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Objective:To explore the risk factors of perioperative outcomes of lung transplantation and establish a predictive model for delayed extubation after lung transplantation.Methods:From January 1, 2020 to December 31, 2022, 104 lung transplantation recipients were retrospectively collected to identify the risk factors of early post-operative outcome.According to the timing of extubation post-lung transplantation, they were assigned into two groups of normal(77 cases)and delayed(27 cases). Baseline profiles, type of primary diagnosis, cold ischemic duration and lung transplantation approach were compared between two groups.The factors with significant difference were examined by univariate and multivariate Logistic regression.Furthermore, multivariate logistic model was visualized by a nomogram.Receiver operating characteristic(ROC)curve and decision curve analysis(DCA) were performed for evaluating the model's predictive performance and its value for clinical utilization.Results:The postoperative mortality rate was 9.6%.Delayed extubation was a strong predictor for postoperative mortality.Cold ischemic time outperformed others variates in terms of delayed extubation prediction.AUC of cold ischemic time and multivariate logistic model was 0.75(95% CI: 0.69-0.81)and 0.87(95% CI: 0.82-0.91). Conclusions:Delayed postoperative extubation is a key predictor of early post-lung transplantation mortality.The established predictive model may effectively identify high-risk patients for preventive intervention and survival improvement post-lung transplantation.
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OBJECTIVE@#To observe the ferroptosis triggered by in different pathways during cecal ligation and puncture (CLP)-induced liver injury in septic mice, and to investigate whether mitochondrial aldehyde dehydrogenase 2 (ALDH2) can alleviate sepsis-induced liver injury by inhibiting ferroptosis.@*METHODS@#Sixty 8-week-old male C57BL/6J mice were randomly divided into sham operation group (Sham group), CLP group, ferroptosis inhibitor ferrostain-1 (Fer-1) group, ALDH2-specific agonist Alda-1 group, iron chelator deferasirox Fe3+ chelate (DXZ) group and dimethyl sulfoxide (DMSO) group, with 10 mice in each group. The septic liver injury was induced by CLP in mice model. In the Sham group, only laparotomy was performed without ligation and puncture of the cecum. 10 mL/kg 5% DMSO, 5 mg/kg Fer-1, 50 mg/kg DXZ and 10 mg/kg Alda-1 were injected intraperitoneally 1 hour before CLP in the DMSO, Fer-1, DXZ and Alda-1 groups respectively. At 24 hours after operation, eyeball blood and liver tissue were collected from anesthetized mice. The hepatic structure and inflammatory infiltration were observed by hematoxylin-eosin (HE) staining. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) in serum, the levels of hepatic malondialdehyde (MDA), superoxide dismutase (SOD) and reactive oxygen species (ROS) were detected. Western blotting was used to detect the protein expressions of ALDH2, ferroptosis-related proteins glutathione peroxidase 4 (GPX4), ferroptosis suppressor protein 1 (FSP1) and transferrin receptor 1 (TFR1) in liver tissue.@*RESULTS@#Compared with Sham group, the mice in CLP group showed varying degrees of congestion, disorganized hepatocyte arrangement, inflammatory cell infiltration at 24 hours after operation. Compared with the CLP group, the mice in the Fer-1 group, DXZ group and Alda-1 group liver morphology, liver injury and inflammatory cell infiltration was improved. Compared with Sham group, the serum levels of ALT and AST, the contents of MDA and ROS, and the expression of TFR1 protein in CLP group were significantly increased, while the activity of SOD and the expressions of ALDH2, GPX4 and FSP1 protein in CLP group were significantly decreased. Compared with CLP group, serum ALT and AST levels in Fer-1, DXZ and Alda-1 groups were significantly decreased [ALT (U/L): 45.76±10.81, 37.30±2.98, 36.40±12.75 vs. 73.06±12.20, AST (U/L): 61.57±2.69, 52.41±6.92, 56.05±8.29 vs. 81.59±5.46, all P < 0.05], and the contents of MDA, ROS and TFR1 protein expression in liver tissue were significantly decreased [MDA (μmol/L): 0.60±0.10, 0.57±0.18, 0.83±0.39 vs. 1.61±0.30, ROS (fluorescence intensity): 270.34±9.64, 276.02±62.33, 262.05±18.55 vs. 455.38±36.07, TFR1/GAPDH: 0.90±0.04, 1.01±0.09, 0.55±0.08 vs. 1.18±0.06, all P < 0.05], and the SOD activity and ALDH2, GPX4 and FSP1 protein expressions in liver tissue were significantly increased [SOD (kU/g): 88.77±8.20, 88.37±4.47, 93.43±7.24 vs. 50.27±3.57, ALDH2/GAPDH: 1.10±0.15, 1.02±0.07, 1.14±0.07 vs. 0.70±0.04, GPX4/GAPDH: 1.02±0.12, 0.99±0.08, 1.05±0.19 vs. 0.71±0.10, FSP1/GAPDH: 1.06±0.24, 1.02±0.08, 0.93±0.09 vs. 0.66±0.03, all P < 0.05]. There was no significant difference in the parameters between DMSO group and CLP group.@*CONCLUSIONS@#Both GPX4 and FSP1 mediated ferroptosis are involved in liver injury in septic mice. Activation of ALDH2 and inhibition of ferroptosis can alleviatehepatic injury. ALDH2 may play a protective role by regulating FSP1 and GPX4 mediated ferroptosis.
