China ; epidemiology ; Data Collection ; standards ; Humans ; Occupational Diseases ; chemically induced ; epidemiology ; Occupational Exposure ; statistics & numerical data ; Occupational Health ; statistics & numerical data ; Occupational Medicine ; legislation & jurisprudence

Objective To summarize the recent progress in pathogenetic,diagnostic and therapeutic researches on the intestinal barrier dysfunction(IBD) of severe acute pancreatitis(SAP).Methods The advancement of IBD in SAP,which was published recently at home and abroad,was collected and reviewed.Results The pathogenesis of IBD in patients with SAP was complex.Ischemia-reperfusion injury,endotoxin,inflammatory mediators and gastrointestinal hormone played an important role in the process of IBD.There were many ways to detect IBD,and the ratio of lactulose and mannitol,plasma diamine oxidase were relatively ideal markers.Medical therapies,such as treatment of SAP and maintaining the perfusion of intestines,were essential to cure IBD.On this basis,the propulsives,nutritional support and traditional Chinese drugs should be administered reasonably.Conclusions IBD is a sophisticated process of pathophysiology.In recent years,abundant of animal experiments and clinical researches have provided new clue for prevention and cure of IBD,but further researches are still needed on the mechanism of the cells and molecules implicated.

We analyzed the anticancer effect and mechanism of the novel indoleamine 2,‍3-dioxygenase 1 (IDO1) inhibitor NLG-919 combined with temozolomide (TMZ) on human glioma cell lines. The anti-tumor activity of NLG-919 and temozolomide after single and combined treatments was detected by MTT assay. Colony formation assay, invasion assay and migration assays were used to detect the effects of NLG-919 and temozolomide alone or in combination on proliferation, invasion and migration of human glioma cells. A flow cytometry assay was used to detect cell apoptosis, cell cycle arrest, reactive oxygen species (ROS) production and mitochondrial membrane potential damage (JC-1). An immunofluorescence assay was used to detect the expression level of IDO1 and HPLC was used to detect the expression level of L-kynurenine (Kyn) to explore the anti-tumor mechanism of NLG-919 and temozolomide. The results show that NLG-919 had a weak in vitro inhibitory effect compared to that of temozolomide. The IC₅₀ of NLG-919 on U251 cells and U87 after 72 h was 26.9 and 30.7 μmol·L^-1, respectively. However, when NLG-919 was used in combination with temozolomide, its anti-glioma activity was significantly increased. Compared with the single treatment, the combination treatment had a potent ability to inhibit proliferation, invasion and migration of glioma cells. Combination treatment improved the capacity of temozolomide to induce cell cycle arrest and inhibit the growth of glioma cells. NLG-919 significantly down-regulated the expression and activity of IDO1 in glioma cells, and the inhibitory effect was improved after combination with temozolomide, and effectively blocked the production of Kyn through the metabolism of L-tryptophan (Trp). In conclusion, the IDO1 inhibitor NLG-919 and temozolomide showed synergistic effects in the anticancer therapy of human glioma cell lines.

Objective To discuss the set-up isocenter error based on kilovolt cone beam computed tomography (KVCBCT) and to investigate dose deviation led to set-up isocenter error. Methods 21 cases of nasopharyngeal carcinoma ( NPC ) treated with image guided intensity modulated radiotherapy (IG-IMRT)were investigated. The online KVCBCT scan, rigid image registration, set-up error was gained for 376 sets before radiotherapy. We sampled ten and fifteen setup isocenter error in the 376 sets randomly. Without changing beam angle,fields size and leaf sequences and dose weight et al. , we only replaced new isocenter and accumulated the new plan for ten or fifteen plans. We compared the percentage deviation between ten,fifteen times accumulated plans and normal ten , fifteen times plans. Results All 376 sets of KVCBCT image were analyzed for 21 cases. Under the condition of non-correction, the setup isocenter errors are 0. 75mm ± 1.13 mm, 0. 92 mm ±2. 15 mm,0. 82 mm ± 1.24 mm in left-right, superior-inferior and anteriorposterior directions respectively. So, we developed the margins which were 4 mm,6 mm、4 mm in three directions respectively from clinical tumor volume to planning tumor volume (PTV) calculated by two parameters model. In the fifteen accumulated plan, the deviation in the dose of 95% PTV (D95) was -7. 5% - - 11.9%, and the deviation in the D50 was -5. 1% - -8. 2%. Conclusions It is possible of small effects to normal organs and targets because of small error of patient displacement in one fraction.However, many small errors can led to considerable dose difference in targets and normal tissue in thirty fractions of all treatments period. So, according to two parameters model, PTV margin can be designed new planning and depended on IG-IMRT technique, which it will be significantly reduced these dose differences.

Objective To determine the planning target volume margins of head and neck cancers treated by image guided radiotherapy (IGRT).Methods 464 sets cone beam computed tomography (CBCT) images before setup correction and 126 sets CBCT images after correction were obtained from 51 head and neck cancer patients treated by IGRT in our department.The systematic and random errors were evaluated by either online or offline correction through registering the CBCT images to the planning CT.The data was divided into 3 groups according to the online correction times.Results The isocenter shift were 0.37 mm±2.37 mm, -0.43 mm±2.30 mm and 0.47 mm±2.65 mm in right-left (RL), anterior-posterior (AP) and superior-inferior (SI) directions respectively before correction, and it reduced to 0.08 mm±0.68 mm, -0.03 mm±0.74 mm and 0.03 mm±0.80 mm when evaluated by 126 sets corrected CBCT images.The planning target volume (PTV) margin from clinical target volume (CTV) before correction were:6.41 mm,6.15 mm and 7.10 mm based on two parameter model, and it reduced to 1.78 mm,1.80 mm and 1.97 mm after correction.The PTV margins were 3.8 mm,3.8 mm,4.0 mm;4.0 mm,4.0 mm,5.0 mm and 5.4 mm,5.2 mm,6.1 mm in RL, AP and SI respectively when online-correction times were more than 15 times, 11-15 times,5-10 times.Conclusions CBCT-based on online correction reduce the PTV margin for head and neck cancers treated by IGRT and ensure more precise dose delivery and less normal tissue complications.

