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Tumor neovascularization plays an important role in the occurrence, development and metastasis of cancer. Non-invasive quantification and detection of tumor neovascularization is crucial for early diagnosis and prognosis assessment of cancer. Targeted molecular imaging has arisen in vascular targeting imaging and precise treatment based on the molecular characteristics of neovascularization. Aminopeptidase N (APN, or CD13) is a multifunctional membrane-bound exopeptidase that is overexpressed in neovascular endothelial cells and some tumor cells but rarely expressed in normal blood vessels, which makes it a potential target for tumor neovascularization imaging and anti-angiogenic therapy. This review summarizes the application progress and the future development trend of target molecular imaging and precise treatment based on CD13.
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Objective To investigate the clinical characteristics,diagnosis and treatment of pregnancy complicated with hypedipidemic pancreatitis (HLAP).Methods The clinical data of 12 patients with hyperlipidemic pancreatitis in our hospital from 2010 to 2017 were analyzed retrospectively,including general data,clinical manifestations,laboratory examinations,imaging examinations,treatment methods and prognosis.Results 12 cases of HLAP were mainly occurred in the middle and late pregnancy and often recurs.The main cause of the disease was the high fat diet.The main manifestations of the disease are abdominal pain and vomiting.It may be accompanied by gestational diabetes or hypothyroidism.Blood amylase and lipase are often not significantly elevated,with pseudohyponatremia and abnormal coagulation function.Ultrasonography and computed tomography (CT) are important methods for the diagnosis of HLAP.In 12 cases of HLAP,except for one abortion,all the other 11 cases were successfully treated.Conclusions For pregnancy complicated with hyperlipidemic pancreatitis,prevention is the first,and the key is the correct diagnosis.After combined treatment,the patients usually have a good prognosis.
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Objective To investgate the application value of low-dose CT scanning in right adrenal vein imaging.Methods A total of 124 patients were enrolled in the study who were suspected as primary aldosteronism and requiring a contrast enhanced CT examination on adrenal glands.Four patients were excluded according to the exclusion criteria,so that the rest 120 patients were divided equally into three groups.Group A was a control group with conventional radiation dose using tube voltage of 120 kV and automatic mA.It was divided into A1,A2 and A3 groups according to arterial phase,portal venous phase and parenchymal phase.Group B was a experimental group with conventional tube voltage of 120 kV and automatic mA,which was divided into B1,B2 and n3 groups according to arterial phase,late arterial phase and portal venous phase.Group C was a low-dose experimental group with a tube voltage of 100 kV and a tube current of 150 mA only in the second phase,the remaining scanning parameters and method were the same as that of group B.The subjective scores of the images of groups A,B and C were statistically analyzed,and the CT values of the right adrenal vein(RAV),the right adrenal gland(RAG),and the fat of anterior abdominal wall at different scan phases were measured.The dose length products (DLP) were recorded and the signal-to-noise ratios (SNR),contrast-to-noise ratios (CNR),effective doses (E) of the three groups were calculated and compared.Results The subjective scores of the two observers were consistent (Kappa value =0.63);the subjective scores of the B2 images were statistically significant (H =7.18,P＜0.05).Difference of subjective scores between B2 and A2was statistically significant (t=-18.03,P＜0.05).The CT values of RAV,SNR,and CNR of the B2 group were higher than those of the A2 group (t=36.99,6.92,9.02,P＜0.05).The radiation dose comparison showed that the effective dose (E) was 45.52％ lower in the low-dose group than the conventional dose group with the statistically significant difference(t =12.19,P＜0.05).Conclusions Using MDCT scanning technique with lower tube voltage and lower tube current of 100 kV-150 mA,the detection rate of right adrenal vein can reach 95％ in the late arterial phase,and the effective dose can be reduced about 45.52％ on the basis of ensuring image quality.
