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Ultrasound-guided radioactive 125I particle implantation for the treatment of advanced gallbladder cancer is susceptible to factors such as ribs, respiratory activity, and biliary reflex, which brings great inconvenience to the operation. We reported one case of gallbladder cancer patients with unclear ultrasound imaging under general anesthesia mechanical ventilation and successful transplantation after sustained inflation with general anesthesia in order to providing basis of clinical diagnosis and treatment.
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Objective:To construct a simple, precise and personalized comprehensive nomogram for prediction the risk of multidrug-resistant tuberculosis (MDR-TB) and to evaluate its prediction value among individuals with previous tuberculosis history (PTBH).Methods:A matched case-control study (1∶2 ratios) was performed in 1 881 patients with PTBH treated in 12 designated tuberculosis hospitals in Hangzhou City between January 1, 2005 and December 31, 2019, and there were 1 719 patients in training set, and 162 in validation set. A multivariable Cox regression analysis was used to evaluate independent predictors for the incident of MDR-TB in individuals with PTBH. A comprehensive nomogram was developed based on the multivariable Cox model. The accuracy of the prediction was assessed using concordance index (C-index), calibration curve and area under the receiver operator characteristic (ROC) curve.Results:The nomogram constructed based on the multivariable Cox regression model incorporated 10 independent predictors of the risk of MDR-TB. A history of direct contact (grade 1, 0-100.0 points) ranked on the top of all risk factors, followed by duration of positive sputum culture (grade 2, 0-84.5 points), unfavorable treatment outcome (grade 3, 0-52.0 points), human immunodeficiency virus infection (grade 4, 0-48.5 points), retreated tuberculosis history (grade 5, 0-40.0 points), non-standardized treatment regimens of retreated tuberculosis (grade 6, 0-32.5 points), duration of pulmonary cavities (grade 7, 0-31.0 points), passive mode of tuberculosis case finding (grade 8, 0-25.0 points), age<60 years (grade 9, 0-17.5 points), and standard frequencies of chest X-ray examination (grade 10, 0-14.0 points). The C-indexes of this nomogram for the training and validation sets were 0.833 (95% confidence interval ( CI) 0.807-0.859) and 0.871 (95% CI 0.773-0.969), respectively, indicating that the nomogram had good fitting effect. The calibration curves for the risk of incident MDR-TB showed an optimal agreement between nomogram prediction and actual observation in the training and validation sets, respectively.The areas under ROC curve of the 1-year, 5-year, and 10-year MDR-TB risk probability of the training set were 0.904, 0.921, and 0.908, respectively, and those of the validation set were 0.954, 0.970, and 0.919, respectively. Conclusion:Through this nomogram model, clinicians could precisely predict the risk of incident MDR-TB among individuals with PTBH in the clinical practice.
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Objective:To investigate the inhibitory effects of resveratrol (Res) on the apoptosis of retinal neurons of diabetic rats and ARPE-19 cells induced by high glucose.Methods:Streptozotocin was intraperitoneally injected to establish a diabetes model in 25 adult male SD rats, and 20 successful models were randomized into diabetic model group and Res-administered group according to random number table method.Another 10 matched normal rats were served as normal control group.Res was intragastrically given to the rats in the Res-administered group with the dose of 40 mg/(kg·d), and an equivalent volume of normal saline solution was used in the same way in the diabetic model group and normal control group.The body weight and blood glucose level were measured on the 0th, 4th, 8th, 12th week of administration.The rats were sacrificed on the 12th week by over-anesthesia and the eyeballs were enucleated.The ultrastructure of the retinal ganglion cells (RGCs) were examined under the transmission electron microscope.The terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) assay was to assess the apoptosis of retinal neurons.ARPE-19 cells were divided into normal control group, high glucose group and Res-treated group and cultured for 48 hours in medium containing 5.5 mmol/L