ABSTRACT
Immune checkpoint inhibitors （ICIs） have shown good efficacy in tumor treatment and have changed the landscape of tumor treatment. However， some patients treated with ICIs have not only failed to achieve the desired therapeutic effect， but also developed an atypical response pattern of abnormally accelerated tumor growth， namely hyperprogressive disease （HPD）. The pathogenesis of HPD is still unclear and it is difficult to diagnose， which poses a challenge for clinical identification and treatment decisions. Exploring the underlying mechanism of HPD is important to improve the effect of immunotherapy. Based on the theory of "Yang deficiency and toxic knot"， this paper discussed the mechanism of HPD in immunotherapy from the perspective of "spleen and kidney Yang deficiency and hefty toxic pathogens". It was concluded that the inactivation of p53 oncogene and immunosuppressive microenvironment were the manifestations of the deficiency of healthy qi in the body and declined yang in the spleen and kidney， serving as an important basis for the occurrence of HPD. Adverse reactions caused by ICIs belong to the category of "drug toxicity". The occurrence and development of murine double minute 2 （MDM2）/murine double minute 4 （MDM4） activation， epidermal growth factor receptor （EGFR） mutation， and tumor inflammatory microenvironment are the manifestations of the hyperactivity of pathogenic Qi， conflict of cancer toxicity and drug toxicity， and being hefty by virtue of deficiency， which can promote the abnormal proliferation of tumor cells， and they are the core pathogenic elements of HPD and are closely related to disease prognosis. In terms of treatment， under the guidance of the theory of "five views on differentiation and treatment" （time-space view， core view， symptom view， precision view， and disease-before-onset view）， which was summarized according to the clinical practice of this research team， this paper， taking the prevention and treatment of HPD as the entry point， formulated traditional Chinese medicine （TCM） compounds to reinforce healthy Qi and warm Yang and realize the dynamic management of the whole spatiotemporal cycle， and removed toxins and resisted cancer to realize the all-round systemic intervention of the specimen. Additionally， targets were enriched in the macro-clinical manifestations and microscopic pathological changes of HPD to improve the targeting of drug selection and the precision of prevention and treatment， giving full play to the unique therapeutic advantages of TCM， and providing new ideas for the clinical application of TCM in the prevention and treatment of HPD.
ABSTRACT
With reference to the comprehensive evaluation system for the clinical effectiveness of Chinese patent medicine， this paper summarized the current status and problems of the comprehensive evaluation of the clinical effectiveness of traditional Chinese medicine （TCM） in the treatment of malignant tumors from seven aspects， including safety， effectiveness， cost-effectiveness， innovation， suitability， accessibility， and TCM features. On this basis， the characteristics of TCM and the disciplinary characteristics of oncology are considered， and multiple sources of evidence， focus on dominant groups of people， consideration of economic toxicity， paying attention to post-marketing research， targeting at patients' willingness of medication， anchoring the supply of TCM services， and introducing symptoms threshold events are further emphasized. Moreover， methods such as nested case-control studies， enrichment designs， real-world research， and intelligent TCM diagnosis and treatment platforms are used to obtain high-level clinical evidence， ultimately building a scientific， homogeneous， and standardized comprehensive evaluation system for the clinical effectiveness of TCM in the treatment of malignant tumors.
ABSTRACT
Objective:To compare the genotypes and phenotypes between the monozygotic twins via whole genome sequencing to further clarify the autosomal dominant inherited neurofibromatosis type 1 (NF1) variants related to congenital pseudarthrosis (CP).Methods:According to the diagnostic criteria of congenital tibial pseudarthrosis and the clinical diagnostic criteria of NF1, two pairs of monozygotic twins with NF1 were included. Both were female and only one of each pair had congenital pseudarthrosis. The other did not have congenital pseudarthrosis. Whole genome sequencing was performed using the peripheral blood of the two pairs of monozygotic twins. Customized bioinformatics analysis was then performed to identify single nucleotide variants (SNVs), short insertion deletion variants (InDel), copy number variants (CNVs), and structural variants (SVs). Classified the variants according to the American College of Medical Genetics and Genomics (ACMG) and ClinGen criteria. The germline variants within the monozygotic twins were compared to identify the CP patients' unique variants. The shared pathogenic or likely pathogenic germline variants between the unique variants in the CP patients from the twins were also analyzed. Further, the identified disease-causing variants were validated by Sanger sequencing in the family of the twins and their parents. Finally, the genotypes and phenotypes regarding the pathogenic variants of the NF1 gene among the twins were characterized. Results:Both the two monozygotic twins were identified pathogenic variants in the NF1 gene. One with c.3047_3048del (p.Cys1016SerfsTer4), and the other with c.4267A>G (p.Lys1423Glu). By Sanger sequencing validation in family quads, the two CP patients and their siblings harbored de novo heterozygous variants of the NF1 gene. In addition to the NF1 gene, no other genes were identified pathogenic or likely pathogenic variants uniquely in the CP patients compared with their twin sisters, as well as SVs and CNVs. In addition, by analyzing the rare and damaging variants in the two CP patients from the two twins, they had no overlapping genes against the SNVs, InDels, SVs, or CNVs. Conclusion:Whole genome sequencing revealed that both the two monozygotic twins with NF1 were detected pathogenic variants of gene NF1. No other pathogenic variants specific to the CP patients among the twins were identified. The two CP patients shared no other common genes from the detected likely pathogenic variants.
