Humans ; Minimally Invasive Surgical Procedures ; adverse effects ; methods

BACKGROUND:Tumor stem cels have self-renewal, drug resistance and metastasis tumorigenicity, which play an important role in occurrence, development and metastasis of tumors. Currently, there are two methods to identify tumor stem cels, namely, in vitro tumor sphere culture experiments and in vivo mouse tumorigenic experiments. However, there ia a lack of reports regarding clinicaly enriched gastric cancer cels by chemotherapy. OBJECTIVE:To investigate the enrichment of rat gastric cancer stem cels by cisplatin, and to explore the screening methods for their surface marker proteins. METHODS: BCG-823 gastric cancer model was established in rats, and then rat models were randomized into two groups: rats in experimental groups were subjected to intravenous injection of 0.1, 0.2, 0.25, 0.3 g/L cisplatin via the tail vein; those in control group were injected with normal salinevia the tail vein. After three courses of chemotherapy, gastric stem cels-enriched tissues were colected. Tumor surface proteins were extracted using high-throughput protein microarray and identified by western blot assay. Effects of cisplatin on enrichment of rat gastric cancer stem cels and screening methods for surface marker proteins were compared. RESULTS AND CONCLUSION:Cisplatin at a dose of 0.3 g/L×200μL exhibited the best therapeutic effects, and moreover, with the dose increasing, the tolerance became worse and the incidence of adverse reaction became higher. Transplantation tumors were verified by hematoxylin-eosin staining. Western blot test results were similar to the findings of protein microarray method, that is, HLA-DQ, PMP22 and Claudin7 protein expressions increased in gastric tissues, but HLA-DR, CD14, CD16 and CD56 protein expression decreased. These findings suggest that cisplatin can be used to enrich gastric cancer stem cels in rats, and to successfuly screen the corresponding surface marker proteins.

Objective To investigate the influence of antiepileptic drugs (AEDs) on levels of serum homocysteine (Hcy),folate,vitamin B12 and B6 in patients with post-stroke epilepsy (PSE).Methods The serum levels of Hcy,folate,vitamin B12 and B6 of 194 PSE patients with AEDs treatment for more than 1 year (AEDs treatment group) and 40 newly diagnosed PSE patients without AEDs therapy (control group) were detected.The effects of AEDs on above indexes were analyzed.Results Compared with control group,the serum level of serum Hcy was significantly increased,and the serum levels of folate,B12 were significantly decreased in AEDs treatment group (all P<0.05).The difference of the serum levels of vitamin B6 among the groups was not significant.Compared with monothetapy subgroup,the serum levels of Hcy was significantly increased in the combination therapy subgroup (P<0.05).Compared with control group,the serum levels of Hcy were significantly increased in patients with Valproate (VPA),Carbamazepine (CBZ) and Oxcarbazepine (OXC) monotherapy,the serum levels of folate were significantly decreased in patients with VPA and CBZ monotherapy,and the serum level of B12 was significantly decreased in patients with VPA monotherapy (all P<0.05).Compared with control group,the serum levels of Hcy were significantly increased in patients with 2 kinds of AEDs combination treatment [VPA+CBZ,VPA+Levetiracetam (LEV),VPA+OXC,CBZ+LEV] or ≥3 kinds of AEDs combination treatment,the serum levels of folate was significantly decreased in patients with 2 kinds of AEDs combination treatment (VPA+LEV,VPA+OXC,CBZ+LEV) or ≥3 kinds of AEDs combination treatment,the serum levels of B12 were siginificantly decreased in patients with 2 kinds of AEDs combination treatment (VPA+CBZ,VPA+OXC,CBZ+LEV) or ≥3 kinds of AEDs combination treatment (all P<0.05).The incidence of hyperhomocysteinemia (HHcy) in AEDs treatment group (36.6%) was significantly higher than that in control group (20.0%) (χ2=4.085,P=0.043).And the difference of HHcy incidence between the combination therapy subgroup (47.6%) and the control group was statistical significant (χ2=6.950,P=0.008).The difference of HHcy incidence between the monotherapy subgroup (33.6%) and the control group was not significant.The HHcy incidence of patients with VPA and CBZ monotherapy (40.5%;43.8%) were significantly higer than those in the control group (χ2=3.871,P=0.049;χ2=4.726,P=0.030).The differences of HHcy incidence between patients with OXC,LEV monotherapy (29.2%;22.9%) and the control group were not significant.Conclusions AEDs therapy has little influence on the serum levels of vitamin B6,while has great influence on the serum levels of Hcy,folate and vitamin B12.Combination treatment of AEDs and monotherapy of VPA,CBZ may increase the incidence of HHcy in PSE patients.

