OBJECTIVETo study the effect of Huoxiang Zhengqi soft capsule on protecting intestinal barrier.

METHODLower limb ischemic reperfusion model was induced in Wistar rats. The Chinese medicine groups were administered orally with Huoxiang Zhengqi soft capsule before inoculation respectively. The small intestinal histopathology and ultrastructural of rats were observed with optical microscope and electronic microscope respectively. Mucus was observed under AB-PAS staining, mast cells were studied under toluidine blue staining, and serum NO was determined.

RESULTAfter Lower limb ischemic reperfusion, the intestinal barrier function was severely damaged. Huoxiang Zhengqi soft capsule could significantly reduce the levels of the serum NO (P < 0.01).

CONCLUSIONHuoxiang Zhengqi soft capsule has apparent protective effect on the intestinal barrier function in lower limb ischemic reperfusion rats.

Animals ; Capsules ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Female ; Hindlimb ; blood supply ; Ileum ; pathology ; Intestinal Mucosa ; pathology ; ultrastructure ; Ischemia ; complications ; Male ; Mast Cells ; drug effects ; Mucus ; drug effects ; Plants, Medicinal ; chemistry ; Protective Agents ; pharmacology ; Rats ; Rats, Wistar ; Reperfusion Injury ; pathology

BACKGROUND:Dysphagia is one of common early complications after anterior cervical fusion. Medium and severe dysphagia often causes serious influence on the patients. A variety of factors have been shown to have a correlation with the postoperative dysphagia, but specific mechanism is stil unclear. OBJECTIVE:To explore the risk factors for dysphagia after single-level anterior cervical fusion. METHODS:From January 2011 to June 2013, data of 44 patients with dysphagia and 213 patients without dysphagia after single-level anterior cervical fusion were compared. The baseline data (age, gender, ethnicity, body mass index, smoking history, drinking history, hypertension, diabetes, course length, and type of cervical spondylosis) and perioperative data (intraoperative blood loss, internal fixation, the location of the operated level, operation time, and the side of operation approach) between two groups were compared by Logistic regression analysis to determine risk factors for postoperative dysphagia.RESULTS AND CONCLUSION:A total of 257 patients were included with a fol ow-up for 6 to 24 months postoperatively and 44 of them suffered from dysphagia after single-level anterior cervical fusion. The overal prevalence for postoperative dysphagia was 17.1%. Univariate analysis indicated that age, gender, the location of the operated level, and course length were associated with postoperative dysphagia. Logistic regression analysis of multivariate analysis demonstrated that independent predictors for postoperative dysphagia included gender (female), age (>60 years), the location of the operated level (C 4-5 , C 5-6 ), and course length (>12 months). Clinicians should give appropriate recognition and take corresponding measures to avoid it.

OBJECTIVETo investigate the clinical safety and effectiveness of percutaneous embolization in treating the late failed renal allograft in patients with graft intolerance syndrome (GIS).

METHODSTranscatheter embolization of renal graft artery was performed in 18 patients with late graft dysfunction and GIS. The subsequent complications, postoperative symptom remission rate, and prognosis were assessed.

RESULTSGIS was relieved in 15 patients (83.3%), of which 6 patients (33.3%) had severer fever and pain in the area of renal graft after embolization, which lasted for a mean of 3.5 days (range: 2-5 days). GIS persisted for more than 2 weeks in 3 patients (16.7%), who ultimately underwent surgical removal of grafts. No severe embolism-associated complications were noted.

CONCLUSIONPercutaneous embolization can effectively avoid surgical graft removal in patients with late renal allograft failure, and therefore can be used as a safe and effective treatment for the late failed renal allograft combined with GIS.

Adult ; Aged ; Embolization, Therapeutic ; Female ; Graft Rejection ; complications ; therapy ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Postoperative Complications ; therapy ; Renal Insufficiency ; complications ; therapy ; Transplantation, Homologous ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the early changes of the blue-on-yellow (B/Y) perimetry in patients with early primary open-angle glaucoma(POAG).

METHODSThirty-one cases (45 eyes) of POAG underwent the central 30 degrees field examination of B/Y as well as routine white-on-white (W/W).

RESULTNo significant difference of mean index deficiency (MD) between B/Y and W/W perimetry was detected (P>0.05). However, there were marked changes in index GHT (glaucoma hemisphere test) and more defect points in B/Y visual field than those in W/W (P<0.01).

CONCLUSIONB/Y perimetry might be more sensitive than W/W perimetry a potentially more and valuable method in detection of early POAG lesion.

