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Objective:To investigate the influene of sarcopenia on quality of life in patients with adenocarcinoma of gastroesophageal junction (AEG).Methods:The retrospective cohort study was conducted. The clinicopathological data of 109 patients with AEG who were admitted to Henan Provincial People′s Hospital from January 2019 to December 2022 were collected. There were 63 males and 46 females, aged (63±11)years. All patients underwent 3D laparoscopic assisted radical total gastrectomy+D 2 lymph node dissection. The skeletal muscle content of patient was obtained within 3 days before surgery by using a multi-frequency bioelectrical impedance human body composition analyzer. Observation indicators: (1) clinical characteristics of patients with sarco-penia and non sarcopenia; (2) intraoperative and postoperative conditions in patients with sarco-penia and non sarcopenia; (3) analysis of serious postoperative complications in patients with AEG; (4) preoperative and postoperative quality of life score in patients with sarcopenia and non sarco-penia. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the Mann-Whitney U non-parameter rank sum test. Repeated measurement data were analyzed using the repeated ANOVA, and their variances were tested using a spherical test. Univariate analysis was conducted using the Logistic regression model, and multivariate analysis was conducted using the Logistic stepwise regression model. Results:(1) Clinical characteristics of patients with sarcopenia and non sarcopenia. Of 109 patients with AEG, there were 42 cases with sarcopenia and 67 cases with non sarcopenia. The body mass index (BMI), forced expiratory volume in 1 second (FEV1), rate of FEV1/forced vital capacity were (20.3±2.3)kg/m 2, 92%±9%, 79%±11% in patients with sarcopenia, respectively, versus (24.4±2.7)kg/m 2, 97%±9%, 85%±11% in patients with non sarcopenia, showing significant differences in the above indicators between them ( t=8.07, 2.46, 2.77, P<0.05). (2) Intraoperative and postoperative conditions in patients with sarcopenia and non sarco-penia. The volume of intraoperative blood loss, time to postoperative first flatus, duration of post-operative hospital stay, cases with postoperative complications were 208(192, 231)mL, (3.4±0.9)days, (11.4±3.2)days, 26 in patients with sarcopenia, respectively, versus 195(150,215)mL, (2.8±0.7)days, (9.9±1.6)days, 14 in patients with non sarcopenia, showing significant differences in the above indi-cators between them ( Z=-2.14, t=3.25, 3.38, χ2=18.69, P<0.05). (3) Analysis of serious postoperative complications in patients with AEG. Results of multivariate analysis showed that sarcopenia and BMI reduction were independent risk factors influencing serious postoperative complications in patients with AEG ( odds ratio=2.04, 1.98, 95% confidence interval as 1.24-3.36, 1.09-3.60, P<0.05). (4) Pre-operative and postoperative quality of life score in patients with sarcopenia and non sarcopenia. Results of multivariate test in physical function, role function, social function, overall score of patients with sarcopenia and non sarcopenia before surgery, 2 weeks after surgery, 4 weeks after surgery, and 8 weeks after surgery showed that there were significant differences in the temporal effect, intergroup effect and interaction effect of the above indicators between patients with sarcopenia and non sarcopenia ( P<0.05). Results of individual effects showed that there were significant differences in the intergroup effect of the above indicators between patients with sarcopenia and non sarcopenia ( P<0.05). Conclusion:Preoperative sarcopenia increases the risk of severe postoperative complications and reduces the postoperative quality of life in patients with AEG.
