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Objective:To analyze the clinical characteristics, diagnosis and treatments of patients with POEMS syndrome initially diagnosed as pulmonary hypertension (PH).Methods:Clinical data of 7 patients who were initially diagnosed as PH and finally diagnosed as POEMS syndrome in Shanghai Pulmonary Hospital from May 2013 to November 2021 were retrospectively reviewed. Clinical manifestations, laboratory tests, echocardiography, hemodynamic findings, treatment and prognosis of patients were analyzed.Results:Seven patients, including 4 males and 3 female, aged (55±9) (44-62) years were presented with elevated pulmonary artery pressure by echocardiography at admission. Chest tightness and shortness of breath (7/7), fatigue (6/7) and lower limb edema (4/7) were the most common symptoms in the first-episode. Meanwhile, patients also presented symptoms associated with POEMS syndrome, including multiple peripheral neuropathy (7/7), multiserosal cavity effusion (6/7), organomegaly (5/7), skin changes (5/7), and endocrine lesions (4/7). Serum levels of vascular endothelial growth factor (VEGF) were significantly increased in all patients. The pulmonary arterial systolic blood pressure was (66±21)mmHg (1 mmHg=0.133 kPa) estimated by echocardiography. Six patients underwent right heart catheterization and significantly increased mean pulmonary artery pressure((35±9) mmHg) was confirmed; and their pulmonary vascular resistance was (4.00±2.10) Wood U. All patients received corresponding treatment for POEMS syndrome. The excise tolerance was improved in 5 patients after successful treatment with stable or reversed WHO functional class. One patient received hemodialysis treatment for uncontrolled POEMS. One patient died during follow-up. The echocardiography was followed up in 4 patients, and 2 of whom had a complete reversal of PH, 1 had a partial reversal, and 1 had not yet reversed.Conclusions:In patients with PH who have multisystem manifestations, such as multiple peripheral neuropathy, multiserosal cavity effusion, organomegaly and skin changes, POEMS syndrome should be considered, and proper and active treatment of POEMS may reverse PH and improve the prognosis of patients.
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B lymphocyte is an important component of the human immune system and it has a role in the process of the body's specific immunity. In recent years, the research on B cells and tumor immune escape has rapidly progressed. Studies have shown that different types of B cells play different roles in tumor microenvironment through a variety of mechanisms. B cells in the tertiary lymphatic structure promote anti-tumor immunity, while regulatory B cells promote tumor immune escape. Antibody drugs targeting B cells are a promising direction for tumor immunotherapy.
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Humans , B-Lymphocytes/pathology , Immunotherapy , Neoplasms/therapy , Tumor Escape , Tumor MicroenvironmentABSTRACT
Breast cancer is a systemic malignant tumor caused by multiple pathogenic factors， and its pathological mechanism is complex and has not been clarified so far. It has gradually become the largest killer threatening women's life. The common method for the treatment of breast cancer is lesion resection combined with radiation and chemical therapy， endocrine therapy， or targeted therapy. However， due to the limitations of western medicine therapies， there are still considerable breast cancer patients with poor disease control and high tumor recurrence rate in clinical practice. At the same time， the side effects and complications produced by these therapies affect the quality of life of patients. Therefore， it is urgent to develop new drugs or find safe and effective alternative therapies against breast cancer. Volatile oil （VO）， as a unique volatile component of Chinese herbal medicines， has anti-inflammatory， antiviral， and anti-tumor activities. It has been applied in the treatment of breast cancer and has demonstrated good efficacy by exerting the unique effects of strengthening healthy Qi， eliminating pathogenic factors， moving Qi， resolving stasis， warming Yang， soothing liver， and relieving depression. The recent studies have confirmed that VO and its chemical components can prevent and treat breast cancer via multiple mechanisms， while there is a lack of systematic review. The relevant literature published in recent years has demonstrated that VO can inhibit the occurrence and development of breast cancer by regulating the level of estrogen， inhibiting the proliferation and inducing the apoptosis of cancer cells， enhancing immunity， resisting inflammation， and regulating emotions. We introduced the pathogenesis of breast cancer， as well as the mechanisms and advantages of VO in the prevention and treatment of breast cancer， aiming to provide new ideas for the research on VO in the treatment of breast cancer.
