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The purpose of this study is to investigate whether chrysin reduces cerebral ischemia-reperfusion injury(CIRI) by inhi-biting ferroptosis in rats. Male SD rats were randomly divided into a sham group, a model group, high-, medium-, and low-dose chrysin groups(200, 100, and 50 mg·kg~(-1)), and a positive drug group(Ginaton, 21.6 mg·kg~(-1)). The CIRI model was induced in rats by transient middle cerebral artery occlusion(tMCAO). The indexes were evaluated and the samples were taken 24 h after the operation. The neurological deficit score was used to detect neurological function. The 2,3,5-triphenyl tetrazolium chloride(TTC) staining was used to detect the cerebral infarction area. Hematoxylin-eosin(HE) staining and Nissl staining were used to observe the morphological structure of brain tissues. Prussian blue staining was used to observe the iron accumulation in the brain. Total iron, lipid pero-xide, and malondialdehyde in serum and brain tissues were detected by biochemical reagents. Real-time quantitative polymerase chain reaction(RT-qPCR), immunohistochemistry, and Western blot were used to detect mRNA and protein expression of solute carrier fa-mily 7 member 11(SLC7A11), transferrin receptor 1(TFR1), glutathione peroxidase 4(GPX4), acyl-CoA synthetase long chain family member 4(ACSL4), and prostaglandin-endoperoxide synthase 2(PTGS2) in brain tissues. Compared with the model group, the groups with drug intervention showed restored neurological function, decreased cerebral infarction rate, and alleviated pathological changes. The low-dose chrysin group was selected as the optimal dosing group. Compared with the model group, the chrysin groups showed reduced content of total iron, lipid peroxide, and malondialdehyde in brain tissues and serum, increased mRNA and protein expression levels of SLC7A11 and GPX4, and decreased mRNA and protein expression levels of TFR1, PTGS2, and ACSL4. Chrysin may regulate iron metabolism via regulating the related targets of ferroptosis and inhibit neuronal ferroptosis induced by CIRI.
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Ratos , Masculino , Animais , Ratos Sprague-Dawley , Ferroptose , Transdução de Sinais , Isquemia Encefálica/metabolismo , Ciclo-Oxigenase 2/metabolismo , RNA Mensageiro , Infarto Cerebral , Traumatismo por Reperfusão/metabolismo , Malondialdeído , Infarto da Artéria Cerebral MédiaRESUMO
AIM: To investigate long-term efficacy and safety of patients after excimer laser in situ keratomileusis(LASIK)surgery in 20a.METHODS: A retrospective study.Patients who underwent LASIK in our hospital from January 1998 to December 2001 were recruited. The patients were notified by telephone to the outpatient for follow-up. The collected data included demographic characteristics(gender and age), preoperative uncorrected distance visual acuity(UCVA)and best corrected visual acuity(BCVA), preoperative diopter, intraoperative corneal flap thickness and corneal stromal residual thickness(RST). The main indicators were long-term efficacy index, safety index, UCVA, BCVA, corneal thickness and axial length. The slit lamp, fundus and optical coherence tomography(OCT)examination were performed at the same time.RESULTS: A total of 95 patients(190 eyes)were recruited. At the final postoperative visit, there were 71 patients(142 eyes, 74.7%)had UCVA≥1.0, and 82 patients(164 eyes, 86.3%)had BCVA≥1.0. There were 2 eyes among them had bad BCVA(≤0.6)due to macular retinoschisis and glaucoma, respectively, while other patients' BCVA was 0.8. There was no significant correlation between the UCVA and BCVA of patients after surgery in 20a and the factors such as age at surgery, preoperative diopter and corneal thickness(P>0.05), but there was a negative correlation with the increase of axis length(rs=-0.32, -0.31, all P<0.05). UCVA and BCVA were positively correlated with corneal stromal residual thickness at the last postoperative follow-up(P<0.05). The safety and efficacy indexes of LASIK after surgery in 20a were 1.00±0.10 and 0.83±0.27, respectively. During the follow-up, no patients were found to have corneal ectasia and complications related to corneal flap, and no patients underwent secondary surgery. No patients with corneal dryness were found after silt lamp examination.CONCLUSION: LASIK after surgery in 20a shows good safety and efficacy.