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Ovarian cancer is one of the three major cancers in gynecology. Ovarian cancer has insidious symptoms in its early stages and mostly has progressed to advanced stages when detected. Surgical treatment combined with chemotherapy is currently the main treatment, but the 5-year survival rate is still less than 45%. Angiogenesis is a key step in the growth and metastasis of ovarian cancer. The inhibition of ovarian cancer angiogenesis has become a new hotspot in anti-tumor targeted therapy, which has many advantages such as less drug resistance, high specificity, few side effects, and broad anti-tumor spectrum. Modern research has confirmed that traditional Chinese medicine(TCM) can inhibit tumor angiogenesis by inhibiting the expression of pro-angiogenic factors, up-regulating the expression of anti-angiogenic factors, inhibiting the proliferation of vascular endothelial cells, reducing the density of tumor microvessels, and regulating related signaling pathways, with unique advantages in the treatment of ovarian cancer. This paper presented a review of the role of TCM in inhibiting ovarian cancer angiogenesis in order to provide references for the optimization of clinical ovarian cancer treatment strategies.
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Humans , Female , Medicine, Chinese Traditional , Vascular Endothelial Growth Factor A/metabolism , Endothelial Cells/metabolism , Angiogenesis , Angiogenesis Inhibitors/therapeutic use , Ovarian Neoplasms/genetics , Neovascularization, Pathologic/geneticsРеферат
Aim To investigate the effects of total saponins from Trillium tschonoskii maxim(TST)on cognitive impairment and mitochondrial autophagy in aging rats induced by D-galactose(D-gal). Methods Male SD rats were randomly divided into normal control group,model group(D-gal,subcutaneous injection),intervention group(TST,low,medium and high dose groups by intragastric administration),with 10 rats in each group,and administered for 6 weeks. Morris water maze was used to evaluate the cognitive function. HE and Nissl staining were used to test the hippocampal and brain cortex morphology. Immunohistochemistry staining was applied to detect the localization expression of Pink1 and Parkin. Western blot was employed to detect the expressions of Pink1,Parkin,LC3-Ⅱ,p62 and Beclin1. Results Compared with the normal control group,the escape latency time was prolonged and the number of crossing platform decreased in D-gal model group(P<0.05). The number of neurons in hippocampus significantly decreased. The positive cells labeled by Pink1 and Parkin staining in hippocampus significantly decreased. The expressions of Pink1,Parkin,LC3-Ⅱ and Beclin1 were markedly reduced,while the expression of p62 was significantly raised(P<0.05). Compared with D-gal model group,the escape latency time of TST dose groups was shortened,the Times of crossing the platform was more,and the time of staying in the platform quadrant increased(P<0.05). The number of neurons in hippocampus significantly increased. The positive cells labeled by Pink1 and Parkin staining in hippocampus significantly increased. The expressions of Pink1,Parkin,LC3-Ⅱ and Beclin1 in hippocampus were apparently up-regulated,while the protein expression of p62 was evidently down-regulated(P<0.05). Conclusions TST has neuroprotective effects on the learning and memory capacities in aging rats induced by D-gal,which may be related to the increasing levels of Pink1,Parkin,LC3-Ⅱ and Beclin1 proteins and the activation of mitochondrial autophagy.
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In recent years, the clinical experts consensuses or guidelines of ankylosing spondylitis (AS)/spondyloarthritis (SpA) have been constantly updated, but to better understand and practice, patient self-participation management is one of the key points to improve the level of diagnosis and treatment. Through questionnaire survey of these patients, we screened out the most concerned issues, and established the AS/SpA patient practice guideline working group with multidisciplinary physicians and patients. Fifteen opinions, as the AS/SpA patient practice guidelines, are proposed in accordance with the relevant principles of the "WHO guidelines development manual" , and with the international normative process.
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Hyperuricemia/gout is a common metabolic disease in China, which is a serious threat to people′s health. In clinical practice, the standardization of prevention and diagnosis and the rate of treat-to-target need to be improved. There is still a lack of education for the patients about the understanding of clinical guidelines, the disease knowledge and the importance of cooperating with doctors to carry out diagnosis and treatment. From the most concerned issues of the patients, we established the hyperuricemia/gout patient practice guideline working group with multidisciplinary physicians and patients. Seventeen opinions, as the hyperuricemia/gout patient practice guidelines, are proposed in accordance with the relevant principles of the "WHO guidelines development manual" , and with the international normative process, aiming to improve the patients compliance, improve the level of health management of the disease.
