ABSTRACT
OBJECTIVE: This study aimed to investigate the structure of the mitral valve in patients undergoing mitral valvuloplasty (MVP) using real-time three-dimensional transesophageal echocardiography (RT-3D-TEE). The main objective was to study the relationship between intraoperative annuloplasty ring size and mitral valve structure dimensions, with a focus on exploring the application value of RT-3D-TEE in MVP. METHODS: A total of 28 patients with degenerative mitral regurgitation (DMR), who underwent MVP between February and September 2022, as well as 12 normal control cases, were enrolled in this study. The MV annulus and leaflets were quantitatively analyzed using MVN software. RESULTS: The DMR group exhibited significantly greater dimensions in various parameters of the mitral valve, including the anterolateral-to-posteromedial diameter (DAlPm ), anterior-to-posterior diameter (DAP ), annulus height (HA ), three-dimensional annulus circumference (CA3D ), two-dimensional annulus area (AA2D ), anterior leaflet area (Aant ), posterior leaflet area (Apost ), anterior leaflet length (Lant ), posterior leaflet length (Lpost ), and tenting volume (Vtent ) compared to the control group. CONCLUSION: Real-time three-dimensional transesophageal echocardiography provides valuable insights into the morphological structure of the mitral valve and lesion location. It can aid in surgical decision-making, validate the success of MVP, and potentially reduce mortality and complications associated with mitral valve repair procedures.
Subject(s)
Balloon Valvuloplasty , Echocardiography, Three-Dimensional , Echocardiography, Transesophageal , Mitral Valve Insufficiency , Humans , Echocardiography, Three-Dimensional/methods , Echocardiography, Transesophageal/methods , Electrocardiography , Mitral Valve/diagnostic imaging , Mitral Valve/surgery , Mitral Valve Insufficiency/diagnostic imaging , Mitral Valve Insufficiency/surgeryABSTRACT
Objectives:To evaluate the tricuspid valve(TV)geometric remodeling in patients with idiopathic pulmonary arterial hypertension(IPAH)by three-dimensional transthoracic echocardiography. Methods:Two-dimensional and three-dimensional transthoracic echocardiography were performed in 30 IPAH patients and 15 healthy controls,and the geometry parameters of TV were obtained by four-dimensional auto tricuspid valve quantitative(4D Auto-TVQ)in the right ventricular-focused apical view.Pulmonary arterial hypertension was determined by right heart catheterization within 48 hours of echocardiography. Results:The 4-chamber diameter,tricuspid annular(TA)perimeter,TA area,maximal tenting height,coaptation point height and tenting volume were larger in IPAH patients than those in healthy controls(all P<0.05),2-chamber diameter was similar between two groups.In IPAH group,maximal tenting height and coaptation point height were moderately correlated with right ventricular end-diastolic volume(r=0.710,r=0.515,both P<0.05),while TA perimeter,4-chamber diameter and TA area were moderately correlated with right atrial end-systolic volume(r=0.712,r=0.558,r=0.545,all P<0.05). Conclusions:IPAH patients have larger maximal tenting height,coaptation point height and tenting volume,TA enlargement is mainly visible in 4-chamber diameter.TV tenting height is associated with right ventricular volume,but TA size is associated with right atrial volume in IPAH patients.
ABSTRACT
Objective:To search, evaluate and summarize the best evidence summary of perioperative accelerated rehabilitation nursing for patients undergoing hip and knee arthroplasty, so as to provide reference for clinical perioperative nursing.Methods:Evidence-based nursing methods were used to search for relevant databases such as BMJ Best Practice, UpToDate, PubMed, CINAHL, and CNKI, etc.. The search period was from December 2010 to December 2022. Four researchers independently evaluated the quality of the guidelines, and two researchers independently evaluated the quality of expert consensus and system evaluation. Finally, the included literature was summarized.Results:A total of 12 pieces of literature, 3 guidelines, 5 expert consensus and 4 systematic reviews were included. From 13 aspects of preoperative education, preoperative optimization, anesthesia management, perioperative blood management, perioperative pain management, perioperative fluid management, perioperative temperature protection, infection prevention, thrombus prevention, postoperative nausea and vomiting, postoperative drainage, functional exercise, and perioperative rehabilitation promotion, 35 pieces of the best evidence for hip and knee replacement patients to accelerate rehabilitation nursing in the perioperative period was summarized.Conclusions:This study summarizes the best evidence of accelerated rehabilitation nursing in the perioperative period of hip and knee arthroplasty, aiming to build and standardize the accelerated rehabilitation nursing scheme in the perioperative period of hip and knee arthroplasty, so as to provide reference for clinical perioperative nursing.
