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Objective:To systematically review the prevalence, influencing factors of financial toxicity and coping strategies in cancer patients.Methods:The studies on financial toxicity among cancer patients were searched in PubMed, Embase, The Cochrane Library, Web of Science, CINAHL, WangFang Data, CNKI, Sinomed, VIP from inception to June 2022. Stata14.0 software was used to analyze the prevalence of financial toxicity and coping strategies with a single group meta-analysis. Descriptive analysis was used to analyze the influencing factors.Results:A total of 25 papers including 2 939 cancer patients were included. Meta-analysis results showed that the prevalence of financial toxicity in cancer patients was 47% (95% CI 39%-55%). The influencing factors of financial toxicity included sociodemographic factors, disease related factors, medical insurance related factors and psychological factors. Conclusions:The high incidence of financial toxicity in cancer patients is associated with a variety of factors. Health care professionals should pay attention to early screening of cancer patients, dynamically collect relevant data such as patient expenditure items, continuously assess patients' economic status, and make relevant preventive efforts.
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Objective:To investigate the treatment of Omalizumab for allergic asthma (AS) combined with atopic dermatitis (AD) in children.Methods:Five children who were diagnosed with moderate-to-severe AS combined with AD were admitted in the Department of Respiratory, Children′s Hospital of Nanjing Medical University from November 2018 to August 2020.All children were treated with standardized treatment of AS and Omalizumab.The efficacy and adverse reactions of Omalizumab treated for AD were observed.The scoring atopic dermatitis index (SCORAD), eczema area and severity index (EASI), the children′s dermatology life quality index (CDLQI) and numerical rating scale (NRS) were selected, the scales were used to evaluate the severity, area, itching and quality of life of AD children.Results:The AD-related evaluation indexes were remarkably decreased through the treatment of Omalizumab for 4 months, including SCORAD, EASI, CDLQI, and NRS(60.80±10.79 vs.40.30±15.62; 13.93±6.81 vs.6.18±2.70; 18.80±6.26 vs.13.20±4.82; 8.60±0.89 vs.6.00±1.87), the differences were statistically significant ( t=7.833, 4.106, 5.199, 5.099, all P<0.05). Two children administered the combination of Omalizumab and allergen specific immunotherapy, and no adverse reactions were observed in the process of immunotherapy.Totally, 104 hypodermic injections were accepted in all children, without adverse reactions being observed. Conclusions:This study suggested that the Omalizumab treatment can significantly reduce the severity and area of AD, and improve the quality of life for children with moderate-to-severe AS combined with AD.The application of Omalizumab before the allergen specific immunotherapy can improve the immunotolerance and security.There were mild adverse reactions in the treatment with the long-term hypodermic injection of Omalizumab that has higher security.Being taken together, Omalizumab is a potential novel target drug for the treatment of AD in children, and perhaps it is an adjuvant administration for allergen specific immunotherapy.
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Objective:To investigate the clinical efficacy of postoperative radiotherapy combined with compound matrine injection on the patients with breast cancer.Methods:Eighty-three patients with breast cancer received breast-conserving and sentinel lymph node biopsy before the study who were admitted in our hospital were divided into the control group and observation group.Forty-two patients in control group were treated with postoperative radiotherapy,and forty-one patients in observation group were received postoperative radiotherapy combined with compound matrine injection.The CA125,CA153,CA724,levels of CD3+,CD4+,CD8+,CD4+/CD8+,NK,and adverse reaction in the two groups were detected and compared.Results:After treatment,the CA125,CA153,and CA724 in both groups were obviously decreased (P＜0.05),which were significantly lower in the observation group than those of the control group (P＜0.05).CD3+,CD4+,CD8+,CD4+/CD8+,and NK cell in the observation group showed remarkable improvement (P＜0.05) compared with those before treatment.And CD3+,CD4+,CD4+/CD8+,and NK cell of the observation group were significantly higher than those of the control group,while CD8+ was much lower (P＜0.05).During the treatment period,the incidence of skin reaction over grade Ⅱ,and myelosuppression in observation group were much lower than those of control group (P＜0.05).Conclusion:Postoperative radiotherapy combined with compound matrine injection had good ability in enhancing the cellular immune function and reducing adverse reaction on the patients with breast cancer.