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In recent years, the clinical guidelines for the diagnosis and treatment of rheumatoid arthritis (RA) have been constantly updated. Among the general principles, it is particularly emphasized that, in order to improve the ratio of treat to target(T2T) of RA, doctors and patients should work together to negotiate the details of the guidelines. Therefore, it is important for patients to further understand the disease and clinical guidelines of RA, and to better cooperate with doctors. This study was based on the most concerned issues of RA patients and international standard procedure of guideline study, we organized the working group and introduce the following 16 recommendations constituting the RA patients′ practice guidelines.
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In recent years, osteoporosis (OP) has become one of the main diseases affecting the health of middle-aged and elderly people in China, and the prevalence of OP has increased significantly. The clinical diagnosis and treatment guidelines for this disease are also constantly updated. The overall principles speciallyemphasise that doctors and patients need to work together to negotiate the details of the diagnosis and treatment guidelines, in order to improve the OP clinical diagnosis and treatment rate. Therefore, patients′ knowledge of the disease, understanding of clinical guidelines, and cooperation with doctors to implement diagnosis and treatment plans are very important. In this study, from the most concerned issues of the patients, we established the OP patient practice guideline working group. 14 recommendations, as the OP patient practice guidelines, are proposed in accordance with the relevant principles of the "World Health Organization guidelines development manual" and the international normative process.
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This study was designed to investigate the effect of dihydromyricetin (DHM) on inducing apoptosis of ovarian cancer cells A2780 through endoplasmic reticulum stress (ERS) pathway and the mechanisms involved in vitro and in vivo. A2780 cells were treated with different concentrations of DHM, and the protein expression levels of glucose-regulated protein 78 (GRP78) which is related to ERS increased, apoptotic proteins C/EBP-homologous protein (CHOP), and cysteinyl aspartate specific proteinase-12 (caspase-12) elevated. After pretreatment with ERS inhibitor, 4-phenyl butyric acid (4-PBA), following the intervention with DHM, the A2780 cell viability decreased and apoptotic rate increased. All animal welfare and experimental procedures were approved by the Animal Ethics Committee of Chongqing Medical University. Intraperitoneal injection of DHM suspension into nude mice with ovarian cancer could significantly inhibit the growth of transplanted tumor in vivo, increase the protein expression levels of GRP78, CHOP, and caspase-3. Moreover, swollen and broken endoplasmic reticulum could be observed in tumor tissues, suggesting that DHM intervention induces apoptosis mediated by ERS. The results indicated that DHM could induce apoptosis of ovarian cancer cells and inhibit the growth of transplanted tumors in nude mice, which might be related to the activation of ERS pathway.
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Objectives: To explore the association between outdoor physical activities and PM2.5in Chinese adults. Methods: Data from present study were derived from the prospective urban and rural epidemiology study in China (PURE-China), outdoor physical activities were obtained by using structured and standardized questionnaire, and PM2.5and NO2values were simulated via the longitudes and latitudes of enrolled communities from NASA satellites. Finally, data form 34 064 residents were analyzed. Residents were divided into low physical activity group (<1 386 METs-min/week, n=16 369) and high physical activity group (≥1 386 METs-min/week, n=17 695). Linear correlation and binary logistic regression were used to evaluate the association between outdoor physical activities and PM2.5. Results: Of the 34 064 people included in the study, men and women accounted for 43.6% and 56.4% respectively, the average annual PM2.5concentration was 67.8 μg/m3. PM2.5was associated with high adult outdoor physical activity (OR<1), and with the increase of PM2.5cocentration, the relationship of outdoor physical activity is negative (trend test P<0.05). There was a certain association between PM2.5and high outdoor physical activity among different age groups and gender groups. Conclusions: There is a negative correlation between PM2.5and outdoor physical activity. The possibility of high outdoor physical activity decreases in proportion to the increase of PM2.5concentration. Our results suggest that people actively change their physical activity under the condition of air pollution.