ABSTRACT
OBJECTIVE: To investigate the expression level and the diagnostic value of serum free light chain in B-cell non-Hodgkin's lymphoma (B-NHL). METHODS: We retrospectively analyzed the results of serum free light chain (sFLC) of 394 newly treated B-NHL patients in our hospital from January 2014 to December 2021 and compared the secretion levels of sFLC among different subtypes of B-NHL. The value of sFLC secretion levels in the diagnosis of WM was evaluated using ROC. RESULTS: Increased proportion of sFLC, abnormal ratio of sFLC (κ / λ) and the secretion levels of sFLC (κ+λ) were different in different B-NHL subtypes, Waldenstrom's macroglobulinemia (WM) had the highest proportion of elevated sFLC(82.68%) and abnormal sFLC(κ/ λ)(87.0%), the proportion of FL(18.0%) and DLBCL patients(12.8%) with elevated sFLC was lower (P<0.05). The expression levels of sFLC can helpful in the diagnosis of WM (AUC=0.874ï¼P<0.001ï¼ 95% CI: 0.779-0.970). At the same time, higher sFLC levels and sFLC cloning patterns predicted the possibility of bone marrow infiltration of lymphoma. CONCLUSION: The serum free light chains is common in patients with B-NHL. The elevated level and type of free light chain are associated with the type of lymphoma, and the patients with bone marrow infiltration have higher sFLCï¼κ+ λï¼ expression level.
Subject(s)
Immunoglobulin Light Chains , Lymphoma, B-Cell , Humans , Retrospective Studies , Lymphoma, B-Cell/diagnosisABSTRACT
The suppressor of variegation enhancer of zeste-trithorax (SET) domain methyltransferases have been reported to function as key regulators in multiple tumor types by catalyzing histone lysine methylation. Nevertheless, our understanding on the role of these lysine methyltransferases, including SETD4, in prostate cancer (PCa) remains limited. Hence, the specific role of SETD4 in PCa was investigated in this study. The expression of SETD4 in PCa cells and tissue samples was downregulated in PCa cells and tissue specimens, and decreased SETD4 expression led to inferior clinicopathological characteristics in patients with PCa. knockdown of SETD4 facilitated the proliferation of PCa cells and accelerated cell cycle progression. Mechanistically, SETD4 repressed NUPR1 transcription by methylating H3K27 to generate H3K27me3, subsequently inactivated Akt pathway and impeded the tumorigenesis of PCa. Our results highlight that SETD4 prevents the development of PCa by catalyzing the methylation of H3K27 and suppressing NUPR1 transcription, subsequently inactivating the Akt signaling pathway. The findings suggest the potential application of SETD4 in PCa prognosis and therapeutics.
Subject(s)
Histones , Prostatic Neoplasms , Humans , Male , Cell Cycle Checkpoints/genetics , Cell Line, Tumor , Cell Proliferation , Histones/genetics , Histones/metabolism , Lysine/metabolism , Methyltransferases/metabolism , Prostatic Neoplasms/genetics , Prostatic Neoplasms/pathology , Proto-Oncogene Proteins c-akt/metabolismABSTRACT
The feasibility of the degradation of phenazone (PNZ), a common anti-inflammatory drug used for reducing pain and fever, in water at neutral pH by an electrochemically assisted Fe3+-ethylenediamine disuccinate-activated persulfate process (EC/Fe3+-EDDS/PS) was investigated. The efficient removal of PNZ at neutral pH condition was mainly attributed to the continuous activation of PS via electrochemically driven regenerated Fe2+ from a Fe3+-EDDS complex at the cathode. The influence of several critical parameters, including current density, Fe3+ concentration, EDDS to Fe3+ molar ratio, and PS dosage, on PNZ degradation was evaluated and optimized. Both hydroxyl radicals (â¢OH) and sulfate radicals (SO4â-) were considered major reactive species responsible for PNZ degradation. To understand the mechanistic model of action at the molecular level, the thermodynamic and kinetic behaviors of the reactions between PNZ with â¢OH and SO4â- were theoretically calculated using a density functional theory (DFT) method. The results revealed that radical adduct formation (RAF) is the most favorable pathway for the â¢OH-driven oxidation of PNZ, while single electron transfer (SET) appears to be the dominant pathway for the reaction of SO4â- with PNZ. In total, thirteen oxidation intermediates were identified, and hydroxylation, pyrazole ring opening, dephenylization, and demethylation were speculated to be the major degradation pathways. Furthermore, predicted toxicity to aquatic organisms indicated that PNZ degradation resulted in products that were less harmful. However, the developmental toxicity of PNZ and its intermediate products should be further investigated in the environment. The findings of this work demonstrate the viability of effectively removing organic contaminants in water at near-neutral pH by using EDDS chelation combined with electrochemistry in a Fe3+/persulfate system.