ObjectiveTo explore the early rehabilitation for the fracture suffered from earthquake. Methods11 cases were reported. ResultsAll the patients recovered satisfactorily. ConclusionEarly physiotherapy is effective on fracture suffered from earthquake.

Adult ; Bronchoalveolar Lavage ; methods ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy ; Treatment Outcome

Objective:To investigate the breakthrough points and methods of pharmaceutical care performed by clinical pharma-cists for chemotherapy-induced Ⅳ degree myelosuppression. Methods: One advanced lung adenocarcinoma patient suffering from IV degree myolosuppression after being treated with pemetrexed combined with nedaplatin was selected as the example, and the chemother-apy regimen, the cause and treatment of IV degree myolosuppression and the pharmaceutical service could be carried out were ana-lyzed. Results: With the help of clinical pharmacists, the patient conquered chemotherapy-induced myelosuppression, and clinical pharmacists enhanced the awareness of pharmaceutical care and played a positive role in the safe and effective drug use. Conclusion:The participation of clinical pharmacists in clinical pharmaceutical care through providing pharmaceutical service is beneficial to safer and more effective drug therapy.

Objective To investigate whether the inhibition of caveolin-1 (Cav-1) phosphorylation will regulate effectively nuclear factor-erythroid 2-related factor (Nrf2) signal pathway and downstream effector molecules and protest against ventilation induced lung injury (VILI) in an animal model in vivo. Methods Ninety male Sprague-Dawley (SD) rats were randomly divided into nine groups (each n = 10): sham group in which rats did not receive ventilation but received tracheotomy; lung protective ventilation (PV) for 1 hour or 2 hours group; mechanical ventilation (MV) at high volume tidal (VT, 40 mL/kg) for 1 hour or 2 hours group; protein tyrosine kinase inhibitor PP2 or rosiglitazone (Rsg) pretreatment + high VT ventilation for 1 hour or 2 hours groups. The two pretreatment groups were given intraperitoneal injection PP2 15 mg/kg or intragastric administration of Rsg 5 mg/kg 1 hour before ventilation respectively. The rats were sacrificed after model reproduction, and bronchoalveolar lavage fluid (BALF) was collected. Pulmonary vascular permeability was measured by Evans blue (EB). The levels of tumor necrosis factor-α (TNF-α), activator protein-1 (AP-1), nuclear factor-κB (NF-κB), and interleukin-8 (IL-8) in BALF were determined by enzyme linked immunosorbent assay (ELISA). Then the lung tissues were collected, the lung wet/dry ratio (W/D) was calculated, the changes in pathology was observed with light microscope, and myeloperoxidase (MPO) activity was determined by colorimetric analysis. Nrf2 mRNA was determined by reverse transcription-polymerase chain reaction (RT-PCR). The expressions of Cav-1 tyrosine residues 14 phosphorylation (pCav-1-Y14), Cav-1, peroxisome proliferators-activated receptor γ (PPARγ) and claudin-5 as well as Nrf2 in cytoplasm and nucleus were determined by Western Blot. The positive expressions of PPARγ and claudin-5 in lung tissues were assayed with immunohistochemistry staining. Results There were no obvious pathological changes in the lung tissue in sham group and PV groups, and there were no significant differences in all the parameters between the two groups either. However, the injury in lung tissue was severe in the high VT groups in which W/D ratio, EB contents, MPO activity, and TNF-α, AP-1, IL-8, NF-κB levels in BALF as well as the protein expressions of Cav-1 and pCav-1-Y14 were significantly higher than those of sham group and PV groups, and the protein expressions of PPARγ and claudin-5 were significant lower than those of sham group and PV groups with a dose-dependent manner; but Nrf2 expressions in cytoplasm and nucleus did not show a statistical increase. After pretreatment of PP2 or Rsg, W/D ratio, MPO activity, EB contents, TNF-α, AP-1, IL-8, and NF-κB in BALF were significantly decreased as compared with those of high VT group, and RT-PCR showed significant up-regulation of Nrf2 mRNA in lung tissues too. Moreover, there was a statistically significant increase in expressed Nrf2 proteins in nucleus in PP2 or Rsg groups as compared with those of high VT groups [Nrf2 in nucleus (gray value): 0.61±0.06, 0.56±0.06 vs. 0.31±0.02 at 1 hour, 0.38±0.06, 0.43±0.07 vs. 0.22±0.03 at 2 hours; all P < 0.05], but no significant difference was found in the expression of Nrf2 protein in the cytoplasm among all groups. The protein expressions of pCav-1-Y14 in PP2 pretreatment groups were significantly lower than those of high VT groups (gray value: 0.89±0.04 vs. 1.48±0.02 at 1 hour, 0.86±0.02 vs. 1.31±0.01 at 2 hours; both P < 0.05); but expressed PPARγ proteins and expressed claudin-5 proteins in PP2 or Rsg pretreatment groups were significantly higher than those of high VT groups [PPARγ (gray value): 0.34±0.07, 0.42±0.13 vs. 0.17±0.07 at 1 hour, 0.38±0.09, 0.33±0.07 vs. 0.16±0.03 at 2 hours; claudin-5 (gray value): 0.33±0.05, 0.38±0.07 vs. 0.14±0.03 at 1 hour; 0.30±0.06, 0.31±0.04 vs. 0.17±0.04 at 2 hours; all P < 0.05]. Conclusions The inhibition of Cav-1-Y14 phosphorylation can increase the expression of Nrf2 in the nucleus, then result in an increase in the protein expressions of PPARγ and claudin-5 of its effector molecules. This effect can reduce the inflammation and capillary permeability of lung tissue in the model of VILI.

