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1.
Phytomedicine ; 132: 155856, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39024674

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) is a common skin condition that causes chronic and recurring eczema lesions. Prior research has indicated that Cannabis fructus, the mature fruit of Cannabis sativa, has an antioxidant effect. Historically, Cannabis fructus has been used in cosmetics and medicine. However, there is limited knowledge regarding its biological components and the mechanisms by which it prevents and treats AD. OBJECTIVES: HPLC-ESI-MS/MS analysis was utilized to identify the main compounds of Cannabis fructus, and trilinolein was extracted using chromatographic techniques. The potential of trilinolein in the prevention of AD was assessed, and its underlying mechanisms of action were elucidated. METHODS: The distribution of distinct cellular subpopulations and the principal biological processes implicated in the pathogenesis of AD were assessed through a comparative study involving chronic AD patients and healthy controls (HCs). Differential gene expression was validated in clinical samples from the lesions of AD patients and the healthy skin of controls. The pharmacodynamic activity of trilinolein was validated in dinitrochlorobenzene (DNCB)-induced BALB/c mice and in IL-4- and TNF-α-induced HaCaT cells. Proteomics analyse was employed to investigate its mechanisms. RESULTS: Single-cell transcriptome analysis revealed that chronic AD is characterized by abnormal keratinocyte differentiation and oxidative stress damage. When topically applied, trilinolein can effectively improve AD-like skin lesions induced by DNCB. It increases the expression of terminal differentiation proteins and decreases the expression of NADPH oxidase 2 (NOX2), with a therapeutic effect comparable to that of the positive control drug crisaborole. Additionally, trilinolein reduced ROS fluorescence intensity, restored mitochondrial morphology and membrane potential, and decreased mitochondrial DNA (mtDNA) release in keratinocytes stimulated with IL-4 and TNF-α. Moreover, trilinolein increased the protein expression of AhR, CYP1A1, and Nrf2 in a dose-dependent manner. The effect of trilinolein on keratinocyte terminal differentiation proteins and ROS levels was blocked by the addition of an AhR inhibitor. CONCLUSION: The study suggests that trilinolein from Cannabis fructus alleviates NOX2-dependent mitochondrial dysfunction and repair the skin barrier via AhR-Nrf2 pathway, making it a promising agent for the prevention and treatment of AD.


Subject(s)
Cannabis , Dermatitis, Atopic , Mice, Inbred BALB C , Dermatitis, Atopic/drug therapy , Animals , Humans , Cannabis/chemistry , Mice , Mitochondria/drug effects , Fruit/chemistry , Female , Male , Plants, Medicinal/chemistry , Dinitrochlorobenzene , HaCaT Cells , Keratinocytes/drug effects , Tandem Mass Spectrometry , Plant Extracts/pharmacology , Plant Extracts/chemistry , Reactive Oxygen Species/metabolism , Antioxidants/pharmacology
2.
Aging (Albany NY) ; 16(14): 11208-11223, 2024 Jun 26.
Article in English | MEDLINE | ID: mdl-39024509

ABSTRACT

Chemoresistance is a common and thorny problem in the treatment of osteosarcoma (OS), which obstructs the response of relapse or metastasis of OS to chemotherapy and leads to the unfavorable prognosis of OS patients. Cyclin L1 (CCNL1) is a non-canonical cyclin that plays an important role in the regulation of tumor cell proliferation and lymph node metastasis. In this work, we explored the impact of CCNL1 expression levels on proliferation, migration, and Adriamycin (ADM) resistance in OS and related mechanisms. We found that CCNL1 expression levels were significantly associated with clinical prognosis of patients with OS and CCNL1 could promote OS proliferation and migration. In addition, we also revealed that cellular CCNL1 was significantly increased in ADM-resistant OS cells and promoted ADM resistance. The PI3K/AKT-mTOR pathway is involved in CCNL1-mediated ADM resistance in OS. In summary, CCNL1 is involved in the progression of ADM resistance and OS through the PI3K/AKT-mTOR pathway, which will provide a new clue to the mechanism of ADM resistance and a potential target for the treatment of ADM-resistant OS.