ABSTRACT
Objective:To investigate the effect of miRNA-296-5p (miR-296-5p) on the migration and invasion of hypoxia-induced pancreatic cancer cells and its related mechanisms.Methods:Human pancreatic cancer cell line PANC-1 was selected. Pancreatic cancer tissues from 55 pancreatic cancer patients who underwent the resection and adjacent carcinoma normal pancreatic tissues from 10 patients at Shanghai Fengxian District Central Hospital and Bengbu Medical College First Affiliated Hospital between January 2010 and December 2014 were collected. The expression levels of hypoxia-inducible factor 1α (HIF-1α) and miR-296-5p in tissue microarray of pancreatic cancer and adjacent carcinoma normal pancreatic tissues were detected by using immunohistochemistry and in situ hybridization. The relationship between miR-296-5p and HIF-1α as well as their correlation with clinicopathological characteristics of patients were analyzed. PANC-1 cells were divided into hypoxic group and normoxic group. Transwell assay was used to detect the cell migration and invasion ability of both groups. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to examine the expressions of HIF-1α and miR-296-5p under hypoxic environment of both groups. The expression of HIF-1α was interfered by transfecting small interfering RNA (siRNA). PANC-1 cells were divided into PANC-1 group (the empty control), PANC-1-NC group (the negative control) and PANC-1-siRNA group. The expression of miR-296-5p was measured. After co-transfecting miR-296-5p agonist and miR-296-5p inhibitor, the cells were divided into Agomir-miR-296-5p group (agonist group), Agomir-miR-296-5p-NC group (agonist negative control group), Antagomir-miR-296-5p group (inhibitor group) and Antagomir-miR-296-5p-NC group (inhibitor negative control group). Transwell assay was used to detect the cell migration and invasion ability of all groups. Luciferase reporter gene system was used to verify whether miR-296-5p promoter region had binding site of HIF-1α.Results:The high expression rate of HIF-1α in pancreatic cancer tissues was higher than that of adjacent carcinoma normal pancreatic tissues [81.8% (45/55) vs. 0 (0/10), P<0.01], and the high expression rate of miR-296-5p in pancreatic cancer tissues was lower than that of adjacent carcinoma normal pancreatic tissues [12.7% (7/55) vs. 90.0% (9/10), χ2 = 27.23, P<0.01]. The expression of HIF-1α was negatively correlated with that of miR-296-5p ( r = -0.53, P<0.01). The low expression of miR-296-5p was closely related with the tumor diameter, TNM staging, lymph node metastasis (all P<0.05). The number of PANC-1 invasion cell was 15.3±2.1 in normoxic group and 24.7±1.5 in hypoxic group, and the difference was statistically significant ( t = 0.26, P = 0.003). The number of PANC-1 migration cell was 20.7±3.8 in hypoxic group and 32.7±1.2 in normoxic group, and the difference was statistically significant ( t = 5.25, P = 0.006). The relative expression level of HIF-1α mRNA in PANC-1 cell of hypoxic group was higher than that of normoxic group [(1.00±0.01) vs. (0.30±0.02)], and the difference was statistically significant ( t = 56.45, P<0.01); the relative expression level of miR-296-5p in PANC-1 cell of hypoxic group was lower than that of normoxic group [(1.14±0.04) vs. (3.05±0.20)], and the difference was statistically significant ( t = 16.05, P<0.01). The number of invasion cells in PANC-1 group, PANC-1-NC group and PANC-1-siRNA group was 24.7±1.5, 25.7±1.5, 12.0±1.7, respectively, and the difference was statistically significant ( F = 68.13, P<0.01).The cell invasion ability in PANC-1-siRNA group was decreased compared with that in PANC-1 group ( t = 9.50, P = 0.001). The number of cell migration was 32.7±1.2, 37±1.0, 17.3±1.2, respectively in PANC-1 group, PANC-1-NC group and PANC-1-siRNA group, and the difference was statistically significant ( F = 262.09, P<0.01). The cell migration ability in PANC-1-siRNA group was decreased compared with that in PANC-1 group ( t = 16.26, P<0.01). The cell invasion and migration ability in Antagomir-miR-296-5p group was increased compared with that in PANC-1 group (all P<0.05); the cell invasion and migration ability in Agomir-miR-296-5p group was decreased compared with that in PANC-1 group (all P<0.05). The results of luciferase activity detected by luciferase reporter gene system showed that miR-296-5p had the target binding to HIF-1α. Conclusions:HIF-1α plays a key role in the invasion and migration of hypoxia-induced pancreatic cancer cells through negatively reducing miR-296-5p.
