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Objective:To explore the application effect of three mode pre-rehabilitation strategy in gastric cancer patients after laparoscopic radical operation and its effect on the recovery of physical function and quality of life after operation.Methods:Totally 96 patients undergoing elective laparoscopic-assisted radical gastric cancer surgery admitted in the Second Affiliated Hospital of Anhui Medical University from January 2019 to September 2020 were divided into control group (48 cases) and observation group (48 cases) by the random number table. Finally two cases in control group were excluded. The control group received gastric cancer regular preoperative health guidance, the observation group received trimodal pre-habilitation strategy for 6-8 days on the basis of the control group. The perioperative indicators and complications were compared between the two groups. The 36-item Health Survey Summary (SF-36) scores were measured before and after intervention.Results:The first postoperative exhaust time, first out of bed time, first oral meal time, hospital stay in the observation group were (61.49 ± 6.71) hours, (19.54 ± 6.13) hours, (71.23 ± 6.79) days, (5.62 ± 1.03) days, which lower than (79.21 ± 8.15) hours, (22.95 ± 7.19) hours, (78.95 ± 7.21) days, (6.64 ± 1.17) days in the control group, and the differences were statistically significant between the two group ( t values were 2.48-11.53, all P<0.05). The incidence of complications was 6.25% (3/48) in the observation group and 21.74% (10/46) in the control group, and the difference was statistically significant between the two groups ( χ2=8.72, P<0.05). At 1 d before operation and 30 d after operation, the average scores of SF-36 were (68.74 ± 8.02), (65.85 ± 7.44) points in the observation group and (60.73 ± 7.43), (61.04 ± 6.85) points in the control group, and the differences were statistically significant ( t=5.02, 3.26, both P<0.05). Conclusions:Preoperative three mode pre-rehabilitation training for gastric cancer patients is beneficial to improving the state of exercise, nutrition and immune function, speeding up postoperative gastrointestinal function and overall rehabilitation, reducing the incidence of postoperative complications and improving the quality of life of patients.
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The cultivation of medical students' scientific research and innovation ability is the need of our country to accelerate the construction of an innovative country. This paper starts from the significance of strengthening the cultivation of medical students' scientific research and innovation ability, emphasizes participation in teacher's scientific research in colleges and universities to strengthen the feasibility of the medical students' scientific research and innovation ability cultivation, and summarizes the practical experience of cultivating medical students' scientific research ability based on scientific research projects of teachers in colleges and universities, which can provide reference for peers.
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With the global aging, the incidence rate of HCC in the elderly population is gradually increasing , and thus it has become a global health issue.With reference to relevant literature, this article analyzes the clinical features of elderly HCC patients and reviews the current status of therapies and clinical outcomes .The review of clinical outcomes is mainly based on the comparison of therapeutic outcome between elderly and non -elderly HCC patients in many countries and regions in the world .This article points out that elderly HCC patients have their own clinical features, and since elderly HCC patients often have other diseases , such as diabetes, renal failure, and lung and cardiovascular diseases, there is an increase in the risk of treatment, but they often have positive treatment outcomes .With the deepening of research and the improvement of various treatment methods , the therapeutic outcome of elderly HCC patients will also be improved .Therefore,positive attitude and strategies should be adopted in the clinical treatment of elderly HCC patients .
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Colon cancer is a common malignant tumor. Early diagnosis and treatment is one of the most important clinical challenges. Since MicroRNA is discovered to closely relate to cancer, it has been suggested to be used in the diagnosis and treatment of cancer. This review focuses on recent advances in the diagnosis and treatment of MicroRNA in colon cancer and the role of MicroRNA in Wnt signaling pathways and epidermal growth factor receptor (EGFR) signaling pathways.
