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Objective To evaluate the application value of perioperative interventional strategy guided by enhanced recovery after surgery (ERAS) in elderly recipients undergoing liver transplantation. Methods Clinical data of 405 liver transplant recipients were retrospectively analyzed. According to age, all recipients were divided into the elderly (≥60 years, n=122) and non-elderly groups (< 60 years, n=283). All patients received perioperative interventions under the guidance of ERAS. Intraoperative and postoperative indexes, incidence of postoperative complications and discharge were analyzed between two groups. Results There were no significant differences in the duration of anesthesia, operation time, anhepatic phase, hemorrhage volume, blood transfusion volume, lactic acid level before abdominal closure, ventilator-assisted time, the length of intensive care unit (ICU) stay, Caprini score, CHIPPS score, time of gastric tube, urinary tube and drainage tube removal, time to first drinking, time to first physical activity and time to first flatus between two groups (all P > 0.05). In the elderly group, the time to first feeding was later than that in the non-elderly group (P < 0.05). There were no significant differences in the incidence of fever, ascites, pulmonary infection, delayed gastric emptying, hemorrhage and inactive venous thrombosis between two groups (all P > 0.05). No significant differences were observed in the levels of aspartate aminotransferase, total bilirubin, direct bilirubin, serum creatinine before discharge and total length of hospital stay between two groups (all P > 0.05). The alanine aminotransferase level in elderly recipients was lower than that in non-elderly counterparts, and the difference was statistically significant (P < 0.05). No unplanned reoperation was performed within postoperative 30 d in two groups. There was no significant difference in the re-hospitalization rate within 30 d after discharge (P > 0.05). Conclusions ERAS-guided interventional strategy contributes to perioperative recovery of elderly recipients undergoing liver transplantation, and yields equivalent postoperative recovery between elderly and non-elderly recipients.
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OBJECTIVE@#To investigate the effect of electroacupuncture on osteoarthritis in rats and explore the possible mechanism.@*METHODS@#Thirty SD rats were randomly divided into osteoarthritis model group, electro-acupuncture group and control group (n=10), and in the former two groups, early osteoarthritis was induced using a modified DMM surgical modeling method. After successful modeling, the rats in the electro-acupuncture group were treated with electro-acupuncture at bilateral "Housanli" and "Anterior knee point". Behavioral tests of the rats were performed and scored using the LequesneMG scale. Subchondral bone degeneration was observed in each group, and serum levels of IL-1β, ADAMTS-7, MMP-3 and COMP were measured using ELISA. The mRNA and protein expressions of IL-1β, Wnt-7B, β-catenin, ADAMTS-7, and MMP-3 in the cartilage tissue of the knee joints were detected using RT-PCR and Western blotting.@*RESULTS@#In behavioral tests, the rats in the model and electroacupuncture groups had significantly higher LequesneMG scores after modeling than those in the control group (P < 0.05). After 20 days of treatment, LequesneMG scores were significantly lowered in rats in the electroacupuncture as compared with the model rats (P < 0.05). Imaging examination revealed obvious subchondral bone damage in both the electroacupuncture group and the model group, but the damages were significantly milder with former group. Compared with the model rats, the rats receiving electroacupuncture had significantly lower serum levels of IL-1β, ADAMTS-7, MMP-3 and COMP (P < 0.05) with also lower expressions of IL-1β, Wnt-7B, β-catenin, ADAMTS-7 and MMP-3 in the cartilage tissues at both the mRNA and protein levels (P < 0.05).@*CONCLUSION@#Electroacupuncture can alleviate joint pain and improve subchondral bone damage in rats with osteoarthritis by reducing IL-1β levels in the joint cartilage tissue and serum to alleviate joint inflammation and by reducing such cytokines as ADAMTS-7 and MMP-3 via regulating the Wnt-7B/β-catenin signaling pathway.