ABSTRACT
As one of the diseases with high incidence in China， cancer seriously endangers human health. The scientific research and clinical practice of traditional Chinese medicine （TCM） in the prevention and treatment of tumors during the Sixth Five-Year Plan period and the 13th Five-Year Plan period show that TCM has certain advantages in preventing and treating postoperative metastasis and recurrence， prolonging survival period， alleviating adverse reactions， and improving the quality of life of patients with advanced tumors. However， innovation of the TCM theoretical thinking and realization of the TCM full-cycle management are needed urgently， which limits the improvement of clinical efficacy. Malignant tumor is a truly representative of major difficult diseases. The simple mode of syndrome differentiation and treatment cannot meet the clinical needs， and thus the triple mode of disease， syndrome and symptom differentiation and treatment emerged， and has received widespread attention. However， since malignant tumors have their own characteristics of occurrence， development and evolvement， it is urgent to establish a new system of TCM differentiation and treatment for special diseases to adapt to the law of modern disease development. Therefore， on the basis of the triple mode， this paper innovatively proposed a new system of cancer prevention and treatment based on five views on differentiation and treatment in TCM， forming a new paradigm of whole-cycle， whole-chain and all-directional integrated Chinese and western medicine prevention and treatment of tumors. Specifically， time-space view： On the basis of the holistic concept and combined with the complex characteristics of different pathological types， lesion location， disease course and treatment stages of malignant tumors， the dynamic and systematic participation of TCM in the whole process of tumor treatment was brought into play from the time and space dimensions. Core view： The core pathogenesis was summarized based on the combination of disease and syndrome， and its key role in guiding differentiation and treatment of malignant tumors was emphasized. Additionally， the pathogenesis characteristics and evolvement rules of various cancer types in different stages were paid attention. Symptom view： The symptoms were ameliorated and the quality of life was improved. The current obvious contradictions of patients were solved to enhance the humanistic nature of treatment. Precision view： In combination of modern medical concepts， TCM constitutions and laboratory indicators， TCM advantages were enriched and emphasized for precise clinical positioning. Disease-before-onset view： As prevention is more important than treatment， precaution was focused on in each stage of tumors. The five views had different emphases and were interrelated， covering new understandings of the existing TCM prevention and treatment system of malignant tumors. In addition， new ideas and concepts have been introduced on the basis of the original TCM theory， which provided new strategies for the comprehensive prevention and treatment of tumors.