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Objective To investigate the effect of enhanced recovery after surgery (ERAS) on stress hyperglycemia in patients after pancreaticoduodenectomy (PD). Methods Patients matched inclusion and exclusion standards were divided into two groups. The patients after PD before the implementation of ERAS programme were named as the control group (40 cases). The patients after PD with the implementation of ERAS programme were named as the experimental group (52 cases). The fast blood glucose (FBG) in postoperative day (POD) 1, 3, 7 and the volatility of capillary blood glucose during postoperative 3 days were compared between the two groups. Results The FBG in POD1, POD3, POD7 were (8.27 ± 1.99), (6.78 ± 1.22), (5.97 ± 1.21) mmol/L in the experimental group respectively, and the FBG in POD1, POD3, POD7 were (10.46 ± 5.17), (7.88 ± 2.98), (7.29 ± 2.94) mmol/L in the control group respectively, there were significant differences between two groups (t=2.545, 2.219, 2.683, all P 0.05), while significant differences were found in the volatility of capillary blood glucose in POD3 between the two groups (t=2.739, P<0.05). Conclusions It can be concluded that ERAS may be useful to decrease stress hyperglycemia and the volatility of capillary blood glucosein patients after PD, and accelerate the recovery of patients after PD.
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Objective To observe the mechanism of action of different extracts ofTangwang Mingmu Granules on high glucose induced VEGF and IL-1α gene and protein expressions in vascular endothelial cells.Methods Human umbilical vein endothelial cells EA.hy926 were divided into six groups: blank, high glucose,Tangwang Mingmu Granules, extract 1 (glycoside and flavonoid), extract 2 (organic acid and polysaccharides) and extract 3 (alkaloids) groups. High concentration glucose was used to establish the high glucose model in EA.hy926 cells. The expressions of VEGF and IL-1α mRNA were detected by semi-quantitative RT-PCR. The contents of VEGF and IL-1α protein were tested by ELISA.Results The gene expression and protein levels of VEGF and IL-1α were significantly up-regulated under the high glucose condition (P extract 3> extract 2.Conclusion The action intensity of glycosides and flavonoids, alkaloids, organic acids and polysaccharides on VEGF and IL-1α expression inTangwang Mingmu Granules weakens in sequence.
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BACKGROUND:Animal studies have shown that cauda equina compression can induce apoptosis of lumbosacral spinal cord anterior horn motor neurons. OBJECTIVE:To explore the pathological change in lumbosacral spinal cord after acute cauda equina compression in dogs. METHODS:A total of 27 dogs were randomly divided into nine groups, with three dogs in each group. There were one normal control group, seven experimental groups and one sham surgery group. In the experimental group, an empty water sac was implanted above epidural fat below L6 vertebral plate. Compression was given by injecting water at 4, 8, 12, 24, 48, 72 and 168 hours. In the sham surgery group, an empty water sac was implanted, but compression was not given. At the time of compression, the spinal cord sent out by cauda equina nerve and adjacent to the head end was subjected to histopathological examination. RESULTS AND CONCLUSION:(1) Results of light microscope:at 4-48 hours of compression, spinal cord anterior horn motor neurons did not alter. At 72 hours, motor neurons became smal , cel membrane shrank and separated from surrounding tissues. Cel s were homogenous and darkly stained. At 168 hours, motor neurons disappeared, but spinal cord sections of the adjacent head end did not shown abnormal motor neurons in the spinal cord anterior horn. (2) Results of electron microscope:at 12 hours, spinal cord tissue began to swel , and the swel ing aggravated with prolonged time of compression. The swel ing of glial cel s was apparent. At 168 hours, myelin sheath structure dissolved;axons showed vacuolization;axoplasm spil ed, and exhibited inflammatory injury-like changes. (3) Apoptotic results of spinal cord anterior horn motor neurons:apoptosis appeared at 12 hours of compression, became increased, and showed an increased trend at 168 hours.
