OBJECTIVETo observe the effects ot Guben Yiliu II (GY II) combined with arterial perfusion with chemotherapeutic agent on advanced pancreatic cancer (APC).

METHODSSixty-five APC patients were randomly assigned to the treated group (35 cases) given GY II and arterial perfusion with chemotherapeutic agent and the control group (30 cases) with chemotherapeutic agent alone.

RESULTSThe clinical beneficial rate was 54.2% in the treated group and 40.0% in the control group, with significant difference between them (P < 0.05), the overall effective rate being 17.1% and 13.3%, and the effective rate in relieving pain being 64.5% and 59.2% in the treated and the control group respectively, all showed insignificant difference between groups (P > 0.05). Furthermore, in the treated group after treatment, the blood hypercoagulation state ameliorated, cellular immunity elevated, the toxic and side- effects of chemical medicine relieved, and the quality of life improved.

CONCLUSIONGY II is effective in enhancing clinical effects and relieving toxic and side-effects of chemotherapy, and so, better efficacy could be obtained by therapy of GY II and arterial perfusion with chemotherapeutic agent for treatment of APC.

Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Infusions, Intra-Arterial ; Male ; Middle Aged ; Pancreatic Neoplasms ; drug therapy ; pathology ; Phytotherapy ; Treatment Outcome

BACKGROUNDControlling plasma glucose levels, blood pressure and lipid levels is proven to reduce the risk of vascular complications in patients with type 2 diabetes mellitus. This has prompted intensive multitherapy targeted at several macrovascular risk factors. Carotid intima-media thickness (cIMT) is a reliable measure of early atherosclerosis. We sought to determine whether a 6-month intensive mutiltherapy program resulted in better goal attainment than usual care and its effect on the development of cIMT among patients with newly diagnosed type 2 diabetes mellitus.

METHODSThe study randomly assigned 220 patients with newly diagnosed type 2 diabetes mellitus to intensive or traditional therapy groups. The clinical parameters, such as fasting plasma glucose, total cholesterol, triglyceride, blood pressure, body weight and insulin were assessed at the baseline and after the 6-month therapy. cIMT of the patients was also obtained.

RESULTSThe average levels of fasting plasma glucose, hemoglobin A1c, total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) in the intensive group were significantly lower than those in the control group at the end of 6-month treatment. By 6 months, a higher proportion of patients in the intensive therapy group than in the control group attained goals for fasting plasma glucose (FPG), TC, LDL-C and hemoglobin A1c. With intensive multherapy the level of carotid intima-media thickness in the intensive therapy group was lower than that in the control group ((0.88 +/- 0.26) mm vs (0.96 +/- 0.22) mm, P < 0.01).

CONCLUSIONSThe evidence from this clinical trial demonstrates that intensive glucose, lipid and blood pressure control in patients with newly diagnosed type 2 diabetes is associated with diabetic macrovascular benefits. Intensive multitherapy allows more patients to achieve aims of control and may reduce macrovascular complications and delay disease progression.

Arteriosclerosis ; prevention & control ; Carotid Arteries ; pathology ; Diabetes Complications ; prevention & control ; Diabetes Mellitus, Type 2 ; drug therapy ; Drug Therapy, Combination ; Humans ; Hypoglycemic Agents ; administration & dosage ; Middle Aged ; Prospective Studies ; Tunica Intima ; pathology

BACKGROUNDInsulin treatment plays a key role in management of diabetes mellitus. Clinical researches showed that extra improvements in restoration of insulin secretion of pancreatic beta cells were found in patients with newly diagnosed type 2 diabetes. The purpose of this study was to investigate the effects of early insulin treatment on insulin mRNA expression and morphological alterations of beta cells in a Sprague Dawley (SD) rat model of type 2 diabetes.