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Ratos , Animais , Eletroacupuntura , Metaloproteinase 3 da Matriz/metabolismo , Ratos Sprague-Dawley , beta Catenina/metabolismo , Osteoartrite/metabolismo , Via de Sinalização Wnt , Cartilagem Articular , Inflamação/metabolismoRESUMO
Novel cancer immunotherapy can treat tumors through regulating innate immunity and adaptive immune system. cGMP-AMP synthase (cGAS) is a key regulator of innate immune response to both exogenous and endogenous DNA. After recognizing the cytoplasmic DNA, cGAS produces the second messenger cyclic GMP-AMP (cGAMP), which subsequently combines with the adaptor STING (also known as MITA, MPYS and ERIS) to mediate innate immunity by inducing the production of type I interferons and inflammatory cytokines. Recent studies have revealed that the cGAS/STING signaling pathway can be activated by tumor-derived DNA and by-products of genomic instability and affect the incidence and development of tumors, which plays a critical role in the natural antitumor immunity across cancer types and immune checkpoint blockade therapy. In this article, current understanding of cGAS/STING signaling pathway in tumors was summarized, the pivotal role in tumor immunity and radiotherapy was highlighted, and the potential targeted or alternative therapy of this signaling pathway was reviewed.
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Objective@#To explore the association between polycyclic aromatic hydrocarbons (PAHs) exposure and cytochrome P450 CYP1A1 expression at gene and enzyme activity levels in the peripheral blood monocyte cells in coke oven workers, and to provide a certain basis for the biological monitoring of health damage in coke oven workers.@*Methods@#We surveyed 118 coke oven workers and 63 controls (energy power workers in the same company) using self-designed questionnaire, determined their post-shift urinary 1-hydroxypyrene (1-OH-Py) concentration using high performance liquid chromatography (HPLC)-fluorescence detector method. We also isolated the peripheral blood mononuclear cell (PBMC) from fasting venous blood, and detected DNA damage using comet assay, CYP1A1 mRNA level using the real-time fluorescent quantitative PCR (FQ-PCR), and EROD activity using spectrophotometry. Statistical analyses including one-way analysis of variance and multiple linear regressions were used to analyze the association of urinary 1-OH-Py and CYP1A1 mRNA level and EROD activity.@*Results@#Compared to the control group, the urinary 1-OH-Py concentration and PBMC DNA tail moment were significantly increased in coke oven workers (P<0.05), and CYP1A1 gene level and EROD activity in PBMC were significantly decreased (P<0.05). Multiple linear regression showed that a ten-fold increase of urinary 1-OH-Pycon centration was associated with a decrease of 0.77 (95%CI: -1.33--0.21) in CYP1A1 gene level, and a decline of 0.15 (95%CI: -0.76--0.16) in EROD activity of PBMC in coke oven workers (P<0.05).@*Conclusion@#Occupational PAHs exposure induced DNA damage, which was associated with the decreased level in CYP1A1 gene cavel and EROD activity in PBMC of coke oven workers.
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Objective To explore the clinical application value of transparent cap gastroscope in the Billroth Ⅱ procedure after subtotal gastrectomy in patients with bile duct diseases by endoscopic retrograde cholangiopancreatography(ERCP).Methods 20 patients underwent ERCP with Billroth Ⅱ gastrectomy postoperation with biliary diseases were selected as the research subjects,selected the transparent cap gastroscope ERCP,successful intubation received endoscopic sphincterotomy(EST) and(or) endoscopic nasobiliary drainage(ENBD),endoscopic papillary balloon dilatation(EPBD),endoscopic biliary metal stent drainage(EMBE),endoscopic biliary drainage(ERBD) treatment.Results 20 patients with Billroth Ⅱ gastrectomy after angiography were successful,the successful rate was 100.00%,14 cases of EST patients,4 patients underwent EPBD surgery,common bile duct stones all took the net,took the net rate of 100.00%;1 case of bile duct cancer underwent EMRE resection,1 case of bile duct stenosis after biliary tract surgery ERBD operation,hyperamylasemia occurred in 1 case,no serious complications such as bleeding and perforation of digestive tract.Conclusion Billroth Ⅱ gastrectomy postoperative patients with bile duct disease receiving ERCP,endoscopic transparent cap can provide good operative field for jejunal loop inside the mirror,improve the success rate of bile duct intubation,conducive to the removal of stones,improve the success rate of surgery,reduce complications security,safety of operation,and can be used in clinical application.
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Objective To summarize the experience in nursing patients with gut leak after liver transplantation. Methods Two patients with recurrent gut leakafter liver transplantation underwent surgical repair. The nursing measures included strict observation of postoperative disease, observation of drainage fluid and abdominal signs, early nutritional support, good psychological nursing and health education. Results Gut leak occurred in the two cases again after liver transplantation.One case was treated with repair again and the other with end-stage ileotomy and ileostomy. The patients were discharged after medication and nursing care. Conclusions The close postoperative observation of the disease, observation of drainage fluid and abdominal signs can prompt the discovery of intestinal re-perforation.The early nutritional support plays an important role in the rehabilitation of patients with gut leak after liver transplantation.Mental care and health education can enhance patient's confidence in treatment.
