OBJECTIVETo explore the effect of Compound Tongtu Granule (CTG) on intestinal permeability in elderly sepsis patients.

METHODSEighty elderly sepsis patients were randomly assigned to the experimental group and the control group by randomized double blinded method, 40 in each group. On the basis of conventional antiseptic treatment program, patients in the experimental group took CTG, while those in the control group took placebos. The dosage for CTG or placebos was 14.3 g each package, one package each time, twice daily for 14 successive days. Patients' abdominal symptoms and signs, levels of serum inflammatory factors (high-sensitivity C-reactive protein and procalcitonin), levels of plasma endotoxin, and the intestinal permeability (IP, represented by urinary lactulose/mannitol excretion rate) were compared between the two groups before and after treatment.

RESULTSAfter 14-day treatment, patients in the experimental group had improved abdominal symptoms, increased frequency of defecation, significantly decreased levels of plasma endotoxin and IP, when compared with the control group (P < 0.05).

CONCLUSIONCTG could improve the intestinal barrier function in elderly sepsis patients.

Aged ; C-Reactive Protein ; metabolism ; Calcitonin ; metabolism ; Calcitonin Gene-Related Peptide ; Defecation ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Endotoxins ; metabolism ; Humans ; Intestines ; metabolism ; Permeability ; Protein Precursors ; metabolism ; Sepsis ; drug therapy ; physiopathology

OBJECTIVETo study the multi-row detector CT angiography (MDCTA) for preoperative evaluation of nourished vessels of flaps.

METHODSPreoperative MDCTA was performed to obtain the anatomic information about the nourished vessels of flaps, including ceassel course, localization, diameter and number of perforator artery. Then the flaps were designed according to the MDCTA results. The postoperative results were observed.

RESULTSFrom Aug 2006 to Aug 2007, 24 flaps (in 16 cases) were performed, including 10 flaps with deep inferior epigastric artery, 4 flaps with descending branch of the lateral circumflex femoral artery, and 10 flaps with thoracodorsal artery. The primary preoperative flap design was chaged according to the MDCTA results in 3 flaps. The distribution of the nourished vessels of flaps were exactly the same as the results of MDCTA. All the flaps were survived with satisfactory results.

CONCLUSIONSMDCTA is a convenient and reliable technique for preoperative detection of nourished vessels of flaps. The MDCTA results can provide right and direct anatomic information for preoperative flap design to make sure the safety and good results of surgery.

Adult ; Angiography ; methods ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Surgical Flaps ; blood supply ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; methods ; Young Adult

INTRODUCTIONHigh levels of toxicities have been observed when docetaxel is administered at the standard dose of 75 mg/mevery 3 weeks (Q3W) in the real-world treatment of Asian patients with metastatic castrate-resistant prostate cancer (CRPC). This study aimed to evaluate the efficacy and tolerability of 2 attenuated regimens more widely used in an Asian setting to minimise toxicity - 60 mg/mQ3W and weekly docetaxel (20 mg/mto 35 mg/m).

MATERIALS AND METHODSMedical records of 89 CRPC patients between December 2003 and April 2013 were reviewed. Pairwise statistical analysis was performed, comparing efficacy and safety outcomes of 75 mg/mQ3W and weekly docetaxel with 60 mg/mQ3W. Treatment endpoints used were prostate-specific antigen (PSA) response (decrease of ≥50% from baseline), pain improvement after cycle 2, overall survival, time to disease progression and radiological response.

RESULTSPatients who received docetaxel at 75 mg/mQ3W were younger than those who received 60 mg/mQ3W (62 years and 66 years, respectively;= 0.0489). Both groups had similar response rates. Compared with patients on 60 mg/mQ3W, more patients on weekly regimens were symptomatic at baseline (63.2% and 87.5%, respectively;= 0.0173). Longer overall survival was observed in the 60 mg/mQ3W arm than the weekly docetaxel arm (16.9 months and 10.6 months, respectively;= 0.0131), though other measures of response did not differ significantly.

