About 2/3 patients with chest tumor requires radiation therapy .Normal lung tissues inevitably receive a certain amount of radiation during the treatment ,which results in the most frequent complication in tho-racic tumor radiotherapy:radiation-induced lung injury(radiation-induced lung injury,RILI).Usually,radio-logical changes are more common than clinical manifestations .RILI has become the bottleneck in radiotherapy which restricts the improvement of efficacy .At present ,there is no accurate and reliable method to predict the oc-currence of RILI .Once RILI occurs ,the condition is irreversible and treatment in recent decades has been stag-nant.In the present review ,we summarized the RILI predictors and RILI treatment methods .

Bone marrow (BM) and umbilical cord (UC) are the major sources of mesenchymal stem cells for therapeutics. This study was aimed to compare the basic biologic characteristics of bone marrow-derived and umbilical cord derived-mesenchymal stem cells (BM-MSC and UC-MSC) and their immunosuppressive capability in vitro. The BM-MSC and UC-MSC were cultured and amplified under same culture condition. The growth kinetics, phenotypic characteristics and immunosuppressive effects of UC-MSC were compared with those of BM-MSC.Gene chip was used to compare the genes differentially expressed between UC-MSC and BM-MSC. The results showed that UC-MSC shared most of the characteristics of BM-MSC, including morphology and immunophenotype. UC-MSC could be ready expanded for 30 passages without visible changes. However, BM-MSC grew slowly, and the mean doubling time increased notably after passage 6. Both UC-MSC and BM-MSC could inhibit phytohemagglutinin-stimulated peripheral blood mononuclear cell proliferation, in which BM-MSC mediated more inhibitory effect. Compared with UC-MSC, BM-MSC expressed more genes associated with immune response. Meanwhile, the categories of up-regulated genes in UC-MSC were concentrated in organ development and growth. It is concluded that the higher proliferation capacity, low human leukocyte antigen-ABC expression and immunosuppression make UC-MSC an excellent alternative to BM-MSC for cell therapy. The differences between BM-MSC and UC-MSC gene expressions can be explained by their ontogeny and different microenvironment in origin tissue. These differences can affect their efficacy in different therapeutic applications.
Adult ; Bone Marrow Cells ; cytology ; Cell Differentiation ; Cell Separation ; Cells, Cultured ; Humans ; Mesenchymal Stromal Cells ; cytology ; Middle Aged ; Umbilical Cord ; cytology ; Young Adult

OBJECTIVETo investigate the correlation between uncoupling protein 2 (UCP2) expression and myocardial mitochondria injury in rats with sepsis induced by lipopolysaccharide (LPS).

METHODSThe rat model of sepsis was established through an intraperitoneal injection of LPS. Forty male Sprague-Dawley rats were randomly and equally divided into control group (an intraperitoneal injection of normal saline), sepsis 6 h group (LPS-6 h group), sepsis 12 h group (LPS-12 h group), sepsis 24 h group (LPS-24 h group), and sepsis 48 h group (LPS-48 h group). The serum and heart tissues were harvested at corresponding time points and myocardial mitochondria was extracted. The microplate reader was applied to measure creatine kinase (CK), creatine kinase-MB (CK-MB), and reactive oxygen species (ROS). Flow cytometry was applied to measure the degree of mitochondrial swelling and mitochondrial membrane potential (MMP). Western blot was used to measure the expression level of UCP2. Electron microscopy was applied to observe the morphological changes in heart tissues and myocardial mitochondria.

RESULTSCompared with the control group, the LPS groups had significantly increased serum levels of CK, CK-MB, and myocardial ROS, as well as a significantly increased degree of mitochondrial swelling (P<0.05), and these values reached their peaks at 24 hours after LPS injection. The LPS groups had a significant decrease in MMP (P<0.05), which reached the lowest level at 24 hours after LPS injection. Western blot showed that the LPS groups had a significant increase in the expression level of myocardial UCP2 compared with the control group (P<0.05), which reached its peak at 24 hours after LPS injection. The results of electron microscopy showed mitochondrial swelling, partial rupture of the mitochondrial membrane, and cavity formation in rats in the LPS groups. The most severe lesions occurred in the LPS-24 h group. In rats with LPS, the ROS level in the myocardial mitochondria and the degree of mitochondrial swelling were positively correlated with the expression level of UCP2 (r=0.796 and 0.893, respectively; P<0.05), while MMP was negatively correlated with the expression level of UCP2 (r=-0.903, P<0.05).

CONCLUSIONSIn the rat model of sepsis, the myocardium and myocardial mitochondria have obvious injuries, and the expression level of UCP2 is closely correlated with mitochondrial injury. Therefore, UCP2 might play an important role in myocardial mitochondrial injury in sepsis.

Animals ; Cardiomyopathies ; genetics ; metabolism ; Disease Models, Animal ; Humans ; Ion Channels ; genetics ; metabolism ; Lipopolysaccharides ; adverse effects ; Male ; Mitochondria, Heart ; metabolism ; Mitochondrial Proteins ; genetics ; metabolism ; Myocardium ; metabolism ; Rats ; Rats, Sprague-Dawley ; Sepsis ; genetics ; metabolism ; Uncoupling Protein 2

OBJECTIVETo explore the diagnostic value of MRI in the transient dislocation of the patella.

