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The purpose of this paper is to review the research on the influence and mechanism of intolerance of uncertainty （IU） on anxiety both at home and abroad in recent years. IU refers to the individual's disgust response due to the intolerance of perceived lack of prominent， critical or sufficient information， and it has individual tendency. IU plays an important role in the occurrence and development of anxiety， but the specific process and mechanism remain unclear. This paper reviews the influence of IU on anxiety， and clarifies its mechanism of action on the generation and development of anxiety from the perspectives of cognition， emotion and behavior， so as to provide references for preventing the development of general anxiety into anxiety disorders and developing new psychological intervention and treatment strategies.
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Objective To evaluate the peri-operative and survival outcomes of hepatectomy combined with splenectomy in patients with hepatocellular carcinoma with Barcelona Clinic Liver Cancer Stage A and portal hypertension.Methods We retrospectively analyzed the data on patients with hepatocellular carcinoma with Barcelona Clinic Liver Cancer Stage A and portal hypertension who underwent surgery at the Shengli Oilfield Central Hospital between July 2008 and June 2015.According to the operative method,the patients were classified as the experimental group (hepatectomy combined with splenectomy) and the control group (hepatectomy).We compared and analyzed the clinical data between these two groups,which included the operation time,blood loss,duration of hepatic portal occlusion,width of surgical resection margin,liver function,PLT,HBV reactivation,time to remove drainage tube,complications,upper gastrointestinal hemorrhage rate and survival outcomes.Results (1) The operation time,blood loss,PLT at 1 week and 1 month after surgery in the experimental group were all significantly higher than the control group [(161.4 ± 38.3) min vs.(119.2±36.4) min,(268.7±72.1) vs.(201.3±61.3) ml,(189.2±51.3) ×109/L vs.(81.9±32.2) ×109/L,(327.4±69.1) ×109/L vs.(84.5±28.5) × 109/L (all P＜0.05),respectively].The time to remove drainage tube,duration of hepatic portal occlusion,width of resection surgical margin,TBil,complications and upper gastrointestinal hemorrhage rates of the two groups were not significantly different (all P ＞ 0.05).The HBV reactivation rate,ALT and AST in the experimental group were significantly lower than the control group [3.9％ (2/51) vs.18.2％ (12/66),(45.7 ± 11.4) U/L vs.(58.3±14.7) U/L,(48.1±12.4) U/Lvs.(61.3±15.1) U/L (allP＜0.05),respectively].(2) The 1,3 and 5-year recurrence free survival rates were not significantly different between the experimental and control groups [84.3 ％,34.1％,27.3 ％ vs.78.8 ％,42.1％,9.7 ％ (all P ＞ 0.05),respectively].The 1,3 and 5-year overall survival rates in the experimental Group were significantly higher than the control group [94.1％,66.3 ％,33.5 ％ vs.90.9％,46.7％,16.1％ (all P ＜ 0.05),respectively].Conclusion Combined liver and spleen resection was a safe and efficacious modality to treat patients with BCLC A hepatocellular carcinoma,which reduced the incidence of HBV reactivation and improved the overall survival.
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Objective To evaluate the impact of obesity and spleen length on laparoscopic splenectomy combined with pericardial devascularization.Methods We retrospectively analyzed 121 patients with portal hypertension who underwent laparoscopic splenectomy combined with pericardial devascularization in our hospital.Using BMI,these patients were classified as the obesity and the non-obesity groups.Using length of the spleen,the patients were divided into two subgroups:spleen AC diameter ＞ 20 cm and spleen AC diameter ≤20 cm.Results (1) For the Obesity group,the operation time,the rate of conversion to open operation and the complication rate after operation were higher than the non-obesity group [(184.0 ± 49.0) min vs (142.0 ±39.0) min,26.1％ vs 8.0％,26.1％ vs 6.7％,respectively,P＜0.05].However,the differences were not significant for mean blood loss,intraperitoneal drainage and complication rate after operation.For patients with massive splenomegaly,the obesity group had higher rates of conversion into open operation and complication (42.9％ vs 11.7％,33.3％ vs 8.8％,respectively,P ＜0.05).For patients with non-massive splenomegaly,the differences were not significant between the obesity and non-obesity groups (P ＞ 0.05).(2) For obesity patients,the spleen AC diameter ＞ 20 cm group had a longer operation time and a higher rate of conversion to open operation [(224.0 ± 42.0) min vs (152.0 ± 44.0) min,42.9％ vs 12.0％,respectively,P ＜ 0.05].The length of spleen had no effect on the operation and its complication (P ＞ 0.05).Conclusions Obesity extended the operation time and increased the rates of conversion to open operation and complication after operation.The spleen length had a major impact on the rates of conversion to open operation and complication after operation for the groups of obesity patients.