METHODSA rat model of type 2 diabetes mellitus (T2DM) was induced by a high fat diet (high energy, HE) and low doses of streptozotoxin (STZ, 40 mg/kg). A group of diabetic rats was then injected with protamine zinc insulin [PZI, 1 - 2 U x kg(-1) x d(-1)] for one week. Insulin mRNA expression, morphological features of pancreatic islets, and metabolic parameters were examined in rats using reverse transcriptase-polymerase chain reaction (RT-PCR), immunohistochemistry, and other techniques.

RESULTSIn insulin-treated diabetic rats, insulin mRNA levels prominently increased by 81.3% (P < 0.05), as compared with untreated diabetic rats. Moreover, timely insulin treatment noticeably improved the insulin content of beta cells, with an increase of 10.2% (P < 0.05), despite a slight reduction in fasting blood glucose (FBG), triglyceride (TG), and free fatty acid (FFA) levels, as compared to an untreated diabetic group.

CONCLUSIONInsulin treatment at the onset of T2DM effectively improves insulin synthesis, as confirmed by morphological changes to beta cells in a rat model of type 2 diabetes.

Adipose Tissue ; metabolism ; Animals ; Body Weight ; drug effects ; Diabetes Mellitus, Experimental ; drug therapy ; metabolism ; Diabetes Mellitus, Type 2 ; drug therapy ; metabolism ; Insulin ; administration & dosage ; analysis ; genetics ; Islets of Langerhans ; drug effects ; Male ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Streptozocin

Objective A resistin binding peptide (RBP) was selected by phage display in our previous work. Studies had shown that RBP could antagonize the role of resistin on the lipid metabolism and endocrine function of adipose tissue, but whether RBP affects the insulin secretion of pancreatic cells is still unknown. The aim of this study is to assess the effect of RBP on basal insulin secretion in RINm5F insulinoma cells. Methods The cell viability was measured by 3-[4,5-dimethyhhiazol-2-yl]-2,5-diphenyltetra-zolium bromide (MTT) cytotoxicity assay. The supernatants were assayed for insulin content by enzyme linked immunosorbent assay (ELISA). Reverse transcriptase-PCR assay and Western blotting were used to determine the expression of glucose transporter 2 (GLUT2) involved in insulin secretion. Cytosolic Ca2+, the trigger of insulin exocytosis, was analyzed with the fluorescent probe FURA-3/AM. Results RBP did no effect on the cell viability with a concentration of 10-8-10-12mol/L of 2 hours intervention. But it stimulated basal insulin secretion of RINm5F cells, accompanied by up-regulated increased expression of GLUT2 and elevated concentration of cytosolic Ca2+. Conclusion RBP could stimulate basal insulin secretion without affecting the cell viability.

Background: Health-care providers typically undergo shift work and are subjected to increased stress. Night shift work may induce disturbed sleep cycles and circadian rhythm. The objective of this study was to explore if night shift workers (NSWs) show an increased risk of abnormal thyroid-stimulating hormone (TSH). Methods: We conducted a retrospective cohort study of 574 employees without thyroid disease and abnormal TSH at baseline who underwent annual check-ups between 2007 and 2016 in a medical center. NSWs were defined as those with working time schedules other than daytime hours. We calculated the incidence rate and estimated the adjusted hazard ratio (HR) for incident abnormal TSH and subclinical hypothyroidism compared with non-NSWs using a Cox regression model. Results: A total of 56 incident abnormal TSH cases and 39 subclinical hypothyroidism cases in NSWs were identified during 3000 person-years of follow-up. In models adjusted for age, sex, obesity, and working departments, we found no increased relative risk for incident abnormal TSH (HR: 0.72, 95% confidence interval: 0.33–1.60) or subclinical hypothyroidism (HR: 0.52, 95% confidence interval: 0.19–1.45) when comparing NSWs to non-NSWs; nor were incidence rates significantly different among exclusively medical employees after excluding administrative staff. Conclusion In this hospital-based nine-year follow-up retrospective cohort study, NSWs were not associated with increased relative risk of incident abnormal TSH and subclinical hypothyroidism, in contrast to previous cross-sectional studies.