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Objective To detect the changes of cell invasion and proliferation in hepatocellular carcino -ma cell line HepG2 through the upregulation of miR -222.Methods The expression of miR-222 was up-reg-ulated by liposomal transfection .The expression of PTEN which is the targeting protein of miR -222 was detected by using Western Blot assay .The changes of proliferative capacity and invasive ability in HepG 2 cells after the upregulation of miR-222 were detected through MTT assay and Transwell assay .Results In Western Blot ex-periments,the expression of PTEN in transfection groups were lower than that in negative control groups and blank control groups.In MTT assay,the OD values in transfected group were higher than that in negative control group and blank control group(P<0.05).In transwell experiments,the number of penetrating cells in transfected group were higher than that in negative control group and blank control group (P<0.05).Conclusion Our results sug-gest that PTEN is significantly down regulated by the upregulation of miR -222.The proliferative capacity and inva-sive ability are raised in hepatocellular carcinoma cell line HepG 2 through the upregulation of miR-222.
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Objective To compare set?up error and the positioning and error correction time between the infrared markers automatic positioning+ ExacTrac ( A) and the manual positioning+ cone?beam computed tomography ( CBCT) image?guided radiotherapy ( IGRT) ( B) in intensity?modulated radiotherapy ( IMRT) for lung cancer. Methods A total of 20 patients with lung cancer were randomly divided into Group A and Group B. In Group A, after automatic positioning, a group of orthogonal X?rays images were taken using kV X?rays, which matched digitally reconstructed radiographs to obtain errors before correction. In group B, after manual positioning, images were taken using CBCT, which matched reference computed tomography images to obtain errors before correction. The positioning and error correction time was recorded in both groups. After error correction, errors after correction were obtained in each group using IGRT. Between?group comparison was made using the paired t test. Results The errors in lateral, longitudinal, vertical, and spinning vertical directions were significantly reduced after correction in both Group A and B (A:1.8±1?3 vs. 0.4±0?1, P=0?000;2.7±1?9 vs. 0.5±0?1, P=0?000;2.8±1?7 vs. 0.4±0?1, P=0?000;1.6±1?0 vs. 0.3±0?9, P=0?000;B:2.6±1?9 vs. 0.5±0?5, P=0?000;3.1±2?5 vs. 0.6±0?6, P=0?000;2.1±1?8 vs. 0.5±0?5, P=0?000;0.9±0?7 vs. 0.3±0?1, P=0?000). There were no significant differences in errors after correction between Group A and Group B (0.4±0?1 vs. 0.5±0?5, P=0?204;0.5±0?1 vs. 0.6± 0?6, P=0?257;0.4± 0?1 vs. 0.5± 0?5, P=0?518;0.3± 0?9 vs. 0.3± 0?1, P=0?755 ) . However, the positioning and error correction time in Group A was significantly shorter than that in Group B (199.1±16?2 vs. 315.2±13?7, P=0?000). Conclusions The application of ExacTrac or CBCT IGRT can substantially reduce set?up errors and improve set?up accuracy in IMRT. In addition, the application of the ExacTrac system can substantially shorten the positioning and error correction time.
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Objective To reduce the occurrence of nursing adverse events in emergency first aid and improve the safety of nursing.Methods To set up the quality control (QC) team,root cause analysis (RCA) method was applied to analyze the occurrence of nursing adverse events in emergency first aid in our department from December 2008 to December 2011.Measures were produced by identifying the reasons of the proximal and the root cause.Lots of measures had been taken,such as revising the nursing working process and regime,changing the work schedule,strengthening education of nurses risk consciousness and the communication ability,paying attention to the details of daily nursing work management.Results In December 2012,nursing adverse events in our hospital was reduced from 9.81％ to 2.75％ in 2011.Conclusions The key point to reduce nursing adverse events in emergency first aid is to perfect nursing working process and regime,improve the ability to solve emergency first aid events and nursing crisis consciousness training,practice flexible working schedule and attach importance to the detail management.