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Objective:To explore the clinical characteristics,diagnosis,and treatments of adrenal insufficiency (AI) in the patients with acquired immune deficiency syndrome (AIDS),and to improve the clinician's understanding of the disease and provide evidences for its diagnosis and treatments.Methods:The clinical data of one patient with AIDS and AI were retrospectively analyzed and the diagnosis and treatments were summarized,and the relative literatures were reviewed.Results:The patient was clearly diagnosed as AIDS and AI after relevant examinations.The symptoms such as fatigue,nausea and vomiting of the patient were disappeared,the food intake of the patient was increased,and the electrolyte was normal after some treatments such as hormone replacement therapy (oral prednisone acetate 5.0 mg at 8:00 am.and 2.5 mg at 4:00 pm.) and symptomatic treatments.The patient died of a severe opportunistic infection when followed up for 37 d.Conclusion:The possibility of AI should be taken into account when the patients with AIDS have unexplained symptoms such as anorexia,nausea,weight loss and more characteristic manifestations such as orthostatic hypotension,hyponatremia or hyperkalemia.Early administration of glucocorticoid replacement therapy is feasible and effective.
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Objective:To explore the clinical characteristics,diagnosis,and treatments of adrenal insufficiency (AI) in the patients with acquired immune deficiency syndrome (AIDS),and to improve the clinician's understanding of the disease and provide evidences for its diagnosis and treatments.Methods:The clinical data of one patient with AIDS and AI were retrospectively analyzed and the diagnosis and treatments were summarized,and the relative literatures were reviewed.Results:The patient was clearly diagnosed as AIDS and AI after relevant examinations.The symptoms such as fatigue,nausea and vomiting of the patient were disappeared,the food intake of the patient was increased,and the electrolyte was normal after some treatments such as hormone replacement therapy (oral prednisone acetate 5.0 mg at 8:00 am.and 2.5 mg at 4:00 pm.) and symptomatic treatments.The patient died of a severe opportunistic infection when followed up for 37 d.Conclusion:The possibility of AI should be taken into account when the patients with AIDS have unexplained symptoms such as anorexia,nausea,weight loss and more characteristic manifestations such as orthostatic hypotension,hyponatremia or hyperkalemia.Early administration of glucocorticoid replacement therapy is feasible and effective.
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Objective To investigate the polymorphisms of human cytomegalovirus ( HCMV ) UL146 gene in asymptomatic children. Methods Urine samples were collected from 47 asymptomatic chil-dren who were positive for HCMV DNA. PCR was performed to amplify the open reading frame ( ORF) of UL146 gene. Positive bands were sequenced and variations in UL146 gene were analyzed by using bioinfor-matics software. Results Seventeen samples were successfully amplified and sequenced. Variations spread all over the sequence of UL146 gene and the variability in nucleotide and amino acid sequences ranged from 0％ to 42. 5％ and 0％ to 67. 7％ respectively. Compared with the Towne strain, there was diversity in sig-nal sequence and C-terminal region. Phylogenetic analysis indicated that UL146 in the 17 asymptomatic chil-dren belonged to four genotypes, which were G1, G8, G9 and G11. Forms of post-translational modification varied greatly among the four genotypes, while the important functional region of ELRCXC chemokine was highly conservative. Secondary structure prediction showed that random-coli conformation was the predomi-nant structure of active proteins. Isoelectric point ( PI) and molecular weight ( MW) were dissimilar among the four genotypes. Conclusion HCMV UL146 gene in asymptomatic children was hypervariable in both nucleotide sequence and amino acid structure. However, the important functional region was highly con-served. The predominant genotypes of UL146 in these children were G1, G8, G9 and G11, and the geno-type distribution in them showed no significant difference with previous findings in children with symptomatic HCMV infection.
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Objective To investigate the polymorphisms of human cytomegalovirus ( HCMV ) UL146 gene in asymptomatic children. Methods Urine samples were collected from 47 asymptomatic chil-dren who were positive for HCMV DNA. PCR was performed to amplify the open reading frame ( ORF) of UL146 gene. Positive bands were sequenced and variations in UL146 gene were analyzed by using bioinfor-matics software. Results Seventeen samples were successfully amplified and sequenced. Variations spread all over the sequence of UL146 gene and the variability in nucleotide and amino acid sequences ranged from 0％ to 42. 5％ and 0％ to 67. 7％ respectively. Compared with the Towne strain, there was diversity in sig-nal sequence and C-terminal region. Phylogenetic analysis indicated that UL146 in the 17 asymptomatic chil-dren belonged to four genotypes, which were G1, G8, G9 and G11. Forms of post-translational modification varied greatly among the four genotypes, while the important functional region of ELRCXC chemokine was highly conservative. Secondary structure prediction showed that random-coli conformation was the predomi-nant structure of active proteins. Isoelectric point ( PI) and molecular weight ( MW) were dissimilar among the four genotypes. Conclusion HCMV UL146 gene in asymptomatic children was hypervariable in both nucleotide sequence and amino acid structure. However, the important functional region was highly con-served. The predominant genotypes of UL146 in these children were G1, G8, G9 and G11, and the geno-type distribution in them showed no significant difference with previous findings in children with symptomatic HCMV infection.