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Mice , Male , Animals , Aldehyde Dehydrogenase, Mitochondrial , Ferroptosis , Reactive Oxygen Species , Chemical and Drug Induced Liver Injury, Chronic , Dimethyl Sulfoxide , Mice, Inbred C57BL , Sepsis , Disease Models, AnimalABSTRACT
Acute respiratory distress syndrome (ARDS), a common respiratory critical illness with multiple causes, is associated with high mortality. The high degree of heterogeneity may be the reason why it is lack of highly specific and sensitive biological biomarkers. Therefore, it is an urgent need to explore biomarkers, perform phenotypic analysis and establish risk stratification model for diagnosis, prognosis, and treatment of ARDS. Endothelial cells specificity molecular-1 (ESM-1, endocan), is a soluble dermatan sulfate proteoglycan, and be involved in regulating biological behaviors such as cell proliferation, differentiation and migration. Numerous studies have confirmed that ESM-1 is closely related to inflammation, endothelial activation and dysfunction. However, the role of ESM-1 in the initiating and developing process of ARDS is still unclear. To provide a scientific basis for its clinical applications in ARDS, such as early prognosis assessment and timely prevent strategies, this paper focuses on the biological properties and the clinical value of ESM-1 as a potential biomarker for ARDS.
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Objective:To evaluate the effect of prolonged graft cold ischemia time(CIT)on outcomes of lung transplantation(LTx).Methods:Clinical data are retrospectively reviewed for 111 patients undergoing LTx at Affiliated Shanghai Pulmonary Hospital of Tongji University between January 2019 and January 2022. They are divided into two groups of prolonged CIT(8~12 h, 41 cases)and control(<8 h, 70 cases)according to CIT. Kaplan-Meier method is employed for estimating 1-year cumulative survival rate and multivariable Cox proportional hazard regression model for identifying independent risk factors of 1-year mortality.Results:No significant inter-group difference existed in the incidence of primary graft dysfunction grade Ⅲ within the first 72 h post-LTx(21.2% vs. 16.3%). The 30-day(90.2% vs. 94.3%)and 90-day(82.9% vs. 82.9%)survival rates are comparable between two groups. Similarly 1-year cumulative survival is also comparable between two groups (74.6% vs. 60.4%, Log-rank P=0.279). Multivariate Cox regression analysis indicated that prolonged CIT was not associated with an elevated risk of 1-year mortality( HR 0.691; 95% CI: 0.317~1.506). However, an absence of ECMO support during surgery( HR 3.562; 95% CI: 1.061~11.959)and postoperative mechanical ventilation for >3 days(HR 2.892; 95% CI: 1.387~6.031)elevate 1-year risk of mortality. Conclusions:Prolongation of CIT to 8~12 h has no adverse effect on the prognosis of recipients. Given a great scarcity of donor lungs and a growing number of LTx candidates, it is reasonable to accept prolonged CIT donor lungs for clinical LTx.
