ABSTRACT
Postoperative delirium is a common postoperative complication of neurocognitive dysfunction, especially in elderly surgical patients. Postoperative delirium not only damages patients' recovery but also increases social costs. Therefore, its prevention and treatment has essential clinical and social significance. However, due to its intricate pathogenesis and limited pharmacological interventions, the effective prevention and treatment of postoperative delirium remains a thorny problem. As traditional acupuncture therapy has been shown to be an effective treatment in many neurological disorders, and in recent years, it has begun to be clinically used as an intervention for postoperative delirium. Although most clinical and animal studies confirm that multiple types of acupuncture interventions can alleviate or prevent postoperative delirium by relieving acute postoperative pain, reducing the consumption of anesthetics and analgesics, attenuating neuroinflammation and neuronal lesions, while more evidence-based medical evidence and clinical validation are needed for these encouraging effects.
Subject(s)
Acupuncture Therapy , Anesthetics , Delirium , Emergence Delirium , Humans , Delirium/etiology , Delirium/prevention & control , Postoperative Complications/prevention & controlABSTRACT
OBJECTIVE: To explore the therapeutic schemes for refractory ascites of advanced schistosomiasis. METHODS: The advanced schistosomiasis patients with refractory ascites were randomly divided into 4 groups: a conventional group, high-dose albumin group, high-dose diuretic group, and comprehensive group, and the course of the treatment was 4 weeks. The abdominal circumference, urine volume, and weight changes were observed daily, and B-ultrasound, liver function, and renal function were performed weekly. RESULTS: In the total effective rates, recurrence rates and A/G and renal function changes, the high-dose albumin group and comprehensive group were superior to the conventional group and high-dose diuretic group (P < 0.01). The death rate of the comprehensive group was the lowest among the 4 groups. CONCLUSION: The therapeutic scheme of the comprehensive group is optimum.
Subject(s)
Albumins/therapeutic use , Ascites/drug therapy , Diuretics/therapeutic use , Liver Cirrhosis/drug therapy , Schistosomiasis/complications , Adult , Ascites/etiology , Female , Humans , Liver Cirrhosis/etiology , Male , Middle AgedABSTRACT
AIM: To explore the role of transforming growth factor-beta1 (TGF-beta1)-smad signal transduction pathway in patients with hepatocellular carcinoma. METHODS: Thirty-six hepatocellular carcinoma specimens were obtained from Qidong Liver Cancer Institute and Department of Pathology of the Second Affiliated Hospital of Nanjing Medical University. All primary antibodies (polyclonal antibodies) to TGF-beta1, type II Transforming growth factor-beta receptor (TbetaR-II), nuclear factor-kappaB (NF-kappaB), CD34, smad4 and smad7,secondary antibodies and immunohistochemical kit were purchased from Zhongshan Biotechnology Limited Company (Beijing, China). The expressions of TGF-beta1, TbetaR-II, NF-kappaB, smad4 and smad7 proteins in 36 specimens of hepatocellular carcinoma (HCC) and its adjacent tissue were separately detected by immunohistochemistry to observe the relationship between TGF-beta1 and TbetaR-II, between NF-kappaB and TGF-beta1, between smad4 and smad7 and between TGF-beta1 or TbetaR-IIand microvessel density (MVD). MVD was determined by labelling the vessel endothelial cells with CD34. RESULTS: The expression of TGF-beta1, smad7 and MVD was higher in HCC tissue than in adjacent HCC tissue (P<0.01, P<0.05, P<0.01 respectively). The expression of TbetaR-IIand smad4 was lower in HCC tissue than in its adjacent tissue (P<0.01, P<0.05 respectively). The expression of TGF-beta1 protein and NF-kappaB protein was consistent in HCC tissue. The expression of TGF-beta1 and MVD was also consistent in HCC tissue. The expression of TbetaR-IIwas negatively correlated with that of MVD in HCC tissue. CONCLUSION: The expressions of TGF-beta1, TbetaR-II, NF-kappaB, smad4 and smad7 in HCC tissue, which are major up and down stream factors of TGF-beta1-smad signal transduction pathway , are abnormal. These factors are closely related with MVD and may play an important role in HCC angiogenesis. The inhibitory action of TGF-beta1 is weakened in hepatic carcinoma cells because of abnormality of TGF-beta1 receptors (such as TbetaR-II) and postreceptors (such as smad4 and smad7). NF-kappaB may cause activation and production of TGF-beta1.