glucose, 30 mmol/L glucose, 30 mmol/L glucose and 10 mol/L Res, respectively.Apoptosis rate was detected by a flow cytometry.The distribution and expression of bax and bcl-2 in the cells was detected by immunofluorescence and Western blot assay, respectively.This study protocol was approved by an Experimental Animal Ethic Committee of Hubei University of Science and Technology, and the use and care of the animals complied with the Statement of ARVO.Results:Compared with the diabetic model group, the body weight was increased at 4-12 weeks and the blood glucose level was lowered at 8-12 weeks of Res administration in the Res-administered group (both at P<0.01). The chromatin condensation, mitochondrial swelling and vacuolation in cytoplasm were obviously slight and the apoptosis rate was reduced in the Res-administered group in comparison with the diabetic model group.The apoptosis indexes of the retinal ganglion cell layer cells and inner nuclear layer cells in the Res-administered group were (18.36±3.37)% and (23.67±8.98)%, respectively, which were significantly lower than (83.91±9.8)% and (64.26±10.66)% in the diabetic model group (both at P<0.01). The apoptosis rate of the ARPE-19 cells in the normal control group, high glucose group and Res-treated group was (3.11±0.26)%, (11.41±1.06)% and (5.38±0.58)%, respectively, and the apoptosis rate in the Res-treated group was significantly lower than that in the high glucose group (all at P<0.01). Immunofluorescence assay showed that the fluorescence of bax in the cell nucleus of Res-treated group was obviously enhanced in comparison with the normal control group and weaker in comparison with the high glucose group.The fluorescence of bcl-2 protein in the Res-interfered group was weaker in comparison with the normal control group and enhanced in comparison with the high glucose group.The relative expressions level of bax protein in the Res-treated group was 0.21±0.08, which was significantly higher than 0.15±0.06 in the normal control group and lower than 0.31±0.09 in the high glucose group (both at P<0.05). The relative expressions of bcl-2 protein was 0.66±0.25 in the Res-treated group, which was significantly lower than 0.80±0.14 in the normal control group and higher than 0.23±0.09 in the high glucose group (both at P<0.05). The bcl-2/bax ratio in the Res-treated group was significantly higher than that in the high glucose group ( P<0.01). Conclusions:Res can inhibit the apoptosis of RGCs of diabetic rats and high glucose-induced RPE cells in vitro.
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Objective:To identify the significance of interstitial implantation of radioactive seeds for stage IV pancreatic cancer.Methods:Clinical and follow-up data of 37 patients of stage Ⅳ pancreatic cancer with ultrasound-guided percutaneous radioactive seeds implantation as the primary treatment were retrospectively analyzed.Results:The postoperative survival time of 37 cases in the whole group was (7.49±4.08) months, ranging from 3 to17 months. Of the 30 patients who had upper abdominal and/or back pain before operation, 27 patients got different degrees of pain relief after operation; 20 cases were found with ascites before operation, but ascites in 18 cases decreased or disappeared after operation.Conclusion:The treatment of interstitial implantation of 125I radioactive seeds can effectively upgrade the life quality of stage IV pancreatic cancer patients.
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OBJECTIVE@#To assess the association of Eph-receptor tyrosinekinase-type A2 (EphA2) gene polymorphisms with susceptibility to age-related cataract (ARC) among ethnic Han Chinese from Hubei Province.@*METHODS@#280 patients with cortical ARC and 200 healthy controls were recruited. Polymorphisms at four loci (rs3768293, rs3754334, rs477558 and rs7548209) of the EphA2 gene were detected by PCR-restriction fragment length polymorphism (PCR-RELP) assay. Allelic and genotypic frequencies of the two groups were compared.@*RESULTS@#Compared with the control group, the AA genotype of rs3768293 locus was more common, while the AC genotype was much rarer (P 0.05). The AA genotype of the rs477558 locus was more common in the patient group, while the AG genotype was much rarer (P 0.05).@*CONCLUSION@#Polymorphisms of rs477558, rs7548209 and rs3768293 loci of the EphA2 gene are associated with susceptibility to ARC among ethnic Han Chinese from Hubei province.