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Objective:To explore the effect of traditional Chinese medicine comprehensive nursing on psychological state, skin degree and quality of life in patients with rectal cancer.Methods:A total of 88 cases with rectal cancer chemotherapy in Nanyang Nanshi Hospital from August 2017 to August 2020 were as the research object, all patients were divided into two groups with 44 cases in each group by random number table method. The control group received routine nursing, the observation group was given traditional Chinese medicine comprehensive nursing based on the control group. The more satisfaction with the two groups, psychological state before and after nursing, cancer fatigue degree, the quality of life, adverse reaction after chemotherapy were compared between the two groups.Results:The satisfaction score of the observation group was (80.24±9.02) points, which was higher than that of the control group (74.64±9.02) points, there was statistically significant ( t value was 2.912, P<0.05). The probability of adverse reactions was 4.55%(2/44), which was lower than that of the control group (20.45%, 9/44), there was statistically significant ( χ2 value was 5.090, P<0.05). There were no differences in psychological state, cancer fatigue degree and quality of life between the two groups before intervention ( P>0.05). The scores of anxiety, depression, cognitive fatigue, body fatigue, emotional fatigue and behavioral fatigue after intervention were (58.24±3.56), (57.82±3.36), (5.64±1.32), (6.56±0.88), (6.04±0.64), (5.98±1.52) points in the observation group, and (60.12±3.72), (59.27±3.12), (6.28±1.48), (7.24±0.90), (6.48±0.72), (6.78±1.56) points in the control group, there were statistically significant( t values were 2.141-3.583, P<0.05).The quality of life score of the observation group after intervention was (211.68±17.12) points, which was higher than that of the control group (199.08±17.36) points, there was statistically significant( t value was 3.428, P<0.05). Conclusions:Comprehensive nursing of traditional Chinese medicine for patients with rectal cancer chemotherapy can make patients more satisfied with nursing service, relieve negative emotions and cancer fatigue, reduce the occurrence of adverse reactions to chemotherapy, and promote the improvement of patients' quality of life. It is worth popularizing.
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@#The quality control of lung transplantation involves many aspects, such as team building, selection of recipients, preoperative diagnosis and evaluation of recipients, maintenance of brain-dead donors, evaluation and acquisition of donors, surgical operation, postoperative management and postoperative follow-up. Precision management is the core concept of operation quality control. Only by normalizing the operation quality control of lung transplantation to provide basic guarantee for multi-team cooperation and development of lung transplantation management in the future, building a complete lung transplantation database to excavate data resources and improve the quality of transplanta-tion, and comprehensively building a Chinese lung transplantation quality control system with multi-team participation and cooperation, can we improve the overall level of surgical diagnosis and treatment of lung transplantation in China.
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Objective:To evaluate the inpatient PE incidence and thromboprophylaxis after thoracic surgery according to adjusted Caprini VTE risk assessment model.Methods:The study selected consecutively 500 patients who received thoracic surgery from first of June in consecutive three years of 2015, 2016 and 2017. We retrospectively assessed these 1 500 patients using Caprini VTE risk model and recorded baseline characteristics, postoperative prophylaxis, and PE incidence.Results:Only 19.4% of 2015-year patients received pharmacologic prophylaxis, while the rate reached up to 65.2% in 2016 and 77.2% in 2017. PE occurred on 4 cases in 2015, 1 case in 2016, and 0 case in 2017. The overall incidence of PE was 0.3%(5/1 500). The PE incidence negatively correlated with the implementation of prophylaxis( r=-0.04, P=0.07). The PE risk(odds ratio) increased 4.68 times(95% CI: 0.525-41.800) when patients did not receive prophylaxis in PE cohort. Postoperative pharmacologic prophylaxis with current dosing did not affect the drainage of chest tube after surgery. Conclusion:Implementation of an adjusted Caprini risk assessment protocol can be useful for the thoracic postoperative patients to receive appropriate thromboprophylaxis. Current pharmacologic prophylaxis protocol should be safe and enough to prevent PE after thoracic surgery.