METHODSThe DR and MRI data of 35 patients with acute patellar transient dislocation from January 2015 to December 2017 were retrospectively analyzed, including 12 males and 23 females, ranging in age from 10 to 23 years old, with an average of 17 years old. The differences between DR and MRI diagnosis and surgical or discharge diagnosis were compared, and the difference between them in diagnosis of knee anatomical position, bone injury, signs and soft tissue injury were compared. The R statistical software WiLcoxon signed rank test (WiLcoxon signed rank test) was used for statistical analysis.

RESULTSAll 35 MRI findings were completely consistent with postoperative or discharge diagnosis. According to MRI, 7 cases of high patella and 7 cases of patella subluxation were diagnosed. According to DR, 7 cases of high patella and 0 cases of patella subluxation were diagnosed. Fourteen dislocations were diagnosed by MRI and 7 dislocations were diagnosed by DR. There was statistically significant difference between the two methods in the diagnosis of abnormal position of patella(=10, <0.05). Total 112 cases of bone injuries were diagnosed by MRI, and 0 was diagnosed by DR. There was statistically significant difference between the two methods in the diagnosis of bone injuries(=16, <0.05). Total 43 cases of soft tissue injuries were diagnosed by MRI, and 0 was diagnosed by DR. There was statistically significant difference between the two methods in the diagnosis of soft tissue injuries (=21, <0.05). Total 35 cases of hydrops of the knee joint were diagnosed by MRI, and 30 were diagnosed by DR. There was statistically significant difference between the two methods in the diagnosis of hydrops of the knee joint(=32, >0.05).

CONCLUSIONSMRI is superior to DR in the diagnosis of acute temporal bone dislocation. MRI should be used as the first choice for imaging diagnosis of acute temporal bone dislocation. It can avoid missed diagnosis and misdiagnosis.

Cannula ; Catheters ; Drainage ; Duodenal Diseases ; Humans ; Intestinal Fistula/surgery*

OBJECTIVETo evaluate the feasibility of endoscopic gastrostomy combined with magnetic compression techniques in dogs.

METHODSThe magnetic compression device consisted of a couple of cylindrical magnets with a hole in the center. A 14-French gastric tube was inserted through the hole and fixed on the parent magnets. Four male mongrel dogs were selected randomly for the operation. The daughter magnet was placed into the dog's gastric body by a Zebra Guidewire under endoscopy, then a skin incision was performed on the left upper abdomen, through which the subcutaneous tissues and muscle were isolated up to the peritoneum. The parent magnet was placed on the surface of the peritoneum, which attracted the daughter magnet inside the gastric cavity automatically to compress the gastric wall and peritoneum. A needle was inserted through the gastric tube and punctured the tissue in the hole of the magnets repeatedly to form a fistula. After removing the needle, the gastrostomy was complete. The fistula was observed and its specimen was taken two weeks later under laparotomy.

RESULTSAll the four operations were successfully performed, and the operation time was 11-15 minutes. The stoma was matured immediately, through which early enteral nutrition support was administered. The gastric wall and peritoneum were observed with well healing and no adhesion in the abdominal cavity under laparotomy two weeks after the operation.

CONCLUSIONThe gastrostomy performed by magnetic compression technique combined with endoscopy is convenient, minimally invasive and safe, which may be used in future clinical practice.

Abdomen ; Animals ; Catheterization ; Dogs ; Enteral Nutrition ; Gastroscopy ; Gastrostomy ; Laparotomy ; Magnetics ; Male ; Santonin ; analogs & derivatives ; Stomach ; Surgical Stomas ; Wound Healing

OBJECTIVETo preliminarily investigate the long-term structural and functional injuries of mitochondria in rat brain caused by sepsis.

METHODSWistar rats were randomly assigned into sepsis and control groups. A rat model of sepsis was prepared by an intraperitoneal injection of 10 mg/kg lipopolysaccharide (LPS) of gram-negative bacteria, and the survival assay was performed. Eight rats in the sepsis group were sacrificed at 12, 24, 48, or 72 hours after LPS injection, while rats in the control group were sacrificed after an intraperitoneal injection of an equal volume of normal saline. Mitochondria were extracted from rat brain tissue. Mitochondrial membrane potential (MMP) and mitochondrial swelling level were determined by flow cytometry, and the activities of electron transport chain complexes (I-V) were measured using enzyme assay kits. Hematoxylin-eosin (HE) staining and electron microscopy were used to observe morphological changes in brain tissue and mitochondria.

