoiesis reconstitution in BMT mice.</p><p><b>METHODS</b>Inhibition of endostatin / VCAM-1 protein and mRNA expression was investigated by transfection of antisense oligonucleotide targeting endostatin with confocal microscopy, Western blot and RT-PCR. Bone marrow stromal cells were cultured and divided into 4 groups: group (1) without any treatment; group (2) BMT only; group (3) BMT + endostatin-ASON transfection; group (4) BMT + endostatin scrambled sequence transfection.</p><p><b>RESULTS</b>(1) Endostatin-ASON was successfully introduced into BMSC in vitro, and the transfecting rate was 86% ;(2) After Endostatin-ASON transfected into BMSC, the expression of Endostatin mRNA and its protein on the BMSC was signficantly inhibited at different time point after BMT [the grey value of Endostatin was (0.09 +/- 0.03) - (1.44 +/- 1.19) and (0.02 + 0.02) - (0.14 +/- 0.05), respectively] (P < 0.01 and P < 0.05); (3) Transfecting with Endostatin-ASON effectively promoted the expression of VCAM-1 mRNA and its protein on the BMSC [the gray value of VCAM-1 was (1.60 +/- 0. 92) - (8.05 +/- 0.87) and (0.07 +/- 0.02) - (0.67 +/- 0.09) , respectively] (P <0.01 and P <0.05) ; (4) There was no effects of transfecting Endostatin scrambled sequence on the expression of Endostatin and VCAM-1 on the BMSC (P > 0.05).</p><p><b>CONCLUSION</b>Endostatin-ASON could inhibit Endostatin expression and enhance VCAM-1 expression in BMSC after syngeneic-BMT in mice, which might be one of the mechanisms underlying the endostatin-ASON accelerating hematopoiesis reconstitution after allogeneic-BMT.</p>
Subject(s)
Animals , Female , Male , Mice , Bone Marrow Cells , Metabolism , Bone Marrow Transplantation , Dose-Response Relationship, Drug , Endostatins , Genetics , Hematopoiesis , Intercellular Adhesion Molecule-1 , Genetics , Mice, Inbred BALB C , Oligonucleotides, Antisense , Pharmacology , RNA, Messenger , Reverse Transcriptase Polymerase Chain Reaction , TransfectionABSTRACT
OBJECTIVE@#To set up the method for analyzing HLA-B gene polymorphism with PCR-RFLP, and to gain population data among northern Chinese Hans of HLA-B's restricted fragments after NlaIII digestion, and to achieve application in forensic medicine practice.@*METHODS@#Sample DNA was extracted by the phenol/chloroform extraction method, 943 bp-long fragments containing HLA-B exon 2 and 3 were got by PCR. The endonuclease NlaIII was applied to cut the PCR products into polymorphic fragments shorter than 943bp, then PAGE and silver staining were used to detect the digestion results, finally the digestion sites were assured by DNA sequencing.@*RESULTS@#Along 943bp-long PCR products, 14 length-different fragments, 20 kinds of fragment combinations were got and 6 cutting site were observed after NlaIII digestion.@*CONCLUSION@#HLA-B gene was highly polymorphic among Chinese northern Hans. Even with only one endonuclease, 14 restricted fragments were got and the PIC was great. Such a HLA-B PCR-RFLP analysis will have values in forensic medicine applications.
Subject(s)
Humans , Asian People/genetics , Base Sequence , China/ethnology , DNA/isolation & purification , Exons , Forensic Medicine/methods , Gene Frequency , HLA-B Antigens/genetics , Polymerase Chain Reaction/methods , Polymorphism, Restriction Fragment LengthABSTRACT
<p><b>AIM</b>To study the effects of 9-cis-retinoic acid (9-cis-RA) on cell cycle and expression of cyclin D1 and cdk4 in lung cancer cells.</p><p><b>METHODS</b>9-cis-RA (1 x 10(-6) mol.L-1) was used to treat lung cancer cells for 24 h; Flow cytometry (FCM) was used to detect the percent of G0/G1 phase and S phase cells of three groups including blank control, DMSO control and 9-cis-RA groups; RT-PCR was used to analyze the expression changes of cyclin D1 and cdk4 before and after treatment with 9-cis-RA in lung cancer cells.</p><p><b>RESULTS</b>The percent of G0/G1 phase cells of 9-cis-RA groups was significantly higher than that of the control groups (P < 0.01 or P < 0.05) and the percent of S phase cells of 9-cis-RA groups was lower than that of the control groups (P < 0.01 or P < 0.05); the expression of cyclin D1 of PG, SPC-A1 and L78 cells was decreased (P < 0.01) and the expression of cdk4 of PG, A549 and L78 cells was also decreased (P < 0.01) after treatment with 9-cis-RA.</p><p><b>CONCLUSION</b>Most of the proliferation and the expression of cyclin D1 and cdk4 of PG, A549, SPC-A1 and L78 were inhibited by 9-cis-RA.</p>