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OBJECTIVE: To explore the effects of UVB and Nano-CaCO_3 co-treatment in inhibiting cell proliferation and inducing cell apoptosis in human HaCaT keratinocytes,and to explore its possible mechanisms. METHODS: HaCaT cells( logarithmic growth phase) were divided into control group,UVB group,Nano-CaCO_3 group and co-treatment group. UVB group and co-treatment group were irradiated with UVB irradiation with cumulative exposure dose of 2. 97 × 10~(-2)J / cm~2.Control group and Nano-CaCO_3 group were irradiated with UVB irradiation with cumulative exposure dose of zero on equal terms. After that,control group and UVB group were treated with 10. 00% phosphate buffer solution in high-sugar Dulbecco's modified Eagle's medium( DMEM) and incubated,Nano-CaCO_3 group and co-treatment group were treated with high-sugar DMEM with Nano-CaCO_3 at 250 mg / L mass concentration and incubated. Subsequently,HaCaT cells were harvested at incubation time of 0,6,12,18 and 24 hours. Then methyl thiazolyl tetrazolium assay was performed to estimate cellular proliferative activity,flow cytometry was used to detect cell apoptosis,Western blot was used to detect the expression of P53 and Caspases-3 protein. RESULTS: Contrast to control group at the parallel incubation time points of 6-24 hours,the cell viability of HaCaT cells was significant decreased in the other three groups( P < 0. 05) except for UVB group at incubation time of 6 hours( P > 0. 05). The cell viability of co-treatment group was lower than UVB group at all the incubation time( P < 0. 05),and lower than Nano-CaCO_3 group at incubation time of 18 and 24 hours( P < 0. 05).The apoptosis rate of HaCaT cells in UVB group was higher than control group( P < 0. 05),and which in co-treatment group was higher than the other three groups( P < 0. 05). Contrast to control group,the protein expressions of P53 and Caspases-3 in HaCaT cells were upregulated in UVB group and Nano-CaCO_3 group. In co-treatment group,the protein expressions of P53 and Caspases-3 were upregulated contrast to the other three groups. CONCLUSION: Contrast to single damage of UVB or Nano-CaCO_3,co-treatment of UVB with Nano-CaCO_3 increased damage to HaCaT cells,likely by inhibiting proliferative activity,inducing apoptosis,and enhancing protein expressions of P53 and Caspases-3.
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<p><b>OBJECTIVE</b>To compare the short-term outcomes of surgical treatment for non-small cell lung cancer (NSCLC) by video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT).</p><p><b>METHODS</b>Data of 737 consecutive NSCLC patients who underwent surgical treatment for non-small cell lung cancer by video-assisted thoracoscopic surgery and 630 patients who underwent pulmonary resection via open thoracotomy (as controls) in Cancer Institute & Hospital, Chinese Academy of Medical Sciences between January 2009 and August 2011 were retrospectively reviewed. The risk factors after lobectomy were also analyzed.</p><p><b>RESULTS</b>In the 506 NSCLC patients who received VATS lobectomy, postoperative complications occurred in 13 patients (2.6%) and one patient died of acute respiratory distress syndrome (0.2%). In the 521 patients who received open thoracotomy (OT) lobectomy, postoperative complications occurred in 21 patients (4.0%) and one patient died of pulmonary infection (0.2%). There was no significant difference in the morbidity rate (P > 0.05) and mortality rate (P > 0.05) between the VATS group and OT group. In the 190 patients who received VATS wedge resections, postoperative complications occurred in 3 patients (1.6%). One hundred and nine patients received OT wedge resections. Postoperative complications occurred in 4 patients (3.7%). There were no significant differences for morbidity rate (P = 0.262) between these two groups, and there was no perioperative death in these two groups. Univariate and multivariate analyses demonstrated that age (OR = 1.047, 95%CI: 1.004 - 1.091), history of smoking (OR = 6.374, 95%CI: 2.588 - 15.695) and operation time (OR = 1.418, 95%CI: 1.075 - 1.871) were independent risk factors of postoperative complications.</p><p><b>CONCLUSIONS</b>To compare with the NSCLC patients who should undergo lobectomy or wedge resection via open thoracotomy, a similar short-term outcome can be achieved via VATS approach.</p>