Subject(s)
Antipyrine , Water Pollutants, Chemical , Chelating Agents , Hydroxyl Radical , Water , Hydrogen-Ion Concentration , Oxidation-Reduction , Water Pollutants, Chemical/analysis , Sulfates/chemistry , KineticsABSTRACT
OBJECTIVE@#To investigate the expression level and the diagnostic value of serum free light chain in B-cell non-Hodgkin's lymphoma (B-NHL).@*METHODS@#We retrospectively analyzed the results of serum free light chain (sFLC) of 394 newly treated B-NHL patients in our hospital from January 2014 to December 2021 and compared the secretion levels of sFLC among different subtypes of B-NHL. The value of sFLC secretion levels in the diagnosis of WM was evaluated using ROC.@*RESULTS@#Increased proportion of sFLC, abnormal ratio of sFLC (κ / λ) and the secretion levels of sFLC (κ+λ) were different in different B-NHL subtypes, Waldenstrom's macroglobulinemia (WM) had the highest proportion of elevated sFLC(82.68%) and abnormal sFLC(κ/ λ)(87.0%), the proportion of FL(18.0%) and DLBCL patients(12.8%) with elevated sFLC was lower (P<0.05). The expression levels of sFLC can helpful in the diagnosis of WM (AUC=0.874,P<0.001, 95% CI: 0.779-0.970). At the same time, higher sFLC levels and sFLC cloning patterns predicted the possibility of bone marrow infiltration of lymphoma.@*CONCLUSION@#The serum free light chains is common in patients with B-NHL. The elevated level and type of free light chain are associated with the type of lymphoma, and the patients with bone marrow infiltration have higher sFLC(κ+ λ) expression level.
Subject(s)
Humans , Retrospective Studies , Immunoglobulin Light Chains , Lymphoma, B-Cell/diagnosisABSTRACT
The infection of Hepatitis B virus (HBV) can result in severe consequences, including chronic hepatitis, liver fibrosis, cirrhosis, and even liver cancer. Effective antiviral treatment has the potential to slow down the progression of the disease. HBV serum biomarkers play a crucial role in the dynamic management of chronic hepatitis B (CHB) patients. However, the conventional hepatitis B virus markers, such as hepatitis B serologic testing and HBV DNA, are insufficient to meet the clinical requirements. This review provided a comprehensive overview of the current research on the quantification of HBsAg and anti-HBc, HBV RNA and HBV core-associated antigen, which summarized the crucial role these markers play in the administration of antiviral medications, predicting the efficacy of treatment and anticipating the likelihood of virologic rebound following drug cessation, as well as assessing disease progression in CHB patients.