OBJECTIVETo develop a life quality scale suitable for idiopathic pulmonary fibrosis (IPF) patients, objectively reflecting its changes.

METHODSAuthors first put forward a theoretical structure model of a scale according to patient-reported outcome (PRO) scale formulation principle by combining basic theories of Chinese medicine (CM). Then authors developed an initial scale on the basis of various life quality scales for respiratory disease patients by using structural decision making. Totally 34 patients with confirmed diagnosis of IPF were tested by questionnaire. Items were screened using expert importance scoring method, factor analysis, correlation coefficient method, Cronbach's alpha coefficient method. IPF patient reported outcomes (IPF PRO, IP) were finally defined.

RESULTSA new IP scale was developed covering three areas and 38 items. Pearson correlation coefficient for correlation analysis of clinical symptom scores in ST-George Respiratory Questionnaire and IP scale was 0.828 (P < 0.01). Pearson correlation coefficient for correlation analysis of activity ability scores was 0.929 (P < 0.01). Pearson correlation coefficient for correlation analysis of total scores was 0.862 (P < 0.01). By reliability of IP scale itself (reliability) analysis, Cronbach's alpha coefficient was 0.713. By using factor analysis method for data analysis, KMO statistics was 0.902.

CONCLUSIONIP scale fully reflected the connotation of IPF patients' quality of life, so it could be used as CM clinical therapeutic effect evaluation tool.