Adult ; Female ; Glaucoma, Open-Angle ; diagnosis ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Visual Field Tests ; Visual Fields

OBJECTIVETo investigate the antitumor effect of lycorine on renal cell carcinoma ACHN cells and explore the possible mechanism.

METHODSWe used flow cytometry to examine the effect of lycorine on ACHN cell cycle and apoptosis. The cell proliferation, migration and invasion were assessed with MTS assay, wound healing assay, and Transwell assay, respectively. Colony forming assay was performed, and the mRNA and protein levels of Bax, Bcl-2, survivin, caspase-3, cyclin D1 and CDK4 were measured with qRT-PCR and Western blotting.

RESULTSLycorine obviously inhibited the proliferation of ACHN cells with an IC(50) of 24.34 µmol/L. Lycorine also induced apoptosis of ACHN cells, caused cell cycle arrest at G(0)/G(1) phase, and suppressed the colony forming ability of the cells in a dose-dependent manner. The migration and invasion of ACHN cells were significantly inhibited by 5 µmol/L lycorine. Lycorine up-regulated the mRNA levels of CDK4, Bax, caspase-3 while down-regulated the levels of survivin, Bcl-2 and Cyclin D1; the protein levels of CDK4 and Bax were increased and cyclin D1, Bcl-2 and surviving expressions were decreased, but caspase-3 expression showed no significant changes following the treatment.

CONCLUSIONLycorine has obvious antitumor effect against ACHN cells, suggesting its value as a new therapeutic agent for renal cell carcinoma.

Amaryllidaceae Alkaloids ; pharmacology ; Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; Carcinoma, Renal Cell ; pathology ; Caspase 3 ; metabolism ; Cell Cycle Checkpoints ; Cell Line, Tumor ; drug effects ; Cell Proliferation ; Cyclin D1 ; metabolism ; Cyclin-Dependent Kinase 4 ; metabolism ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; Phenanthridines ; pharmacology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; bcl-2-Associated X Protein ; metabolism

BACKGROUNDAn important characteristic of renal cell carcinomas and adrenal tumors is that these tumors may expand into the renal vein and inferior vena cava, and transform into tumor thrombi. This study was to evaluate the use of piggyback liver transplant techniques for surgical management of urological tumors with inferior vena cava tumor thrombus.

METHODSNineteen patients with renal cell carcinomas or adrenal tumors with inferior vena cava tumor thrombus were treated from November 1995 to April 2008. Their ages ranged from 29 years to 76 years (mean 54 years). The extent of tumor thrombus was infrahepatic (level I) in 2, retrohepatic (level II) in 7, suprahepatic (level III) in 6, and intra-atrial (level IV) in 4 patients. We used cardiopulmonary bypass with deep hypothermic circulatory arrest to remove the thrombi in 3 cases of level IV and in 2 cases of level III. In all level II, 4 level III, and 2 level IV cases, we used piggyback liver transplant techniques to mobilize the liver off of the inferior vena cava and to separate the inferior vena cava from the posterior abdominal wall.

RESULTSMean operative time was 5.1 hours, mean estimated blood loss was 2289 ml and mean blood transfusion was 12.84 U. One patient with adrenal cortical carcinoma and level IV thrombus died in the immediate postoperative period. Three patients were lost to follow up, and the other 15 survivors were followed from 5 months to 56 months. Eight of these 15 patients died due to metastasis; however 7 were still alive at the last follow-up.

CONCLUSIONSAn aggressive surgical approach is the only hope for curing patients diagnosed with urological tumors combined with inferior vena cava tumor thrombus. The use of piggyback liver transplant techniques to mobilize the liver off of the inferior vena cava provides excellent exposure of the inferior vena cava. Patients with a level II or level III inferior vena cava thrombus may be treated without using cardiopulmonary bypass.

Adrenal Gland Neoplasms ; pathology ; surgery ; Adult ; Aged ; Carcinoma, Renal Cell ; pathology ; surgery ; Female ; Humans ; Liver Transplantation ; methods ; Male ; Middle Aged ; Neoplastic Cells, Circulating ; Vena Cava, Inferior ; pathology

OBJECTIVETo investigate the types and therapies of malignancies in renal allograft recipients.

METHODSWe retrospectively analyzed the occurrence, types, and therapies of malignancies in 498 renal allograft recipients who had received operations in Peking Union Medical College Hospital from May 1986 to October 2008.