Subject(s)
Bone Neoplasms , Doxorubicin , Drug Resistance, Neoplasm , Osteosarcoma , Phosphatidylinositol 3-Kinases , Proto-Oncogene Proteins c-akt , Signal Transduction , TOR Serine-Threonine Kinases , Osteosarcoma/drug therapy , Osteosarcoma/metabolism , Osteosarcoma/pathology , Osteosarcoma/genetics , Humans , TOR Serine-Threonine Kinases/metabolism , TOR Serine-Threonine Kinases/genetics , Drug Resistance, Neoplasm/genetics , Proto-Oncogene Proteins c-akt/metabolism , Doxorubicin/pharmacology , Doxorubicin/therapeutic use , Phosphatidylinositol 3-Kinases/metabolism , Phosphatidylinositol 3-Kinases/genetics , Cell Line, Tumor , Signal Transduction/drug effects , Bone Neoplasms/drug therapy , Bone Neoplasms/metabolism , Bone Neoplasms/pathology , Bone Neoplasms/genetics , Cell Proliferation/drug effects , Antibiotics, Antineoplastic/pharmacology , Antibiotics, Antineoplastic/therapeutic use , Cell Movement/drug effects , Disease Progression , Male , Female , Gene Expression Regulation, Neoplastic , Prognosis
3.
ACS Omega ; 9(17): 18813-18826, 2024 Apr 30.
Article in English | MEDLINE | ID: mdl-38708242

ABSTRACT

This study explored the impact of varying weight percentages of TiMoVWCr high-entropy alloy (HEA) powder addition on A356 composites produced using friction stir processing (FSP). Unlike previous research that often focused on singular aspects, such as mechanical properties, or microstructural analysis, this investigation systematically examined the multifaceted performance of A356 composites by comprehensively assessing the microstructure, interfacial bonding strength, mechanical properties, and wear behavior. The study identified a uniform distribution of TiMoVWCr HEA powder in the composition A356/2%Ti2%Mo2%V2%W2%Cr, highlighting the effectiveness of the FSP technique in achieving homogeneous dispersion. Strong bonding between the reinforcement and matrix material was observed in the same composition, indicating favorable interfacial characteristics. Mechanical properties, including tensile strength and hardness, were evaluated for various compositions, demonstrating significant improvements across the board. The addition of 2%Ti2%Mo2%V2%W2%Cr powder enhanced the tensile strength by 36.39%, while hardness improved by 62.71%. Similarly, wear resistance showed notable enhancements ranging from 35.56 to 48.89% for different compositions. Microstructural analysis revealed approximately 1640.59 grains per square inch for the A356/2%Ti2%Mo2%V2%W2%Cr processed composite at 500 magnifications. In reinforcing Al composites with Ti, Mo, V, W, and Cr high-entropy alloy (HEA) particles, each element imparted distinct benefits. Titanium (Ti) enhanced strength and wear resistance, molybdenum (Mo) contributed to improved hardness, vanadium (V) promoted hardenability, tungsten (W) enhanced wear resistance, and chromium (Cr) provided wear resistance and hardness. Anticipating the potential applications of the developed composite, the study suggests its suitability for the aerospace sector, particularly in casting lightweight yet high-strength parts such as aircraft components, engine components, and structural components, underlining the significance of the investigated TiMoVWCr HEA powder-modified A356 composites.

4.
J Electrocardiol ; 84: 137-144, 2024.
Article in English | MEDLINE | ID: mdl-38696980

ABSTRACT

BACKGROUND: Metabolic syndrome (MetS) is associated with increased rates of cardiovascular disease and mortality and is linked to abnormal electrocardiogram (ECG) parameters. We aimed to explore the relationships and interactions among MetS and its components, abnormal P-wave axis (aPWA), and mortality rates. METHODS: We analyzed data from 7526 adult participants with sinus rhythm recruited from the National Health and Nutrition Examination Survey III. MetS was classified based on the NCEP ATP III-2005 definition. aPWA included all P-wave axis outside 0-75°. The National Death Index was utilized to identify survival status. Hazard ratios (HRs) and 95% confidence intervals (CIs) categorized by aPWA, MetS, and their components were analyzed using Cox proportional hazards models to investigate all-cause and cardiovascular mortalities. RESULTS: Within a median follow-up period of 20.76 years, 4686 deaths were recorded, of which 1414 were attributable to cardiovascular disease. Participants with both MetS and aPWA had higher all-cause (HR: 1.45, 95% CI: 1.29-1.64, interaction P = 0.043) and cardiovascular (HR: 1.36, 95% CI: 1.02-1.79, interaction P-value = 0.058) mortality rates than participants without MetS and with a normal P-wave axis. Participants with the greatest number of MetS components and aPWA had a higher risk of all-cause mortality (HR: 1.70, 95% CI: 1.13-2.55, P = 0.011). CONCLUSIONS: Individuals with both aPWA and MetS have a higher risk of mortality, and those with a greater number of MetS components and aPWA have a higher risk of all-cause mortality. These findings highlight the significance of integrating ECG characteristics with metabolic health status in clinical assessment.