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Objective To evaluate the effect of cisplatin on analgesia with morphine in rats with incisional pain.Methods Forty-two adult male Sprague-Dawley rats,weighing 180-220 g,were randomly divided into 6 groups (n =7 each) using a random number table:normal saline group (group C),normal saline + Pglycoprotein inhibitor LY335979 group (group CL),normal saline + morphine group (group CM),cisplatin group (group S),cisplatin + morphine group (group SM) and cisplatin + morphine + LY335979 group (group SML).Cisplatin 2 mg/kg was injected intraperitoneally once every two days for 5 times in S,SM and SML groups,while the equal volume of normal saline was injected intraperitoneally in C,CL and CM groups.At 2 days after the end of administration,the incisional pain models were established.At 10 min after establishing the model,normal saline 2 ml was injected subcutaneously in C and S groups; LY335979 20 mg/kg was injected via the caudal vein and normal saline 2 ml was injected subcutaneously in group CL; morphine 2 mg/kg was injected subcutaneously in CM and SM groups; LY335979 20 mg/kg was injected via the caudal vein and morphine 2 mg/kg was injected subcutaneously in group SML.Cumulative pain score was used to evaluate analgesia.Results Compared with group C,cumulative pain scores were significantly decreased in group CM,and no significant change was found in cumulative pain scores in CL and S groups.Compared with group CM,cumulative pain scores were significantly increased in group SM,and no significant change was found in cumulative pain scores in group SML.Cumulative pain scores were significantly lower in group SML than in group SM.Conclusion Cisplatin can weaken analgesia induced by morphine in rats with incisional pain through enhancing P-glycoprotein function in the blood-brain barrier.
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Objective To analyze the clinicopathologic data and operative parameters of 209 elderly co-lon cancer patients treated by radical resection between January 2002 and December 2011 ,and to investigate the factors related to recurrence and metastasis after colon cancer radical resection in elderly patients .Methods We used univariate and multivariate analysis of Cox regression ,including 14 variables:age,gender,disease duration, hospitalization duration,surgeon experience,operation duration,laparoscopicsurgery,tumor location,tumor size, gross morphology ,differentiate degree ,depth of bowel wall invasion ,lymph node involvement and obstruction .The survival curve was obtained by Kaplan -Meier method.Results Univariate analysis showed that tumor size (RR=2.658,P<0.0001),gross morphology(Infiltrating type,RR=3.407,P=0.0054),degree of differentiation (RR=0.32,P<0.0001) were associated with tumor relapse and metastasis .Multivariate analysis showed that gender(RR=0.585,P=0.0359),tumor size(RR=2.364,P<0.0001),degree of differentiation (Infiltrating type,RR=0.246,P=0.0437),gross morphology(RR=0.31,P<0.0001)were the significant factors.Conclu-sion Gender,tumor size,degree of differentiation,gross morphology were the independent factors of recurrence and metastasis of colon cancer after radical resection in elderly patients .Targeted follow -up for high -risk groups will improve patients′life quality and prolong their survival time .
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Objective To establish a rabbit model of acute lung injury induced by one-lung ventilation (OLV) .Methods Sixteen New Zealand white rabbits weighing 2.3-2.7 kg were randomly divided into 2 groups (n=8 each):conventional tidal volume(VT) group (group Ⅰ) and high VT group (group Ⅱ).All the rabbits were tracheostomized and a tracheal tube was inserted into the right bronchus for right lung ventilation in the two groups. VT was set at 6 ml/kg in group Ⅰ and at 12 ml/kg in group Ⅱ and the other ventilatory parameters were the same in the two groups (FiO2 50% , RR 40 bpm, I∶E=1∶2). Immediately before OLV(T0) and at 1, 2 and 3 h of OLV (T1-3), peak airway pressure was measured and arterial blood samples were taken for blood gas analysis and oxygenation index (OI) was calculated. The animals were sacrificed at 3 h of OLV and lung tissues obtained for microscopic examination.The lung injury was scored. W/D lung weight ratio was calculated. Bron-choalveolar lavage fluid (BALF) was collected for measurement of protein concentrations and neutrophil counts. Results The peak airway pressure was significantly higher at T1-3 in group Ⅱ and OI was significantly lower at T2,3 in the two groups than those at T0(P＜0.05) .W/D lung weight ratio and lung injury scores of the right lung were significantly lower than those of the left lung in the two groups(P＜0.05).The peak airway pressure was significantly higher at T1-3, OI was significantly lower at T3, and W/D lung weight ratio, protein concentrations and neutrophil counts in BALF and lung injury scores of the right lung were significantly higher in group Ⅱ than in group Ⅰ(P＜0.05). Conclusion OLV with VT of 12 ml/kg for 3 h can successfully establish a rabbit model of acute lung injury.