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Objective To observe the effect of simvastatin on bone metastasis of breast cancer in nude mice model.Methods Sixty mice were divided into three groups randomly with 20 in each group.Mice were inoculated with MDA-MB-231 cells into the left cardiac ventricle.After 7 days,mice were treated with either simvastatin,saline,or nothing twice per week for 19 days.The area of osteolytic metastases was subsequently measured in long bones of all mice using an image analysis system.After sacrifice,parathyroid hormone-related protein (PTHrP) concentrations in bone marrow from all mice were determined using a two-site immunoradiometric assay.Osteoclast number expressed per millimeter of tumor/bone interface was assessed using an OsteoMeasure System.Measured data were compared with analysis of variance,and P ＜ 0.05 for the difference was statistically significant.Results The area of osteolytic lesions was significantly lower in mice treated with simvastatin compared with mice receiving saline and no treatment (0.51 ±0.18 mm2 vs 2.13 ± 1.24 mm2 vs 2.29 ± 1.22 mm2 ; F =15.600,P =0.002 ; F =15.673,P =0.001).In addition,treatment with simvastatin decreased the concentrations of PTHrP in bone marrow plasma (0.98 ±0.20 pmol/L vs 2.11 ±0.31 pmoL/L vs 1.99 ± 0.29 pmol/L; F =61.469,P ＜ 0.001 ; F =58.274,P ＜ 0.001) and the osteoclast numbers per millimeter of tumor/bone interface (4.00 ± 1.73 vs 11.40 ±4.93 vs 10.91 ± 3.87 ; F =17.820,P =0.001 ; F =17.184,P =0.002) compared with controls.Conclusion Simvastatin may reduce the production of PTHrP of breast cancer cells,which suppresses the development of destructive bone lesions as well as the growth of breast cancer cells in bone.
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Objective To observe the preventive and therapeutic effects of the new process extracts ofTangwang Mingmu Granule on rats with diabetic retinopathy.Methods The best preparation process technology of drug extraction was improved and selected based on the traditional water decoction of Chinese medicine. The active ingredient of two processes were detected and compared by HPLC. In vitro and in vivo pharmacodynamic evaluation models were used to evaluate the drug effects and analyze its mechanism. MTT assay was used to analyze the inhibitory effects of extracts in the two processes on EA.hy 926 cell proliferation in vitro. The effects of two extracts on STZ induced rat diabetic microvascular disease and its related factors were observed by retinal slice staining and ELISA.Results Compared with the traditional process, the active ingredients of the extracts were improved by the new technology ofTangwang Mingmu Granule. The preparation process ofTangwang Mingmu Granule could significantly improve the diabetic rat retinal microvascular pathological state, and reduce the protein expression levels of angiogenesis related factors.Conclusion The new preparation process could effectively improve the active ingredients in the herbal extract. The extract of new technology showed a significantly effect on the diabetic rats in retinal microvascular pathology state. The mechanism may be related to the regulation of vascular cell adhesion molecules and inflammatory factors.
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ObjectiveTo observe the effect of different extracts ofTangwang Mingmu Granule on hypoxia induced gene expressions in vascular endothelial cells.Methods COCl2 intervention cells were used to copy hypoxia models. Human umbilical vein endothelial cells EA. Hy926 were divided into blank group, hypoxia model group,Tangwang Mingmu Granule group, extract 1 (glycosides and flavonoids) group, extract 2 (orgain acids and polysaccharides) group and extract 3 (alkaloids) group. The changes in gene expressions of VEGF, VEGFR-1, VEGFR-2, ICAM-1 and IL-1α mRNA were detected by semi-quantitative RT-PCR.ResultsThe gene expression levels of VEGF, VEGFR-1, VEGFR-2, ICAM-1 and IL-1α were significantly up-regulated under the hypoxic condition (Palkaloids>organic acids and polysaccharides inTangwang Mingmu Granule.
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Objective To study the reasons of seroma formation and long-term existence after modified radi-cal mastectomy ( MRM) .Methods The structure of fibrous lamina for seroma postoperative breast cancer was ana-lyzed by pathological methods;the composition of drainage fluids after MRM in the different postoperative time peri-ods was determined;and the structure of fibrous lamina following an experimental mastectomy model created in rats was investigated,which the process of fibrous lamina formation was imitated.Results There were three layer struc-tures in fibrous lamina,including fibrous leakage,capillaries and fiber lay.Hematology test results supported seroma for exudate.Animal model showed that with the extension of time,fibrous lamina thickened gradually.Conclusion It is capillaries in fibrous lamina that seroma long-standing histological basis.Maybe excising or destructing the structure of subcutaneous fibrous lamina,making the procedure of wound healing to begin again as soon as possible,which is a kind of effective method to solve the problem of seroma long-term existence after MRM.