Objective There have been few research on the relationship between expression of HDAC4 and chemotherapy resistance in human lung adenocarcinoma.The present study aims to investigate the expression and clinical significance of HDAC4 in human lung adenocarcinoma tissues.Methods We selected 72 tissues in lung adenocarcinoma patients with docetaxel-resistant from January 2006 to December 2007 in Department of Oncology and Thoracic Surgery, Nanjing General Hospital of Nanjing Military Region, then evaluated the recent efficacy according to the RECIST criteria and divided the tissues into sensitive(n=32, included complete remission and partial remission) and insensitive(n=40, included stability and progress) groups.The expression of HDAC4 in tissues≥the HDAC4 optimal relative expression cut-off value(78.7) was high level HDAC4 group(n=35), otherwise it was low level HDAC4 group(n=37).QRT-PCR analysis was performed to detect the HDAC4 expression levels in sensitive group and insensitive group.Analyzed the progression free survival in high level HDAC4 group and low level HDAC4 group.Results The expression of HDAC4 was significantly higher in the insensitive group compared with the sensitive group [(1.42±0.30) vs (0.60±0.15), P<0.01].The median progression free survival was significantly shortened in the high level HDAC4 group compared with the low level HDAC4 group (10.2 months vs 5.8 months, P<0.05).ConclusionThe expression of HDAC4 increased in docetaxel-resistant lung adenocarcinoma patients, and it is expected to be a predictive indicator of the resistance of docetaxel.

Dental Bonding ; methods ; Dentin ; Dentin-Bonding Agents ; chemistry ; Electricity ; Humans

ObjectiveTo assess and compare the resting energy expenditure measured by indirect calorimetry (MREE) and calculated with Harris-Benedict formula adjusted with correction factors (CREE) in critically ill surgical patients receiving mechanical ventilation,and to evaluate the relationship between resting energy expenditure and the severity of diseases.MethodsFrom August 2008 to February 2010,21 patients fitting the inclusion criteria were selected into the present study.The data of the patients were collected to calculate acute physiology and chronic health evaluation Ⅱ score ( APACHE Ⅱ score) and multiple organ dysfunction score ( Marshall score).MREEs were measured using indirect calorimetry of a MedGraphics CCM/D System,and CREEs were calculated at the same time with the Harris-Benedict formula.ResultsWithin the week of nutrition support,the mean CREE of the 21 patients was significantly higher than the mean MREE [ ( 8305.09 ± 1392.76 ) kJ vs.(6544.84 ±2079.65) kJ,P =0.000].The differences between MREE and CREE were statistically significant on the 0 ( P =0.000),1 ( P =0.000 ),2 ( P =0.000 ),and 4 day ( P =0.003 ) of nutritional support.There was no correlation between MREE and CREE (r =0.064,P =0.408 ),nor between MREE and APACHE Ⅱ ( r=-0.045,P =0.563 ).There was a correlation between MREE and Marshall score (P =0.001 ),but the correlation coefficient was low ( r =0.263).ConclusionsThe Harris-Benedict prediction modified with correction factors for severity of diseases overestimates the resting energy expenditure of critically ill surgical patients.Indirect calorimetry is a more accurate method for determining resting enenrgy expenditure.

Dust ; prevention & control ; Humans ; Occupational Exposure ; prevention & control ; United States ; Workplace

Objective To investigate the relative factors of insulin resistance(IR)during elective abdominal surgery and the mechanism of IR induced by surgery.Methods Fourteen patients underging elective abdominal surgery were studied.Fasting blood glucose(FBG),fasting plasma insulin(FPI),plasma TNF-α,IL-6 and CRP were tested for elective surgery patients on the day before,during operation and on one day after surgery.Insulin resistance index(HOMA-IR)and the index of insulin secretion(HOMA-β)were ealculated with homeostasis model assessment(HOMA).Insulin receptor and GLUT4 mRNA expression in skeletal muscle were assessed before operation and at the end of operation by use of RT-PCR.Results Significant differences were found in fasting blood glucose (5.95±1.08)mmol/L vs(8.92±2.41)mmol/L,fasting plasma insulin(19.95±3.33)mU/L vs(25.44±5.36)mU/L,IL-6(33.98±5.01)ng/L vs(45.29±7.81)ng/L and plasma TNF-α(86.70±9.27)ng/L vs(114.46±15.33)ng/L during and after operation(P＜0.01).A significant elevation of HOMA-IR levels was found after operation compared with that before operation[(9.59±2.89)vs(4.111.86)](P＜0.001).However there wag no significant difference in HOMA-β among three points(groups)of time(P=0.103).The result of RT-PCR showed that the expression of GLUT4 in muscle of patients at the end of operation reduced significantly compared with preoperation(t=12.488,P＜0.001)but there was no significance in INSR mRNA expression(P=0.165).ISI showed negative correlation with opermive time(r=-0.736、P＜0.001),blooding during operating (r=-0.594、P=0.032)and post-operative TNF-α(r=-0.641、P=0.018).Conclusion Insulin resistance occurs in elective abdominal surgery patients.The defective site is at postreceptor.To shorten the operation time,control the intensity of surgery and reduce the bleeding is helpful for decreasing IR.