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Objective To compare the efficacy and safety of tacrolimus with those of cyclosporine in treating idiopathic membranous nephropathy (IMN) via network meta-analysis. Methods Databases including PubMed,Embase,CENTRAL (Cochrane),Wanfang Database,CNKI,and VIP citation database were searched for relevant studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Package Meta 4.5.0 and Gemtc 0.8.1 in R 3.3.1 were used to analyze the included studies. Results In this network meta-analysis,the complete remission rate (RR=0.98,95% CI:0.70-1.40)and the total remission rate (RR=1.00,95% CI:0.90-1.20)of idiopathic membranous nephropathy did not differ significantly between IMN patients treated with cyclosporine A or tacrolimusand,nor did the incidences of hepatic dysfunction(RR=1.40,95% CI:0.52-4.00),infection(RR=0.75,95% CI:0.18-3.10),or gastrointestinal syndrome(RR=2.1,95% CI:0.36-28.00). Conclusion Cyclosporine A seems to have similar effectiveness and safety to tacrolimus in treating IMN.
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OBJECTIVE:To investigate clinical efficacy and safety of Miao medicine Jinyin huashi granules combined with western medicine in the treatment of chronic calculous cholecystitis(CCC). METHODS:A total of 120 CCC patients in our hospi-tal during Jan. 2014-Jan. 2016 were randomly divided into control group and observation group,with 60 cases in each group. Con-trol group was given 50% Magnesium sulfate solution 10 mL orally before meal,tid;amoxicillin 0.5 g orally,tid+Racanisodamine tablets 10 mg,tid+Compound dantong tablets 1 slice,tid,after meal. Observation group was additionally treated with Miao medi-cine Jinyin huashi granules 15 g,tid,on the basis of control group. Both groups were treated for consecutive 4 weeks. Clinical effi-cacies,the improvement of upper abdominal pain,nausea and greasy,calculus were observed in 2 groups. The thickness of gall-bladder,serum levels of IL-2 and IL-5,mRNA and protein expression of CYP7A1 and B-UCT were compared between 2 groups before and after treatment. The occurrence of ADR was recorded in 2 groups. RESULTS:Total response rate of observation group was 96.67%,which was significantly higher than 88.33% of control group,with statistical significance (P<0.05). One d and one week after treatment,the improvement rates of upper abdominal pain were 63.33% and 81.67% in observation group, which were significantly than 36.67% and 50.00% of control group,with statistical significance(P<0.05). There was no statisti-cal significance in the improvement rate of nausea or greasy after treatment between 2 groups(P>0.05). The stone-free rate of ob-servation group was 33.33% and significantly higher than 11.67% of control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in the thickness of gallbladder wall,serum levels of IL-2 or IL-15,mRNA and pro-tein expression of CYP7A1 or B-UCT between 2 groups(P>0.05). After treatment,the thickness of gallbladder wall,serum lev-els of IL-2 and IL-15 were all decreased significantly in 2 groups,while mRNA and protein expression of CYP7A1 and B-UCT were increased significantly;observation group was significantly better than control group,with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Miao medicine Jinyin huashi granules combined with western medicine show significant therapeutic efficacy for CCC,can effectively improve right upper quadrant pain,nausea and greasy,decrease serum levels of IL-2 and IL-5 and up-regulate mRNA and protein expression of CYP7A1 and B-UCT with good safety.