Subject(s)
Cardiovascular Diseases , Electrocardiography , Metabolic Syndrome , Nutrition Surveys , Humans , Metabolic Syndrome/mortality , Male , Female , United States/epidemiology , Middle Aged , Cardiovascular Diseases/mortality , Adult , Risk Factors , Cause of Death , Survival Rate
5.
World J Surg Oncol ; 22(1): 144, 2024 May 31.
Article in English | MEDLINE | ID: mdl-38822337

ABSTRACT

BACKGROUND: Hepatocellular carcinoma with peritoneal metastasis (HCC-PM) has a poor outlook. Traditional treatments have limited effect on survival. The safety and efficacy of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) have been shown in other peritoneal cancers. This study evaluates the role of CRS + HIPEC in HCC-PM. METHODS: A retrospective analysis of HCC-PM patients treated with CRS + HIPEC at Beijing Shijitan Hospital from March 2017 to December 2023 was conducted, assessing clinical features, severe adverse events (SAEs), and overall survival (OS) rates. RESULTS: The study population comprised 10 HCC-PM patients who underwent CRS + HIPEC. The median peritoneal cancer index (PCI) was 25, and complete cytoreduction (CC0 ~ 1) was achieved in half of the patients. Three patients experienced SAEs within 30 days postoperatively. The 1-year, 3-year, and 5-year OS rates were recorded as 89.0%, 89.0%, and 21.0% respectively, with a median OS1 of 107.8 months and OS2 of 49.9 months. The median progression-free survival (PFS) was 5.0 months. CONCLUSION: The application of CRS + HIPEC offers significant benefits to patients with HCC-PM. A selected group of patients may achieve prolonged PFS. Incorporating CRS + HIPEC into the treatment paradigm can thus be considered a strategic therapeutic option for patients with HCC-PM.


Subject(s)
Carcinoma, Hepatocellular , Cytoreduction Surgical Procedures , Hyperthermic Intraperitoneal Chemotherapy , Liver Neoplasms , Peritoneal Neoplasms , Humans , Liver Neoplasms/therapy , Liver Neoplasms/mortality , Liver Neoplasms/secondary , Liver Neoplasms/pathology , Peritoneal Neoplasms/therapy , Peritoneal Neoplasms/mortality , Peritoneal Neoplasms/secondary , Cytoreduction Surgical Procedures/mortality , Cytoreduction Surgical Procedures/methods , Hyperthermic Intraperitoneal Chemotherapy/methods , Male , Female , Carcinoma, Hepatocellular/therapy , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/mortality , Retrospective Studies , Middle Aged , Survival Rate , Combined Modality Therapy , Prognosis , Follow-Up Studies , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use
6.
Front Nutr ; 11: 1296774, 2024.
Article in English | MEDLINE | ID: mdl-38757129

ABSTRACT

Background: Green tea intake has been reported to improve the clinical outcomes of patients with cardiovascular diseases or cancer. It may have a certain role in the development of venous thromboembolism (VTE) among cancer patients. The current study aimed to address this issue, which has been understudied. Methods: We carried out a retrospective study to explore the role of green tea intake in cancer patients. Patients with and without green tea intake were enrolled in a 1:1 ratio by using propensity scoring matching. The primary and secondary outcomes were VTE development and mortality 1 year after cancer diagnosis, respectively. Results: The cancer patients with green tea intake (n = 425) had less VTE development (10 [2.4%] vs. 23 [5.4%], p = 0.021), VTE-related death (7 [1.6%] vs. 18 [4.2%], p = 0.026), and fatal pulmonary embolism (PE) (3 [0.7%] vs. 12 [2.8%], p = 0.019), compared with those without green tea intake (n = 425). No intake of green tea was correlated with an increase in VTE development (multivariate hazard ratio (HR) 1.758 [1.476-2.040], p < 0.001) and VTE-related mortality (HR 1.618 [1.242-1.994], p = 0.001), compared with green tea intake. Patients with green tea intake less than 525 mL per day had increased VTE development (area under the curve (AUC) 0.888 [0.829-0.947], p < 0.001; HR1.737 [1.286-2.188], p = 0.001) and VTE-related mortality (AUC 0.887 [0.819-0.954], p < 0.001; HR 1.561 [1.232-1.890], p = 0.016) than those with green tea intake more than 525 mL per day. Green tea intake caused a decrease in platelet (p < 0.001) instead of D-dimer (p = 0.297). The all-cause mortality rates were similar between green tea (39 [9.2%]) and non-green tea (48 [11.3%]) intake groups (p = 0.308), whereas the VTE-related mortality rate in the green tea intake group (7 [1.6%]) was lower than that of the non-green tea intake group (18 [4.2%]) (p = 0.026). The incidences of adverse events were similar between the green tea and non-green tea intake groups. Conclusion: In conclusion, the current study suggests that green tea intake reduces VTE development and VTE-related mortality in cancer patients, most likely through antiplatelet mechanisms. Drinking green tea provides the efficacy of thromboprophylaxis for cancer patients.