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Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Etários , Carcinoma Pulmonar de Células não Pequenas , Mortalidade , Patologia , Cirurgia Geral , Tempo de Internação , Neoplasias Pulmonares , Mortalidade , Patologia , Cirurgia Geral , Metástase Linfática , Duração da Cirurgia , Pneumonectomia , Classificação , Métodos , Complicações Pós-Operatórias , Síndrome do Desconforto Respiratório , Estudos Retrospectivos , Fumar , Cirurgia Torácica Vídeoassistida , Toracotomia , MétodosRESUMO
<p><b>OBJECTIVE</b>To evaluate and compare the value of cardiopulmonary exercise test and conventional pulmonary function tests in the prediction of postoperative cardiopulmonary complications in high risk patients with chest malignant tumors.</p><p><b>METHODS</b>From January 2006 to January 2009, 216 consecutive patients with thoracic malignant tumors underwent conventional pulmonary function tests (PFT, spirometry + DLCOsb for diffusion capacity) and cardiopulmonary exercise test (CPET) preoperatively. The correlation of postoperative cardiopulmonary complications with the parameters of PFT and CPET were retrospectively analyzed using Chi-square test, independent sample t-test and logistic regression analysis. The P value < 0.05 was considered as statistically significant.</p><p><b>RESULTS</b>Of the 216 patients, 57 did not receive operation due to advanced stage diseases or poor cardiopulmonary function in most of them. The remaining 159 underwent different modes of operations. Thirty-six patients (22.6%) in this operated group had postoperative cardiopulmonary complications and 10 patients (6.3%) developed operation-related complications. Three patients (1.9%) died of the complications within 30 days postoperatively. The patients were stratified into groups based on V(O(2)) max/pred (≥ 65.0%, < 65.0%); V(O(2)) max×kg(-1)×min(-1) (≥ 20 ml, 15 - 19.9 ml, < 15 ml) and FEV1 (≥ 2.0 L, 1.2 - 1.99 L, < 1.2 L) according to the criteria in reported papers. There was statistically significant difference among these groups in the parameters (P < 0.05), the rates of postoperative cardiopulmonary complications were much higher in the groups with poor cardiopulmonary function (V(O(2)) max/pred < 65.0%; V(O(2)) max×kg(-1)×min(-1) < 15 ml or FEV1 < 1.2 L). It was shown by logistic regression analysis that postoperative cardiopulmonary complications were significantly correlated with age, associated diseases, poor results of PFT or CPET, operation modes and operation-related complications.</p><p><b>CONCLUSIONS</b>FEV1 in spirometry, V(O(2)) max×kg(-1)×min(-1) and V(O(2)) max/pred in cardiopulmonary exercise test can be used to stratify the patients' cardiopulmonary function status and is correlated well with FEV1. V(O(2)) max×kg(-1)×min(-1) is the best parameter among these three parameters to predict the risk of postoperative cardiopulmonary complications in patients with chest malignant tumors and borderline cardiopulmonary function.</p>
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Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Arritmias Cardíacas , Teste de Esforço , Pneumonectomia , Pneumonia , Complicações Pós-Operatórias , Valor Preditivo dos Testes , Testes de Função Respiratória , Insuficiência Respiratória , Estudos Retrospectivos , Espirometria , Neoplasias Torácicas , Cirurgia GeralRESUMO
The definition of esophagogastric junction (EGJ) adenocarcinoma and progress in multidisciplinary treatment for the tumor were revised in this review. Siewert classification is especially useful for the surgical approach of EGJ adenocarcinoma. Siewert I should be treated as esophageal cancer, and Ivor-Lewis esophagogastrectomy (right thoracotomy and laparotomy) is recommended as an extended two-field lymphadenectomy. For Siewert II or III tumors, left thoracophreno-laparotomy is preferred, especially in case of positive thoracic lymph nodes or positive resection margin. If there is any contraindication against thoracotomy, or a high operating risk, a transhiatal esophagectomy with lower mediastinal lymphadenectomy is an alternative. Preoperative chemoradiotherapy or perioperative chemotherapy improves overall survival and the rate of complete resection for patients with large tumor or lymph node metastasis. Neoadjuvant chemoradiotherapy is associated with high but acceptable postoperative complications. Adjuvant chemoradiotherapy remains a rational standard therapy for curatively resected EGJ cancer with T3 or greater lesion or positive nodes.