CONCLUSIONOur data supports the use of 60 mg/mQ3W docetaxel which has similar efficacy and an acceptable toxicity profile compared to the standard 75 mg/mQ3W regimen. Weekly docetaxel has significant palliative benefits among symptomatic patients despite lower overall survival.

The aim of study was to explore the potential application of targeting at Toll-like receptors (TLRs) in the immunotherapy of acute myelocytic leukemia, and to investigate the expression of TLR and the effects of TLR 8 agonist ssRNA40/LyoVec on proliferation, apoptosis and cell cycle of U937 cells. The expression of TLR 1 - 9 in U937 cells was detected by using reverse transcription polymerase chain reaction (RT-PCR) and the expression of TLR 8 was assayed by flow cytometry (FCM). The effect of TLR 8 agonist, ssRNA40/LyoVec, at different concentrations on U937 cells proliferation was evaluated by CCK-8, apoptosis and cell cycle were detected by FCM. The results showed that U937 cells expressed TLR 1 - 9. TLR 8 agonist ssRNA40/LyoVec could inhibit the growth of U937 cells both in time-and dose-dependent manner and the inhibitory rate could reach 70%. It also increased the percentage of cells in G(0)/G(1) phase. There was no significant difference in percentage of apoptotic cells between control and treated groups. It is concluded that TLRs including TLR 1 - 9 express on U937 cells and TLR 8 agonist ssRNA40/LyoVec may be able to inhibit the growth of U937 cells, arrest the cells in G(0)/G(1) phase, but have no effect of promoting apoptosis.
Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Dose-Response Relationship, Drug ; Humans ; Leukemia, Myeloid, Acute ; metabolism ; pathology ; Reverse Transcriptase Polymerase Chain Reaction ; Toll-Like Receptor 8 ; agonists ; Toll-Like Receptors ; metabolism ; U937 Cells

Objective:To explore the phenomenon of spontaneous regression of optic pathway glioma in children, and to improve the understanding of optic pathway glioma.Methods:The clinical data of 3 patients with spontaneous regression of optic pathway glioma in Beijing Children's Hospital of Capital Medical University from September 2012 to June 2019 were retrospectively analyzed.Results:There were 2 girls and 1 boy among the 3 patients. The median age of onset was 4 months (3-5 months), the median age of tumor regression was 10 months (8-13 months), and the interval median time from onset to tumor regression was 5 months (4-10 months). One patient was accompanied with diencephalic syndrome, and the other was accompanied with disseminated metastasis.Conclusions:The phenomenon of spontaneous regression of optic pathway glioma mostly occurs in the early childhood. Optic pathway glioma pediatric patients complicated with diencephalic syndrome or intracranial metastasis may have the possibility of tumor regression, but spontaneous regression does not mean that the symptoms can be completely improved.

Wuhan is the city with the most serious outbreak of corona virus disease 2019 (COVID-19) in China. The outbreak of community has exhausted the current medical resources. With integrating local and support medical resources from other province, Wuhan City has rapidly rebuilt a new emergency medical system of classified treatment, and effectively responded to the overload medical demand after the outbreak in the community.