Subject(s)
Humans , Hepatitis B virus/genetics , Clinical Relevance , Hepatitis B, Chronic/drug therapy , Hepatitis B Core Antigens/therapeutic use , Biomarkers , Liver Cirrhosis/drug therapy , Antiviral Agents/therapeutic use , Hepatitis B Surface Antigens/therapeutic use , DNA, Viral/therapeutic use , Hepatitis B e Antigens/therapeutic use , Hepatitis B/drug therapyABSTRACT
BACKGROUND: Circular RNAs (circRNAs) mediate the infiltration of tumor-associated macrophages (TAMs) to facilitate carcinogenesis and development of various types of cancers. However, the role of circRNAs in regulating macrophages in prostate cancer (PCa) remains uncertain. METHODS: Differentially expressed circRNAs in PCa were identified by RNA sequencing. The expression of circSMARCC1 was recognized and evaluated using fluorescence in situ hybridization and quantitative real-time PCR. The oncogenic role of circSMARCC1 in PCa tumor proliferation and metastasis was investigated through a series of in vitro and in vivo assays. Finally, Western blot, biotin-labeled RNA pulldown, luciferase assay, rescue experiments, and co-culture experiments with TAMs were conducted to reveal the mechanistic role of circSMARCC1. RESULTS: CircSMARCC1 was dramatically up-regulated in PCa cells, plasma and tissues. Overexpression of circSMARCC1 promotes tumor proliferation and metastasis both in vitro and in vivo, whereas knockdown of circSMARCC1 exerts the opposite effects. Mechanistically, circSMARCC1 regulates the expression of CC-chemokine ligand 20 (CCL20) via sponging miR-1322 and activate PI3K-Akt signaling pathway involved in the proliferation and epithelial mesenchymal transformation. More importantly, high expression of circSMARCC1 was positively associated with colonization of CD68+/CD163+/CD206+ TAMs in tumor microenvironment. In addition, overexpression of circSMARCC1 facilitates the expression of CD163 in macrophages through the CCL20-CCR6 axis, induces TAMs infiltration and M2 polarization, thereby leading to PCa progression. CONCLUSIONS: CircSMARCC1 up-regulates the chemokine CCL20 secretion by sponging miR-1322, which is involved in the crosstalk between tumor cells and TAMs by targeting CCL20/CCR6 signaling to promote progression of PCa.
Subject(s)
Prostatic Neoplasms , RNA, Circular , Tumor Microenvironment , Cell Line, Tumor , Cell Proliferation , Chemokine CCL20 , Chemokines, CC , Humans , In Situ Hybridization, Fluorescence , Ligands , Male , MicroRNAs/genetics , Phosphatidylinositol 3-Kinases/genetics , Prostatic Neoplasms/genetics , Prostatic Neoplasms/metabolism , RNA, Circular/genetics , Receptors, CCR6/genetics , Signal Transduction , Tumor Microenvironment/genetics , Tumor-Associated MacrophagesABSTRACT
Background: BAP1 is an important tumor suppressor involved in various biological processes and is commonly lost or inactivated in clear-cell renal cell carcinoma (ccRCC). However, the role of the BAP1-deficient tumor competing endogenous RNA (ceRNA) network involved in ccRCC remains unclear. Thus, this study aims to investigate the prognostic BAP1-related ceRNA in ccRCC. Methods: Raw data was obtained from the TCGA and the differentially expressed genes were screened to establish a BAP1-related ceRNA network. Subsequently, the role of the ceRNA axis was validated using phenotypic experiments. Dual-luciferase reporter assays and fluorescence in situ hybridization (FISH) assays were used to confirm the ceRNA network. Results: Nuclear enriched abundant transcript 1 (NEAT1) expression was significantly increased in kidney cancer cell lines. NEAT1 knockdown significantly inhibited cell proliferation and migration, which could be reversed by miR-10a-5p inhibitor. Dual-luciferase reporter assay confirmed miR-10a-5p as a common target of NEAT1 and Serine protease inhibitor family E member 1 (SERPINE1). FISH assays revealed the co-localization of NEAT1 and miR-10a-5p in the cytoplasm. Additionally, the methylation level of SERPINE1 in ccRCC was significantly lower than that in normal tissues. Furthermore, SERPINE1 expression was positively correlated with multiple immune cell infiltration levels. Conclusions: In BAP1-deficient ccRCC, NEAT1 competitively binds to miR-10a-5p, indirectly upregulating SERPINE1 expression to promote kidney cancer cell proliferation. Furthermore, NEAT1/miR-10a-5p/SERPINE1 were found to be independent prognostic factors of ccRCC.
