Ammonia ; blood ; Humans ; Liver Failure ; blood ; pathology ; therapy ; Liver, Artificial ; Urea ; blood

OBJECTIVETo analyze the distribution and significance of occludin mRNA expression in human gastric cancer, as well as its relationship with gastric cancer pathology and multidrug resistance (MDR) in vivo.

METHODSIn situ hybridization (ISH) technique was used to evaluate the expression of occludin mRNA in 42 gastric carcinoma specimens obtained by surgery and 23 relatively normal gastric mucosa obtained by gastric endoscopy. All specimens had been stored in cryostatic section.

RESULTSOccludin mRNA was found positive in the cytoplasm of gastric glandulous epithelia as blue particles with intensive stain in 14 of 42 gastric carcinomas (33.3%), 23 of 42 paracancerous gastric tissues (54.8%), 14 of 23 relatively normal gastric tissues (60.9%), 9 of 16 well differentiated carcinomas (56.3%), 4 of 14 moderately differentiated carcinomas (28.6%), 1 of 10 poorly differentiated carcinomas (10.0%) and none of 2 mucosal carcinomas. There were significant differences in occludin mRNA positive rate between relatively normal gastric tissue and gastric cancer as well as between paracancerous gastric tissue and gastric cancer. The expression of occludin mRNA in moderately and poorly differentiated groups was gradually reduced when compared with well differentiated group, which suggests that there be a significant correlation between tumor differentiation and the expression of occludin mRNA. Furthermore, the positive signals of occludin mRNA distributed extensively in the cytoplasm of SGC7901/VCR cell, being vincristine resistant, derived from parental gastric cell line SGC7901. The positive signals of SGC7901/VCR were stronger than those of SGC7901 cells.

CONCLUSIONOccludin mRNA, being mainly located in epithelial cells and its expression correlated with tumor differentiation, may be involved in the development of multi-drug resistance in gastric cancer.

Drug Resistance, Multiple ; physiology ; Drug Resistance, Neoplasm ; physiology ; Humans ; In Situ Hybridization ; Membrane Proteins ; genetics ; metabolism ; Occludin ; RNA, Messenger ; metabolism ; Stomach Neoplasms ; metabolism ; Tight Junctions ; metabolism

OBJECTIVETo summarize the experience of a single treatment using molecular adsorbent recirculating system (MARS) in patients with acute-on-chronic liver failure.

METHODSTwenty-five eases treated by MARS-artificial liver were followed up and reviewed.

RESULTSThe levels of serum total bilirubin, non-conjugated bilirubin and blood ammonia were significantly decreased from (618.51 200.68) mmol/L to (390.81 146.02) mmol/L (t=2.729, P<0.01), (490.03 163.39) mmol/L to (303.28 113.06) mmol/L (t =2.516, P<0.01), and (152.44 82.62)mmol/L to (84.80 13.30)mmol/L (t=2.174, P<0.05), respectively. Prothrombin activity was significantly increased from 70.55% 32.39% to 93.63% 14.20% (t=1.728, P<0.05) in patients during a single 6 h treatment with MARS. No difference was presented in the markers of liver zymogram, serum protein, kidney function, electrolyte, blood routine and blood gas analysis before and after the MARS. Thirteen of 17 patients have been cured or improved, 4 died, and the survival rate was 76.5%.

CONCLUSIONSMARS is a safe and an effective treatment for patients with liver failure.

Adult ; Aged ; Ammonia ; blood ; Bilirubin ; blood ; Chronic Disease ; Female ; Follow-Up Studies ; Humans ; Kidney Function Tests ; Liver Failure, Acute ; blood ; therapy ; Liver Function Tests ; Liver, Artificial ; adverse effects ; Male ; Middle Aged

Objective:To retrieve, evaluate, and integrate the best evidence for early ambulation in patients undergoing open lumbar surgery.Methods:A systematic search was conducted in databases including UpToDate, British Medical Journal (BMJ) Best Practice, Guidelines International Network (GIN), The National Institute for Health and Care Excellence (NICE), The Agency for Healthcare Research and Quality (AHRQ), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses' Association of Ontario (RNAO), Medlive, North American Spine Society (NASS), Best Practice in General Surgery Group from the University of Toronto, ERAS? Society, PubMed, Embase, Web of Science, Medline, CNKI, and Wanfang. The search included literature on early ambulation post-open lumbar surgery, such as guidelines, expert consensus, evidence summaries, recommended practices, systematic reviews, and high-quality original research. The search period was from January 1, 2014, to June 20, 2023. Two researchers independently evaluated the quality of the literature and extracted relevant data.Results:A total of 23 articles were included, comprising three guidelines, two systematic reviews, six expert consensus statements, seven randomized controlled trials, one quasi-experimental study, and four cohort studies. The evidence was categorized into six themes: multidisciplinary team collaboration, health education, facilitation measures, pre-activity assessment, activity content, and safety assurance, resulting in 25 evidence-based recommendations.Conclusions:This study summarizes 25 best evidence-based recommendations for early ambulation in patients undergoing open lumbar surgery. Healthcare providers are advised to apply these recommendations in clinical practice while considering the specific clinical context and individual patient differences. Multidisciplinary collaboration is essential to develop personalized early ambulation plans.