1.Clinical Study on Treatment of Iliac-Femoral Venous Thrombus Via Double Femoral Veins
Haozhou WANG ; Shanyan LIANG ; Shuhou WANG ; Wenbin ZHANG ; Junsheng KANG
Journal of Practical Radiology 2000;0(02):-
Objective To evaluate the efficiency of treatment of iliac-femoral venous thrombus(I-FVT)via double femoral veins.Methods Eighteen patients with I-FVT were treated with implantation of inferior vena caval filter,catheter-directed cut,balloon-directed extend and drag.Some patients were treated with ATD or OASIS catheter.After operation,the catheter was kept in iliac-femoral veins for one to six days.Meanwhile,strict anti-coagulation was necessary.Results The treatment was successful in seventeen patients,the iliac-femoral veins were patent after the opration.Swollen symptom of lower limb and pain disappeared in fifteen patients,swollen symptom of lower limb became better in two patients.The treatment was fail in one patient.Follow-up study showed no pulmonary embolization or recrudescence in all eighteen patients.Conclusion The treatment of I-FVT via double femoral veins is a safe and effective method,there are no serious complications.
2.Role of adapter protein p66Shc in injured mediating alveolar epithelial cells induced by hyperoxia
Lin GUO ; Wenbin DONG ; Zhongli CHE ; Qingping LI ; Lan KANG
Chinese Journal of Applied Clinical Pediatrics 2014;29(14):1083-1086
Objective To determine the expression of adapter protein p66Shc in mediating alveolar epithelial cells induced by hyperoxia and to explore their relationship.Methods A549 cells were cultured in vitro and divided randomly into a control group and a hyperoxia group.The hyperoxia group was exposed to a mixture of oxygen(O2,900 mL/L) and carbon dioxide(CO2,50 mL/L) for 10 min,then cultured in a closed environment.The changes in morphology were observed under inverted microscope after exposure to oxygen or air for 24 hours.The cell apoptosis was detected by flow cytometry (FC) after 24 hours.And the expression of p66Shc was detected by immunohistochemical method after 24 hours.The correlation of the changes in mitochondrial membrane potential and p66Shc protein expression was analyzed by using Bivariate correlation analysis.Results 1.Under inverted microscopy,A549 cells from the air group significantly increased,stuck to each other tightly and grew very quickly.Their adhesion was better,multy-angle oblate and many cells were in division phase.Compared with the control group,the changes in morphology of A549 were remarked and obvious than those in the hyperoxia group.The cells grew slowly,their counts decreased and the cell morphology changed from typical multi-angle oblate to round or ellipse.2.Compared with the control group,after 24 h,in hyperoxia group of A549 cells,red fluorescence decreased,and green fluorescence enhanced.3.Compared with the controls (0.057 664 88 ± 0.006 517 84),the expression of p66Shc (0.123 600 50 ± 0.004 227 23) was significantly increased in the hyperoxia group(t =-24.006,P < 0.001).4.The decline of membrane potential was negatively correlated with the increased expression of p66Shc protein (R =-0.988,P < 0.001).Conclusions The hyperoxia induction could significantly increase in injured mediating alveolar epithelial cells induced by hyperoxia,the expression of p66Shc increases,the membrane potential declined,and they exhibit a negative correlation.So p66Shc may be involved in the process of high oxygen damage to human alveolar epithelial cells.