ABSTRACT
BACKGROUND: More and more studies have shown that circular RNAs (circRNAs) play a critical regulatory role in many cancers. However, the potential molecular mechanism of circRNAs in prostate cancer (PCa) remains largely unknown. METHODS: Differentially expressed circRNAs were identified by RNA sequencing. The expression of hsa_circ_0003258 was evaluated using quantitative real-time PCR and RNA in situ hybridization. The impacts of hsa_circ_0003258 on the metastasis of PCa cells were investigated by a series of in vitro and in vivo assays. Lastly, the underlying mechanism of hsa_circ_0003258 was revealed by Western blot, biotin-labeled RNA pulldown, RNA immunoprecipitation, luciferase assays and rescue experiments. RESULTS: Increased expression of hsa_circ_0003258 was found in PCa tissues and was associated with advanced TNM stage and ISUP grade. Overexpression of hsa_circ_0003258 promoted PCa cell migration by inducing epithelial mesenchymal transformation (EMT) in vitro as well as tumor metastasis in vivo, while knockdown of hsa_circ_0003258 exerts the opposite effect. Mechanistically, hsa_circ_0003258 could elevate the expression of Rho GTPase activating protein 5 (ARHGAP5) via sponging miR-653-5p. In addition, hsa_circ_0003258 physically binds to insulin like growth factor 2 mRNA binding protein 3 (IGF2BP3) in the cytoplasm and enhanced HDAC4 mRNA stability, in which it activates ERK signalling pathway, then triggers EMT programming and finally accelerates the metastasis of PCa. CONCLUSIONS: Upregulation of hsa_circ_0003258 drives tumor progression through both hsa_circ_0003258/miR-653-5p/ARHGAP5 axis and hsa_circ_0003258/IGF2BP3 /HDAC4 axis. Hsa_circ_0003258 may act as a promising biomarker for metastasis of PCa and an attractive target for PCa intervention.
Subject(s)
Gene Expression Regulation, Neoplastic , MicroRNAs/genetics , Prostatic Neoplasms/genetics , RNA Interference , RNA, Circular/genetics , RNA-Binding Proteins/genetics , Aged , Aged, 80 and over , Animals , Case-Control Studies , Cell Line, Tumor , Disease Models, Animal , Disease Progression , Humans , MAP Kinase Signaling System , Male , Middle Aged , Neoplasm Grading , Neoplasm Staging , RNA Stability , RNA-Binding Proteins/metabolismABSTRACT
The present study comparatively investigated the ultrasonic degradation of ketoprofen (KET) and paracetamol (PCT) in water. Ultrasonic irradiation at 555 kHz achieved rapid degradation of KET and PCT in water, the removal efficiencies of KET (2.5-80 µM) and PCT (2.5-80 µM) reached 87.7%-100% and 50.6%-86.9%, respectively, after 10 min of reaction under an ultrasonic power of 60 W. The degradation behaviors of both KET and PCT followed the Langmuir-Hinshelwood model. KET was eliminated faster than PCT because of its higher hydrophobicity. Acidic media favored ultrasonic degradation of KET and PCT. Organic compounds in water matrices exerted a great negative effect on the ultrasonic degradation rates of KET and PCT major by competing with target compounds with the generated radicals at the bubble/water interfacial region. The effects of anions were species dependent. The introduction of ClO4- and Cl- enhanced KET and PCT degradation to different extents, while the introduction of HCO3- posed a negative effect on both KET and PCT. KET and PCT degradation are accompanied by the generation of several transform intermediates, as identified via LC/MS/MS analysis, and corresponding reaction pathways have been proposed. A human umbilical vein endothelial cell (HUVEC) toxicity evaluation indicated that ultrasonic treatment was capable of controlling the toxicity of KET or PCT degradation. Of note, the enhanced formation of disinfection byproducts (DBPs), i.e., trichloromethane (TCM) and trichloronitromethane (TCNM), was found due to chlorination after ultrasonic treatment for both KET and PCT.
Subject(s)
Ultrasonics , Acetaminophen , Disinfection , Humans , Ketoprofen , Kinetics , Tandem Mass Spectrometry , Water , Water Pollutants, Chemical/analysis , Water PurificationABSTRACT
To test high cadmium (Cd) concentration may not be high in health risk when considering Cd bioavailability, we assessed variation of Cd relative bioavailability (RBA, relative to CdCl2) using a mouse assay for 14 vegetables of water spinach, amaranth, and pakchoi. Cadmium concentration varied from 0.13 ± 0.01-0.37 ± 0.00 µg g-1 fw. Cadmium-RBA also varied significantly from 22.9 ± 2.12-77.2 ± 4.46%, however, the variation was overall opposite to that of Cd concentration, as indicated by a strong negative correlation between Cd-RBA and Cd concentration (R2 = 0.43). Based on both Cd concentration and bioavailability, the identified high-Cd pakchoi variety resulted in significantly lower Cd intake than the high-Cd varieties of water spinach and amaranth (4.74 ± 0.05 vs. 10.1 ± 0.54 and 8.03 ± 0.04 µg kg-1 bw week-1) due to significantly lower Cd-RBA (22.9 ± 2.12 vs. 77.2 ± 4.46 and 51.3 ± 2.93%). The lower Cd-RBA in pakchoi was due to its significantly higher Ca and lower phytate concentrations, which facilitated the role of Ca in inhibiting intestinal Cd absorption. This was ascertained by observation of decreased Cd-RBA (90.5 ± 12.0% to 63.5 ± 5.53%) for a water spinach when elevating its Ca concentration by 30% with foliar Ca application. Our results suggest that to assess food Cd risk, both total Cd and Cd bioavailability should be considered.