7.
ACS Appl Mater Interfaces ; 16(21): 27087-27101, 2024 May 29.
Article in English | MEDLINE | ID: mdl-38752799

ABSTRACT

An ideal vehicle with a high transfection efficiency is crucial for gene delivery. In this study, a type of cationic carbon dot (CCD) known as APCDs were first prepared with arginine (Arg) and pentaethylenehexamine (PEHA) as precursors and conjugated with oleic acid (OA) for gene delivery. By tuning the mass ratio of APCDs to OA, APCDs-OA conjugates, namely, APCDs-0.5OA, APCDs-1.0OA, and APCDs-1.5OA were synthesized. All three amphiphilic APCDs-OA conjugates show high affinity to DNA through electrostatic interactions. APCDs-0.5OA exhibit strong binding with small interfering RNA (siRNA). After being internalized by Human Embryonic Kidney (HEK 293) and osteosarcoma (U2OS) cells, they could distribute in both the cytoplasm and the nucleus. With APCDs-OA conjugates as gene delivery vehicles, plasmid DNA (pDNA) that encodes the gene for the green fluorescence protein (GFP) can be successfully delivered in both HEK 293 and U2OS cells. The GFP expression levels mediated by APCDs-0.5OA and APCDs-1.0OA are ten times greater than that of PEI in HEK 293 cells. Furthermore, APCDs-0.5OA show prominent siRNA transfection efficiency, which is proven by the significantly downregulated expression of FANCA and FANCD2 proteins upon delivery of FANCA siRNA and FANCD2 siRNA into U2OS cells. In conclusion, our work demonstrates that conjugation of CCDs with a lipid structure such as OA significantly improves the gene transfection efficiency, providing a new idea about the designation of nonviral carriers in gene delivery systems.


Subject(s)
Carbon , RNA, Small Interfering , Transfection , Humans , HEK293 Cells , Carbon/chemistry , Transfection/methods , RNA, Small Interfering/chemistry , RNA, Small Interfering/metabolism , Lipids/chemistry , Cations/chemistry , DNA/chemistry , Quantum Dots/chemistry , Gene Transfer Techniques , Oleic Acid/chemistry , Green Fluorescent Proteins/metabolism , Green Fluorescent Proteins/genetics , Cell Line, Tumor
8.
Haemophilia ; 30(3): 809-816, 2024 May.
Article in English | MEDLINE | ID: mdl-38616526

ABSTRACT

BACKGROUND: There is a lack of research on the relationship between pain catastrophizing, kinesiophobia, and physical activity (PA) in people with haemophilia (PWH), and the underlying mechanisms connecting these variables remain unclear. AIM: The study's aim was to clarify the roles of kinesiophobia and self-efficacy in the relationship between pain catastrophizing and PA in PWH. METHODS: This cross-sectional study included adult PWH at the Haemophilia Centre of a Tertiary hospital in Beijing, China. The following questionnaires were used to collect data: the general information, the International Physical Activity Short Questionnaire, the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia Scale, and the Exercise Self-Efficacy Scale. RESULTS: The study included a total of 187 PWH, including 154 having haemophilia A and 33 having haemophilia B. The median interquartile range of PA was 594 (198, 1554) MET-min/wk. There were significant differences in PA of patients based on age stage, treatment modality, highest pain score within the last seven days, and presence of haemophilic arthropathy (p < .05). It was showed that pain catastrophizing could directly predict PA (p < .001), accounting for 38.13% of the total effect. Pain catastrophizing also had indirect effects on PA through the mediating factors of kinesiophobia or self-efficacy, and through the chain-mediating effect of kinesiophobia and self-efficacy, accounting for 38.40%, 17.07%, and 6.40%, respectively. CONCLUSION: The study discovered that PWH have limited PA due to pain catastrophizing. This not only directly affects their activity but also indirectly influences it through kinesiophobia and self-efficacy.