ObjectiveTo determine whether the inhibition of caveolin-1 tyrosine residues 14 (Cav-1-Y14) phosphorylation with protein tyrosine kinase inhibitors (PP2) will upregulate heme oxygenase-1 (HO-1) activity to protect against ventilation induced lung injury in vivo of an animal model.Methods Fifty-four male Sprague-Dawley (SD) rats were randomly divided into nine groups (eachn = 6). Group A served as normal control group, in which rats did not receive ventilation but tracheotomy. Groups B1 and B2 received lung protective ventilation respectively for 1 hour or 2 hours. Groups C1 and C2 received high tidal volume (40 mL/kg) ventilation for 1 hour or 2 hours, respectively. The group D1 or D2 also received high tidal volume ventilation for 1 hour or 2 hour respectively, but they were given PP2 1 hour before high tidal volume ventilation. The groups E1 and E2 also received high tidal volume ventilation respectively for 1 hour or 2 hours, but tyrosine kinase inhibitor PP2 and HO-1 inhibitor zinc protoporphyrinⅨ(ZnPPⅨ) were given to animals 18 hours before high tidal volume ventilation. All the animals were sacrificed after ventilation, and the specimens of lung tissues and bronchoalveolar lavage fluid (BALF) were harvested. Then the changes in pathology of lung tissue was observed, and diffuse alveolar damage scores (DAD) were calculated, myeloperoxidase (MPO) activity was measured by colorimetric analysis, lung wet/dry ratio (W/D) was estimated. The expressions of phosphorylated caveolin-1 (P-Cav-1-Y14), caveolin-1 (Cav-1) and HO-1 were determined by Western Blot. The expressions of high mobility group B1 (HMGB1) and advanced glycation end product receptor (RAGE) in lung tissues were assayed with immunohistochemistry staining. The levels of tumor necrosis factor-α(TNF-α) in BALF were measured by enzyme linked immunosorbent assay (ELISA).Results There was no significant difference in all the parameters between group A and groups B. Compared with group B1, DAD score, W/D ratio, the activity of MPO and the concentration of TNF-α in BALF in group C1 were significantly increased [DAD score:7.97±0.59 vs. 0.55±0.13, W/D ratio: 5.70±1.61 vs. 5.04±0.63, MPO (U/g): 1.82±0.14 vs. 0.77±0.26, TNF-α(ng/L): 370.10±29.61 vs. 54.38±8.18, allP< 0.05], and the injury in ventilation 2 hours group was more serious than that in ventilation 1 hour group. Compared with groups C, all the parameters in groups D were significantly decreased. The parameters in groups E were significantly higher than those in groups A, B, and D, but no significant difference was found as compared with groups C. Compared with groups B, the protein expressions of Cav-1 and P-Cav-1-Y14 (gray value) in groups C were significantly increased (1 hour: 1.49±0.02 vs. 1.26±0.13, 1.34±0.02 vs. 0.87±0.04;2 hours: 1.58±0.02 vs. 1.27±0.27, 1.31±0.01 vs. 0.95±0.02, allP< 0.05), and the expression of HO-1 protein (gray value) was significantly decreased (1 hour: 0.59±0.02 vs. 1.10±0.01, 2 hours: 0.49±0.01 vs. 1.20±0.02, both P< 0.05). No significant difference in Cav-1 protein expression between groups D as well as groups E and groups C. The protein expression of P-Cav-1-Y14 in groups D and E was significantly lower than that in groups C. The protein expression of HO-1 in groups D was significantly higher than that in groups C, but the phenomenon was not found in groups E as compared with groups C. Compared with group A, the positive expression of HMGB1 and RAGE in lung tissue in groups C and E was significantly increased, but no significant difference was found between groups B as well as groups D and group A.Conclusion Cav-1-Y14 phosphorylation is the key factor for ventilator induced lung injury, which can not only lead to a decrease in vascular barrier function, but also inhibit the activity of HO-1 enzyme, thus further aggravates inflammatory injury of the lung as induced by mechanical ventilation.

Objective To compare the high risk factors, complications, treatment and prognosis of respiratory distress syndrome (NRDS) in neonates at different gestational age (GA). Methods Between August 2012 and July 2013, 156 neonates with RDS were selected and distributed into 3 groups, 42 early preterm (GA<34weeks), 52 late preterm (GA 35 to 36 weeks), and 62 in term group (GA≥37 weeks). Retrospectively analysis was performed for high risk factors, complications, treatment and prognosis of the three groups. Results In 156 neonates with RDS, the male and female proportion was 2.25:1. All groups had more males, but the gender difference has no statistical signiifcance in three groups (P=0.923). The onset time of RDS and the hospitalization time both show an increasing trend of statistical signiifcance (P<0.05). Comparing the difference of high risk factors for RDS of the 3 groups, birth asphyxia, placental abnormalities, multiple pregnancy, premature rupture of membranes was most common in early preterm group, and followed by late preterm group, and C-section was most common in term group and unexplained preterm was more common in early preterm group than that in late preterm group (all P<0.05). Among the three groups, the ratio of pulmonary surfactant application was the lowest in the term group, the ratio of X-ray grade over II was high-est in early preterm group, oxygen and hospitalization time were the longest in early preterm group (P<0.05). The risks of com-plicated with pulmonary infection, intracranial hemorrhages and bronchopulmonary dysplasia were the highest in early preterm group and the risk of complicated pneumothorax was the highest in term group. Among three groups, the recovery rate was the lowest in the early preterm group (P<0.01). Conclusion The clinical characteristics, high risk factors, complications and treat-ment responses of RDS in neonates with different GA were different, so GA should be considered for diagnose and treatment. For the term infants, the elective caesarean section should be strictly controlled, in order to reduce the incidence of RDS.