ABSTRACT
Objective:To identify and analyze different proteins expression in the periosteum of congenital pseudarthrosis of the tibia (CPT) using tandem mass tags (TMT) proteomics.Methods:The samples were divided into three groups, namely CPT with neurofibromatosis type 1 (NF1) group (NF1-CPT group), CPT without NF1 group (nonNF1-CPT group) and control group (patients with open tibial fracture). A fold change ≥1.5 or ≤0.66 and P-value <0.05 was regarded as the threshold to screen differentially expressed proteins (DEPs). Subsequently, bioinformatics resources such as online tools DAVID and STRING were used to conduct GO annotation, KEGG pathways enrichment and protein-protein interaction (PPI) network with DEPs. Results:A total of 347 proteins differentially expressed in NF1-CPT group, 212 of which were up-regulated and 135 down-regulated. We identified 467 DEPs in nonNF1-CPT group, including 281 up-regulated and 186 down-regulated. Among of them, NF1-CPT group and nonNF1-CPT group shared 231 DEPs, except for HLA-DRB1 which increased in NF1-CPT group but decreased in nonNF1-CPT group. The remaining 230 DEPs showed the same expression trend in the two positive groups, including 117 up-regulated and 113 down-regulated. In particular, a total of 116 proteins were altered only in NF1-CPT group, including 94 up-regulated and 22 down-regulated. However, there were 236 proteins altered only in nonNF1-CPT group, including 164 up-regulated and 72 down-regulated. The results indicated that the pathogenesis of NF1-CPT was similar as nonNF1-CPT largely with a few differences. Finally, compared with nonNF1-CPT, there were 47 proteins changed 1.5-fold and P-value <0.05 in NF1-CPT group. Conclusion:The proteins expression in the periosteum of CPT is different from that of normal tibia. The expression of periosteal protein is also different between NF1-CPT and nonNF1-CPT. The present study will deepen our understanding of the pathogenesis of CPT in the protein level.
ABSTRACT
Objective@#To detect the expression of miR-373 in osteosarcoma cells and explore its effects on cell proliferation, invasion, and migration.@*Methods@#Human osteosarcoma cell line SJSA-1 and human osteoblast hFOB 1.19 cultured in vitro. Human osteosarcoma cell line SJSA-1 were randomly divided into four groups: blank control group (CK group), negative control group (NC group), miR-373 over-expressed plasmid group (miR-373 mimic group) and miR-373 inhibited plasmid group (miR-373 inhibitor group). Cells were transfected with FuGENE® HD transfection reagent. After 48 hours of transfection, the relative expression of miR-373 was detected by quantitative real-time polymerase chain reaction (qRT-PCR), cell proliferation by cell counting kit-8 (CCK-8) and cell invasion and migration by Transwell.@*Results@#The relative expression of miR-373 in SJSA-1 cells was significantly higher than that in hFOB-1.19 cells (P<0.05); compared with CK group and NC group, the relative expression of miR-373 in the miR-373 mimic group increased significantly (P<0.05), and the relative expression of miR-373 in the miR-373 inhibitor group was significantly lower than that in the control group (P<0.05); optical density (OD) value of miR-373 mimic group at 24 h, 36 h, and 48 h were significantly higher than that of CK group and NC group (P<0.05), and OD value of miR-373 inhibitor group at 24 h, 36 h, and 48 h were significantly lower than that of CK group and NC group (P<0.05); the number of cell migration in the miR-373 mimic group was significantly higher than that in the CK group and NC group (P<0.05), and the number of cell migration in the miR-373 inhibitor group was significantly lower than that in CK group and NC group (P<0.05); the number of cell migration in the miR-373 mimic group was significantly higher than that in the CK group and NC group (P<0.05), and the number of cell migration in the miR-373 inhibitor group was significantly lower than that in CK group and NC group (P<0.05).@*Conclusions@#The expression of miR-373 is up-regulated in osteosarcoma. Overexpression of miR-373 can promote the proliferation, invasion, and migration of osteosarcoma cells, while the low expression of miR-373 can inhibit the proliferation, invasion, and migration of osteosarcoma cells, which may be an important target for the diagnosis and treatment of osteosarcoma.