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Objective To investigate the effect and mechanism of metformin on endometrial carcinoma subline of progestin-resistance and find whether metformin could regulate progestin-resistance in endometrial carcinoma. Methods Ishikawa endometrial carcinoma cells were cultured for a long period in the presence of the synthetic medroxyprogesterone 17-acetate (MPA) to generate a subline refractory to the growth-suppressive effects of MPA,named Ishikawa/MPA cells. The effect of MPA (1, 5, 10, 20, 40 and 60 μmol/L) or metformin (1, 10, 20, 40, 60, 70 and 80 mmol/L) on proliferation of the Ishikawa/MPA and parental Ishikawa cells was detected by cell counting kit-8 (CCK-8) method. Western blot was used to detect the effect of metformin and(or)MPA on the expression of PR-B in the Ishikawa/MPA and Ishikawa cells. Results The Ishikawa/MPA showed that growth stimulation rather than inhibition in the Ishikawa cells after low MPA concentration treatment. The doubling time of Ishikawa/MPA cell lines were (43±4) hours and that of Ishikawa cell line were (47 ± 3) hours. No changes in doubling time were observed (t=0.349,P=0.572). Low concentration (1 and 5μmol/L) of MPA could promote the growth of Ishikawa/MPA cells (by 3% and 13%). High concentration (10, 20, 40 and 60 μmol/L) of MPA could inhibited the growth of Ishikawa/MPA cells (by 4%, 3%, 9%and 40%) and the growth of Ishikawa cells (by 41%, 55%, 65%and 66%). At the same concentration, the difference of inhibition rates between the two cell lines were statistically significant (P<0.01). Metformin (1, 10, 20, 40, 60, 70 and 80 mmol/L) could inhibite the growth of Ishikawa/MPA (by-10%, 20%, 56%, 89%, 97%, 98%and 99%) greater than those in parental Ishikawa cells (by-6%, 19%, 37%, 54%, 70%, 72%and 83%), and the inhibitory effect was dose-dependent manner. Western blot assay showed that for Ishikawa cells, the protein expression levels of PR-B in metformin group and MPA+metformin group were respectively (53.5±4.0)%and (37.7±5.2)%, which were higher than that in the control group [(23.4 ± 3.0)%], and there were significant the differences (P<0.01). For Ishikawa/MPA cells, the protein expression levels of PR-B in metformin group and MPA+metformin group were respectively (38.6 ± 1.7)%,(36.3 ± 2.5)%,which were higher than those in the control group [(6.4 ± 1.6)%], and there were also significant differences (P<0.01). Conclusion Metformin may regulate the progestin-resistance in endometrial carcinoma by increasing the expression of PR-B.
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In this study, we used Shirasu porous glass membrane (SPG) as a template and hydroxy camptothecin (HCPT) as a model drug to prepare the comet-shaped MePEG[methoxyl poly(ethylene glycol)]-PLGA[poly(lactic-co-glycolic acid)-HCPT amphiphilic block copolymer. Our method was optimized by the orthogonal design method. The partical size, zeta potential, drug-loaded content, yield, shape and status of the obtained comet-shaped MePEG-PLGA-HCPT particles were further characterized by dynamic light scattering (DLS), scanning electron microscopy (SEM)/transmission electron microscopy (TEM), X-ray diffraction (XRD) and differential scanning calorimetry (DSC) et al, respectively. In vitro release was preliminary evaluated. MTT assay to preliminary evaluate the cytotoxicity of particles against human liver BEL-7402 cells. Based on these experimental results, the optimal preparation conditions contain:weight ratio of HCPT to MePEG-PLGA was 1:1, nitrogen pressure was 100 kPa and SPG membrane pore size was 1.1 μm. The particles exhibited a comet-shaped shape, fairly uniform size and were well dispersed. The drug-loading content was 46.2%, with yield of 96.4%, and zeta -31.4 mV. The distribution of HCPT in particles was very uniform, and HCPT showed a amorphous state existed in particles. The release behavior in vitro showed sustained releasing,and with the drug loading content in proportion to the release of the drug. MTT test indicated that the HCPT-loaded comet-shaped particles had enhanced the cytotoxicity against human liver BEL-7402 cells relatively to the HCPT-loaded spherical particles in vitro. The results showed a promising potential application of the preparation in clinical treatment of tumor.