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Humanos , Adenocarcinoma , Cirurgia Geral , Terapêutica , Terapia Combinada , Neoplasias Esofágicas , Cirurgia Geral , Terapêutica , Junção Esofagogástrica , Neoplasias Gástricas , Cirurgia Geral , TerapêuticaRESUMO
<p><b>BACKGROUND</b>It is still unclear whether pulmonary function tests (PFTs) are sufficient for predicting perioperative risk, and whether all patients or only a subset of them need a cardiopulmonary exercise test (CPET) for further assessment. Thus, this study was designed to evaluate the CPET and compare the results of CPET and conventional PFTs to identify which parameters are more reliable and valuable in predicting perioperative risks for high risk patients with lung cancer.</p><p><b>METHODS</b>From January 2005 to August 2008, 297 consecutive lung cancer patients underwent conventional PFTs (spirometry + single-breath carbon monoxide diffusing capacity of the lungs (DLCOsb) for diffusion capacity) and CPET preoperatively. The correlation of postoperative cardiopulmonary complications with the parameters of PFT and CPET was retrospectively analyzed using the chi-square test, independent sample t test and binary Logistic regression analysis.</p><p><b>RESULTS</b>Of the 297 patients, 78 did not receive operation due to advanced disease stage or poor cardiopulmonary function. The remaining 219 underwent different modes of operations. Twenty-one cases were excluded from this study due to exploration alone (15 cases) and operation-related complications (6 cases). Thus, 198 cases were eligible for evaluation. Fifty of the 198 patients (25.2%) had postoperative cardiopulmonary complications. Three patients (1.5%) died of complications within 30 postoperative days. The patients were stratified into groups based on VO(2)max/pred (≥ 70.0%, < 70.0%); VO(2)max×kg(-1)×min(-1) (≥ 20.0 ml, 15.0 - 19.9 ml, < 15.0 ml) and FEV1 (≥ 2.0 L, 1.2 - 1.99 L, < 1.2 L), respectively. The rate of postoperative cardiopulmonary complications was significantly higher in the group with VO(2)max/pred< 70.0% or VO(2)max×kg(-1)×min(-1) < 15.0 ml or FEV1 < 1.2 L than that in the group with VO(2)max/pred ≥ 70.0% or VO(2)max×kg(-1)×min(-1) ≥ 15.0 ml or FEV1 ≥ 1.2 L, respectively. Logistic regression analysis revealed that postoperative cardiopulmonary complications were significantly correlated with age, comorbidities, and poor PFT and CPET results.</p><p><b>CONCLUSIONS</b>FEV1 in spirometry, VO(2)max×kg(-1)×min(-1) and VO(2)max/pred in cardiopulmonary exercise tests can all be used to stratify the patients' cardiopulmonary function status and to predict the risk of postoperative cardiopulmonary complications for the high risk patients with lung cancer. FEV1 and VO(2)max×kg(-1)×min(-1) are better than VO(2)max/pred in predicting perioperative risk. If available, cardiopulmonary exercise testing is strongly suggested for high-risk lung cancer patients in addition to conventional pulmonary function tests, and both should be combined to assess cardiopulmonary function status.</p>
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Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Teste de Esforço , Métodos , Neoplasias Pulmonares , Testes de Função Respiratória , MétodosRESUMO
<p><b>OBJECTIVE</b>To investigate the clinical characteristics and prognostic factors in metachronous squamous cell carcinoma of the esophagus and gastric adenocarcinoma.</p><p><b>METHODS</b>From July 1979 to March 2005, 27 patients with metachronous carcinomas of the esophagus and stomach were treated, and the data were retrospectively reviewed. The clinical features were analyzed, which included sex, age, family history of cancers, TNM stages of the gastric and esophageal carcinomas, resection mode, chemotherapy and/or radiotherapy, and the sequence of the two carcinomas taking place.</p><p><b>RESULTS</b>There were 27 patients in this series including 24 males and 3 females, with a median age of 60 years (range: 36 - 73 years). Of the 27 patients, 29.6% had a family history of malignant tumors. The overall 5- and 10-year survival rates were 61.0% and 52.0%, respectively, with a median survival of 105 months. Patients treated with surgical resection had a significantly longer survival than those without (P < 0.001).</p><p><b>CONCLUSION</b>Metachronous squamous cell carcinoma of the esophagus and gastric adenocarcinoma show distinct clinical characteristics. Surgical resection is mostly effective and the first choice of treatment.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adenocarcinoma , Genética , Cirurgia Geral , Terapêutica , Carcinoma de Células Escamosas , Genética , Cirurgia Geral , Terapêutica , Quimioterapia Adjuvante , Neoplasias Esofágicas , Genética , Cirurgia Geral , Terapêutica , Esofagectomia , Métodos , Seguimentos , Gastrectomia , Métodos , Predisposição Genética para Doença , Segunda Neoplasia Primária , Genética , Cirurgia Geral , Terapêutica , Radioterapia Adjuvante , Estudos Retrospectivos , Neoplasias Gástricas , Genética , Cirurgia Geral , Terapêutica , Taxa de SobrevidaRESUMO