ABSTRACT
Objective To detect the expression of miR-373 in osteosarcoma cells and explore its effects on cell proliferation,invasion,and migration.Methods Human osteosarcoma cell line SJSA-1 and human osteoblast hFOB 1.19 cultured in vitro.Human osteosarcoma cell line SJSA-1 were randomly divided into four groups:blank control group (CK group),negative control group (NC group),miR-373 over-expressed plasmid group (miR-373 mimic group) and miR-373 inhibited plasmid group (miR-373 inhibitor group).Cells were transfected with FuGENE(R) HD transfection reagent.After 48 hours of transfection,the relative expression of miR-373 was detected by quantitative real-time polymerase chain reaction (qRT-PCR),cell proliferation by cell counting kit-8 (CCK-8) and cell invasion and migration by Transwell.Results The relative expression of miR-373 in SJSA-1 cells was significantly higher than that in hFOB-1.19 cells (P ＜ 0.05);compared with CK group and NC group,the relative expression of miR-373 in the miR-373 mimic group increased significantly (P ＜ 0.05),and the relative expression of miR-373 in the miR-373 inhibitor group was significantly lower than that in the control group (P ＜ 0.05);optical density (OD) value of miR-373 mimic group at 24 h,36 h,and 48 h were significantly higher than that of CK group and NC group (P ＜ 0.05),and OD value of miR-373 inhibitor group at 24 h,36 h,and 48 h were significantly lower than that of CK group and NC group (P ＜ 0.05);the number of cell migration in the miR-373 mimic group was significantly higher than that in the CK group and NC group (P ＜ 0.05),and the number of cell migration in the miR-373 inhibitor group was significantly lower than that in CK group and NC group (P ＜ 0.05);the number of cell migration in the miR-373 mimic group was significantly higher than that in the CK group and NC group (P ＜ 0.05),and the number of cell migration in the miR-373 inhibitor group was significantly lower than that in CK group and NC group (P ＜ 0.05).Conclusions The expression of miR-373 is up-regulated in osteosarcoma.Overexpression of miR-373 can promote the proliferation,invasion,and migration of osteosarcoma cells,while the low expression of miR-373 can inhibit the proliferation,invasion,and migration of osteosarcoma cells,which may be an important target for the diagnosis and treatment of osteosarcoma.
ABSTRACT
Objective:To explore the clinical curative effect observation of Bixie Qufeng Decoction combined with western medicine in the treatment of acute gouty arthritis and its influence on inflammatory factors.Methods:Ninety patients with acute gouty arthritis in Taizhou Traditional Chinese Medicine Hospital from April 2018 to April 2019 were enrolled. According to the random table method, they were divided into two groups, with 45 patients in the control group and 45 patients in the observation group. The control group was treated with loxoprofen sodium tablets, while the observation group was treated combined with Bixie Qufeng Decoction on the basis of oral administration. Both groups were treated for 2 weeks. The therapeutic effects of the two groups were compared. The changes of joint tenderness, joint swelling score, erythrocyte sedimentation rate, serum uric acid and inflammatory factors before and after treatment were compared.Results:The total effective rate of the observation group was higher than that of the control group [93.33%(42/45) vs. 71.11%(32/45)], and there was significant difference ( P<0.05). After treatment, the scores of joint tenderness and joint swelling in two groups decreased significantly ( P<0.05), and the scores of joint tenderness and joint swelling in the observation group were lower than those in the control group [(0.42 ± 0.13) scores vs. (0.97 ± 0.26) scores, (0.35 ± 0.09) scores vs. (0.85 ± 0.14) scores] ( P<0.05). After treatment, the levels of erythrocyte sedimentation rate (ESR) and uric acid in the two groups decreased significantly ( P<0.05), and the levels of ESR and uric acid in the observation group were lower than those in the control group [(10.83 ± 2.46) mm/1 h vs.(17.69 ± 5.14) mm/1 h, (341.24 ± 17.89) μmol/L vs. (423.16 ± 14.36) μmol/L] ( P<0.05). After treatment, the levels of C-reactive protein (CRP), interleukin (IL)-1β and IL-6 in serum of the two groups decreased significantly ( P<0.05), and the levels of CRP, IL-1β and IL-6 in serum of the observation group were lower than those of the control group [(6.14 ± 1.27) mg/L vs. (11.32 ± 3.12) mg/L, (3.28 ± 0.49) ng/L vs. (5.48 ± 0.91) ng/L, (5.47 ± 2.19) n/L vs.(9.98±1.65) ng/L]( P<0.05). Conclusions:The combination of Bixie Qufeng Decoction and western medicine has obvious clinical effect on acute gouty arthritis patients, and can reduce inflammation, which is worthy of clinical reference.
