1.Non-surgical therapy for 412 patients with early lower extremity deep venous thrombosis
Kunmei GONG ; Le XIAO ; Kunhua WANG ; Yongxue ZHANG ; Yiming OUYANG ; Jian ZHANG ; Yaxin LONG ; Linhai LI
Chinese Journal of General Practitioners 2008;7(6):378-380
Objective This report was to discuss the efficacy and complications of non-surgical therapy for patients with early lower extremity deep vein thrombosis.Methods A total of 412 patients were treated with thrombolysis or anticoagulation in our department during January 2000 and December 2006.Their clinical data were retrospectively analyzed.Results All patients were followed up for 12 to 83 months (mean,41 months).After treatment,42 patients(10.2%)were completely recovered,331 patients (80.3%)experienced large improvement,32 patients(7.8%)had mild improvement and 7 patients (1.7%)were failed,resulting in total effective rate of 98.3%.In comparison with long clinical course group(>7 days),the recovery rate and improvement rate of short clinical course group(≤7 days)was significantly increased(11.0% vs 5.4%,χ2=4.17,P<0.05;8.7%vs 1.8%,χ2=4.96,P<0.05).Complications included bleeding(2.2%),pulmonary embolism(1.9%),cerebral accident(0.7%),post-thrombotic syndrome(84.0%)and recurrence(6.1%).Bleeding rate in patients≥60 years was significantly higher(4.3%vs 0.8%,χ2=6.82,P<0.01).Incidence of post-thrombotic syndrome was significantly increased in long clinical course group(98.2% vs 81.7%,χ2=3.67,P<0.05).Condusions Non-surgical therapy,including thrombolysis and anticoagulation,might be safe and effective for patients with early lower extremity deep vein thrombosis.Early identification and management would be helpful to improve outcomes and reduce post-thrombotic syndrome.
2.Revascularization of arteriosclerosis obliterans of the lower extremity
Kunmei GONG ; Le XIAO ; Kunhua WANG ; Yongxue ZHANG ; Yiming OUYANG ; Ping LING ; Yingguang HUANG ; Linhai LI ; Yaxin LONG ; Jian ZHANG ; Yu ZHU
Chinese Journal of General Surgery 2009;24(6):459-462
Objective To evaluate traditional surgical treatment, intraluminal strategy and hybrid operation on revascularization of atherosclerosis obliterans (ASO) of the lower extremity. Methods Clinical data of 197 ASO cases receiving revascularization from January, 1998 to December, 2008 were retrospectively analyzed. Seventy-seven cases underwent surgical treatment, 82 cases received intraluminal therapy, and 38 cases were treated by hybrid operation. The indications, clinical effect, complication and perioperational mortality of these three strategies were evaluated. Results 71% patients (164 cases) were followed up from 2 to 112 months. Surgical and intraluminal method had no statistical difference on long-term patency of aortic-iliac and femoral-popliteal artery (57% vs. 51%;48% vs. 42%). Hybrid procedure led to higher patency on multi-level lesion and concurrent thrombosis. The complications after surgery was higher than intraluminal on aortic- iliac and femoral-popliteal artery (31% vs. 12%;31% vs. 11%), and higher than intraluminal and hybrid on multi-level lesion (36% vs. 12% vs. 15%). The perioperative mortality of surgical group was 1.5% and 2.0% on aortic-iliac and multilevel lesion and 0% on other site;and that of intraluminal and hybrid procedure was 0%. Conclusion For aortic-iliac and femoral-popliteal artery revascularization, surgery was preferred in cases of long occlusive lesion and intervention was preferred for cases with short non-occlusive lesion. Hybrid procedure was the best for multi-level and concurrent thrombosis.