Subject(s)
Cadmium , Soil Pollutants , Biological Availability , Cadmium/analysis , Cadmium/toxicity , Calcium , Phytic Acid , Soil Pollutants/analysis , VegetablesABSTRACT
In this study, electrochemically activated peroxymonosulfate (EC/PMS) with a sacrificial iron electrode was used for the removal of chloramphenicol (CAP) from water. Compared to electrolysis alone, peroxymonosulfate (PMS) alone, and Fe2+/PMS, EC/PMS significantly enhanced the CAP degradation. Various parameters, such as the applied current, electrolyte concentration, and PMS dose, were investigated to optimize the process. In addition, acidic conditions facilitated the CAP degradation. The presence of Cl- slightly enhanced the CAP degradation, while both HCO3- and NO3- exhibited an inhibitory effect on the CAP degradation. The floccules were also analyzed after the reaction by XPS and XRD. Quenching experiments indicated that both sulfate radicals (SO4â-) and hydroxyl radicals (â¢OH) were responsible for the CAP degradation. In addition, the degradation products were identified by LC/TOF/MS, and the degradation pathways were proposed accordingly. These results indicated that EC/PMS is a promising treatment process for the remediation of water polluted by CAP.
Subject(s)
Chloramphenicol , Water Pollutants, Chemical , Hydroxyl Radical , Peroxides , Water , Water Pollutants, Chemical/analysisABSTRACT
Objective: To compare clinical efficacy between laparoscopic radical proximal gastrectomy with double-tract reconstruction (LPG-DTR) and laparoscopic radical total gastrectomy with Roux-en-Y reconstruction (LTG-RY) in patients with early upper gastric cancer, and to provide a reference for the selection of surgical methods in early upper gastric cancer. Methods: A retrospective cohort study method was carried out. Clinical data of 80 patients with early upper gastric cancer who underwent LPG-DTR or LTG-RY by the same surgical team at the Department of General Surgery, the First Affiliated Hospital of Xi'an Jiaotong University from January 2018 to January 2021 were retrospectively analyzed. Patients were divided into the DTR group (32 cases) and R-Y group (48 cases) according to surgical procedures and digestive tract reconstruction methods. Surgical and pathological characteristics, postoperative complications (short-term complications within 30 days after surgery and long-term complications after postoperative 30 days), survival time and nutritinal status were compared between the two groups. For nutritional status, reduction rate was used to represent the changes in total protein, albumin, total cholesterol, body mass, hemoglobin and vitamin B12 levels at postoperative 1-year and 2-year. Non-normally distributed continuous data were presented as median (interquartile range), and the Mann-Whitney U test was used for comparison between groups. The χ(2) test or Fisher's exact test was used for comparison of data between groups. The Mann-Whitney U test was used to compare the ranked data between groups. The survival rate was calculated by Kaplan-Meier method categorical, and compared by using the log-rank test. Results: There were no statistically significant differences in baseline data betweeen the two groups, except that patients in the R-Y group were oldere and had larger tumor. Patients of both groups successfully completed the operation without conversion to laparotomy, combined organ resection, or perioperative death. There were no significant differences in the distance from proximal resection margin to superior margin of tumor, postoperative hospital stay, time to flatus and food-taking, hospitalization cost, short- and long-term complications between the two groups (all P>0.05). Compared with the R-Y group, the DTR group had shorter distal margins [(3.2±0.5) cm vs. (11.7±2.0) cm, t=-23.033, P<0.001], longer surgery time [232.5 (63.7) minutes vs. 185.0 (63.0) minutes, Z=-3.238, P=0.001], longer anastomosis time [62.5 (17.5) minutes vs. 40.0 (10.0) minutes, Z=-6.321, P<0.001], less intraoperative blood loss [(138.1±51.6) ml vs. (184.3±62.1) ml, t=-3.477, P=0.001], with significant differences (all P<0.05). The median follow-up of the whole group was 18 months, and the 2-year cancer-specific survival rate was 97.5%, with 100% in the DTR group and 95.8% in the R-Y group (P=0.373). Compared with R-Y group at postoperative 1 year, the reduction rate of weight, hemoglobin and vitamin B12 were lower in DTR group with significant differences (all P<0.05); at postoperative 2-year, the reduction rate of vitamin B12 was still lower with significant differences (P<0.001), but the reduction rates of total protein, albumin, total cholesterol, body weight and hemoglobin were similar between the two groups (all P>0.05). Conclusions: LPG-DTR is safe and feasible in the treatment of early upper gastric cancer. The short-term postoperative nutritional status and long-term vitamin B12 levels of patients undergoing LPG-DTR are superior to those undergoing LTG-RY.