Background: Health-care providers typically undergo shift work and are subjected to increased stress. Night shift work may induce disturbed sleep cycles and circadian rhythm. The objective of this study was to explore if night shift workers (NSWs) show an increased risk of abnormal thyroid-stimulating hormone (TSH). Methods: We conducted a retrospective cohort study of 574 employees without thyroid disease and abnormal TSH at baseline who underwent annual check-ups between 2007 and 2016 in a medical center. NSWs were defined as those with working time schedules other than daytime hours. We calculated the incidence rate and estimated the adjusted hazard ratio (HR) for incident abnormal TSH and subclinical hypothyroidism compared with non-NSWs using a Cox regression model. Results: A total of 56 incident abnormal TSH cases and 39 subclinical hypothyroidism cases in NSWs were identified during 3000 person-years of follow-up. In models adjusted for age, sex, obesity, and working departments, we found no increased relative risk for incident abnormal TSH (HR: 0.72, 95% confidence interval: 0.33–1.60) or subclinical hypothyroidism (HR: 0.52, 95% confidence interval: 0.19–1.45) when comparing NSWs to non-NSWs; nor were incidence rates significantly different among exclusively medical employees after excluding administrative staff. Conclusion In this hospital-based nine-year follow-up retrospective cohort study, NSWs were not associated with increased relative risk of incident abnormal TSH and subclinical hypothyroidism, in contrast to previous cross-sectional studies.

OBJECTIVETo find out the epidemiology of bacteria infection after orthotopic liver transplantation (OLT).

METHODPostoperative bacteria infection of 451 OLT cases were retrospectively analyzed.

RESULTBacteria infection were detected in 239 OLT cases, and the infection rate was 52.9%. Sum up to 304 bacilli lines were separated from all above cases. Among them, the detectable Gram-positive bacilli (G(+)) accounted for 59.9% (182/304), while Gram-negative bacilli (G(-)) accounted for 40.2% (122/304). The impressionable organ were respiratory tract and bile duct, which occupying 81.5% (248/304) and 15.1% (46/304) among all infective cases respectively. The main infected strain were G(+) bacteria in respiratory tract, account for 65.3%; while G(-) bacteria were mainly in bile duct, account for 60.9%. There was significant difference between each other (P = 0.018).

CONCLUSIONSThe bacteria infection rate was high after OLT, and the main infected strain was the G(+) bacteria. Most fo them were the opportunistic pathogenic bacteria and the antibiotic multi-resistant bacteria. The bacteria category was significantly related to the infected tissue, according to which we could adopt corresponding antibacterial approach.

Adolescent ; Adult ; Aged ; Bacterial Infections ; etiology ; microbiology ; Bile Duct Diseases ; etiology ; microbiology ; Child ; Child, Preschool ; Female ; Gram-Negative Bacteria ; isolation & purification ; Gram-Positive Bacteria ; isolation & purification ; Humans ; Infant ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Postoperative Complications ; Respiratory Tract Infections ; etiology ; microbiology ; Retrospective Studies

OBJECTIVETo study the clinical features, underlying mechanism and management of major neurological complications following liver transplantation.

METHODSThe data of 467 patients undergoing liver transplantation from Oct. 2003 to Sep. 2005 were retrospectively reviewed.

RESULTSNeurological complications occurred in 91 (19.49%) cases. The most common neurological complications were encephalopathy (72 cases), followed by stroke (12 cases), seizure (4 cases), central pontine myelinolysis (3 cases), and central nervous system infections (2 cases). Five encephalopathy cases were treated with continuous renal replacement and 5 intracranial hemorrhage cases with neurosurgical intervention. The mortality related to neurological complications was 10.98% (12/91).

CONCLUSIONSNeurological complications are common and potentially fatal following liver transplantation involving several factors. CsA and FK506 may play an important role in the onset of neurological complications, and stroke, especially intracranial hemorrhage, has a high mortality. Combined therapies and timely modulation of the immunosuppressive regimens may improve the patient's outcome.