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Humans , Asian People , Cataract , Genetics , China , Gene Frequency , Genetic Predisposition to Disease , Genotype , Haplotypes , Polymorphism, GeneticABSTRACT
Objective To investigate the clinical value of arterial first approach in laparoscopic pancreaticoduodenectomy (LPD) for periampullary tumor. Methods The data of 134 patients with periampullary tumor who had underwent LPD between February 2014 and August 2017 were collected. The patients were divided into 2 groups by random digital table method, with 67 cases in each group. The experimental group received arterial first approach LPD, and the control group received traditional approach LPD. The intraoperative, postoperative and survival situations were compared between 2 groups. Follow- up using outpatient examination and telephone interview was performed to detect the tumor- free survival up to February 2018. Results All the patients underwent successful LPD. The time of tumor resection with superior mesenteric venous invasion, volume of intraoperative blood loss and volume of blood transfusion in experimental group were significantly lower than those in control group: (215.6 ± 12.3) min vs. (263.4 ± 21.2) min, (98.9 ± 15.6) ml vs. (130.1 ± 26.7) ml and (1.4 ± 0.9) U vs. (2.9 ± 1.3) U, and there were statistical differences (P<0.05). The rate of R0 resection in experimental group was significantly higher than that in control group: 97.0％ (65/67) vs. 88.1％ (59/67), and there was statistical difference (P<0.05). There was no statistical difference in postoperative 6- month tumor- free survival rate between 2 groups (P>0.05). Conclusions Arterial first approach in LPD can significantly reduce the volumes of intraoperative blood loss and blood transfusion, shorten the time of tumor resection with superior mesenteric venous invasion, and increase the rate of R0 resection.
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Objective To observe the effect of resveratrol(Res)on the expression of Bcl-2 and Bax in the retina of streptozotocin(STZ)induced diabetic rats.Methods Among 35 adult healthy male SD rats,10 were ran-domly divided into normal control group(Control),25 were used for the diabetic animal model with STZ.Success-fully modeled 20 rats were randomly divided into diabetes mellitus group(DM group)and resveratrol treated group (DM+Res group)equally. The DM+Res group were administrated with intragastric Res daily. After 12 weeks of Res administration,the eyes of three groups were dissected. Retinal histology was examined,and the thickness of the retina was measured.And the expression of Bcl-2 and Bax in the retinal tissues was determined by immunohisto-chemical staining. Results Compared with the control group,the thickness of the retina in DM group significant-ly decreased(P < 0.01),while the thickness of the retina in DM+Res group significantly increased(P < 0.05) compared with the DM group.Consistent with these effects,Res treatment increased the Bcl-2 level and decreased Bax expression level,at the same time,increased the ratio of Bcl-2-to-Bax(P<0.01). Conclusion Res is able to reduce apoptosis in retinal neurons caused by diabetes through up-regulating Bcl-2 expression and inhibiting Bax expression,as a result of increasing the ratio of Bcl-2-to-Bax.
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Objective To compare the test performance of different immunoassays for the detection on autoantibodies specific to primary biliary cholangitis,including anti-mitochondrial type 2 antibody(AMA-M2),anti-glycoprotein 210(anti-gp210)and anti-nuclear body protein sp100(anti-sp100).Methods Serum samples from Primary Biliary Cholangitis(PBC, n=91), liver disease control(including viral hepatitis,autoimmune hepatitis and liver cirrhosis,n=67)and healthy individual(n=40)were collected from Beijing Youan Hospital during the period between April 2014 and April 2017.All samples were tested with chemiluminescent immunoassay(CLIA)and enzyme linked immunosorbent assay(ELISA)for AMA-M2, meanwhile the detection on anti-gp210 and anti-sp100 were compared between CLIA and Line Immunoassay(LIA).The Kappa coefficient were used to measure the level of qualitative agreement between different assays.The diagnostic accuracy of AMA-M2 detected with CLIA and ELISA were compared by receiver operating characteristic curve(ROC).Results The overall qualitative agreement between CLIA and ELISA for the detection to AMA-M2 is 88.4%(Kappa =0.765, P<0.01).Excellent qualitative agreement between CLIA and LIA for the detection to anti-gp210 and anti-sp100 was also found with overall agreement as 96.5%(Kappa=0.852,P<0.01)and 98%(Kappa=0.884,P<0.01), respectively.The ROC analysis also showed similar area under the curve(AUC)for CLIA(0.965, P<0.01)and ELISA (0.928,P<0.01)on detection to AMA-M2.Conclusions CLIA and ELISA showed excellent agreement for the detection to AMA-M2.High qualitative agreement between CLIA and LIA was also found when testing anti-gp210 and anti-sp100.