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OBJECTIVE: To investigate the proportion of 8 kinds of ginsenoside to ginsenoside Rg1 in Panax ginseng and the regularity of growth year in Jilin province, and to provide reference for the identification of growth year. METHODS: The samples of garden ginseng, wild-cultivated ginseng and wild ginseng were collected from different growth years (3-30 years) in Jilin province. The contents of 8 ginsenoside (ginsenoside Rg1, Re, Rf, Rb1, Rc, Rb2, Rb3, Rd) in P. ginseng were determined by HPLC. The contents of saponins as well as the proportion of 8 kinds of ginsenoside to ginsenoside Rg1 were calculated; the relationship of the proportion with growth year was investigated. RESULTS: As the increase of growth year, the proportion of 8 kinds of ginsenosides in garden ginseng to ginsenoside Rg1 as well as that of ginsenoside Re, Rb1, Rc, Rd to ginsenoside Rg1 were decreased gradally (P<0.001); the proportion of ginsenoside Re to ginsenoside Rg1 in wild-cultivated ginseng decreased first and then increased(P<0.001); the proportion of 8 kinds of ginsenosides to ginsenoside Rg1 as well as the proportion of ginsenoside Re and Rb1 to ginsenoside Rg1 were increased gradually in wild ginseng (P<0.001); the proportion of ginsenoside Rf, Rb3 to ginsenoside Rg1 in garden ginseng, wild-cultivated ginseng and wild ginseng had no significant difference(P>0.05). CONCLUSIONS: Garden ginseng, wild-cultivated ginseng and wild ginseng contain 8 kinds of ginsenosides. The growth year can be predicted preliminarily according to the proportion of ginsenoside Rg1 and ginsenoside Re, Rb1 to ginsenoside Rg1.
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Objective To determine whether relative abundance of epidermal growth factor receptor (EGFR) mutations in plasma predicts clinical response to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in patients with advanced lung adenocarcinoma. Methods In this prospective study, adult patients with advanced lung adenocarcinoma were enrolled in our hospital from 1 April 2016 to 1 January 2017. EGFR mutations in tumor tissues were detected by ADx-amplification refractory mutation system (ADx-ARMS). EGFR mutations of plasma free tumor DNA were detected by ADx-ARMS and ADx-super amplification refractory mutation system (ADx-SuperARMS) at the same time. Patients with EGFR-mutant in tumor tissues and receiving EGFR-TKIs were finally enrolled. Plasma mutation-positive patients with both methods were high abundance group.Patients with positive mutations by ADx-SuperARMS but negative by ADx-ARMS were medium abundance group. Mutation-negative patients with both methods were recognized as low abundance group. The correlation between EGFR mutation abundance and clinical response to EGFR-TKIs were analyzed. Results Among 71 patients enrolled, 42 harbored EGFR mutations in plasma were detected by ADx-ARMS, while 53 were found by ADx-SuperARMS.There were 42 patients in high abundance group, 11 in medium group while the other 18 in low group. The objective response rates (ORRs) were 69.0%,7/11 and 10/18 in high, medium and low groups, respectively. The difference was significant between high and low abundances groups (P=0.006). Median progression-free survival (PFS) in high,medium and low groups were 11.0, 8.5 and 9.0 monthes, respectively (P<0.001). In patients with tumor 19-Del, the ORRs were 70.4%,5/7 and 6/11 in high,medium and low abundance groups, respectively. The median PFS of high abundance group was significantly longer than the other two groups (12.0 monthes vs 9.0, 9.0 monthes). As to subjects with L858R mutation, the ORRs were 10/15,2/4 and 3/6,respectively, with median PFS 9.6, 5.5 and 9.5 monthes. Conclusions The relative abundance of EGFR mutations in plasma predicts clinical response to EGFR-TKIs in patients with advanced lung adenocarcinoma. The higher the mutation abundance is, the better the efficacy of EGFR-TKIs is.
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Objective Evaluation of self-control suspension under the double hook system used to xiphoid thoracoscope fully the effect of thymectomy.Methods There were 17 cases of thymic adenoma diagnosed before surgery in November to December 2016,including 7 males and 10 females,aged(57 ± 10).The total thymomectomy was performed with a double hook method with a double hook procedure.Results All the 17 patients had smooth operation,and no clear hook related complications were observed after the operation.The operation was convenient and the thymus was completely removed.Conclusion It is worth populating that the double pull hook method is convenient and safe to remove the whole thymus gland.
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Objective To investigate the changes of brain function in moderate and high myopia patients using fractional amplitude of low frequency fluctuation (fALFF),and discuss the correlation between brain function changes and clinical data of patients with myopia.Methods Totally 21 moderate and high myopia patients (myopia group),and 21 healthy volunteers (normal control group) who were matched with myopia patients in age and gender,were selected to take rs-fMRI examination.The difference of fALFF of brain functional activity in patients with myopia and normal controls was compared,and the correlation between the changes of fALFF and clinical data of patients with myopia was analyzed,Results Compared with normal control group,the fALFF values of myopia group in the region of the left inferior frontal gyrus,putamen and right inferior frontal gyrus,putamen and insula were significantly lower (all P < 0.05,AlphaSim corrected).However,in bilateral cingulate gyrus,bilateral anterior cingulate gyrus,left postcentral gyrus,left superior parietal lobule and region,fALFF values were increased (all P < 0.05,AlphaSim corrected).Conclusion Patients with myopia are accompanied by abnormal neuronal activity in many brain areas,which may reflect the dysfunction of language understanding and attention control in myopic patients.