ABSTRACT
Background:CXCR4 is widely expressed in tumor cells and participates in tumor invasion and metastasis. RNA interference technology can effectively reduce or shut down the expression of genes and block tumor invasion and metastasis at different levels. Aims:To investigate the mRNA and protein expressions of CXCR4 and their relationship with clinicopathological features of gastric cancer,and to explore the effect of silencing CXCR4 by siRNA on biological behavior of gastric cancer. Methods:A total of 86 gastric cancer tissues and their adjacent normal mucosa were collected. mRNA and protein expressions of CXCR4 were detected by RT-PCR and Western blotting,respectively,and their relationship with clinicopathological features was analyzed. The CXCR4 RNA interference plasmid vector was constructed,and were transfected into gastric cancer cell line MKN45. Cell proliferation,migration and invasion,apoptosis were detected by MTT assay,Transwell assay and flow cytometry,respectively. Results:mRNA and protein expressions of CXCR4 in gastric cancer tissues were significantly higher than those in adjacent normal tissues (P ＜0.05),and CXCR4 expression was related to TNM staging,tumor differentiation,lymph node metastasis (P＜0.05). Compared with negative control cells, cell proliferation in siRNA transfection group at 24,48,and 72 hours were significantly decreased (P ＜0.05 ),cell migration rate and cell invasion rate were significantly decreased (P ＜0.05),and cell apoptosis rate was significantly increased (P＜0.05). Conclusions:CXCR4 plays an important role in the development of gastric cancer. The silencing CXCR4 gene by siRNA can significantly inhibit the proliferation,migration and invasion of MKN45 cells,and increase apoptosis,thereby providing a new strategy for the treatment of gastric cancer.
ABSTRACT
Objective T o explore the num ber of necrophagous flies and seasonal distribution of com m on necrophagous flies at present in B eijing. Methods T he specim ens of necrophagous flies w ere collected by the m ethods of anim al carcass, trapping and feeding. A nd the specim ens w ere observed and counted after the classification and preservation. Results T he necrophagous flies in B eijing belonged to 4 fam i-lies, 9 subfam ilies, 21 genera and 46 species, and 12 species of them w ere the first records in B eijing. T he necrophagous flies had the characteristics of regional and seasonal distribution. Conclusion T he data of seasonal distribution of necrophagous flies and com m on necrophagous flies in B eijing can provide refer-ence for related research.
ABSTRACT
Progression of tumor is a complex process with multiple steps and multiple factors.MicroRNA-296 (miR-296) plays an important role in tumor progression,involved in the proliferation,differentiation,angiogenesis,invasion,metastasis,apoptosis and drug resistance of the tumor cells.
ABSTRACT
Objective To observe the protein degredation of empty puparium cases ofC. megacephala after weathering and to explore its practical significance on postmortem interval estimation in forensic science. MethodsThe standardized feeding was used inC. megacephala, and the empty puparium cases were collected and put into the forest. They were taken back 5 days, and 10 days later, respectively. The spectra were collected and preprocessed, and then the absorption peaks of amides were read, and curve fitting was performed in the average spectra of each group. The statistical analysis was performed by SPSS 19.0.Results Compared to control group, ifve days post weathering, the position of amideⅠabsorption peak showed blue shift, but the amideⅡabsorption peak showed no shift, moreover, none of the amide absorption peaks showed changes inpeak intensity. For the secondary structures, α-helix decreased and β-sheet increased slightly, however, β-turn did not change; Ten days post weathering, the positions of both amideⅠandⅡabsorption peaks showed blue shift, and an obviousshoulder peak appeared in amide I absorption peak. Meanwhile, both of amideⅠandⅡabsorption peaks showed decreased in peak intensity. Moreover, for the secondary structures, α-helix and β-sheet showed the same tendency as in the 5th day group, except for the β-turn increased dramaticlly.Conclusion The spectra of the empty puparium cases of C. megacephala showed that the absorption peaks of amideⅠandⅡpresented certain characteristic features within ten days post weathering, and estimate relative long-time postmortem interval.
ABSTRACT
Objective To systematically evaluate the role of laparoscopic living donor hepatectomy in living donor liver transplantation (LDLT).Methods A systematic literature search was conducted on Medline-Pubmed,Embase,Cochrane Library to find studies on laparoscopic living donor hepatectomy for LDLT.All extracted data were analyzed using the RevMan 5 software.Results Ten studies with a total of 1 059 participants were included in this analysis.Laparoscopic donor hepatecomy (LDH) was associated with significantly less intraoperative blood loss [SMD =-0.39,95％ CI (-0.73,-0.05),P ＜ 0.05],lower peak level of postoperative total bilirubin [SMD =-0.24,95％ CI (-0.47,-0.01),P ＜ 0.05]and longer operative time [SMD =0.50,95％ CI (0.04,0.96),P ＜0.05] when compared with those operated with open surgery.On subgroup analyses,hospitalization stay decreased in patients who underwent LDLT with grafts obtained by complete living donor hepatectomy (LDH) and left lateral sectionectomy (both P ＜ 0.05).LDH was comparable to open surgery in donor complication rates and in-hospital cost (P ＞ 0.05).There were no differences on the harvested liver graft size,ischemic time,recipient postoperative liver function and complications between the two groups (P ＞ 0.05).Conclusions Laparoscopic hepatectomy in living donor is a safe procedure for graft-harvesting,which improved the clinical outcomes of the donor,liver graft and recipient in LDLT.It has also the advantages of reduced blood loss,low peak levels of postoperative total bilirubin and short hospitalization stay.