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Objective To observe the vaccination reactions and immunogenicity of the application of lyophilized Vero cell rabies vaccine without adjuvant in a way of low-dose intradermal injection for post-exposure group. Methods Conducting post-exposure immunization for 256 persons with the class Ⅱ level exposure to rabies. Based on a randomized, single-blind principle, all subjects were divided into intradermal injection (ID) group (n= 128),injected 0.1 ml for each site in accordance with 0,3,7,28,90 d,2 sites,2 sites,2sites,1 site,1 site respectively, and intramuscular injection(IM) group(n= 128) in accordance with 0,3,7,14,28 d in full-volume (0.5ml) PVRV Deltoid injection. The local and systemic vaccination reactions were observed for the different injection ways. The indirect sandwich ELISA assay was used to analyze the antibody levels. Results For the intradermal injection group, the incidence rates for local redness and swelling, induration, pain, itch were 1.27%, 0.29% ,0.49% ,11.43% respectively,for the intramuscular group, the incidence rates were 1.09% ,0. 16% ,2. 81% ,1.41% respectively. From the point of systemic reactions,the incidence rates of fever,rash,headache,fatigue and weakness were 0.31 % ,0. 16% ,0. 31 % , 1.09% respectively in the intradermal injection group,and the rates were 0.31% ,0.31% ,0.63% , 1.09% respectively in intramuscular group. All the adverse effects often occurred following the 1st,2nd injection. The seroconversion rates for intradermal injection and intramuscular were 94.53% ,95.31% following 14 d immunization respectively,the rates were 96. 83% ,97.64% following 42 d immunization respectively. For the post-exposure group,no statistical difference in significance was found between the two seroconversion rates. Conclusion For the application of domestic lyophilized Vero cell rabies vaccine,its adverse reactions are mild,and immunogenicity is good.
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Objective To discuss the clinical feature of chronic pain of aged people and strategies and effect of its self-management as well as their relationship.Methods Investigation with questionnaires wag carried out in 243 aged people who were above 65 years old to understand the clinical feature of chronic pain and strategies of its self-management.The results underwent analysis.Results Non-narcotic analgesics,physical exercise,cold and heat therapy and spiritual activity were used most frequently in selfmanagement of pain.No statistical difference existed in the use of self-management strategies between people in different age groups.Effect of self-management strategies was negatively correlated with degree of pain,interrupting with daily life and anxiety,but Wag positively correlated with self-efficacy score.Conclusions Aged people ale willing to attemp various strategies to cope with chronic pain.We should pain attention to the standardization of physical exercise,confrontation of anxiety and improvement of self-efficacy to improve the effect of self-management.
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In order to investigate the impairment of mitochondrial membrane phospholipid localization and DNA(3867) (mtDNA(3867)) deletion and the correlation between cardiac and skeletal muscle cells in mice with viral myocarditis, 50 BALB/c mice were divided into two groups randomly. In experimental group (n=40), the mice were intraperitoneally injected with 0.1 mL Eagle liquid with CVB3(TCID50=10(8)), while in the control group (n=10), the mice were subjected to equal volume of Eagle liquid. The impairment of mitochondrial membrane phospholipid localization and mtDNA(3867) deletion rate of cardiac and skeletal muscle were detected separately at day 3, 11 and 24 after injection. The correlation of mitochondrial membrane phospholipid localization and mtDNA(3867) deletion rate between cardiac and skeletal muscle cells cells was analyzed using Spearman method. At the day 3 after injection, in both cardiac and skeletal muscle cells, mtDNA(3867) deletion rate was significantly higher in experimental group than in control group (P0.05). At day 11 after injection, the mtDNA(3867) deletion rate of both cells in experimental group was increased to the peak level (P0.05). At the day 24 after injection, the impairment of mitochondrial membrane phospholipid localization and mtDNA(3867) deletion of both cells showed a recovery tendency, but still severer than those at the day 3 after injection (P<0.05). The impairment of mitochondrial membrane phospholipid localization and mtDNA(3867) deletion were consistent and synchronistic between cardiac and skeletal muscle cells, and showed good correlations (P<0.05). The impairment of mitochondria plays an important role in the pathogenesis of viral myocarditis, and the skeletal muscle cells might act as a peripheral "window" to reflect the mitochondrial damage of cardiac myocytes.