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Objective To evaluate the clinical performance of chemiluminescent immunoassay (CLIA) on anti-nuclear antibody(ANA) specific autoantibodies testing.Methods A multi-center clinical study A total of 811 Sera samples were collected from 6 collaborating hospitals during the period of April to July 2016, and tested with CLIA and line immunoassay (LIA) in parallel for autoantibodies to ribonucleoprotein(RNP), smith antigen(Sm), SSA/Ro60,SSB/La, centromere protein B(CENPB), double-stranded DNA(dsDNA), nucleosome(Nuc), and ribosome P protein(Rib-P).The positive rate,specificity and qualitative coincidence rate for each antibody between CLIA and LIA methods were analyzed.All discrepant samples for systemic lupus erythematosus (SLE) highly specific autoantibodies (including anti-Sm, dsDNA, Nuc and Rib-P) were retested by enzyme linked immunosorbent assay (ELISA) and further analyzed with SLE disease cohort using McNemar test.Results The positive rate and specificity of CLIA and LIA for antibodies to ANA specific antigens were comparable.Excellent qualitative coincidence were found between CLIA and LIA for the detection of anti-RNP, SSA/Ro60, SSB/La and CENPB (Kappa>0.75), while the coincidence rate foranti-Sm, dsDNA, Nuc and Rib-P detection were moderate (0.4
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Objective To compare the efficacy and safety among individualized regimens ( IR ) containing clofazimine ( Cfz ) , linezolid ( Lzd ) or meropenem-clavulanic acid ( MC ) in treatment of multidrug/extensively resistant tuberculosis (MDR/XDR-TB) by using network meta-analysis.Methods Randomized controlled trials ( RCTs) and observational studies of Cfz-IR, Lzd-IR and MC-IR regimens in the treatment of MDR/XDR-TB published from January 2000 to August 2017 at home and abroad were retrieved.The literature was screened according to inclusion and exclusion criteria.The quality of the literature was evaluated and valid data were extracted.The efficacy and safety of Cfz-IR, Lzd-IR and MC-IR in the treatment of MDR/XDR-TB were directly and indirectly compared by network meta-analysis.Relative risk ( RR) or relative comparative effect ( Mean) or adverse reaction rate and 95％confidence interval ( CI) were used as indicators of systematic evaluation , and Berg' s funnel plot was used for the existing publication bias.Results A total of 20 papers and 21 studies were included.There were 2490 cases in the study group and 2303 cases in the control group included.According to the direct comparison of the network meta-analysis, the efficacy for treatment of MDR/XDR-TB of Lzd-IR ( RR=1.18, 95％ CI 1.02-1.36, Z=2.28, P <0.05) and MC-IR(RR=1.23,95％CI 1.01-1.50,Z=2.10,P<0.05)was better than that of IR in control group.The rates of adverse reactions of Lzd-IR, Cfz-IR and MC-IR were 29％(95％CI 0.24-0.35), 21％(95％CI 0.13-0.28) and 7％ (95％ CI 0.03-0.10), respectively.The top-down efficacy outcomes of the 4 individualized chemotherapy regimens were MC-IR (66.4％), Lzd-IR(22.6％), Cfz-IR (10.0％) and IR without Cfz, Lzd or MC (1.0％).The fitting model showed that MC-IR (Z=3.04, P<0.05) and Lzd-IR (Z=2.31, P<0.05) significantly shortened the "off"time compared with IR without Cfz, Lzd or MC.Conclusion The network meta-analysis shows that the efficacy and safety of regimen MC-IR are significantly higher than those of Lzd-IR and Cfz-IR in treatment of MDR/XDR-TB.