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Objective To evaluate the clinical value of CT urography (CTU) in quantitative analysis of single?kidney renal glomerular filtration rate (GFR) in patients with renal tumor and hydronephrosis.Methods A total of 49 patients with renal tumor or hydronephrosis from January 2018 to September 2018 in the Second Hospital of Tianjin Medical University were prospectively collected. In all cases, the CT urography and 99mTc?DTPA renal dynamic imaging data and related clinical data were collected. All patients were divided into two groups: the experimental group (39 patients with a total of 78 kidneys) and the validation group (10 patients with a total of 20 kidneys). According to the presence or absence of renal diseases, the kidneys of the experimental group and the validation group were further divided into four groups, namely, the single kidney group, the tumor group, the stagnant water group and the healthy group. The CT urography protocol consisted of noncontrast, arterial phase, nephrographic, and excretory phase imaging. The total renal GFR was determined by CT measurement of renal clearance of contrast media (CM), and the total CT?GFR was then split into single?kidney CT?GFR by a left and right kidney proportionality factor. Differences between CT?GFR and SPECT?GFR measurements in each group of the experimental group was compared by paired?sample t test. Correlations between CT?GFR and SPECT?GFR in the experimental group and their correlations with RPV was analyzed by Pearson method. The Bland?Altman mapping method was used to evaluate the consistency between CT?GFR and SPECT?GFR in the experimental group. Results Paired difference between single?kidney CT?GFR (48.76 ± 18.50) ml·min-1·1.73 m-2 and single?kidney SPECT?GFR (45.68±17.95) ml·min-1·1.73 m-2 in the experimental group, P<0.05, demonstrating 6.8% systemic overestimation. A good correlation(r=0.80, P<0.01) and consistency (± 22.50 ml·min-1·1.73 m-2, ± 49.2% measurement deviations) was revealed between both measurements. There were positive correlations between CT?GFR and SPECT?GFR in the renal tumor group, hydronephrosis group, and healthy kidney group (r=0.67, 0.92, 0.80; P<0.01) respectively, and with good agreement (95% CI measurement deviation<30 ml·min-1·1.73 m-2). In all validation groups, there was no statistical difference between the estimated and true values of the Gates?GFR (all P>0.05). Pearson Correlation analysis showed that the correlations between CT?GFR and RPV in all experimental groups were better than the correlation between Gates?GFR and RPV (P<0.05). Conclusions This study demonstrated the feasibility of using CT urography to measure single?kidney GFR, verifying its application value in diseases such as kidney tumors and obstructive hydronephrosis, and proved that the proposed single?kidney CT?GFR correlates better than the SPECT?GFR with RPV.
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Objective To investigate the neuroprotective effect and mechanism of liraglutide on diabetic rats. Methods 24 healthy male SPF Goto-Kakizaki (GK) rats with random blood glucose greater than 11.1 mmol/L were selected as the experimental group, and randomly divided into diabetes mellitus group ( n＝12) and liraglutide group (n＝12). Ten healthy male SPF Wistar rats with the same age and weight as GK rats were selected as normal control group. After adaptively feeded for 2 weeks, the liraglutide group was given liraglutide (400 μg·kg－1·d－1, subcutaneous injection), while the control group and diabetes mellitus group were given the same volume of saline, and continued to be administered for 8 weeks. After 10 weeks, data and biochemical indicators were recorded. Effects of liraglutide on learning and memory in diabetes mellitus rats were detected by Morris water maze test. HE staining observed the hippocampal neurons morphology. Western blotting method detected the expression of p- IκB kinase (IKK) β, p-NF-κB, NF-κB, Klotho, and PRX2 in hippocampus. Results Morris water maze test showed that liraglutide can improve the spatial learning and memory ability of diabetes mellitus rats. HE staining showed that liraglutide significantly reduced the pathological damage of hippocampal neurons of diabetes mellitus rats. Western blotting showed that liraglutide inhibited NF-κB signaling pathway in hippocampus of diabetes mellitus rats. The expression of Klotho protein in hippocampus of diabetes mellitus group was significantly lower than that of control group, while the expression of PRX2 protein was higher than control group (t＝8.298,－7.398,all P<0.01). The expression of Klotho and PRX2 protein in hippocampus of liraglutide group were higher than diabetes mellitus group (t＝－13.059, 14.113, all P<0.01). The expression of Klotho protein of liraglutide group was similar to that of control group ( t ＝ －1. 137, P>0. 05 ). The expression of PRX2 protein was significantly higher than control group (t＝－28.055, P<0.01). Conclusions Liraglutide may enhance the expression of antioxidant stress protein including Klotho and PRX2, by inhibiting NF-κB signaling pathway in hippocampus of diabetes mellitus rats, reduced oxidative stress and improved the injury of hippocampal neuronal in diabetes mellitus rats, which seems to play a neuroprotective effect, to prevent and delay the occurrence of diabetic encephalopathy.