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OBJECTIVE To investigate the effect of microRNA-129(miR-129)expression on malignant phenotypes of esophageal squamous cell cancer(ESCC) cells and its possible molecular mechanisms. METHODS The constructed miR-129-overexpressed vector (pGCMV/EGFP/miR-129) and negative control vector (pGCMV/EGFP/miR-NC) were stably transfected into ESCC cell lines (Eca109 and EC9706),respectively. Quantitative real-time PCR(qRT-PCR)was performed to detect the expression of miR-129. MTT and flow cytometry(FCM)assays were performed to analyze the effects of miR-129 on proliferation, cell cycle and apoptosis of ESCC cells. Furthermore,a luciferase reporter vector with the putative B-cell lymphoma-2(Bcl-2)3′-untranslated region(pLUC/Bcl-2-3′-UTR-wt and pLUC/Bcl-2-3′-UTR-mut)was constructed to explore whether Bcl-2 was a direct target gene of miR-129 by detecting luciferase activity. Next,Western blotting was performed to detect the expression of Bcl-2, cleaved caspase 3 and total caspase 3 proteins. RESULTS Overexpression of miR-129 significantly inhibited proliferation(P<0.01),induced cell arrest in G0/G1 phase(P<0.05)and enhanced apoptosis (P<0.05)in ESCC cells. Luciferase reporter assay indicated that Bcl-2 was identified as a direct target gene of miR-129. Results of Western blotting showed that overexpression of miR-129 significantly reduced the expression of Bcl-2 protein and increased the expression of cleaved caspase 3 protein,but induced no changes in total caspase 3 protein in ESCC cells. CONCLUSION miR-129 functions as a tumor suppressor in ESCC cells by targeting Bcl-2 gene. Therefore,miR-129 will be a potential molecular target for the treatment of human ESCC.
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Objective To summarize the experience of nursing the patients with liver transplantation complicated with early portal vein thrombosis treated with post-embolectomic anticoagulation. Method The clinical data of 5 cases of liver transplantation-induced portal vein thrombosis treated with post-embolectomic anticoagulation was reviewed to summarize the curative effect , key points for disease conditions and anticoagulative nursing. Results The anticoagulative effect was not good in only one case. 4 other cases were recovered by embolectomy and postoperative anticoagulation therapy as well as related nursing measures. Conclusion The nursing measures such as close observation of the disease processing, early reasonable anticoagulation, accurate medication, prevention of patent complication are critical for preventing the recurrence of portal vein thrombosis after liver transplantation.
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@#Objective To explore the effects of Sanban manipulation of spine on ankylosing spondylitis (AS) at the early-middle stage.Methods 60 AS patients at the early-middle stage were divided into drug group (n=30) and manipulation group (n=30). The drug group wastreated with sulfasalazine and the sustained-release pills of Zhengqingfengtongning, while the manipulation group were treated with Sanbanmanipulation of spine additionally. Self-developed questionnaire were used to follow up before and 1, 3 and 6 months after treatment. ResultsThe Schober index and the finger-floor distance improved more in the manipulation group than in the drug group (P<0.05) 3 months aftertreatment. All the index improved more in the manipulation group than in the drug group (P<0.05) 6 months after treatment. ConclusionSanban manipulation of spine can improve the thoracolumbar activities in the AS patients at the early-middle stage.