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Objective To observe the role of nitric oxide(NO) in the immune regulatory effect of bone marrow mesenchymal stem cells(MSCs). Methods Bone marrow MSCs were isolated from Lewis rats by adherence screening. Concanavalin A (ConA) was adopted as the stimulator and T-lymphocyte isolated from peripheral blood of SD rats as the reactive cells. The changes of the ability of T-lymphocyte proliferation, when co-cultured with MSCs, were measured by CCK-8 assay. The inducible nitric oxide synthase (iNOS) mRNA and protein expression on MSCs and were detected by RT-PCR, Western blot. The contents of nitrites and the levels of Th1 type cytokine IFN-γand Th2 type cytokine IL-4 were measured by Griess test and ELISA respectively, in the co-cultured supernatant. Results T-lymphocyte proliferation was inhibited by co-cultured MSCs, which was concentration-dependent. In this study, the inhibition was most obviously group[ (79.03 ± 1.70)% ] (P ＞ 0.05 ). The I NOS mRNA expression, protein and nitrite levels were signifigroups, the proliferation rate of T-lymphocyte recovered. The content of IFN-γwas increased with the ratio decline of MSCs in the experimental group and IL-4 in each group has no significant difference( P ＞ 0.05 ).Conclusion MSCs inhibited T-lymphocyte proliferation by influencing Th1/Th2 balance, and the secretion of soluble factor NO, which secreted by MSCs, may plays an important role in the immune regulation.
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Objective To compare the immune regulation of syngenic and allogenic mesenchymal stem cells (MSCs) in the transplantation combined with islets. Methods After induction of diabetes in 30 Lewis rats with streptozotocin (STZ), the recipient Lewis rats received islets from SD rats combined with syngenic (group B) or allogenic (group C) MSCs injection via the portal vein. The group of islets transplanted alone served as control (group A). The survival time of grafts in all groups was assessed by the level of blood glucose. ELISA was used to detect the levels of interferon-γ (IFN-γ), interleukin 2 (IL-2), IL-4 and IL-10 in the peripheral blood on the 1st and 3rd day after transplantation. Results The blood glucose levels in all three groups were decreased in a normal range (13. 9 mmol/L) and the survival time of grafts in group B (11.38 ± 4. 03 days) was significantly longer than in group C (5. 50± 2. 07 days) as well as group A (2. 88 ± 1.25 days). On the 1 st and 3rd day after transplantation, the levels of TH 1 cytokines IFN-γ and IL-2 in group A were significantly higher than in groups C and B (P＜0.05). Meanwhile the levels of TH 2 cytokine IL-10were increased in group B, but there was no significant difference between groups A and C (P＞0.05). The levels of IL-4 had no significant difference among these three groups (P ＞ 0.05).Conclusion Islet transplantation combined with MSCs could prolong the survival time of grafts.Syngenic MSCs, superior to allogenic ones, were more effective in changing the balance of TH1/TH2to TH2. Decreased expression of TH1 cytokine (IFN-γ, IL-2), which was closely related to the induction of immune tolerance, was beneficial to the long-term survival of grafts.
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ObjectiveTo study the effect of lentivirus-mediated microRNA-21 RNAi on biological behaviors in human hepatic cancer cells.MethodsMicroRNA-21 specific siRNA gene was synthesized and cloned into the recombinant lentiviral vector,pGCSIL-GFP.HepG2 cells were infected by microRNA-21 siRNA recombinant lentivirus (miR-21-siRNA-Ⅳ).The HepG2 cells were devided into SI group,NC group and N group in vitro.The expression of the targets of miR-21 was detected by RT-PCR.Cell growth was analyzed by MTT assay.The invasion was dectected by tmnswell method.Apoptosis was detected by Hoechst33258.BALB/c nude mice were randomly divided into SI group and NC group.The growth of transplant tumors in BALB/c nude mice were observed.Results ( 1 ) The expression level of miR-21 was inhibited significantly by miR-21-siRNA-lⅣ.(2) The proliferation of HepG2 was also markedly suppressed in MTT at the 96 h point ( P =0.0031,P ＜ 0.05 ).(3) The number of cells that migrated through the chamber of SI group decreased ( P =0.0004,P ＜ 0.05 ).(4) The cell apopotosis in SI group increased markedly.In addition,the caspase 3 mRNA significantly increased ( P =0.0002,P ＜ 0.05 ).( 5 ) Tumor growth curve was not statistically different between groups ( P =0.0002,P ＜ 0.05 ).ConclusionsMicroRNA-21 specific siRNA suppresses the proliferation and migration of HepG2 cells and induces tumor cell apoptosis inhibiting the growth of transplanted tumor in Balb/c nude mice.