3.Clinical characteristics of 15 glioma cases with leptomeninges and spinal cord metastases
Shan LI ; Jianxin CHEN ; Yan LI ; Zhuang KANG ; Xun KANG ; Hongmei ZHANG ; Wenbin LI
Chinese Journal of Clinical Oncology 2016;43(6):260-264
Objective:To retrospectively analyze and summarize the clinical characteristics of 15 glioma cases that led to leptomenin-ges and spinal cord metastases in Department of Glioma, Beijing Shijitan Hospital, Capital Medical University since 2011. Methods:A total of 15 cases were considered, including 5 patients with World Health Organization gradeⅡ, 6 patients with gradeⅢ, and 4 pa-tients with gradeⅣ. One patient had a tumor at the brain stem, two patients had tumors at the spinal cords, and the other patients had tumors at the hemispheres. One case received biopsy, 4 cases received subtotal resection, and 10 cases received complete resec-tion. Results: Symptoms included low back pain, sensory and motor dysfunction, incontinence, and seizures. After the metastases spread to the cerebrospinal region, patients were treated with chemotherapy, whole spine radiotherapy, intrathecal chemotherapy, and target therapy. The median time of leptomeninges and spinal cord metastasis dissemination appearance was 10 months (1.5-80 months) since surgery. The median overall survival time of the 15 patients was 20 months (9-83 months), and the median survival time was 6 months (2-48 months) after leptomeninges and spinal cord metastases. Conclusion:The prognosis of glioma patients with lepto-meninges and spinal cord metastases was poor, and a proportion of the patients who received appropriate treatment might have a better survival.
4.Mechanism for p47phox-induced reactive oxygen species increasing after oxygen therapy in premature infants
Lingping ZHANG ; Wenbin DONG ; Qingping LI ; Lan KANG ; Lianyu ZHANG ; Youying LU ; Xuesong ZHAI
Chinese Journal of Applied Clinical Pediatrics 2015;30(2):127-130
Objective To explore the mechanism for the increase in reactive oxygen species regulated by p47phox of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase subunit in peripheral blood mononuclear cells (PBMCs) after oxygen therapy in premature infants.Methods According to different volume fractions of oxygen,premature infants less than 32 weeks were divided into 3 groups:fractional concentration of inspired oxygen (FiO2) < 30% was low concentration oxygen group,FiO2 between 30% and 40% as middle concentration oxygen group,and FiO2 > 40% as high concentration oxygen group.Premature infants less than 32 weeks without oxygen was control group.After 48 h,3 mL blood was collected via radial artery from each group,PBMCs and serum were separated.Then intracellular reactive oxygen species (ROS) by confocal laser scanning microscopy,malondialdehyde (MDA) within serum by thiobarbituric acid colorimetric,and the location and activation rate of p47phox through immunofluorescence.Results After premature infants were exposed to oxygen,as the oxygen volume fraction was increasing,ROS and MDA gradually rised.More PBMCs with p47phox translocated to membrane,then the translocation rate of p47phox also increased.Compared with the control group,ROS were significantly higher(q =4.48,6.5,16.22,all P < 0.05) among the other 3 groups ; MDA significantly increased as well(q =5.08,8.22,12.76,all P < 0.05) ; the activation rate of p47phox also had significant differences (x2 =134.008,P < 0.05);compared with the middle concentration oxygen group,the high concentration oxygen group had higher ROS and MDA(q =15.03,4.53,all P < 0.05) ; the activation rate of p47phox increased significantly(x2 =19.26,P < 0.05).Conclusions After oxygen exposure,p47phox translocated to membrane may regulate the NADPH oxidase-derived ROS increase in extremely premature infants.