3.Antiepileptic and neuroprotective mechanism of ursolic acid based on full-length transcriptome analysis
Juanjuan LI ; Yue HUANG ; Yahe WANG ; Lianxiang ZHANG ; Yuanyuan QIANG ; Le GUO ; Kunmei LIU
Journal of China Pharmaceutical University 2024;55(4):512-521
Abstract: This study explores the potential antiepileptic mechanism of ursolic acid (UA) and its improvement of GABAergic interneuron damage induced by epilepsy based on transcriptome analysis. Hippocampal tissues from rats in the control group (NC group), epilepsy group (SE group), and epilepsy UA treatment group (UA group) were subjected to full-length transcriptome sequencing. The obtained sequencing data were analyzed, using gene ontology (GO), the Kyoto Encyclopedia of Genes and Genomes (KEGG), and protein-protein interaction (PPI) to perform the analysis of differential genes (DEGs). The expression levels of key differential genes were verified using RT-qPCR in hippocampal tissue. Finally, an epilepsy in vitro model was constructed on primary neurons, RT-qPCR was used to verify the expression levels of key differential genes, and the expression level of GABAA receptor γ2 subunit (GABRG2) on neurons was further examined using immunofluorescence and Western blot. The heatmap of pairwise sample expression correlation and the clustering analysis of differentially expressed genes showed that the SE group was farthest from the NC group, and that after UA treatment, the overall trend shifted towards the normal group. Compared with the SE group, a total of 220 differential genes were screened in the UA group, including 143 upregulated genes and 77 downregulated genes. GO enrichment analysis showed that it involved three processes in the primary classification: biological processes, cellular components, and molecular functions. KEGG pathway enrichment analysis showed that DEGs were involved in 36 biological pathways, including cAMP signaling pathway and calcium signaling pathway. PPI analysis showed that DEGs were closely related to GABA and inflammation. RT-qPCR results showed that UA treatment increased the expression levels of GABA receptor-related gene (Gng4), GABA synthesis-related gene (Camk2a,Vgf, and Npy) and inflammation-related gene (Timp1 and Spp1) in hippocampal tissue, and decreased the expression levels of GABA synthesis-related gene (Nptx2) and cAMP-related pathway gene (Gnas). It further confirmed that UA treatment increased the expression levels of Gng4 and Camk2a on neurons and decreased the expression level of Gnas. Immunofluorescence and Western blot results showed that, compared with the SE group, the expression level of GABRG2 on primary neurons increased after UA treatment. This study enriched the transcriptome data of UA's antiepileptic effect and laid a theoretical foundation for further research on UA's antiepileptic and neuroprotective effects.
4.Analysis of dose-related factors in small intestine exposure to preoperative radiotherapy for rectal cancer
Hui LIU ; Kunmei LI ; Jindi LIU ; Xuanguang CHEN ; Huilang HE
Chinese Journal of Radiation Oncology 2024;33(4):326-332
Objective:To analyze the related factors affecting the dose to the small intestine exposure to preoperative radiotherapy for rectal cancer, aiming to provide reference for alleviating the adverse reactions of radiotherapy for rectal cancer.Methods:Medical record data and radiotherapy plan information of 138 rectal cancer patients who received intensity-modulated arc radiotherapy at Sun Yat-sen University Cancer Center from May 2021 to February 2023 were retrospectively analyzed. Tumor staging, tumor location, gender, age, planned bladder volume, body mass index (BMI), and small intestine irradiation dose volume were subject to Spearman correlation analysis. Further grouping and comparison were conducted based on the correlation results. Independent sample non parametric tests were used for inter group comparison.Results:The main factors related to the small intestine irradiation dose volume were tumor location, gender, planned bladder volume, and BMI. Tumor location was weakly correlated with the small intestine V 5 Gy-V 45 Gy. Gender was weakly correlated with the small intestine V 30 Gy-V 45 Gy. Planned bladder volume was weakly negatively correlated with the small intestine V 20 Gy-V 45 Gy. BMI was weakly negatively correlated with the small intestine V 10 Gy-V 45 Gy. Grouping comparison analysis showed that the small intestine V 5 Gy-V 45 Gy of rectal cancer patients in the low position group was significantly smaller than those in the middle and high position groups (both P<0.05), and there was no significant difference between the middle and high position groups ( P>0.05). Female rectal cancer patients had higher V 30 Gy-V 45 Gy levels than male counterparts ( P<0.05). The small intestine V 20 Gy and V 25 Gy levels in the planned bladder volume <200 ml group were significantly higher than those in the 200-400 ml and >400 ml groups (all P<0.05), whereas there was no difference between the 200-400 ml and >400 ml groups ( P>0.05). The small intestine V 30 Gy-V 45 Gy levels in the 200-400 ml group were significantly lower than those in the <200 ml group, but higher than those in the >400 ml group, and the differences were statistically significant (all P<0.05). Regarding BMI comparison among groups, the small intestine V 15 Gy-V 45 Gy in the low body weight group was significantly higher than those in the other three groups (all P<0.05). There were no significant differences among the normal, overweight, and obese groups (all P>0.05). Conclusion:In preoperative radiotherapy for rectal cancer, more attention should be paid to the dose to the small intestine in patients with middle and high position rectal cancer, female patients, and patients with low body weight.
5.Biofilm formation dominated by sophisticated social behaviors in Myxococcus xanthus.
Chuandong WANG ; Yan WANG ; Yue ZHENG ; Kunmei ZHANG ; Wei HU ; Wenyuan SHI ; Yuezhong LI
Chinese Journal of Biotechnology 2017;33(9):1582-1595
Myxococcus xanthus is a Gram-negative soil bacterium capable of performing sophisticated cellular behaviors and growing one of the most intricate bacterial single-species biofilms in nature. During the process of biofilm formation, social behaviors of M. xanthus cells dominate key steps of the biofilm establishment, e.g., cellular motility on solid surface, predatory behavior by the grouped cells, kin recognition in the community, fruiting body development, myxospore differentiation, and programmed cell death. This review introduces the recent research progress about the M. xanthus biofilms.