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Objective To prepare pH-responsive osmotic nanocarriers (pMPPs),observe their distribution in the genital tract mucosa in mice,and evaluate their radiosensitizing effects in tumor cells.Methods Amphiphilic polymers containing pH-sensitive hydrazone bonds were synthesized and pMPPs were prepared by ultrasonic emulsification.At the same time,the hydrophobic polymer polylactic acid-glycolic acid copolymer (PLGA) and the amphiphilic polymer PLGA-polyethylene glycol without hydrazine bond were selected,and the mucoadhesive nanoparticles(MPs) and mucus-penetrating particles (MPPs) were prepared in the same way.Fluorescence microscopy was used to observe the distribution of three kinds of nanocarriers labeled with fluorescent dye Cy5.5 in the genital tract mucosa.The toxicity of nanocarriers to human cervical cancer cell line HeLa was tested by thiazolyl blue assay.The amphiphilic polymer containing pH-sensitive hydrazone bond was combined with oil-soluble gold nanoparticles to form a multi-encapsulated nanocarrier,and its radiotherapy sensitization effect in HeLa cells was evaluated by thiazole blue assay.Results The pMPPs were successfully prepared with relatively uniform particle size and good dispersion.Fluorescence microscopy showed that pMPPs not only had good mucus permeability,but also could improve the endocytosis efficiency of the nanocarriers in reproductive tract mucosa.The results of thiazolyl blue test showed that when the concentration of the carrier reached to 0.80 mg/ml,the survival rate of HeLa cells in the pMPPs group was higher than 90％ which was higher than that in the MPs and the MPPs groups,indicating that pMPPs had good biosafety.The HeLa cell survival rate of the CMNa group (0.80 mg/ml) was higher than that of the multi-package nanocarrier group under different doses of X-ray irradiation (4 Gy:82.90％ vs.61.79％;8 Gy:64.75 ％ vs.42.36％).This result indicated that compared with the CMNa,a commonly used clinical radiotherapy sensitizer,the multi-encapsulated nanocarriers can more effectively enhance the sensitivity of tumor cells to radiation therapy,thereby improving the lethality of radiation therapy on tumor cells.Conclusion This study solved the conflict between mucus permeation and endocytosis design of nanocarriers in mucosal tissue application,and provided new insight for the treatment of mucosal tissue diseases.
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Objective To prepare polyethylene glycol/cyclic asparagines-glycine-arginine functionalized gold nanoparticles (GNPs-PEG@cNGR) and evaluate their effectiveness in CT imaging of breast cancer angiogenesis.Methods The GNPs were synthesized by one-step reduction of chloroauric acid by sodium citrate.The thiolated PEG and cysteine-modified cNGR were coupled to the surface of GNPs through Au-S bonds,respectively.The GNPs-PEG@cNGR was characterized by transmission electron microscopy,Zeta potential/hydration particle size analyzer,and Fourier transform infrared spectrometer.The uptake and CT imaging effect of GNPs-PEG@cNGR were assessed by human umbilical vein endothelial cells (HUVEC) and human hepatoma cells (HepG2) positively expressed for aminopeptidase N (APN/CD 13).The in vivo CT imaging effects on tumor angiogenesis and biocompatibility in mice of GNPs-PEG@cNGR were studied by BALB/c mouse model of 4T1 breast cancer.Results A specific CT molecular probe,i.e.GNPs-PEG@cNGR,was successfully constructed,which can target angiogenesis.The probe was spherical,with a hydration particle size of (35.7± 1.0) nm and a Zeta potential of (-13.54± 1.12) mV,and had good stability and biocompatibility.The GNPs-PEG@cNGR has good CT imaging results and can specifically target CD13-positive HUVEC and HepG2 cells.The CT imaging results in 4T1 breast cancer mice indicated that GNPs-PEG@cNGR could be specifically enriched in the tumor tissue after injection.The CT value of tumors in GNPs-PEG@cNGRz group was higher than that of GNPs-PEG group,and the difference was statistically significant (P＜0.05).Conclusions GNPs-PEG@cNGR can specifically target CD13 positive cells and can be used as a CT contrast agent for imaging tumor angiogenesis.