Adult ; Aged ; Female ; Humans ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Nervous System Diseases ; etiology ; therapy ; Postoperative Complications ; etiology ; therapy ; Retrospective Studies ; Risk Factors

OBJECTIVETo evaluate the impact of preoperative three-dimensional visualization and virtual liver surgery planning on hepatic resection.

METHODSAll relevant structures (livers, portal vein, hepatic veins, and tumors) were extracted from multislice CT scans of 142 cases treated from May 2007 to May 2009. By the liver surgery planning system software Liv 1.0, reconstruction and image analysis of the relevant structures was performed and virtual resections of liver were carried out. Data were correlated to intraoperative findings.

RESULTS(1) Three-dimensional visualization revealed the spatial relationship of tumors to the intrahepatic vascular system, thus giving impressions how the neoplasms were situated. Virtual tumor resections corresponded to the intraoperative findings. (2) With the planning, an intended resection could be performed virtually and optimal identification of resection margins could be achieved. The ischemia and congestion territory within the remaining liver parenchyma could be calculated. Simulation resections could avoid liver parenchyma over resection and maintain a sufficient amount of liver tissue to sustain hepatic function. Virtual simulations of tumor resection were used successfully to plan of surgical procedures in the hepatic tumors. Hepatectomy was performed in 29 cases after virtual tumor resections but seemed impossible with conventional CT scan. Resection plans of 92 cases were optimized after virtual resections. (3) The mean liver volume of patients with primary hepatocellular carcinoma measured by the software and the real resected was (477 +/- 223) ml and (451 +/- 209) ml respectively. Comparison by means of linear regression analysis between volume measurement on the software and the real resected showed a nearly ideal correlation coefficient (R = 0.922, P < 0.01). The mean error was 6.1%.

CONCLUSIONSThe three-dimensional tumor visualization and virtual simulation of tumor resections of the software Liv 1.0 provide an important reference for a valuable planning of complex hepatic resections. It is not only benefit to improve the predictability and security of hepatectomy but also helpful to improve the success rate of complex hepatic resections.

Adult ; Aged ; Computer Simulation ; Female ; Hepatectomy ; methods ; Humans ; Imaging, Three-Dimensional ; Liver ; diagnostic imaging ; surgery ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed ; User-Computer Interface ; Young Adult

OBJECTIVETo explore the treatment and appropriate management of invasive aspergillosis infection following orthotopic liver transplantation.

METHODSThe clinical data of 576 cases who underwent orthotopic liver transplantation consecutively between January 2000 and January 2005 were analyzed retrospectively.

RESULTSThe prevalence of invasive aspergillosis infection was 1.74 (9/576), included 8 cases with pulmonary aspergillosis and 1 case with cerebral aspergillosis. The interval between transplantation and diagnosis were from 10 days to 2 months. Persistent or discontinuous low fever maybe the main clinical presentation after operation. Liposomal amphotericin B (AmBisome) is the mainly treatment for invasive aspergillosis infections, 5 patients were cured and 2 patients developed multi-organ aspergillosis infection died.

CONCLUSIONSThe clinical features of invasive aspergillosis infection following orthotopic liver transplantation were un-typical presentations in the early stage and easy to disseminate. Appropriate modification of immunosuppression therapy and early, high dose and long-term application of antifungal treatment is effective and safe to cure the disease.

Adult ; Aged ; Amphotericin B ; therapeutic use ; Antifungal Agents ; therapeutic use ; Aspergillosis ; diagnosis ; drug therapy ; etiology ; Female ; Humans ; Liver Transplantation ; adverse effects ; Lung Diseases, Fungal ; diagnosis ; drug therapy ; etiology ; Male ; Middle Aged ; Neuroaspergillosis ; diagnosis ; drug therapy ; etiology ; Postoperative Complications ; Retrospective Studies