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Objective To explore the relation of donor liver's heme oxygenase-1 level to ische-mia/reperfusion injury and the liver function after liver transplantation. Methods Twenty-eight pa-tients receiving orthotopic liver transplantation (OLT) were divided into two groups according to the donor liver's heme oxygenase level of high HO-1 expression group and low HO-1 expression group.The recipients' serum levels of ALT, AST, bile salt output and the expression of HO-1 mRNA were determined and compared between the 2 groups. Results HO-1 mRNA of low expression group in-creased significantly after the reperfusion. Meanwhile, the HO-1 mRNA of high expression group de-creased. The serum levels of ALT and AST of HO-1 in low expression group were much lower but bile salt concentration higher than those in high expression group. Conclusion HO-1 can be further induced in the liver of HO-1 low expression group during the reperfusion period. The I/R injury in the HO-1 low expression group was less severe than that in high expression group, but the liver function was better. The increase of HO-1 during the transplantation seems better for protecting the liver than the initial HO-1 high expression. Kupffer cells are of the main localization for HO-1 protein in human liver.
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Objective:Tumor suppressor gene nitrogen permease regulator like 2 (NPRL2), also called tumor suppressor candidate gene 4 (TUSC4), widely exists in all kinds of human tissues and is highly conserved in different kinds of biological species. The expression of NPRL2 is markedly decreased in many human tumor tissues, such as lung cancer, breast cancer,renal carcinoma, et al. NPRL2 is located in human chromosome 3p2.13, and participates in DNA mismatch modification, regulation of signal transduction du-ring cell cycle progression, and apoptosis induction. NPRL2 gene inactivation is related with the initiation and progression of several malignant tumors. The mechanism underlying the tumor-inhibiting activity of NPRL2 gene is not clear and needs to be further investigated.
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Objective To investigate the effective route and proper method in transfecting gene into liver graft mediated by adeno-associated virus vector.Methods Three routes including hepatic artery,portal vein and hepatic artery+portal vein,and 3 methods,i.e.routine,circulation and clamping were employed for infusion.The best infusion route and method of gene transfection into liver graft were determined by observing the color change of liver and detecting liver function and transfoetion rate of liver cells.The safety of these methods was evaluated.Results In all the infusion procedures,the color of the liver grafts turned from red to white,no apparent color differenee of the livers and no enlargement nor mottling were observed under surgical microscope.The liver color was back to normal immediately after blood flow was restored.No significantly statistical differences of the ALT values were observed among all the groups(F=0.343,1.265,0.055,P＞0.05).Adeno-associated virus vectors coding for the enhanced green fluorescence protein(AAV2-EGFP)were successfully transfected into liver cells by the 3 infusion routes 1 week later,and the difierences of transfection rates via the 3 routes had no statistical significance(F=0.080,0.091,0.045,P＞0.05).The transfoction rate of AAV2-EGFP was the highest at any time points when using the clamping method,and then followed by circulation method and routine method,with statistical differenee(F=3.880,2.976,5.129,P＜0.05).The transfection rates of AAV2-EGFP were increased progressively and peaked at the 6th week,and then they were decreased gradually.Conclusions Infusion via hepatic artery is the effective route for gene transfection and clamping the vessels can elevate the transfection rate of AAV2-EGFP.All procedures were performed without detectable liver injury.The transfection of gene into liver graft mediated by adeno-associated virus vector is a slow and persistent process.