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Objective To evaluate the preventive effects of Haishe capsules on the conversion of amnestic mild cognitive impairment (aMCI) to Alzheimer's disease(AD).Methods Patients (n=120) with aMCI from our department were recruited and randomly divided into the treatment group and the control group (n=60 in each group).The treatment group was given 0.9 gram of Haishe capsules three times a day while the control group received no drug treatment.Data on the conversion ratio,memory and cognitive function were comparedbetween the groups in a 24-months follow-up.Results By the end of the study,12 patients in the treatment group and 15 in the control group dropped out.Valid data for 93 patients were available for statistical analysis (48 in the treatment group and 45 in the control group).The number of aMCI patients who converted to AD was 6,with a conversion ratio of 12.5％ (6/48);and the number of patients who went through conversion in the control group was 13,with a conversion ratio of 28.8％ (13/45).The difference in conversion between the two groups was statistically significant (x2 =3.83,P＜0.05).After 24 months,MMSE scores for the treatment group (25.52± 1.07) had no significant change compared with baseline levels,while MMSE scores for the control group decreased significantly(24.75--1.49) and were markedly lower than thosefor the treatment group (t=2.85,P＜0.05).MoCA scores for the treatment group (19.39 ±2.01) did not show decline until the end of the study,while those for the control group started to decrease about half way through the study and were lower than scores for the treatment group (t =2.41,P＜0.05).Compared with baseline levels,ADAS-Cogscores for the treatment group (7.62± 1.06) did not increase significantly during the course of the study.ADAS-Cogscores forthe control group were higher at both half way (7.70±0.75) and the end of the study (8.18±0.80)than base line levels,and there was a statistically significant difference in end-of-study ADAS-Cog scores between the two groups(t =-2.6,P＜ 0.05).Conclusions Haishe capsules not only effectively maintain memory and cognitive function,but also delay the conversion from aMCI to AD.
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Objective To develop a fluorescence signal activatable multifunctional molecular probe with theranostics function through combining ultrasmall gold nanorods(UGNRs) with fluorescein,and to evaluate its therapeutic effect on photothermal therapy (PTT) in breast cancer cells.Methods The UGNRs were synthesized by the one-pot seedless method,then the functionalized modification of UGNRs were conducted using cysteamine.Finally,the activatable ultrasmall gold nanorods (AUGNRs) were synthesized by amide condensation of —NH2 of cysteamine and —COOH of carboxylated fluorescein CyS.The cell uptake ability and GSH-mediated imaging ability of AUGNRs were studied using breast cancer 4T1 cells.4T1 cells co-cultured with AUGNRs were irradiated with 808 nm excitation light,and the PTT effects were assessed by MTT colorimetric staining and calcein-AM/PI staining.Results The AUGNRs were synthesized successfully,which could be uptaken by 4T1 cells quickly and efficiently,and could achieve intracellular glutathione (GSH) triggered fluorescence recovery.No obvious cytotoxicity of AUGNRs to 4T1 cells was observed in the co-cultivation.Moreover,obvious PTT effects could be induced by 808 nm laser,which could effectively kill 4T1 cancer cells.Conclusion The fluorescence signals of AUGNRs can be induced by intracellular GSH,and tumor cell destruction can be achieved by 808 laser-excitated PTT effects.