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Objective To measure the length between the bifurcation of abdominal aorta to the femoral artery puncture point in adult women.Methods 127 patients were enrolled in the study.Femoral artery puncture using of the roberts uterine catheter (RUC) for the diagnosis and treatment of obstetrics and gynecologic disease was conducted.When the RUC bending vertex code located at the bifurcation above, fingers fixed femoral artery puncture point at the mouth of the catheter's sheath and evacuate the catheter and measure the code to the fixed position.Results In this group, the length of the bifurcation of abdominal aorta to the femoral artery puncture point was 24.38-25.33 cm.There was no significant difference in the length with patient age (P>0.05), but there were statistical significances with the patients height and weight(P<0.05).Conclusion The length of adult women abdominal aortic bifurcation to the femoral artery puncture point has no significant difference with patient age.The individual height and weight are very much significant.The length estimation can be done according to the patient's height and weight for low abdominal aortic catheter,on clinic for avording X-ray irradiation or no X-ray equipment condition.
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objective To clarify the significance and puncture path of 125I radioactive seeds implantation in treatment of postoperative local recurrence and pelvic metastasis in patients with rectal cancer.Methods Clinical data of 8 rectal cancer patients with postoperative local recurrence and pelvic metastasis treated by ultrasound guided 125I radioactive seed implantation were retrospectively analyzed and the therapeutic effects were observed.Results After the treatment,the symptoms of 5 cases suffering from hematochezia and 2 cases with vaginal bleeding disappeared within 21 to 30 days.7 patients with preoperative pain relieved after treatment.There was no tumor progression from postoperative imaging examination.Conclusion 125I radioactive seed implantation can effectively improve the life quality of rectal cancer patients with postoperative local recurrence and pelvic metastasis.
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Objective To make clear the clinical safety of ultrasound guided percutaneous 125I radioactive seed interstitial implantation for treatment of pancreatic cancer.Methods 92 cases of pancreatic cancer treated with ultrasound guided percutaneous 125I radioactive seed interstitial implantation were retrospectively ana lyzed.Results All the 92 cases were performed successfully according to the preoperative plan.25 cases suffered puncture-hemorrhage and blood loss about 2 to 20 ml,and all got hemostasis successfully.2 cases had pancreatic duct injury during puncture,but no pancreatic fistula was found after conservative treatment.No case had bile duct injury.No digestive tract perforation occurred in the 55 cases whose puncture path was through the gastrointestinal tract.No serious complications occurred during the surgery.Conclusions Ultrasound guided percutaneous 125I radioactive seed interstitial implantation for treatment of pancreatic cancer is safe and reliable.
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Pulse waves contain rich physiological and pathological information of the human vascular system. The pulse wave diagnosis systems are very helpful for the clinical diagnosis and treatment of cardiovascular diseases. Accurate pulse waveform is necessary to evaluate the performances of the pulse wave equipment. However, it is difficult to obtain accurate pulse waveform due to several kinds of physiological and pathological conditions for testing and maintaining the pulse wave acquisition devices. A pulse wave generator was designed and implemented in the present study for this application. The blood flow in the vessel was simulated by modeling the cardiovascular system with windkessel model. Pulse waves can be generated based on the vascular systems with four kinds of resistance. Some functional models such as setting up noise types and signal noise ratio (SNR) values were also added in the designed generator. With the need of portability, high speed dynamic response, scalability and low power consumption for the system, field programmable gate array (FPGA) was chosen as hardware platform, and almost all the works, such as developing an algorithm for pulse waveform and interfacing with memory and liquid crystal display (LCD), were implemented under the flow of system on a programmable chip (SOPC) development. When users input in the key parameters through LCD and touch screen, the corresponding pulse wave will be displayed on the LCD and the desired pulse waveform can be accessed from the analog output channel as well. The structure of the designed pulse wave generator is simple and it can provide accurate solutions for studying and teaching pulse waves and the detection of the equipments for acquisition and diagnosis of pulse wave.