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Objective To observe the protective effect of Ulinastatin in rat islet isolation and advance an improved method in rat pancreas islet isolation.Methods Rat pancreas was perfused with Hanks solution containing collagenase. The rats were divided into 3 group according the Ulinastatin concentrations in collagense: low-concentration Ulinastatin ( 2500 U/ml) group, high-concentration Ulinastatin ( 5000 U/ml) and control group (no Ulinastatin). The isolated pancreases were compared among the groups. Results The shape and number of the isolated pancreases in low-concentration Ulinastatin and high-concentration Ulinastatin groups were superior to those in control group (P
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Objective To explore the operative technique of endoscopic thyroidectomy and prevent its complications.Methods A retrospective analysis was made on the clinical data of 32 patients with benign thyroid diseases who were treated with endoscopic thyroidectomy between May 2002 and March 2005.Results Thirty-two cases were successfully treated with the mean operation time 130 min(80～180 min).Twelve cases with thyroid adenomas and 20 cases with thyroid tubers were confirmed by histologic examinations.In this group,the postoperative complications included fat liquefaction in 2 cases and transient hoarseness in 1 case who recovered 3 months after operation.No parathyroid injury occurred.The drainage tubes were removed 2~3 days after operation.All of the patients were discharged 2~5 days after operation.Conclusion Endoscopic thyroidectomy is safe and feasible with favorable cosmetic effect.
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0.05). But there were statistic difference in the those indexes and pathological changes of bile duct and liver between A and ligation groups on the 30th and 90th day after operation (P
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Objective To evaluate the role of combined use of tacrolimus and leflunomide (Lef) in prevention of acute allograft rejection in rats.Methods The rats were randomly divided into control group, tacrolimus treated group, Lef treated group and tacrolimus +Lef treated group. The drugs were given by gavage from day 0 to day 9 after transplantation. Graft survival was observed. Some cases of allografts were examined histologically 7 days after transplantation. At the same time, the levels of CD4 + , CD8 + T cell subsets in peripheral blood were examined by using flow cytometry and the hepatic function as well as renal function of recipents were also tested. Results The graft survival time in control group, tacrolimus treated group, Lef treated group and tacrolimus+Lef treated group was 7.14 ? 1.07 days, 11.14 ? 1.73 days, 11.29 ? 1.80 days and 14.00 ? 2.49 days, respectively. The histological study revealed the rejection in the tacrolimus+Lef treated group was slighter than the tacrolimus treated group and Lef treated group. The levels of CD4 + T cell subsets in the peripheral blood of the tacrolimus+Lef treated group were much lower than those of the tacrolimus treated group and Lef treated group 7 days after transplantation. The levels of CD8 + T cell subsets and the hepatic function and renal function had no significant difference.Conclusion Combined use of tacrolimus and Lef had better effect in prevention of acute rejection in allograft rats than monotherapy without increasing side effects.
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Objective To assess the preventive effects of FK506 and Leflunomide (Lef) on islet xenograft acute rejection in rat-to-mouse models. Methods The islets of rat were transplanted under the kidney capsule of streptozotocin-induced diabetic mouse. The recipients were randomly divided into control group, un-treatment group, mono-therapy group and combination-therapy group. All immunosuppressants were administrated daily from 0 to 9 days. CD4 +\, CD8 + T-cell subsets and IL-2 were examined on the 5?th day after transplantation. Results Compared with un-treatment group, xenoislet survival could be significally prolonged in mono-therapy group. Combination-therapy of FK506 with Lef could significantly prolong the survival of xenoislet when compared with FK506 or Lef used alone. The number of CD4 + T-cells in mono-therapy group and combination-therapy group was much less than in un-treatment group. Conclusion Both FK506 and Lef can suppress proliferation of CD4 + T-cells and prevent or delay islet xenograft rejection.