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Objective To explore the clinical features and treatment of upper gastrointestinal bleeding with rare etiologies.Methods A total of 45 cases with rare etiologies was selected from a group of 1200 patients with upper gastrointestinal bleeding admitted from January 2012 to December 2015.Results The incidence of gastric stromal tumor (24.4％) and Dieulafoy's lesion (20.0％) was the highest.Among rare etiologies of upper gastrointestinal bleeding were Mallory-Weiss syndrome (17.8％) and stomal ulcer and hemorrhage of efferent loops after subtotal gastrectomy (17.8％),as well as left-side portal hypertension (6.7％),liver cirrhosis complicated with variceal bleeding in the descending part of the duodenum (2.1％),esophageal hematoma (2.1％),esophageal mucosa avulsion (2.1％),P-J syndrome (2.1％),duodenal adenocarcinoma (2.1％),and cutaneous malignant melanoma with duodenal metastasis (2.1％).Conclusions Gastroscopy in early stages played a role in etiologies identification,while etiological treatments could substantially reduce recurrent bleeding rate,thus enhanced cure rate.Analysis on rare etiologies promoted the medical understanding,with clinical diagnosis and treatment improved.
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Objective To investigate the effect of liraglutide on the expression of NF-kappa B (NF-κB), tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) in renal tissue of insulin resistance rats. Method The rats were divided into 4 groups, control group ,high fat group ,liraglutide low dose group [100 μg/(kg· d)], liraglutide high dose group[100 μg/(kg·d)]. Detection of serum creatinine and urea nitrogen by automatic biochemical analyzer, and 24 h urine micro albumin was determined by immunoassay. The protein concentration of serum NF-κB,TNF-α and IL-6 was measured by ELISA. The expression of NF-κB,TNF-α and IL-6 mRNA in renal tissues was determined by RT-PCR. Results Compared with the control group, the serum creatinine, blood urea nitrogen,urinary protein, and the expression of NF-κB, TNF-α and IL-6 were significantly higher in high fat group, respectively (P < 0.05). The glomerular basement membrance thickening and foot process fusion were seen under electron microscope. Liraglutide high dose intervention can significantly reduce these changes. Conclusions Liraglutide can inhibit the expression of NF-κB,TNF-α and IL-6 in renal tissues of high fat induced insulin resistance rats,in a concentration dependent manner, which possibly improve renal function.
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<p><b>OBJECTIVE</b>To explore the feasibility and safety of dexmedetomidine combined with remifentanil for lower eyelid blepharoplasty.</p><p><b>METHODS</b>50 patients undergoing lower eyelid blepharoplasty ASA I - II were randomly divided into 2 groups (25 in each group) as observation group and control group. Dexmedetomidine (0.3 microg x kg(-1) x h(-1)) and remifentanil (0.05 microg x kg(-1) x min(-1)) were used in observation group. Local anesthesia by lidocaine (1%) combined with midazolam (0.04 mg/kg) intravenous sedation were used in control group. HR, mean arterial pressure (MAP), heart rate (HR), breathing rate (RR), pulse oxygen saturation (SpO2) change were monitored and recorded before and after the administration of the drug, as well as at the beginning of operation, during the operation, at the end of the operation, and 5 minutes after the operation. Patients sedation degree was evaluated by Ramsay. Operation time, recovery time, the incidence of adverse reactions, the satisfaction of patients and doctors were also recorded.</p><p><b>RESULTS</b>Patients had no obvious difference of intraoperative MAP, RR, SpO2, operation time and postoperative recovery time between the two groups (P > 0.05). Compared with control group, HR during the operation were decreased significantly [(64.2 +/- 8.2) bpm, P < 0.05] in observation group. In control group, there were 18 cases of patients with agitation, but they endured the operation anyway. In observation group, 24 cases of patients underwent operation without agitation. The satisfaction of patients and the operation doctors (96%) in observation group were markedly higher than that in control group (P < 0.05).</p><p><b>CONCLUSION</b>Dexmedetomidine combined with remifentanil is practical and safe. The effect of reducing HR should be noticed.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Blepharoplasty , Dexmedetomidine , Therapeutic Uses , Double-Blind Method , Hypnotics and Sedatives , Therapeutic Uses , Piperidines , Therapeutic UsesABSTRACT