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Humans , Algorithms , Equipment Design , Heart Rate , Liquid Crystals , Models, Cardiovascular , Pulse Wave Analysis , Regional Blood FlowABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of tetrandrine (Tet) on the expression of bax, bcl-2, and transforming growth factor-β2 (TGF-β2) mRNA in cultured human fibroblasts of Tenon's capsules (TCFS) and explore its possible mechanism.</p><p><b>METHODS</b>The third passage of TCFS cultured in vitro were exposed to 1×10(-5) mol/L Tet for 24 h, and real-time fluorescence quantitative PCR was used to detect the changes in the expressions of bax, bcl-2, and TGF-β2 mRNA.</p><p><b>RESULTS</b>The expression level of bax mRNA was obviously higher, while bcl-2 and TGF-β2 mRNA levels were significantly lower in Tet-treated TCFS than those in the control cells (P<0.05).</p><p><b>CONCLUSION</b>Tet can inhibit the proliferation of TCFS possibly by reducing the expressions of bcl-2 and TGF-β2 mRNA, enhancing the expression of bax mRNA and inducing cell apoptosis, suggesting its potential in preventing fibrous scar formation after glaucoma filtration surgery.</p>
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Humans , Apoptosis , Benzylisoquinolines , Pharmacology , Cell Proliferation , Cells, Cultured , Cicatrix , Metabolism , Fibroblasts , Cell Biology , Metabolism , Proto-Oncogene Proteins c-bcl-2 , Genetics , Metabolism , RNA, Messenger , Genetics , Metabolism , Tenon Capsule , Cell Biology , Transforming Growth Factor beta2 , Genetics , Metabolism , bcl-2-Associated X Protein , Genetics , MetabolismABSTRACT
@#Objective To prepare completely biological tissue-engineered small-diameter blood vessel based on a biological hybrid scaffold.MethodsEndothelial cells and smooth muscle cells were isolated from the porcine aorta and expanded in vitro. Mixture of smooth muscle cells and porcine fibrin was prayed coating on the decellularized canine carotid artery. Then, the inner surface of the decellularized artery was seeded with the endothelial cells to construction of completely biological tissue-engineered small-diameter blood vessel. The tissue-engineered blood vessel was evaluated with Hematoxylin and Eosin (H&E) staining and scanning electron microscopy.ResultsHistology examination revealed that the completely biological tissue-engineered small-diameter had intact media and intima. Scanning electron microscopy examination confirmed that the inner surface of tissue-engineered blood vessel was covered with intact monolayer endothelial cells and the external surface was covered with multilayer smooth muscle cells.ConclusionThe completely biological tissue-engineered small-diameter with intact media and intima was prepared using mixture of blood vessel cells and porcine fibrin on the decellularized canine carotid artery.
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@#Objective To prepare a completely biological hybrid scaffold for small-diameter vascular tissue engineering using porcine fibrin and decellularized canine carotid artery.MethodsPorcine fibrin was sprayed coating on the external surface of decellularized canine carotid artery to construct completely biological hybrid scaffold for small-diameter vascular tissue engineering. The completely biological hybrid scaffold was evaluated with Hematoxylin and Eosin (H&E) staining, scanning electron microscopy and biomechanics test.ResultsHistology examination revealed that the porcine fibrin was sprayed coating uniformly on the external surface of decellularized canine carotid artery. Scanning electron microscopy examination confirmed that the external surface of completely biological hybrid scaffold was smooth and uniformly. Compared with fresh canine carotid artery and decellularized artery, the biological hybrid scaffold had similar burst and breaking strength. Furthermore, compared with decellularized artery, the biological hybrid scaffold had higher compliance.ConclusionThe porcine fibrin was sprayed coating uniformly on the external surface of decellularized canine carotid artery to prepare a completely biological hybrid scaffold for small-diameter vascular tissue engineering. The biological hybrid scaffold had appropriate biomechanical properties and had potential to serve as scaffolds for small-diameter vascular tissue engineering.
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Artemisinin and its derivatives,which are known as traditional antimalarial drugs,have anticancer activities by inhibiting cell proliferation,inducing apoptosis of tumor cells,and resisting angiogenesis,etc.The activity of inducing apoptosis has become high-light for studies recently.Most scholars believed this activity was obtained by increasing apoptosis-inducing genes(Bax),decreasing anti-apoptosis genes(Survivin,Bcl-2),and regulating two-ways controlling genes,and finally led to the distinctive morphological changes.
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Multi-partners,unprotected sex,and alcohol and drug use are the main causes of HIV/STD transmission among MSM,and related interventions should be taken promptly.MSM are good candidates for studies and interventions as the retention rate is relatively high among this population group.