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Objective To explore the clinical efficacy of rosuvastatin combined with oxycodone sustained release tablets in patients with advanced non-small cell lung cancer and its effects on serum IL-6 and TNF-αlevels.Methods 62 cases with advanced non-small cell lung cancer from May 2014 to May 2016were divided into observation group and control group according to random number table, each group with 31 cases.Control group were treated with oxycodone sustained-release tablets, and observation group were treated with rosuvastatin and oxycodone sustained-release tablets.The levels of serum IL-6 and TNF-αwere compared pre-and post-treatment betweene two groups.The effective dose, the number of painful pain, the NRS score, the improvement of quality of life of oxycodone hydrochloride sustained-release tablets after treatment and adverse reaction rate were observed. Results After treatment, serum IL-6, TNF-αlevels in two groups were significantly lower than pre-treatment (P <0.05), and which in observation group were significantly lower than control group (P<0.05).Compared with control group, the effective dose of Oxycodone Hydrochloride Prolonged-release Tablets, broke out pain, NRS score in observation group were significantly higher ( P <0.05 ) .The effective rate of cancer pain treatment in observation group was 96.77% (30/31), significantly higher than 74.19% (23/31) of control group (χ2 =12.269, P<0.0001).The improvement of quality of life incontrol group was 32.25%, significantly lower than 80.64% in observation group (P<0.05).There was no significant difference in adverse reactions between two groups.Conclusion Rosuvastatin combined with oxycodone sustained release tablets in treatment with advanced non-small cell lung cancer were effective, and can reduce the patient's serum IL-6, TNF-αlevels effectively.
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BACKGROUND: Cells in contact with nanomaterials can induce oxidative stress, allergic reactions, and then produce cytotoxicity and genotoxicity. Therefore, studies on nano toxicology have attracted more and more attention.OBJECTIVE: To comparatively evaluate the cytocompatibility of Pluronic (P85, F127, F87) tri-block copolymer nanoparticles modified with folic acid (FA) and polylactic acid (PLA).METHODS: Pluronic (P85, F127, F87) tri-block copolymer nanoparticles were modified with FA and PLA to synthesize a variety of amphiphilic block copolymers, including PLA-P85-PLA, FA-P85-PLA, PLA-F127-PLA, FA-F127-PLA,PLA-F87-PLA and FA-F87-PLA. The cytotoxicity of these synthesized nanoparticles was analyzed by cell morphology,cell metabolic activity and cell membrane effects in HepG-2 cells.RESULTS AND CONCLUSION: The relative growth rate of HepG-2 cells had no significant differences under 24-hour induction of various concentrations (5, 10, 20, 50, 100 mg/L) of unmodified P85, F127, and F87 nanoparticles (P > 0.05).The growth and proliferation of cells under the low concentrations (5, 10, 20, 50 mg/L) were enhanced. P85 NPs and F87 NPs could significantly inhibit cell viability at dose of 400 mg/L. In contrast, there were no significant differences towards P85, F127 and F87 nanoparticles (5, 10, 20, 50, 100, 200, 400 mg/L) modified with FA and PLA when compared with the control group (P > 0.05). These findings indicate that the modification of FA and PLA can improve the cytocompatibility of Pluronic (P85, F127, F87) tri-block copolymers, and therefore, PLA-Pluronic-PLA and FA-Pluronic-PLA nanoparticles are both good candidates for drug vectors.
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Objective To investigate risk factors for neonatal clavicular fracture,to provide a reference for clinical treatment.Methods A retrospective analysis was performed towards 3 025 live births,47 cases had neonatal clavicular fracture.The birth weight,mode of delivery,maternal age,parity,gestational age,clavicle second stage of labor,the fundus height plus abdominal circumference,cord around neck,and other fracture potential risk factors were analyzed through univariate and multivariate analysis,and the risk factors were summarized.Results 3 025 cases of live births,of which 47 cases had neonatal clavicular fracture,clavicle fracture rate was 1.55%;univariate results sug-gested that the mode of delivery,birth weight,the second stage of labor,maternal age,gestational age,nuchal cord,ma-ternal weight's clinical data index had statistically significant differences between the fracture group and non -fracture group (χ2 =37.514,34.997,28.647,19.847,18.847,16.694,all P <0.05 );multivariate analysis showed that mode of delivery,birth weight,the second stage of labor,gestational age,nuchal cord,maternal body mass index were a newborn children collarbone fracture independent risk factors.Conclusion Mode of delivery,birth weight,the second stage of labor,gestational age,nuchal cord,maternal body mass index are independent risk factors for neonatal clavicu-lar fracture,obstetric should continue to improve midwifery skills,to develop prevention strategies to reduce the inci-dence of neonatal clavicular fracture.