Objective To explore the therapeutic efficacy and safety of endoscopic sphincterotomy joint balloon dilatation in the treatment of common bile duct calculi in order to reduce the recent and long-term complications.Methods A total of 120 cases of patients with common bile duct calculi was grouped into three groups:endoscopic sphincterotomy joint balloon dilatation,endoscopic sphincterotomy (EST),and endoscopic papillo-sphincter balloon dilatation (EPBD).The operative efficacy of three groupsand the incidence of postoperative immediate and long-term complications were observed and compared.Results No difference was found in total stone-free rate among three groups.No significant difference was found in a stone-free rate and lithotripsy rate between endoscopic sphincterotomy joint balloon dilatation and EST groups (P ＞ 0.05),however,those parameters in the former two groups were better than EPBD group (P ＜ 0.05).The incidence of postoperative bleeding in the endoscopic sphincterotomy joint balloon dilatation group is lower than EST group.The incidence of postoperative pancreatitis in the endoscopic sphincterotomy joint balloon dilatation and EST groups was lower than the EPBD group(P ＜ 0.05).For the long-term complications,the incidence of reflux cholangitis in the endoscopic sphincterotomy joint balloon dilatation group was lower than the EST group (P ＜ 0.05).The recurrence rate of postoperative bile duct calculi in the endoscopic sphincterotomy joint balloon dilatation group was lower than the EST and EPBD groups.Conclusions For the endoscopic sphincterotomy joint balloon dilatation in the treatment of common bile duct calculi,its curative effect was the same as the EST,but better than EPBD; it had a lower incidence of immediate and long-term complications than EST and EPBD.
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Objective To compare the effect of endoscopic nasobiliary drainage (ENBD) and endoscopic retrograde biliary drainage (ERBD) on intestinal mucosal barrier function of patients with obstructive jaundice in clinical practice.Methods Forty patients with significant jaundice due to obstructive disorders of biliary tract and 20 health volunteers as controls were recruited.At the baseline,serum diamine oxidase (DAO) was measured with ultraviolet spectrophotometer,while endotoxin and tumor necrosis factorα (TNF-α) were determined with endotoxin detector and enzyme-linked immunosorbent assay (ELISA)kits,respectively.Forty patients were then divided randomly into ENBD and ERBD groups (n =20 patients per group).Dynamic changes in serum DAO,endotoxin and TNF-α were observed postoperatively.Results In the patients with obstruction of biliary tract,higher serum bilirubin,γ-glutamyl transpeptidas (γ-GT),alkaline phosphatase (ALP),DAO,endotoxin,and TNF-α were found preoperatively relative to those in health control (P ＜ 0.05).After operation,ERBD and ENBD had comparable effect on improving serum bilirubin,γ-GT and ALP,while serum DAO,endotoxin and TNF-α in each group were dramatically decreased.In day 1 after operation,there was no significant difference in serum DAO,endotoxin and TNF-α between two groups.However,in day 3 and 7 after operation,serum DAO,endotoxin and TNF-α in ENBD group were significantly higher than those in ERBD group (P ＜ 0.05).Conclusions It was suggested that ERBD and ENBD have comparable effects on removing obstruction of biliary tract and draining bile.However,ERBD might have greater benefits than ENBD in improving intestinal mucosal barrier function,and thus would be more beneficial in preventing systemic inflammatory response.
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Objective To study the relationship between serum macrophage migration inhibitory factor (MIF) levels and clinical features in the patients with colorectal cancer. Methods Enzyme-linked immunosorbent assays was used to detect the concentration of MIF in sera of 75 patients with colorectal cancer (35 case with primary colorectal cancer and 40 cases with lymphnode metastasis of colorectal cancer) and 40 healthy controls. The relationship between serum MIF levels and clinical features was analyzed. Results Serum MIF was found to be significantly elevated in the patients with colorectal cancer(mean value 31.2ng/ml) compared with healthy subjects (mean value 13.6ng/ml) (P <0. 001). The levels of MIF in colorectal cancer were significantly correlated with advanced clinical progression pathology stages (P <0. 05) and lymph node metastasis (P < 0. 05). Conclusions Increased expression level of MIF in serum may promote the pathogenesis of colorectal cancer and M1F is closely associated with the stages and lymph node metastasis of colorectal cancer.