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Objective To investigate the effects of metformin on cell proliferation in differentiation degree of endometrial carcinoma cells and related mechanisms. Methods The endometrial cancer cell lines Ishikawa and AN3CA were used. Cell proliferation was assessed after exposure to metformin with or without epithelial growth factor receptor (EGFR) inhibitor AG1478 by cell counting kit-8 (CCK-8) method. EGFR mRNA was determined by reverse transcription (RT)-PCR. The expression of phosphorylation EGFR (p-EGFR) and total EGFR (t-EGFR) and phosphorylation extracellular signal-regulated kinase 1/2 (p-ERK1/2) and total ERK1/2 (t-ERK1/2) were examined by western blot. Results (1)CCK-8 experiment showed that metformin could inhibit the proliferation of endometrial cancer cells in a time-dependent manner and a dose-dependent manner (P0.05). But the expression levels of p-EGFR and p-ERK1/2 protein were significantly lower between two groups (P<0.01), which showed a time-dependent manner(P<0.01). Conclusion Metformin could inhibit the proliferation of endometrial cancer cells, the inhibition is associated with the differentiation degree of cancer cells. Metformin could enhance the EGFR signaling pathway inhibitor AG1478 inhibition of endometrial cancer cells, which may inhibit EGFR expression of phosphorylated proteins to inhibit the phosphorylation of ERK1/2 proteins and then inhibit proliferation of endometrial cancer cells.
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<p><b>OBJECTIVE</b>To review the 2461 cases of maxillofacial fractures.</p><p><b>METHODS</b>From 2003 to 2009, 2461 maxillofacial fracture cases were treated in Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Traditional Chinese Medicine. Data regarding sex, age, cause of injury, occupation, geographic distribution, blood type, fracture site, multiple associated injuries, injury severity, the patient's first admitted department, treatment results were reviewed.</p><p><b>RESULTS</b>The male and female ratio was 4.28:1, 1424(57.86 %) patients were between 20 and 40 years of age. The most common cause of injury was road traffic accident (938 cases, 40.98%). People in tertiary industry (900 cases, 78.53%) were most vulnerable to injuries. The zygomatic complex (22.08%), nasal bone (20.67%) and mandible (16.35%) were the most frequent fracture sites, which were often associated with skull (21.74%), brain (38.36%) and soft tissue contusion injury (48.84%). 85.98% (2116/2461 cases), of patients' AIS score was less than 2. Orthopaedics (939/2461 cases, 38.16%) was the first admitted department.</p><p><b>CONCLUSIONS</b>The traffic accidents are the main cause of the maxillofacial fractures. Most injuries are found in the young and middle-aged people.</p>
Тема - темы
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Accidents, Traffic , Age Factors , Blood Transfusion , China , Mandibular Fractures , Epidemiology , General Surgery , Maxillofacial Injuries , Epidemiology , General Surgery , Nasal Bone , Wounds and Injuries , Retrospective Studies , Sex Factors , Skull Fractures , Epidemiology , General Surgery , Zygomatic Fractures , Epidemiology , General SurgeryРеферат
<p><b>OBJECTIVE</b>To explore a new access for internal rigid fixation of mandibular mid-and-low condylar fracture.</p><p><b>METHODS</b>16 patients of unilateral mid-and-low condylar fractures were treated with a 2cm mini-retromandibular approach. The subcutaneous tissues superficial to the superficial muscular aponeurotic system (SMAS) were dissected forward that parallel to the masseter muscle fiber bundles, aiming to the fracture. After exposing the fracture, the fracture segments were reduced and fixed under sufficient exposure.</p><p><b>RESULTS</b>Correct anatomic reduction and occlusion were achieved in all cases. Additionally, all patients showed normal articular function and the surgical scars were barely visible.</p><p><b>CONCLUSION</b>The transmasseter approach by retromandibular access is one of the feasible methods for curing mid-and-low condylar fracture, which minimizeing the risk of facial nerve injury and reducing the visible scars.</p>