RESULTSThe sepsis group had a significantly lower survival rate than the control group (P<0.01). The MMP and activities of electron transport chain complexes (I-V) in the sepsis group, which were significantly lower than those in the control group (P<0.05), were reduced to the lowest levels at 48 hours and partially recovered at 72 hours. The mitochondrial swelling level in the sepsis group, which was significantly higher than that in the control group (P<0.05), increased to the peak level at 48 hours and partially recovered at 72 hours. Hematoxylin and Eosin staining revealed substantial damages in the structure of brain tissue, and electron microscopy showed mitochondrial swelling, and vacuolization in a few mitochondria.

CONCLUSIONSIn the rat model of LPS-induced sepsis, both structural and functional injuries are found in cerebral mitochondria, and achieve the peak levels probably at around 48 hours.

Animals ; Brain ; pathology ; physiopathology ; ultrastructure ; Lipopolysaccharides ; toxicity ; Male ; Membrane Potential, Mitochondrial ; Mitochondria ; physiology ; ultrastructure ; Rats ; Rats, Wistar ; Sepsis ; chemically induced ; mortality ; physiopathology

Objective To explore the efficacy and tolerance of adverse reactions of gene detection technique in guiding individualized targeted therapy for advanced metastatic renal cell carcinoma.Methods Retrospective analysis was performed on the clinical data of 62 patients with advanced metastatic renal cell carcinoma before and after receiving targeted drug treatment in our department from October 2015 to October 2017.Among the 62 patients,there were 36 males and 26 females,with an average age of (54 ± 13) years old.16 patients were treated with sunitinib,20 patients were treated with sorafenib and 26 patients were treated with pazopanib.A total of 28 patients (individualized group) were selected to receive targeted drug according to the results of gene detection,and 34 patients were treated with targeted drug empirically (empirical group).In individualized group,there were 17 males and 11 females with the average age of (51.3 ± 15.6) years old.20 patients accepted the operation.The distant metastasis included bone metastasis in 21 cases,lung metastasis in 7 cases,liver metastasis in 16 cases,epidermal metastasis in 4 cases and lymphatic metastasis in 14 cases.According to risk of MSKCC,the case number of low risk,moderate risk and high risk were 15,7,6,respectively.7 patients were treated with sunitinib,8 patients were treated with sorafenib and 13 patients were treated with pazopanib.In empirical group,there were 19 males and 15 females with the average age of (56.3 ± 10.1) years old.22 patients accepted the operation.The distant metastasis included bone metastasis in 20 cases,lung metastasis in 5 cases,liver metastasis in 13 cases,epidermal metastasis in 3 cases and lymphatic metastasis in 15 cases.According to risk of MSKCC,the case number of low risk,moderate risk and high risk were 20,g,6,respectively.9 patients were treated with sunitinib,12 patients were treated with sorafenib and 13 patients were treated with pazopanib.The baseline characteristics of the two groups of patients,including gender,age,whether operation was performed,site of metastasis,and risk of MSKCC,didn't show significant difference.Patients in both groups received the standard treatment regimen and the follow-up duration was 4-26 months to observe the efficacy,progression-free survival and tolerance to adverse reactions of the targeted therapy.Results After 12 months of treatment,15 patients in the individualized group was recorded objective remission.7 patients in the empirical group was recorded objective remission,as well.The tumor control efficacy of the individualized group was significantly better than that of the empirical group (46.4％ vs.20.6％,P =0.03).Meanwhile,the median progression-free survival time (15.2 months,3.7-24.2 months) in the individualized group was significantly longer than that in the empirical group (12.1 months,2.8-22.1 months) (P =0.009).Compared with the empirical group,the higher incidence of targeted treatment-related adverse reactions occurred in the individualized group,including thrombocytopenia (46.4％ vs.17.6％ P =0.014),leukopenia (46.4％ vs.17.6％ P =0.005),hypertension (71.4％ vs.44.1％,P =0.031) and hypothyroidism(60.7％ vs.29.4％,P=0.013).Conclusions Compared with the patients with empirical drugs,the application of gene detection technique to select individualized targeted drugs for the treatment of advanced metastatic renal cancer is obvious curatively effective,and to a certain extent extends the progression-free survival time of patients.

BACKGROUND/AIMS: This study was aimed to investigate the current clinical status of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in Korea based on a National Health Insurance (NHI) database between 2011 and 2014. METHODS: The claims data of ESD for EGC in Korean NHI were reviewed using material codes of Health Insurance Review and Assessment Service between November 2011 and December 2014. The current clinical status was analyzed in terms of treatment pattern, in-hospital length of stay (LOS), total medical costs, and en bloc resection rate according to the hospital type. RESULTS: A total of 23,828 cases of ESD for EGC were evaluated. ESD was performed in 67.4% of cases in tertiary care hospitals, 31.8% in general hospitals, and 0.8% in hospitals, respectively. The median LOS was 5 days, and total median medical costs was approximately 1,300 US dollars. En bloc resection rate was 99%; 8.5% of cases underwent additional treatment within 90 days ESD, and 5.5% in 91 to 365 days after ESD. The clinical status was not significantly different according to the year and hospital type. CONCLUSIONS A majority of ESD for EGC were performed in tertiary care hospitals in Korea. The clinical status showed excellent clinical outcomes and did not differ by the year and between the types of hospitals in Korea.