Subject(s)
Humans , Albumins , Anastomosis, Roux-en-Y/adverse effects , Cholesterol , Gastrectomy/methods , Hemoglobins , Laparoscopy/methods , Postoperative Complications/etiology , Retrospective Studies , Stomach Neoplasms/pathology , Treatment Outcome , Vitamin B 12ABSTRACT
Autophagy is a programmed cell degradation process that is involved in a variety of physiological and pathological processes including malignant tumors. Abnormal induction of autophagy plays a key role in the development of hepatocellular carcinoma (HCC). We established a prognosis prediction model for hepatocellular carcinoma based on autophagy related genes. Two hundred and four differentially expressed autophagy related genes and basic information and clinical characteristics of 377 registered hepatocellular carcinoma patients were retrieved from the cancer genome atlas database. Cox risk regression analysis was used to identify autophagy-related genes associated with survival, and a prognostic model was constructed based on this. A total of 64 differentially expressed autophagy related genes were identified in hepatocellular carcinoma patients. Five risk factors related to the prognosis of hepatocellular carcinoma patients were determined by univariate and multivariate Cox regression analysis, including TMEM74, BIRC5, SQSTM1, CAPN10 and HSPB8. Age, gender, tumor grade and stage, and risk score were included as variables in multivariate Cox regression analysis. The results showed that risk score was an independent prognostic risk factor for patients with hepatocellular carcinoma ( HR = 1.475, 95% CI = 1.280-1.699, P < 0.001). In addition, the area under the curve of the prognostic risk model was 0.739, indicating that the model had a high accuracy in predicting the prognosis of hepatocellular carcinoma. The results suggest that the new prognostic risk model for hepatocellular carcinoma, established by combining the molecular characteristics and clinical parameters of patients, can effectively predict the prognosis of patients.
Subject(s)
Humans , Autophagy/genetics , Biomarkers, Tumor/genetics , Carcinoma, Hepatocellular/pathology , Liver Neoplasms/pathology , Membrane Proteins/genetics , PrognosisABSTRACT
Objective:To investigate the clinical effect of early bronchoalveolar lavage on patients with aspiration pneumonia.Methods:A retrospective study was conducted on 55 patients with aspiration pneumonia who met inclusion criteria but not exclusion criteria in the Intensive Care Department of our hospital from January 2020 to April 2021. The patients were divided into the control group (32 cases) and the bronchoscopic lavage group (23 cases) according to whether they received bronchoscopic lavage within 24 h after aspiration. Basic information (sex, age, body mass index, chest X-ray score, oxidation index, temperature, heart rate, respiratory rate, white blood cells, PCT, IL-6, CPR and APACHE Ⅱ score), etiology changes at the early stage (≤ 3 d) and later stage (4-7 d after admission), and changes in prognostic indexes (mechanical ventilation time, length of ICU stay, length of stay and mortality) were compared between the two groups. The clinical efficacy of early endoscopy lavage for aspiration pneumonia was evaluated.Results:The positive rate of early etiological culture was 85.2%, the bacterial positive rate was 72.9% and the fungal positive rate was 14.6%. Pseudomonas aeruginosa accounted for 20.8%, Klebsiella pneumoniae accounted for 14.6%, Staphylococcus aureus and Streptococcus accounted for 12.5%, and there was no significant difference in the distribution between the bronchoscopic lavage group and the control group (all P>0.05). The positive rate of late etiological culture was 88.6%, the bacterial positive rate was 85.7% and the fungal positive rate was 2.9%. The positive rate of late bacterial culture was significantly decreased in the bronchoscopic lavage group ( P < 0.05), and the other results were not significantly different from the control group (all P>0.05). After early bronchoscopic lavage, the duration of mechanical ventilation, length of ICU stay and length of stay were significantly shortened, and the fifth day CPIS score was significantly decreased (all P< 0.05). Conclusions:Early endotracheal lavage can reduce mechanical ventilation time, length of ICU stay and length of stay of aspiration pneumonia, and reduce the positive rate of bacterial culture in the lung at the later stage, which needs to be further verified by a large randomized controlled study.