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In order to investigate the impairment of mitochondrial membrane phospholipid localization and DNA3867 (mtDNA3867) deletion and the correlation between cardiac and skeletal muscle cells in mice with viral myocarditis, 50 BALB/c mice were divided into two groups randomly. In experimental group (n=40), the mice were intraperitoneally injected with 0.1 mL Eagle liquid with CVB3 (TCID50=108), while in the control group (n=10), the mice were subjected to equal volume of Eagle liquid. The impairment of mitochondrial membrane phospholipid localization and mtDNA3867 deletion rate of cardiac and skeletal muscle were detected separately at day 3, 11 and 24 after injection. The correlation of mitochondrial membrane phospholipid localization and mtDNA3867 deletion rate between cardiac and skeletal muscle cells cells was analyzed using Spearman method. At the day 3 after injection, in both cardiac and skeletal muscle cells, mtDNA3867 deletion rate was significantly higher in experimental group than in control group (P＜0.05), but the localization of mitochondrial membrane phospholipid showed no difference between two groups (P＞0.05). At day 11 after injection, the mtDNA3867 deletion rate of both cells in experimental group was increased to the peak level (P＜0.05), and the impairment of mitochondrial membrane phospholipid localization of both cells also increased markedly in experimental group as compared with control group (P＞0.05). At the day 24 after injection, the impairment of mitochondrial membrane phospholipid localization and mtDNA3867 deletion of both cells showed a recovery tendency, but still severer than those at the day 3 after injection (P＜0.05). The impairment of mitochondrial membrane phospholipid localization and mtDNA3867 deletion were consistent and synchronistic between cardiac and skeletal muscle cells, and showed good correlations (P＜0.05). The impairment of mitochondria plays an important role in the pathogenesis of viral myocardifis, and the skeletal muscle cells might act as a peripheral "window" to reflect the mitochondrial damage of cardiac myocytes.
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Purpose: To explore the therapeutic methods and effects in the treatment of acute and chronic injuries of the ankle joint by Chinese massage therapy in combination with external application of Chinese herbal drugs and functional exercises. Methods: Totally, 36 cases of the patients with acute soft tissue injury, chronic soft tissue injury and post-fracture sequelae of the ankle joint were treated by Chinese massage therapy, external application or external wash of Chinese herbal drugs, and exercises of dorsal flexion and extension of the ankle joint, to observe the restoration of the ankle functions.Results: In 36 cases of the patients, the results showed remarkable effect in 18 cases, effect in 16 cases, failure in 2 cases and the effective rate in 94.4%. Conclusion: The combined use of Chinese massage therapy, external application of Chinese herbal drugs and functional exercises can produce precise effect in the treatment of soft tissue injury of the ankle joint.
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Aim To study the anti-tumor effect of 20(S)-Protopanaxadiol(PPD)at different concentration on human liver cell line SMMC-7721 in vivo and in vitro.Methods The subcutaneous transplantable tumor model of human liver cancer in nude mice was established and the anti-tumor effect was calculated.Cell growth rate was determined with MTT assay.The apoptosis was analyzed by FITC-AnnexinⅤ/PI and Hoechst33342 staining method,and the activity of Caspase-3 was detected.Results In vivo,PPD could obviously inhibit the growth of transplanted tumor.In vitro,PPD induced inhibition of human liver cancer SMMC-7721 cells was time-dependent and dose-dependent.The apoptotic body was observed by Hoechst33342 staining.PPD could induce cell apoptosis of SMMC-7721,and the increase of Caspase-3 activity was observed in each PPD group.Conclusion PPD could inhibit the growth of human liver cancer SMMC-7721 cells in vivo and in vitro by up-regulating the activity of Caspase-3 and inducing the cell apoptosis.
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Objective To observe the expression and distribution of myofibroblasts in the healing process of bile duct and discuss its function and significance in the process of iatrogenic biliary stricture formation. Methods A model of trauma-repair of bile duct in the dog was made . The anastomosis tissues on week 1,3 and month 3,6 after operation were studied with TEM and immunohistochemical SP staining of SMA. Results Myofibroblasts functioned actively and lasted for the whole process, extracellular matrix overdeposited. SMA staining was observed in myofibroblasts and highly expressed from 1 week to 6 months after operation. The consequence easily leaded to scar contracture and anastomoctic stenosis. Conclusion Myofibroblast is the main cause of scar contracture of bile duct.
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The cytochemical method of Ca-ATPase activity was studied in this article. The native made reagent was utilized and worked in our department, The appearance of Ca-ATPase activity was researched for the cells of hepar, kidney, brain and oviduet, especially for the membrane system of myocardium cell.
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Objective To elucidate the relationship between f luoride and cell apoptosis of ameloblasts and to further study the mechanism of dental fluorosis. Methods By establishing an experimental m odel of fluoride intoxication in pregnant C57BL/6N, we observed apoptosis in the fetal secretory ameloblasts in mice by means of transmission electron microscop e and TUNEL. Results High fluoride exposure in pregnant mic e could cause subameloblastic cysts in first lower molar of fetal mice. Programm ed cell death (PCD) occurred in the disturbed ameloblasts above cysts. Conclusion Intoxicat ion mechanism of fluoride on ameloblasts may occur by means of PCD.