Subject(s)
Catastrophization , Exercise , Hemophilia A , Kinesiophobia , Self Efficacy , Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Catastrophization/psychology , Cross-Sectional Studies , Exercise/psychology , Hemophilia A/psychology , Hemophilia A/complications , Kinesiophobia/psychology , Surveys and Questionnaires
9.
Front Oncol ; 14: 1357982, 2024.
Article in English | MEDLINE | ID: mdl-38532934

ABSTRACT

Due to their unique location, airway tumors have a significant impact on patient quality of life and survival. Current research has focused extensively on malignant airway tumors; however, benign airway tumors, especially rare ones, are less understood due to their low incidence. These tumors are often misdiagnosed and mistreated due to diagnostic challenges. Therefore, there is still a lack of consensus on the treatment of some rare benign airway tumors. Our center summarizes the diagnosis and treatment of four rare cases of benign airway stenosis in recent years, highlighting the bronchoscopic manifestations and therapeutic approaches to improve the understanding of these diseases.

10.
Eur J Contracept Reprod Health Care ; 29(2): 76-78, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38284985

ABSTRACT

CASE: Intrauterine device (IUD) is used worldwide as an effective contraceptive method, but the migration of IUD is a serious complication. We report the case of IUD migration leading to bladder calculus formation and a minimally invasive transurethral surgical approach was performed for treatment. Holmium laser was used to break up the bladder calculus and cut through the bladder mucosa where the IUD was attached, finally the IUD was removed through the urethra. This minimally invasive procedure is a safe and effective treatment for IUD migration, and similar cases have not been reported in the literature. CONCLUSION: That the secondary bladder calculus were smashed by intense pulse mode of holmium laser, and the bladder tissue around the attached IUD was opened by cutting mode of holmium laser, and finally the IUD was completely removed from urethra, this surgical method is safe and effective, and there is no case report on IUD removal of transurethral cystoscope in the literature.

11.
Nat Commun ; 15(1): 655, 2024 Jan 22.
Article in English | MEDLINE | ID: mdl-38253534

ABSTRACT

The open-shell catalytically active species, like radical cations or radical anions, generated by one-electron transfer of precatalysts are widely used in energy-consuming redox reactions, but their excited-state lifetimes are usually short. Here, a closed-shell thioxanthone-hydrogen anion species (3), which can be photochemically converted to a potent and long-lived reductant, is generated under electrochemical conditions, enabling the electrophotocatalytic hydrogenation. Notably, TfOH can regulate the redox potential of the active species in this system. In the presence of TfOH, precatalyst (1) reduction can occur at low potential, so that competitive H2 evolution can be inhibited, thus effectively promoting the hydrogenation of imines. In the absence of TfOH, the reducing ability of the system can reach a potency even comparable to that of Na0 or Li0, thereby allowing the hydrogenation, borylation, stannylation and (hetero)arylation of aryl halides to construct C-H, C-B, C-Sn, and C-C bonds.

12.
Eur J Surg Oncol ; 50(2): 107950, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38215549

ABSTRACT

OBJECTIVE: To evaluate the effect of secondary cytoreductive surgery (SeCRS) followed by platinum-based chemotherapy (PBC) and olaparib tablets as maintenance therapy in patients with BRCA mutated recurrent epithelial ovarian cancer. METHODS: This was a retrospective study of a prospective database. We collected information on 623 patients diagnosed with BRCA mutated recurrent epithelial ovarian cancer, all of whom underwent SeCRS followed by PBC in combination with or without olaparib. Overall survival and progression-free survival were measured to evaluate treatment effectiveness. RESULTS: Of the 623 patients recruited, 240 underwent SeCRS plus hyperthermic intraperitoneal chemotherapy followed by PBC and olaparib maintenance therapy (Group A), 248 underwent SeCRS followed by PBC and olaparib maintenance therapy (Group B), and 135 underwent SeCRS followed by PBC only upon recurrence (Group C). The median progression-free survival for Group A was significantly longer than that for Group B (32.5 vs. 24.2 months, P<0.001), and Group B was significantly longer than Group C (24.2 vs. 15.1 months, P<0.001). The median overall survival for Groups A was significantly longer than that for Group B (71.4 vs. 63.5 months, P<0.001), and Group B was significantly longer than Group C (63.5 vs. 47.5 months, P<0.001). CONCLUSIONS: This study suggested that SeCRS followed by PBC and olaparib maintenance therapy resulted in longer overall survival and progression-free survival than SeCRS followed by PBC only in patients with BRCA mutated recurrent ovarian cancer, especially in patients treated with SeCRS plus hyperthermic intraperitoneal chemotherapy.