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Objective To investigate the value of liver resection and radiofrequency ablation (RFA) on reactivation rates of hepatitis B virus (HBV) in hepatocellular cancer (HCC) patients with tumor ≤5 cm and determine influential factors.Methods Retrospective analysis was performed in clinical data of hepatocellular cancer patients with tumor ≤5 cm from Shengli Oilfield Centeral Hospital between July 2007 and March 2012,289 cases were assigned to liver resection group (n =157) and RFA group (n =132).Logistic regression was used to evaluate relative factors associated with HBV reactivation for univariate and multivariate analyses.The stratified x2 test was utilized to assess clinical outcomes in HBV reactivation subgroup with or without antiviral treatment.CD3 +,CD4+,CD8 +,CD4+/CD8 + and NK cell proportions were comparatively analysized.Results (1) The univariate and multivariate logistic regression analyses showed antiviral therapy,Child-Pugh grade,vascular invasion and treatment (liver resection or RFA) were significant risk factors of HBV reactivation (P ＜ 0.05).(2) HBV reactivation was lower in patients who received antiviral therapy than those who did not (10/109 vs 33/180,x2 =4.497,P ＜ 0.05).The viral reactivation rate for the liver resection group was higher than the RFA group in patients who did not receive antiviral therapy (24/98 vs 9/82,x2 =5.446,P ＜ 0.05),but the difference was not significant in patients who received antiviral therapy (6/59 vs 4/50,x2 =0.153,P ＞ 0.05).(3) The proportions of CD3 +,CD4 +,CD4 +/CD8 + and NK cell after treatment for 7 days decreased in various degrees for both the liver resection and RFA groups regardless of patients with or without antiviral therapy (P ＜ O.05).For the patients without antiviral therapy,the cell proportions in 7 days after treatment were significantly higher in the RFA group than that in the liver resection group (P ＜ 0.05),but the difference was not significant in patients with antiviral therapy (P ＞ 0.05).Conclusions For the patients with tumor ≤5 cm,the proportions of immunological cells decreased in liver resection when compared with RFA.Preoperative antiviral therapy may have partial response in immunological suppression,and lowered the incidence of HBV reactivation.
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AIM: To investigate the effect of dihydroartemisinin (DHA) on the proliferation of murine T lymphocytes stimulated by Con A in vitro and its related immunosuppressive mechanism. METHODS: Murine T lymphocytes were stimulated by Con A and treated with different concentrations of DHA. Cell proliferation was measured by carboxyl fluoresce in diacetate succinmidyl ester (CFDA-SE) staining. The expression of CD69, CD25 and CD71,which was the marker of early, middle, later activation of CD3~+ T lymphocytes, was measured by flow cytometry (FCM) combined with two-color immunofluorescent staining of cell surface antigen. Fluorescence calcium indicator fluo-4/AM was used to measure the change of the intracellular calcium concentration ([Ca~(2+)]_i) of murine T lymphocytes. The distribution of the cell cycle was analyzed by PI staining. The expression of CD69, the early activation antigen on CD4~+CD25~(high) Treg was also measured by FCM combined with three-color immunofluorescent staining. RESULTS: The result of CFDA-SE staining showed that DHA efficiently inhibited the Con A-induced proliferation of T-lymphocytes in a time-and dose-dependent manners. DHA showed modestly increased proportions of CD69 and CD25 on Con A-stimulated CD3~+T cells, but inhibited the expression of CD25 in a dose dependent manner. DHA with Con A, but not DHA alone, caused an increase in intracellular calcium concentration of T cells. The results of FCM analysis with PI staining showed that DHA imposed a total cell cycle arrest in G_0/G_1 and prevented cells entering S phase and G_2/M phase. Furthermore, DHA reduced the expression of CD69 on CD4~+CD25~(high) Treg. CONCLUSION: DHA, which exhibits immunosuppressive effect on the proliferation of murine T-lymphocytes, is promising to be developed as an immunosuppressive reagent.
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Objective:To prove that haemodialysis patients sera medium can induce angiogenesis by oxidative stress. Method: Eleven haemodialysis patients were administered 400mg/d of vitamin E for 6 weeks per os (treated group),and another eleven haemodialysis patients were treated regularly(non-treated group).HUVEC were cultured in 10% treated patients sera medium and 10% non-treated patients sera medium respectively. The plasma level of MDA was detected by TBA method. Angiogenesis were observed under inverted microscope,cell proliferation examinded by MTT,cell migration measured in transwell,and ROS investigated by colorimetry. Results:In treated group,the plasma level of MDA was lower after treatment.There were tube formation(average area as 1 438?m2?112?m2) and more cell proliferation and migration after cells were cultured in non- treated haemodialysis patients sera.The production of ROS was higher than that of cells exposed to treated patients sera medium.Conclusion:Haemodialysis patients sera medium can induce angiogenesis and oxidative stress is the important mechanism.
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AIM: To study the changes of mitochondrial membrane potential(△?m) and mitochondrial mass in apoptosis of Jurkat cells induced by camptothecin(CPT).METHODS: Jurkat cells were treated with CPT.Annexin V-FITC/propidium iodine(PI) double stainig was used to detected early stage of apoptosis and PI staining for analyzing the cell cycle.Jurkat cells were stained by annexin V-PE/DiOC_6(3) to detect changes of △?m.The mitochondrial mass was measured by cytometry with NAO staining.RESULTS: 6 h after treated with 10 ?mol/L CPT,the rate of early apoptotic cells(22.59?1.04)% had significantly difference compared with control group(3.93?0.73)%(P0.05).Apoptotic peak appeared obviously after treated with CPT,the percentage of late apoptotic cells(13.58?0.97)% had distinctly difference compared with control group(3.18?0.51)%(P