ABSTRACT
Objective To detect the changes of microbial community functional diversity of corpses with different postmortem interval(PMI)and to evaluate forensic application value for estimating PMI. Methods The cultivation of microbial community from the anal swabs of aSusscrofaand a human corpse placed in field environment from 0 to 240 h after death was performed using the Biolog-Eco Mi-croplate and the variations of the absorbance values were also monitored. Combined with the technology of forensic pathology and flies succession, the metabolic characteristics and changes of microbial commu-nity on the decomposed corpse under natural environment were also observed.Results The diversity of microbial metabolism function was found to be negatively correlated with the number of maggots in the corpses. The freezing processing had the greatest impact on average well color development value at 0 h and the impact almost disappeared after 48 h. The diversity of microbial metabolism of the samples be-came relatively unstable after 192 h. The principal component analysis showed that 31 carbon sources could be consolidated for 5 principal components(accumulative contribution ratio >90%). The carbon source tsquare-analysis showed thatN-acetyl-D-glucosamine andL-serine were the dominant carbon sources for estimating the PMI(0=240 h)of theSusscrofaand human corpse.Conclusion The Biolog-Eco method can be used to reveal the metabolic differences of the carbon resources utilization of the microbial community on the corpses during 0-240 h after death, which could provide a new basis for estimating the PMI.
ABSTRACT
Objective To explore the value of lipidic degradation in puparium cases of C.megacephala during weathering in postmortem interval estimation. Methods The puparium cases of reared C.megacephala were collected, and laid outdoor. They were taken back 5 days and 10 days later, and then be stored at -20℃. The samples of control group were cleaned and cryopreserved immediately. The spectra were collected and preprocessed. The peak position and peak height were read and performed statistical analysis by SPSS 19.0 software. Results Compared to control group, the positions of Vas CH3 band showed no shift, and the Vas CH2 band showed blue shift, meanwhile, the Vs CH2 band disappeared in both experimental groups, moreover, the Vs CH3 band showed red shift only in 10d group;except of the Vs CH3 band in 5d group, the intensities of both the other two lipidic bands reduced in both experimental groups. Compared with 5day group, the Vs CH3 band showed red shift in 10d group, meanwhile, the differences of all the lipidic bands had statistical signiifcance. Conclusion Detection of lipidic degradation in puparium cases of C. megacephala during weathering by micro-FTIR provides a novel way to estimate postmortem interval and performs its potential for forensic applications.
ABSTRACT
Objective To investigate the diagnosis and treatment of pseudomyxoma peritonei (PMP) and provide a reference for diagnosis and treatment of PMP.Methods The clinical features,laboratory examinations,treatment and outcomes of 8 PMP misdiagnosed cases were analyzed with recent relevant reference.Results Ultrasonography,CT,peritoneal cytological examination,tumor markers results are helpful for diagnosis of PMP.PMP will be confirmed and classified by pathological examination after operation.Complete cytoreductive surgery (CRS)or major debulking surgery (MDS) of the tumor combined intraperitoneal chemotherapy and systemic chemotherapy,eight patients in seven cases survived 4-71 month range,one patient died of respiratory failure of pulmonary infection after the third operation.Conclusions Ultrasonography,CT,peritoneal cytological examination,tumor markers tests help avoid misdiagnosis of PMP before operations.Intraoperative findings follow after PMP,CRS or MDS should be executed in the operation or the next time.Intraperitoneal chemotherapy and conventional chemotherapy can improve survival in patients with PMP and prolong their survival time.