Subject(s)
Antineoplastic Agents , Ovarian Neoplasms , Phthalazines , Piperazines , Humans , Female , Carcinoma, Ovarian Epithelial/drug therapy , Carcinoma, Ovarian Epithelial/genetics , Retrospective Studies , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/genetics , Ovarian Neoplasms/surgery , Cytoreduction Surgical Procedures , Neoplasm Recurrence, Local/genetics , Neoplasm Recurrence, Local/drug therapy , Tablets/therapeutic use
13.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-659017

ABSTRACT

Objective:For cancer patients who underwent extensive surgery, drastic release of myoglobin (Mb) after surgery can cause hypermyoglobinemia and related problems. This retrospective cohort study aims to summarize our experience and outcomes of 60 pa-tients with hypermyoglobinemia after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), to investi-gate the changes in postoperative Mb levels, and to explore the clinical value of Mb. Methods:This retrospective study covered 60 pa-tients with peritoneal carcinomatosis who were treated with CRS and HIPEC. All patients developed hypermyoglobinemia after opera-tion. Immediately after CRS and HIPEC, the patients were placed in a comprehensive treatment regimen consisting of hemodynamic stabilization therapies, nutritional support, anti-sepsis therapies, and psycho-physical therapies. For the treatment of hypermyoglo-binemia, intravenous injection of sodium bicarbonate solution according to the Mb level was given to the patients. Moreover, the pre-and post-operative concentrations of Mb, blood urea nitrogen (BUN), and creatinine (Cr) were evaluated. Results:Serum Mb levels af-ter CRS and HIPEC were significantly elevated and peaked on the surgery day. Prompt treatment with intravenous infusion of sodium bicarbonate solution could help decrease the serum Mb levels and alleviate potential damage. Serum Mb levels returned to normal in approximately 3-4 days. The serum BUN levels increased after operation and peaked on the fourth postoperative day. On the other hand, serum Cr levels increased 2 days after operation and began to decrease on the third postoperative day. One patient developed renal failure and sepsis and died on postoperative day 26. The other patients recovered from the surgery without major adverse events. Conclusion:Hypermyoglobinemia is a common lab abnormality after CRS and HIPEC, and serum Mb levels could be an early and sensitive indicator for dramatic disturbances in the internal milieu after surgery. Adequate treatment with sodium bicarbonate could accelerate the reduction in serum Mb levels and reduce the risk for major organ damages.

14.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-661916

ABSTRACT

Objective:For cancer patients who underwent extensive surgery, drastic release of myoglobin (Mb) after surgery can cause hypermyoglobinemia and related problems. This retrospective cohort study aims to summarize our experience and outcomes of 60 pa-tients with hypermyoglobinemia after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), to investi-gate the changes in postoperative Mb levels, and to explore the clinical value of Mb. Methods:This retrospective study covered 60 pa-tients with peritoneal carcinomatosis who were treated with CRS and HIPEC. All patients developed hypermyoglobinemia after opera-tion. Immediately after CRS and HIPEC, the patients were placed in a comprehensive treatment regimen consisting of hemodynamic stabilization therapies, nutritional support, anti-sepsis therapies, and psycho-physical therapies. For the treatment of hypermyoglo-binemia, intravenous injection of sodium bicarbonate solution according to the Mb level was given to the patients. Moreover, the pre-and post-operative concentrations of Mb, blood urea nitrogen (BUN), and creatinine (Cr) were evaluated. Results:Serum Mb levels af-ter CRS and HIPEC were significantly elevated and peaked on the surgery day. Prompt treatment with intravenous infusion of sodium bicarbonate solution could help decrease the serum Mb levels and alleviate potential damage. Serum Mb levels returned to normal in approximately 3-4 days. The serum BUN levels increased after operation and peaked on the fourth postoperative day. On the other hand, serum Cr levels increased 2 days after operation and began to decrease on the third postoperative day. One patient developed renal failure and sepsis and died on postoperative day 26. The other patients recovered from the surgery without major adverse events. Conclusion:Hypermyoglobinemia is a common lab abnormality after CRS and HIPEC, and serum Mb levels could be an early and sensitive indicator for dramatic disturbances in the internal milieu after surgery. Adequate treatment with sodium bicarbonate could accelerate the reduction in serum Mb levels and reduce the risk for major organ damages.

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