5.Effect of Budesonide combined with Poractant Alfa preventing bronchopulmonary dysplasia in preterm infants
Fengling DU ; Wenbin DONG ; Shuai ZHAO ; Lan KANG ; Qingping LI ; Chan ZHANG ; Xuesong ZHAI
Chinese Journal of Applied Clinical Pediatrics 2016;31(11):846-850
Objective To evaluate the effect of Budesonide combined with Poractant Alfa(pulmonary surfactants,PS) on preventing the bronchopulmonary dysplasia (BPD) in preterm infants.Methods One hundred and twenty preterm infants 6 hours after birth(gestational ages≤32 weeks and birth weights ≤1500 g)admitted to the Department of Newborn Medicine,the Affiliated Hospital of Southeast Medical University from October 2013 to February 2015 were randomly divided into 4 group(30 cases in each group).Group A was a control group,group B was neonatal respiratory distress syndrome(NRDS) group,group C was NRDS with PS group,and group D was NRDS with PS and Budesonide group.Thirty-two-week preterms without other diseases and without uptaking oxygen within 48 h were assigned as group A.Group B were treated by continuous uptaking oxygen with continuous positive airway pressure(CPAP) (oxygen uptaken lasting more than 48 h and oxygen concentrations more than 40%).Group C were treated with 100 mg/kg PS within 48 h on the basis of group B.Group D were treated with 0.25 mg/kg Budesonide suspension for inhalation on the basis of group C.The pH value,partial pressure of oxygen [pa(O2)],partial pressure of carbon dioxide [pa(CO2)] in the blood gas analysis were all detected in all groups before treatment,1,6,12,24 and 48 hours after using drug,respectively.All groups were also observed for whether to use respirator assisted ventilation,the duration of high oxygen use,the total time of uptaking oxygen,the rate of using PS again,the rate of BPD,the total hospitalization days and the adverse effects.The adverse effects included high blood pressure,high blood sugar,necrotizing enterocolitis and the incidence of nosocomial infection.Results Compared with group B,the pH value at 1 and 6 hours after using drugs,the pa(O2) and pa(CO2) at 1,6 and 12 hours after using drugs were improved obviously in the group C,and the differences were statistically significant (all P<0.01).Compared with group B,the above indicators were improved more obvious in group D,and the differences were statistically significant (all P<0.01).Moreover,compared with the group B,the oxygen inhalation duration,the rate of having a respirator assisted ventilation and using PS again,and the incidence of BPD were obviously decreased in other groups,the differences were statistically significant (all P<0.05).The incidence of BPD in group D was less than that of group C,and the differences were statistically significant (3.33% vs 10.00%,x2=4.00,P=0.046).The total oxygen time and the rate of adverse effects of each group were similar.The differences were not statistically significant (all P>0.05).Conclusions Budesonide combined with Poractant Alfa can prevent BPD in preterm infants.Its effect is better than the simple use of Poractant Alfa,and the rate of adverse effects are not increased significantly.
6.Down-regulation of Caveolin-l, GFAP, BDNF expression in hippocampus of neonatal rats induced by maternal sepa-ration
Liyuan QIAO ; Hongyan SUN ; Wenbin DONG ; Jianbin ZHANG ; Qingping LI ; Xiaoping LEI ; Lan KANG
Journal of Clinical Pediatrics 2013;(8):752-756
Objective To explore the potential mechanism of abnormal behavior resulted from maternal separation in neo-natal period in rat. Methods Neonatal rats were equally and randomly divided into maternal separation group and control group. The rats in maternal separation group were separated from the dam for 3h per day on postnatal days (PND) 2 to 21, nothing was done to the rats in the control group. The brain tissues were taken out after being killed on PND 7, 14, and 21. The expressions of Caveolin-l, BDNF and GFAP in hippocampal formation were detected by immunohistochemistry. Semiquantitative assessment of immunohistochemical images was performed by Image-Pro Plus software. Results Compared with control groups, the expres-sion of Caveolin-l on PND 7 had no signiifcant change, while BDNF and GFAP were signiifcantly increased in maternal separa-tion group (P<0.05). On PND 14 and 21, the expressions of Caveolin-l, BDNF and GFAP were signiifcantly decreased in maternal separation group (P<0.05). Conclusions Decreased expressions of Caveolin-l, BDNF and GFAP caused by maternal separation in neonatal period may be associated with abnormal behaviors in adulthood in rat.