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Objective To study the expressive changes of RAR-β gene in cervical carcinogenesis and analyze the relation between this differentiated expression and methylation, and discuss the clinical significance of this differentiated expression.Methods RT-PCR method was used to detect the expression of RAR-β in 4 cervical eancer cell lines,38 eases of cevical invasive carcinomatous tissues,30 cases of cevical intraepithelial neoplasia,and 10 cases of normal cervical tissues.Using Western Blot method to detect the expression of RAR-β protein quantificationally, analyze the RAR-β gene expressive difference in protein level.Using the methylation-*specific PCR methods to analyze the RAR-β methylation state in cell lines and tissues.Meanwhile analyze the relationship between the RAR-β gene expression and the clinical pathological parameters.Resuits The expression of RAR-β gene was deleted or deereaseed in cervieal cancer celllines,cevical intraepithelial neoplasia and cevical carcinoma,which was significantly difierent from normal tissues(P<0.05).The same results was found in the protein expression.The methylation in RAR-β gene first exon was detected in 3 types of cell lines,11 cases of carcinoma,1 case of CIN Ⅰ and 5 cases of CIN Ⅱ~Ⅲ.while the RAR-β gene expression was decreased in those cell lines and tissues.There was significant differenee of RAR-β gene methylation in different pathological grades (P=0.037).There was no statistical significant difference of clinical stages(P≈1.000)and the metastasis of lymph node(P≈1.000).Conclusion The defective expression of RAR-β gene plays an important role in the carcinogenesis of cervical cancer.The abnormal methylation of promoter region was the main cause of defective expression of RAR-β gene.
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Objective: To observe the expression of RAR-β gene in SiHa, HeLa, C33A and CasKi cell lines of cervical carcinoma and to investigate the role of methylated RAR-β in its expressive defection. Methods: Reverse transcription polymerase chain reaction (RT-PCR) was used to analyze the mRNA expression of RAR-β gene. Immunohistochemistry and Western Blot were used to analyze the protein expression of RAR-β gene in four cervical cancer cell lines as well as the influence of 5-Aza-cdR on gene expressive defection. Methylation specific PCR (MSP) was used to detect whether there was the methylation in RAR-β gene in four cell lines. The change of RAR-β gene methylation state was also observed by MSP. The cell proliferation rate influenced by the 5-Aza-cdR was observed by MTT assay. Results: The expression of RAR-β mRNA and protein in SiHa, HeLa and CasKi cell lines of cervical cancer was silent or decreased, whereas its expression was detected in C33A cell line. By using MSP method, it was found that there was RAR-β gene methylation in those three cell lines, whereas there was no RAR-β gene methylation in C33A cell line. After treated with the 5-Aza-cdR, methylated RAR-β gene was partly demethylated, and RAR-β mRNA and protein were re-expressed in the previous three cell lines in which RAR-β gene expression was silent or decreased. The 5-Aza-cdR treatment could supress cell proliferation as well. Conclusion: The RAR-β gene expressive defection plays an important role in the carcinogenesis of cervical cancer. The abnormal RAR-β gene methylation in the the promoter region has an important role in gene expressive defection. The cell proliferation can be supressed by demethylated treatment.
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Objective To observe the expression of RAR-β gene in SiHa, HeLa,C33A and CasKi cell lines of cervical carcinoma and to investigate the role of methylated RAR-β in its expressive defection. Methods Reverse transcription polymerase chain reaction (RT-PCR) was used to analyze the mRNA expression of RAR-β gene. Immunohistochemistry and Western Blot were used to analyze the protein expression of RAR-β gene in four cervical cancer cell lines as well as the influence of 5-Aza-cdR on gene expressive defection. Methylation specific PCR (MSP) was used to detect whether there was the methylation in RAR-β gene in four cell lines. The change of RAR-β gene methylation state was also observed by MSP. The cell proliferation rate influenced by the 5-Aza-cdR was observed by MTT assay. Results The expression of RAR-β mRNA and protein in SiHa, HeLa and CasKi cell lines of cervical cancer was silent or decreased, whereas its expression was detected in C33A cell line. By using MSP method, it was found that there was RAR-β gene methylation in those three cell lines, whereas there was no RAR-β gene methylation in C33A cell line. After treated with the 5-Aza-cdR, methylated RAR-β gene was partly demethylated, and RAR-β mRNA and protein were re-expressed in the previous three cell lines in which RAR-β gene expression was silent or decreased. The 5-Aza-cdR treatment could supress cell proliferation as well. Conclusion The RAR-β gene expressive defection plays an important role in the carcinogenesis of cervical cancer. The abnormal RAR-β gene methylation in the the promotor region has an important role in gene expressive defection. The cell proliferation can be supressed by demethylated treatment.
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The current condition of medical students information literacy is briefly described.And the way and methods of information literacy culture of medical students are brought forward.
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This research is to investigate and analyze the reading characteristics of students in medical college of Foshan Science and Tecnoology University during their clinical practice period,to understand the trainee's reading motive,their expectation of a reading teacher,and their demanding of serve from the college library,thus exploring the method and the countermeasures of the reading guides