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Objective To study the clinical curative effect and complication of methylprednisolone in the treatment of patients with acute myelitis.Methods 42 patients with acute myelitis were selected and randomly divid-ed into two groups,21 cases in each group.The control group was treated with dexamethasone,the observation group was treated with methylprednisolone.After treatment,the clinical parameters and effect of the two groups were com-pared.Results The total effective rate of the observation group was 85.7%,which was higher than 42.9% of the control group (χ2 =2.41,P <0.05).The improvement of muscle strength,restore micturition,walk on their own time in the observation group were (10.1 ±4.1)d,(7.1 ±3.4)d,(16.1 ±4.2)d,respectively,which were better than (23.4 ±7.3)d,(10.2 ±3.1)d,(22.6 ±7.3)d in the control group(t =3.15,1.69,1.97,all P <0.05).The total incidence of gastrointestinal reaction and complication rates of the observation group was 4.8%,which was lower than 19.0% of the control group (χ2 =6.37,P <0.05).Conclusion In treatment of patients with acute myelitis,methyl-prednisolone has good effect,which should be used in clinical practice.
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Multidrug resistance (MDR) of tumor cell is the major problem for chemotherapy.However,there is no ef-fective strategy to overcome MDR due to the complicated mechanism.The nano-sized drug delivery system could target to the tumor cell.Moreover,it could delivery different kinds of drugs.Therefore,the nano-sized drug delivery system has become a promising approach to reverse MDR.The nano-sized drug delivery system which is applied to treat the MDR of tumor (osteo-sarcoma) was summarized and the reverse mechanism was discussed.
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BACKGROUND:Studies have found abnormalities in the biological activity and cytokine levels of bone marrow mesenchymal stem cels from psoriasis patients, while the biological activity of skin-derived mesenchymal stem cels from psoriasis lesions is rarely reported. OBJECTIVE:To explore the influences of skin-derived mesenchymal stem cels from psoriasis lesions on T cel proliferation METHODS:After isolation and culture, skin-derived mesenchymal stem cels from psoriasis lesions and normal controls were separately co-cultured with peripheral blood T cels. T cel proliferation was detected using MTT assay,andlevels of epidermal growth factor and transforming growth factor β1 in cel supernatant determined using ELISA method. RESULTS AND CONCLUSION:Skin-derived mesenchymal stem cels frombothpsoriasis lesions and normal controls significantly inhibited T cel proliferation (P< 0.05). Furthermore, skin-derived mesenchymal stem cels from psoriasis lesions exhibited a weaker inhibitory effect on T cel proliferation than normal skin-derived mesenchymal stem cels (P< 0.05). Skin-derived mesenchymal stem cels from psoriasis lesions significantly increased epidermal growth factor but reduced transforming growth factor β1 compared with the normal skin-derived mesenchymal stem cels (P< 0.05). In conclusion, maybe the imbalances of growth factor levels due to skin injury elicit a decrease in the inhibitory effect of skin-derived mesenchymal stem cels from psoriasis lesions on T lymphocytes.
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Objective To investigate the effectiveness of Varenicline combined with MEDCHART application software for health education and follow-up in patients at smoking cessation clinic.Methods A total of 104 cases who had smoking cessation counseling and intervention at smoking cessation clinic from February 2014 to January 2015 were divided randomly into MEDCHART APP group (n=51) and conventional group (n=53).Both groups were intervened by brief admonishment and given Varenicline.The 9-12 weeks and 26th week protracted continuous abstinence rates were observed.Results There were no significant difference in 9-12 week protracted withdrawal rate between 26th week APP and conventional groups (56.9% vs.45.3%),the 26th week abstinence rates in group MEDCHART APP (41.2%) were significantly higher than the conventional group (20.8%)(x2=5.088,P<0.05).There was significant difference in full course completion rates between the two groups;15 cases (29.4%) completed the course in group MEDCHART APP,whereas 5 cases (9.4%) did so in conventional group (x2=4.405,P<0.05).Conclusion MEDCHART APP can strengthen health education and follow-up,which helps extend the time for Varenicline,increase 26th week smoking cessation withdrawal rate.It is a useful tool for smoking cessation education and follow-up.