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Displacement ventilation is described from the aspects of its primary principle, characteristics and differences from the traditional one. The factors that have to be taken account into when a displacement ventilation system designed are also discussed.
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AIM To isolate and identify the active constituents of Erigeron brevisapus (Vant.) Hand. -Mazz. METHODS The chemical constituents were isolated by silica gel column chromatography and two new compounds were obtained. Their structures were elucidated by IR, MS, 1HNMR, 13CNMR, DEPT and 2DNMR. The injury of BCMEC (bovine cerebral microvascular endothelial cell) was determined by lactic dehydrogenase (LDH), the ability of the drugs anti-oxidation and scavenging oxidation of free radical was measured by colorimetric method. RESULTS Two new compounds have been identified as 1-O-methyl-3, 5-O-dicaffeoyl quinic acid methyl ester (III) and 5-O-caffeoyl quinic acid butyl ester (IV). CONCLUSION Compounds III and IV are new compounds. Compound III can protect BCMEC injury by LPC.
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Objective: To investigate the chemical constituents of Erigeron breviscapus (Vant.) Hand. Mazz. Methods: The CHCl 3 extract was isolated and purified with the silica gel column chromatography. The compounds were determined on the basis of spectral analysis(IR, MS, 1HNMR and 13 CNMR). Results: Six compounds were isolated and the structures were identified as 3, 4 dihydroxy phenyl acrylic acid (Ⅶ), ? methoxy ? pyranone (Ⅷ), stigmasterol (Ⅸ), stigmasterol 3 O ? D glucopyranoside(Ⅹ), ? sistosterol (Ⅺ), ? sistosterol 3 O ? D glucopyranoside (ⅩⅡ). Conclusion: Compounds Ⅶ,Ⅷ,Ⅺ,ⅩⅡ are isolated from this plant for the first time. [
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Object To investigate the chemical constituents of Erigeron breviscapus (Vant.) Hand. Mazz. (Compositae) Methods Compounds were isolated from the ethanolic extract with column chromatography and identified on the basis of spectral analysis (IR, EI MS, FAB MS, 1HNMR, 13 CNMR, 2DNMR) and physiochemical properties Results Two compounds were identified as 1 hydroxy 2,3,5 trimethoxy xanthone (Ⅴ), and 1 (2′ ? pyranone) 6 caffeoyl ? D pyranoglucose (Ⅵ) Conclusion Both of the two compounds were new Compound Ⅵ showed inhibitory effects on the adhesion of endothelial induced by TNF ?, indicating its protective effect against injury due to ischemic reperfusion
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Objective To study the bioactive components from stems of Schisandra propinqua var. intermedia. Methods Compounds were separated with acombination of multi-chromatography. Their che- mical structures were determined on the basis of spectral analysis and chemical evidence. Results Nine compounds were isolated from S. propinqua var. intermedia. The structures were elucidated as vanillic acid- 4- O-?-D-allopyranoside (Ⅰ), salidroside (Ⅱ), 2-hydroxy-5-(2-hydroxyethyl)-phenyl-?-D-glucopyranoside (Ⅲ), 3, 4-dimethoxyphenyl-4-?-D-glucopyranoside (Ⅳ), 3, 5-dihydroxybenzoic acid-4-O-?-D-glucopyranoside (Ⅴ), 3, 5-dimethoxy-4-hydroxy-benzoic acid (Ⅵ), 4-methoxy-benzoic acid (Ⅶ), vanillic acid (Ⅷ) and protocatechuic acid (Ⅸ). Conclusion Compound Ⅰ is a new phenolic alloside and others are isolated from S. propinqua var. intermedia for the first time.