ABSTRACT
Objective To explore the diagnostic consistency and correlation between MR discography (MRD) and CT discography (CTD) in diagnosing chronic low back pain. Methods Guided by C - arm fluoroscopy the mixed solution of gadoterate meglumine (GD-DOTA) and Iohexol (GD-DOTA at a dilution of 1 ∶ 400 with Iohexol) was injected into 96 lumbar intervertebral discs of the 36 patients. CT scanning was performed at 15 minutes after the injection of contrast, and axial together with sagittal SE T1WI MR scanning was carried out one hour after the injection. CTD and MRD images were randomly numbered and were independently evaluated by two experienced radiologists according to Dallas discogram scale in order to assess the diagnostic consistency and correlation between (MRD) and (CTD). In addition the diagnostic value of MRD was evaluated. Results The results revealed that in determining disc degeneration grade CTD and MRD were highly consistent with each other(Kappa = 0.836, P < 0.01), and the diagnostic results judged by the two reviewers were essentially in agreement (ICC = 1.00, P < 0.01; r = 0.997, P < 0.01). Higher consistency (Kappa = 0.836, P < 0.01) and correlation(ICC = 0.90, P < 0.01; r = 0.869, P < 0.01; Kappa =0.836, P < 0.01) in determining annulus rupture extent were also obtained. Conclusion MRD is an accurate diagnostic method for the determination of disc degeneration and the severity of annulus rupture, and this technique has greater consistency and correlation with CTD in diagnosing chronic low back pain.
ABSTRACT
Objective To investigate the expression and prognostic significance of CD151, c-Met and integrin alpha 3, alpha6 in pancreatic ductal adenocarcinoma (PDAC). Methods The expression of CD151, c-Met and integrin alpha3, alpha6 in 71 patients with PDAC and 10 samples of normal pancreas tissues were detected by immunohistochemistry, and the relationship between the expression of CD151, c-Met and integrin alpha 3, alpha 6 and the clinicopathological features, prognosis of these patients was analyzed. Results The positive expression rates of CD151, c-Met and integrin alpha 3, alpha 6 in PDAC were 81.69% (58/71) , 69.01% (49/71), 69.01% (49/71) and 84.51% (60/71) , and there was no expression in normal pancreas tissues. The expressions of CD151, c-Met were significantly associated with TNM stage and lymph node metastasis (P < 0.05). The expression of CD151 was positively correlated with the expressions of c-Met and integrin alpha3, alpha6 (r =0.583, P =0.000, r = 0.457;P =0.000, r = 0.671 ;P =0.000). Univariate analysis suggested the expression of CD151, c-Met and integrin alpha3, alpha6 was associated with survival (P<0.05). Multivariate analysis suggested the expression of CD151, c-Met was the independent prognostic factor for post-operative survival. Conclusions CD151, c-Met and integrin alpha3, alpha6 play a role in the development, metastasis and prognosis of PDAC, and they might be new markers to predict biological behavior and the prognosis of PDAC patients.
ABSTRACT
Objective To investigate the antitumor effect of the recombined adeno-associated virus encoding caveolin-1 regulated by progression-elevated gene (PEG) promotor on the angiogenesis of implanted human hepatocellular carcinoma(HCC) cell lines in a nude mouse model. Methods HepG2 cells were inoculated subcutaneously into NOD/SCID mice, and animals were treated with rAAV-PEG-caveolin-1 after tumor cell innoculation. The fluorescence ratio of Evans blue to FITC-dextran was used to assess the changes of microvasculature permeability of the tumor. Western blot and immunohistochemical analyses were employed to detect PECAM-1 expression in tumor microvascular endothelium and microvessel density(MVD), respectively; NOS activity was assessed by citrulline generation. Tumor growth was observed and tumor cell apoptosis in tumor tissues were measured by TUNEL. Results Tumor growth was significantly inhibited in mice injected with rAAV-PEG-caveolin-1. The administration of rAAV-PEG-caveolin-1 significantly blocked vascular leakage in the tumor microcirculation. The levels of PECAM-1 protein detected by Western blot were markedly reduced in rAAV-PEG-caveolin-1-treated mice, and there were fewer MVD in tumors from caveolin-1-treated mice, while NOS catalytic activity was much lower in rAAV-PEG-caveolin-1-treated mice compared to the control and empty vector-treated animals. TUNEL demonstrated significant induction of tumor cell specific apoptosis. Conclusions rAAV-PEG-caveolin-1 can reduce tumor progression through blocking microvascular formation by inhibiting eNOS.