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OBJECTIVE:To investigate the association of Cytochrome P4503A family polypeptide 5 [(CYP)3A5] and IL-10 poly-morphisms with the concentration/dose(C/D) ratio of tacrolimus in lung transplantation recipients. METHODS:CYP3A5 polymor-phisms at rs774746 and IL-10 polymorphisms at rs1800896 from peripheral blood cell of 51 lung transplant recipients was detected by Se-quenom MassArray iPLEX GOLD system. The relationship between gene polymorphism and tacrolimus C/D ratio was analyzed. RE-SULTS:The tacrolimus C/D ratio of the recipients who carried CYP3A5 rs776746 GG genotype were higher than those with AA+GG genotype,with statistical significance(P<0.01). The tacrolimus C/D ratio of the recipients who carried IL-10 rs1800896 AA genotype were higher than those with AG genotype during 1 week and 2 weeks after transplantation,with statistical significance(P<0.05). Com-bined analysis of these two genes,the tacrolimus C/D ratio of the recipients who carried more fast metabolic alleles were higher than those who didn't carry fast metabolic alleles,with statistical significance(P<0.01). CONCLUSIONS:Determination of recipients CYP3A5 at rs 776746and IL-10 at rs800896 genotype may be performed prospectively to help individualizing tacrolimus dose regimen.
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<p><b>OBJECTIVE</b>To investigate the effects of bromodomain-containing protein 4 (BRD4) inhibitor GSK525762A on the proliferation and apoptosis of primary common B-cell acute lymphoblastic leukemia (common B-ALL) cells from adult patients, then to further explore the possible mechanisms.</p><p><b>METHODS</b>Purified leukemia cells from 14 common B-ALL adult patients (4 Ph⁺ and 10 Ph⁻ cases) were obtained by flow cytometry sorting, and maintained in a mimic bone marrow microenvironment culture system for short-term culture. Leukemia cells were treated with various concentrations of GSK525762A. The inhibitory effects of BRD4 inhibitor on common B-ALL leukemia cells were measured by CCK-8 assay and the apoptosis of those cells was determined by AnnexinⅤ/7-AAD staining using flow cytometry. The transcripts of c-MYC, CDK6 and Bcl-2 were detected by quantitative RT-PCR, and the expression of c-MYC, CDK6 and Bcl-2 proteins were detected via Western blot.</p><p><b>RESULTS</b>GSK525762A could inhibit the proliferation of leukemia cells from all 14 common B-ALL patients in a dose-dependent manner, the median value of IC50 was 256.25 (90.64-1 378.39)nmol/L. GSK525762A could promote cells apoptosis of B-ALL leukemia cells in a dose-dependent manner, the median apoptosis rates respectively were 45.17%(9.38%-70.91%), 66.02% (24.36%-96.34%) and 89.29% (39.29%-99.37%) after treated by 500, 1 000 and 2 500 nmol/L GSK525762A. GSK525762A has a similar effect on Ph⁺ ALL and Ph⁻ B-ALL, but the effect of proliferation inhibition and apoptosis enhancement on Ph+ B-ALL is weaker than that on Ph⁻ B-ALL. Compared with vehicle control group, the levels of c-MYC, Bcl-2 and CDK6 transcripts in leukemic cells were reduced after treatment for 24 h and 48 h by 1 000 nmol/L GSK525762A, and there are no significant differences in the downregulation of c-MYC and CDK6 mRNA between Ph⁺ and Ph⁻ B-ALL; however, the inhibitory effect on Bcl-2 transcription was weaker in Ph⁺ B-ALL cells than that in Ph⁻ B-ALL cells. Moreover, c-MYC, Bcl-2 and CDK6 protein levels decreased in GSK525762A treated group.</p><p><b>CONCLUSION</b>GSK525762A could strongly inhibit the proliferation of common B-ALL and trigger apoptosis; meanwhile it has certain effects against Ph⁺ ALL in vitro. The effect may be achieved by down-regulation of c-MYC, CDK6 and Bcl-2 expression.</p>