ABSTRACT
OBJECTIVE: To investigate the application of a simplified technique for reconstruction of vesicourethral support (RVUS) in laparoscopic radical prostatectomy (LRP). METHODS: From January 2017 to August 2019, 122 patients with localized prostate cancer underwent extraperitoneal LRP, 65 with RVUS (the RVUS group) and 57 without RVUS (the non-RVUS group). We compared the operation time, intraoperative blood loss, rate of pelvic lymph node dissection, neurovascular bundle sparing, incidence of urethrovesical anastomotic urinary leakage (UVAUL), postoperative urinary continence, postoperative hospital stay, intraperitoneal drainage tube removal time, and urethral catheter removal time between the two groups of patients. RESULTS: No statistically significant differences were observed between the two groups in the operation time, intraoperative blood loss, rate of pelvic lymph node dissection, neurovascular bundle sparing, or urethral catheter removal time (P > 0.05). The incidence rate of UVAUL was lower in the non-RVUS than in the RVUS group (8.8% vs 0%, P < 0.05), and so were the rates of postoperative urinary continence immediate after (0% vs 32.3%, P < 0.05) and at 1 month (38.6% vs 56.9%, P < 0.05), 3 months (59.6% vs 80%, P < 0.05), 6 months (78.9% vs 84.6%, P > 0.05) and 12 months after catheter removal (87.7% vs 92.3%, P > 0.05). The postoperative hospital stay was dramatically longer in the non-RVUS than in the RVUS group (ï¼»9.1 ± 4.3ï¼½ vs ï¼»6.7 ± 1.8ï¼½ d, P < 0.01) and so was the intraperitoneal drainage tube removal time (ï¼»6.9 ± 4.5ï¼½ vs ï¼»4.8 ± 1.5ï¼½ d, P < 0.01). CONCLUSIONS: The simplified technique for reconstruction of vesicourethral support in laparoscopic radical prostatectomy improves early urinary continence, especially immediate continence, decreases the incidence rate of urethrovesical anastomotic urinary leakage, and shortens the intraperitoneal drainage tube removal time and postoperative hospital stay.?
Subject(s)
Laparoscopy , Prostatectomy , Humans , MaleABSTRACT
Animal bioassays have been developed to estimate oral relative bioavailability (RBA) of metals in soil, dust, or food for accurate health risk assessment. However, the comparability in RBA estimates from different labs remains largely unclear. Using 12 soil and soil-like standard reference materials (SRMs), this study investigated variability in lead (Pb) and arsenic (As) RBA estimates employing a mouse bioassay in 3 labs at Nanjing University, University of Jinan, and Shandong Normal University. Two performances of the bioassay at Nanjing University in 2019 and 2020 showed reproducible Pb and As RBA estimates, but increasing the number of mouse replicates in 2020 produced more precise RBA measurements. Although there were inter-lab variations in diet consumption rate and metal accumulation in mouse liver and kidneys following SRM ingestion due to differences in diet composition, bioassays at 3 labs in 2019 yielded overall similar Pb and As RBA estimates for the 12 SRMs with strong linear correlations between each 2 of the 3 labs for Pb (R2 = 0.95-0.98 and slope = 0.85-1.02) and As RBA outcomes (R2 = 0.46-0.86 and slope = 0.56-0.79). The consistency in RBA estimates was attributed to the relative nature of the final bioavailability outcome, which might overcome the inter-lab variation in diet consumption and metal uptake in mice. These results increased the confidence of use of mouse bioassays in bioavailability studies.