<p><b>OBJECTIVE</b>To investigate the clinical characteristics and prognostic factors of synchronous gastric adenocarcinoma associated with squamous carcinoma of esophagus (SGCEC).</p><p><b>METHODS</b>From June 1979 to April 2005, 44 patients with SGCEC were treated and the data were retrospectively reviewed. There were 34 male and 10 female. The median age was 65 years old (range from 41 to 77 years old). The clinical features including sex, age, history, T stages and N stages of gastric carcinoma and esophageal carcinoma, curative or palliative resection, chemotherapy or/and radiotherapy were analyzed.</p><p><b>RESULTS</b>Of all patients, 22.7% (10/44) had family history of carcinoma. Before or in the operations, some gastric carcinomas could not be easily found out, but they were determined in the resected specimens. The cumulative 5-year overall survival rate was 27%, and median survival was 22 months. Univariate analysis and multivariate analysis of prognostic factors identified both lymph node status of gastric carcinoma and curative resection as the predominating independent predictors of long-term survival.</p><p><b>CONCLUSIONS</b>The patients with SGCEC show distinct clinical characteristics. Receiving curative operation and completely resection of gastric lymph nodes may improve the outcomes.</p>
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Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Esofágicas , Cirurgia Geral , Esofagectomia , Seguimentos , Gastrectomia , Excisão de Linfonodo , Neoplasias Primárias Múltiplas , Cirurgia Geral , Prognóstico , Neoplasias Gástricas , Cirurgia Geral , Análise de Sobrevida , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>An accurate clinical TNM staging of lung cancer is essential for the precise determination of the extent of the disease in order that an optimal therapeutic strategy can be planned. This is especially true in patients with marginally resectable tumors. Clinical over-staging of the disease may deny a patient the benefit of surgery, whereas under-staging may oblige a patient to accept a fruitless or even harmful surgery. We aimed to analyze preoperative clinical (c-TNM) and postoperative surgico-pathologic staging (p-TNM) of lung cancer patients in order to evaluate the accuracy of our clinical staging and its implications on the surgical strategy for lung cancer.</p><p><b>METHODS</b>We did a retrospective comparison of c-TNM and p-TNM staging of 2007 patients with lung cancer surgically treated from January 1999 to May 2003. Preoperative evaluation and c-TNM staging of all patients were based on physical examination, laboratory studies, routine chest X-ray and CT scan of the chest and upper abdomen. Other examinations included sputum cytology, bronchoscopy, abdominal ultrasonography, bone scintiscan, brain CT/MRI, and mediastinoscopy whenever indicated.</p><p><b>RESULTS</b>In the present study the comparison of c-TNM and p-TNM staging of 2007 patients with lung cancer revealed an overall concurrence rate of only 39.0%. In the entire series the extent of disease was clinically underestimated in 45.2% and overestimated in 15.8% of the patients. Among all c-TNM stages the c-IA/B stage of 1105 patients gave the highest rate (55.2%) of underestimating the extent of disease. Clinical staging of T subsets was relatively easy with an overall accuracy rate of 72.9%, while that of N subsets was relatively more difficult with an overall accuracy rate of 53.5%. Analysis also showed that c-IV stage may not be an absolute contraindication to surgery, because in half of the patients, c-M1 turned out to be p-M0, providing the possibility of resectional surgery depending on the status of T and N.</p><p><b>CONCLUSION</b>For reasons to be further determined, the present preoperative clinical TNM staging of lung cancer remains a crude evaluation. Further efforts to improve its accuracy are needed.</p>
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Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma Pulmonar de Células não Pequenas , Patologia , Cirurgia Geral , Neoplasias Pulmonares , Patologia , Cirurgia Geral , Metástase Linfática , Estadiamento de Neoplasias , Pneumonectomia , Estudos RetrospectivosRESUMO
<p><b>AIM</b>To study the synthesis and antitumour activities of some aryl-substituted pteridines.</p><p><b>METHODS</b>A series of aryl-substituted pteridines were synthesized from 4, 6-diamino-5-nitrosopyrimidines by cyclization with 4-aminophenylacetonitriles. The antitumour activities were tested by MTT method.</p><p><b>RESULTS</b>Nine new compounds (I-III) were synthesized and their structures were characterized by EA, IR, 1HNMR and MS spectra. Compounds I-III showed antitumour activities in vitro.</p><p><b>CONCLUSION</b>Compounds I-III showed remarkable antitumour activities in vitro. No interaction was determined between the title compounds and calf thymus DNA. It indicated that these compounds possibly inhibit dihydrofolate reductase (DHFR) or other enzymes on which folic acid depends.</p>