7.PhaseⅠStudy of nimotuzumab combined with postoperative chemoradiotherapy in Chinese patients with malignant glioma
Wenbin LI ; Jing CHEN ; Yanjie ZHAO ; Xun KANG ; Yidong CHEN ; Xiaoguang QIU
Chinese Journal of Clinical Oncology 2013;(23):1455-1459
Objective:The poor prognosis of patients with malignant gliomas (MG) has led to the search for new therapeutic strat-egies. Recently, nimotuzumab has been studied as a new anti-EGFR-receptor humanized monoclonal antibody in patients with MG, who showed improvement of outcome and good tolerability. We conducted phase I of our study to determine the toxicity, tolerated dose, and clinical feasibility of nimotuzumab in combination with concurrent chemoradiotherapy for Chinese MG patients after surgical resection. Methods:Patients with pathologically proven grades 3 and 4 glioma were enrolled in the study. The protocol included infu-sions of nimotuzumab plus standard Stupp schedule (postoperative radiotherapy in a total dose of 60 Gy in combination with daily te-mozolomide). Patients received 6 weekly infusions of nimotuzumab at three levels (100, 200, and 400 mg/week). If none of the first three patients enrolled at a dose level experienced dose-limiting toxicity (DLT), the dose was increased, as appropriate. If DLT was ob-served, another three patients were added to the dose level. Results:Nine patients with MG were enrolled, including 7 with grade 3 MG and 2 with glioblastoma. The treatment was well tolerated, and no evidence of grade 3 or 4 adverse events was detected, even at the highest level (400 mg/week). Grade 1 or 2 myelosuppression was the most common toxicity. Three months after treatment, stable dis-ease occurred in 5 patients, whereas progression disease was observed in 4 patients. Conclusion:Nimotuzumab combined with concur-rent chemoradiotherapy was associated with mild toxicity in Chinese MG patients.
8.The role of PKCβ/p66Shc oxidative stress signaling pathway in hyperoxia induced apoptosis in alveolar epithelial cell A549
Zhongli CHE ; Wenbin DONG ; Qingping LI ; Xiaoping LEI ; Lan KANG ; Lin GUO ; Xuesong ZHAI ; Feng CHEN
Journal of Clinical Pediatrics 2013;(11):1066-1069
Objectives To explore the role of PKCβ/p66Shc oxidative stress signaling pathway in hyperoxia-induced apoptosis of alveolar epithelial cells A549. Methods A549 cells were cultured in vitro and divided randomly into control (incubated with 5%CO2), hyperoxia group (exposed to a mixture of 900 ml/L O2 and 50 ml/L CO2 at speed of 3 L/min for 10 mins, then cultured in a closed environment) and LY333531 group (treated with 10μmol/L of PKCβinhibitor LY333531 for 24h then induced with hyperoxia for 10 mins). The cellular morphology was observed under inverted microscope at 12, 24 and 48 h of treatment. The cell apoptosis was detected by lfow cytometry. Expression of PKCβ/Pin1/p66Shc/p66Shc-Ser36 were detected by immunohistochemistry after 24 h of treatment. Results Comparing to the control group, the cellular morphology of A549 in the hyperoxia group changed to spherical shapes and space between cells increased, the living cell count decreased and suspension cell increased. The living cell count in LY333531 group increased and suspension cell decreased than those in hyperoxia group but not reach the levels of the control group. The apoptosis rate of A549 cells and the expression of PKCβ/Pin1/p66Shc/p66Shc-Ser36 at 24 h were signiifcantly increased in the hyperoxia group than those in the control group, while the apoptosis rate and the expression of PKCβ/Pin1/p66Shc/p66Shc-Ser36 were greatly decreased in the LY333531 group than those in the hyperoxia group (all P<0.01). Conclusions The expression of PKCβin A549 cells can be increased by the hyper-oxia induction but reduced by LY333531, and then the expressions of Pin1, p66Shc and p66Shc-Ser36 are reduced. Thus the re-duced apoptosis of A549 cells relieve the cell injury induced by hyperoxia.