BACKGROUND: Progressive lipid loss of adipose tissue is a major feature of cancer-associated cachexia. In addition to systemic immune/inflammatory effects in response to tumor progression, tumor-secreted cachectic ligands also play essential roles in tumor-induced lipid loss. However, the mechanisms of tumor-adipose tissue interaction in lipid homeostasis are not fully understood. METHODS: The yki -gut tumors were induced in fruit flies. Lipid metabolic assays were performed to investigate the lipolysis level of different types of insulin-like growth factor binding protein-3 (IGFBP-3) treated cells. Immunoblotting was used to display phenotypes of tumor cells and adipocytes. Quantitative polymerase chain reaction (qPCR) analysis was carried out to examine the gene expression levels such as Acc1 , Acly , and Fasn et al . RESULTS: In this study, it was revealed that tumor-derived IGFBP-3 was an important ligand directly causing lipid loss in matured adipocytes. IGFBP-3, which is highly expressed in cachectic tumor cells, antagonized insulin/IGF-like signaling (IIS) and impaired the balance between lipolysis and lipogenesis in 3T3-L1 adipocytes. Conditioned medium from cachectic tumor cells, such as Capan-1 and C26 cells, contained excessive IGFBP-3 that potently induced lipolysis in adipocytes. Notably, neutralization of IGFBP-3 by neutralizing antibody in the conditioned medium of cachectic tumor cells significantly alleviated the lipolytic effect and restored lipid storage in adipocytes. Furthermore, cachectic tumor cells were resistant to IGFBP-3 inhibition of IIS, ensuring their escape from IGFBP-3-associated growth suppression. Finally, cachectic tumor-derived ImpL2, the IGFBP-3 homolog, also impaired lipid homeostasis of host cells in an established cancer-cachexia model in Drosophila . Most importantly, IGFBP-3 was highly expressed in cancer tissues in pancreatic and colorectal cancer patients, especially higher in the sera of cachectic cancer patients than non-cachexia cancer patients. CONCLUSION Our study demonstrates that tumor-derived IGFBP-3 plays a critical role in cachexia-associated lipid loss and could be a biomarker for diagnosis of cachexia in cancer patients.
Humans ; Insulin-Like Growth Factor Binding Protein 3/metabolism* ; Culture Media, Conditioned/pharmacology* ; Cachexia/pathology* ; Gastrointestinal Neoplasms ; Somatomedins/metabolism* ; Insulins/metabolism* ; Lipids

Objective: To investigate the clinical presentation and genetic characteristics of malignant infantile osteopetrosis. Methods: This was a retrospective case study. Thirty-seven children with malignant infantile osteopetrosis admitted into Beijing Children's Hospital from January 2013 to September 2022 were enrolled in this study. According to the gene mutations, the patients were divided into the CLCN7 group and the TCIRG1 group. Clinical characteristics, laboratory tests, and prognosis were compared between two groups. Wilcoxon test or Fisher exact test were used in inter-group comparison. The survival rate was estimated with the Kaplan-Meier method and the Log-Rank test was used to compare the difference in survival between groups. Results: Among the 37 cases, there were 22 males and 15 females. The age of diagnosis was 0.5 (0.2, 1.0) year. There were 13 patients (35%) and 24 patients (65%) with mutations in CLCN7 and TCIRGI gene respectively. Patients in the CLCN7 group had an older age of diagnosis than those in the TCIRGI group (1.2 (0.4, 3.6) vs. 0.4 (0.2, 0.6) years, Z=-2.60, P=0.008). The levels of serum phosphorus (1.7 (1.3, 1.8) vs. 1.1 (0.8, 1.6) mmol/L, Z=-2.59, P=0.010), creatine kinase isoenzyme (CK-MB) (457 (143, 610) vs. 56 (37, 82) U/L, Z=-3.38, P=0.001) and the level of neutrophils (14.0 (9.9, 18.1) vs. 9.2 (6.7, 11.1) ×10⁹/L, Z=-2.07, P=0.039) at diagnosis were higher in the CLCN7 group than that in the TCIRG1 group. However, the level of D-dimer in the CLCN7 group was lower than that in the TCIRGI group (2.7 (1.0, 3.1) vs. 6.3 (2.5, 9.7) μg/L, Z=2.83, P=0.005). After hematopoietic stem cell transplantation, there was no significant difference in 5-year overall survival rate between the two groups (92.3%±7.4% vs. 83.3%±7.6%, χ²=0.56, P=0.456). Conclusions: TCIRGI gene mutations are more common in children with osteopetrosis. Children with TCIRGI gene mutations have younger age, lower levels of phosphorus, CK-MB, and neutrophils and higher level of D-dimer at the onset. After hematopoietic stem cell transplantation, patients with CLCN7 or TCIRGI gene mutations have similar prognosis.
Child ; Male ; Female ; Humans ; Osteopetrosis/therapy* ; Retrospective Studies ; Prognosis ; Genes, Recessive ; Phosphorus ; Chloride Channels/genetics* ; Vacuolar Proton-Translocating ATPases/genetics*