9.Effect of Mild Hypothermia Therapy on Neonatal Bilirubin Encephalopathy:Evaluated with 18F-fluorodeoxyglu-cose Positron Emission Tomography/CT and Amplitude Integrated Electroencephalogram
Yun YAN ; Qingping LI ; Wenbin DONG ; Wen JIA ; Lin GUO ; Xuesong ZHAI ; Lan KANG
Chinese Journal of Rehabilitation Theory and Practice 2017;23(6):690-695
Objective To investigate the clinical effect of mild hypothermia on neonatal bilirubin encephalopathy, and the value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT and amplitude integrated electroencephalogram (aEEG) for diagnosis and evaluation of curative effect. Methods From May, 2013 to December, 2014, 29 newborns with bilirubin encephalopathy were divided into conventional group (n=15) and mild hypothermia group (n=14). The conventional group received conventional therapy, and the other group received mild hypothermia in addition. The aEEG and neuron-specific enolase (NSE) were measured before and after treatment, as well as the glucose metabolism rate with 18F-FDG PET/CT after treatment. Results The NSE was lower after treatment in both groups (t>9.670, P<0.001), and was lower in the mild hypothermia group than in the conventional group (F=46.146, P<0.001). After treatment, sleep-wake cycle (SWC), epileptiform activity and the degree of abnormality were obviously improved (P<0.05), and were better in the mild hypothermia group than in the conventional group (P<0.05). The cerebral glucose metabolism rate was significantly better in the mild hypo-thermia group than in the conventional group (t>2.943, P<0.01). The cerebral glucose metabolism rate was negatively correlated with aEEG and NSE (r>0.640, P<0.05). Conclusion Mild hypothermia therapy could further promote the energy metabolism of brain cells in neonatal bilirubin encephalopathy. 18F-FDG PET/CT and aEEG can be used for early diagnosis and therapeutic evaluation.
10.Meta-analysis of the efficacy and safety of inhaled corticosteroids for preventing chronic lung disease in preterm infants
Xiaoling WANG ; Xiong LI ; Xiaoping LEI ; Lan KANG ; Shenghui WANG ; Wenbin DONG
Journal of Clinical Pediatrics 2017;35(6):467-474
Objective To evaluate the efficacy and safety of inhaled corticosteroids for preventing chronic lung disease (CLD) in preterm infants. Methods PubMed, EMBASE, CENTRAL, the ISI Web of Knowledge databases, CBM, CNKI, VIP and Wanfang Data were searched for the period up to Oct. 2016. All randomized controlled trials (RCTs) about inhaled corticosteroids for preventing CLD in preterm infants were collected. The RCTs had been screened, data were extracted and assessed. The mata-analysis was performed by RevMan 5.3 software. Result A total of 12 RCTs were included (a total of 2051 preterm neonates). Compared with control group, in 28 day old group, the incidence of CLD was not significantly different between experimental and control groups (RR=0.87, 95%CI:0.74-1.03, P=0.11) and (RR=1.19, 95%CI:0.59-2.43, P=0.63) and no significant difference among subgroups budesonide (α), beclomethasone (β), fluticasone (γ) (RR=0.89, 95%CI:0.69-1.14, P=0.35), (RR=0.86, 95%CI:0.69-1.08, P=0.19) and (RR=0.91, 95%CI:0.60-1.38, P=0.19). In 36 wk postmenstrual age group,the incidence of CLD was decreased in experimental group and in subgroups inhalation (A), Intratracheal administration (B), α, γ (RR=0.70, 95%CI: 0.61-0.80, P<0.00001), (RR=0.74, 95%CI: 0.63-0.87, P=0.0003), (RR=0.57, 95%CI: 0.43-0.76, P=0.0002), (RR=0.67, 95%CI: 0.57-0.78, P<0.00001) and (RR=0.58, 95%CI: 0.36-0.94, P=0.03); but it is not significantly different in subgroup β(RR=0.98, 95%CI: 0.69-1.39, P=0.90); There was no difference in the motality in experimental and subgroups A ,B, α, β , γ (RR=1.07, 95%CI:0.86-1.33, P=0.55), (RR=1.24, 95%CI: 0.97-1.59, P=0.09), (RR=0.67, 95%CI: 0.43-1.03, P=0.07), (RR=1.04, 95%CI: 0.81-1.33, P=0.78), (RR=1.47, 95%CI: 0.79-2.74, P=0.22) and (RR=0.91, 95%CI: 0.47-1.74, P=0.77). No clinically significant adverse effects were observed during the study. Conclusions This updated review indicated that early administration of inhaled steroids to very low birth weight preterm neonates was effective in reducing the incidence of CLD. There was no statistically significant effect of inhaled steroids on motality, and there was no significant correlation between the mode of administration and the type of drug delivery, It is recommended to observe the 36 week gestational age as the outcome index. More and larger randomised placebo-controlled trials including long-term follow up are needed to establish the efficacy and safety of inhalation corticosteroids.