RESULTSAmong 498 renal allograft recipients, 18 patients (3.6% ) were diagnosed with malignancies, which included bladder cancer (n = 5), renal pyloric cancer or ureteric cancer (n = 4), leukemia or lymphoma (n = 3), hepatic cancer (n = 2), skin cancer, rectum carcinoma, pulmonary carcinoma and thymoma (n = 1 each). Surgical operations were performed in 10 cases, 6 of whom survived with normal renal function and had no rejection of transplanted kidneys. Three patients with bladder cancer and one patient with ureteric cancer experienced recurrences 7 to 15 months after operations; among them one bladder cancer patient died. One hepatic carcinoma patient died of pulmonary metastasis 8 months after operation. One non-Hodgkin's lymphoma patient died 11 months after chemotherapy. Five cases with advanced unresectable malignancies died 8 to 17 months after the diagnosis.

CONCLUSIONSThe incidences of malignancies, especially urological epithelial carcinoma, are high in renal allograft recipients. Radical surgery of the solid malignancies is a preferred option.

Adult ; Aged ; Female ; Humans ; Kidney Transplantation ; Male ; Middle Aged ; Neoplasms ; epidemiology ; therapy ; Postoperative Complications ; epidemiology ; therapy ; Retrospective Studies

Purpose: This study aimed to identify prognostic factors for patients with distant lymph node-involved gastric cancer (GC) using a machine learning algorithm, a method that offers considerable advantages and new prospects for high-dimensional biomedical data exploration. Materials and Methods: This study employed 79 features of clinical pathology, laboratory tests, and therapeutic details from 289 GC patients whose distant lymphadenopathy was presented as the first episode of recurrence or metastasis. Outcomes were measured as anycause death events and survival months after distant lymph node metastasis. A prediction model was built based on possible outcome predictors using a random survival forest algorithm and confirmed by 5×5 nested cross-validation. The effects of single variables were interpreted using partial dependence plots. A contour plot was used to visually represent survival prediction based on 2 predictive features. Results: The median survival time of patients with GC with distant nodal metastasis was 9.2 months. The optimal model incorporated the prealbumin level and the prothrombin time (PT), and yielded a prediction error of 0.353. The inclusion of other variables resulted in poorer model performance. Patients with higher serum prealbumin levels or shorter PTs had a significantly better prognosis. The predicted one-year survival rate was stratified and illustrated as a contour plot based on the combined effect the prealbumin level and the PT. Conclusions Machine learning is useful for identifying the important determinants of cancer survival using high-dimensional datasets. The prealbumin level and the PT on distant lymph node metastasis are the 2 most crucial factors in predicting the subsequent survival time of advanced GC.Trial Registration: ChiCTR Identifier: ChiCTR1800019978

Purpose: While several prognostic models for the stratification of death risk have been developed for patients with advanced gastric cancer receiving first-line chemotherapy, they have seldom been tested in the Chinese population. This study investigated the performance of these models and identified the optimal tools for Chinese patients. Materials and Methods: Patients diagnosed with metastatic or recurrent gastric adenocarcinoma who received first-line chemotherapy were eligible for inclusion in the validation cohort. Their clinical data and survival outcomes were retrieved and documented. Time-dependent receiver operating characteristic (ROC) and calibration curves were used to evaluate the predictive ability of the models. Kaplan-Meier curves were plotted for patients in different risk groups divided by 7 published stratification tools. Log-rank tests with pairwise comparisons were used to compare survival differences. Results: The analysis included a total of 346 patients with metastatic or recurrent disease.The median overall survival time was 11.9 months. The patients were different into different risk groups according to the prognostic stratification models, which showed variability in distinguishing mortality risk in these patients. The model proposed by Kim et al. showed relative higher predicting abilities compared to the other models, with the highest χ 2 (25.8) value in log-rank tests across subgroups, and areas under the curve values at 6, 12, and 24 months of 0.65 (95% confidence interval [CI]: 0.59–0.72), 0.60 (0.54–0.65), and 0.63 (0.56–0.69), respectively. Conclusions Among existing prognostic tools, the models constructed by Kim et al., which incorporated performance status score, neutrophil-to-lymphocyte ratio, alkaline phosphatase, albumin, and tumor differentiation, were more effective in stratifying Chinese patients with gastric cancer receiving first-line chemotherapy.

Objective To study the factors influencing the blood concentration of caspofungin(CPFG),construct a prediction model,and validate the predictive effect of the model,so as to provide reference for the individualised dosing of patients with fungal infections in haematology.Methods Seventy-five patients admitted to the Department of Haematology,General Hospital of Tianjin Medical University,who were treated with CPFG for antifungal therapy during the period of March 2021 to June 2022 were selected as the study subjects,and CPFG blood concentration monitoring was carried out to explore the influencing factors of CPFG blood concentration and to construct a prediction model accordingly.Hosmer-Lemeshow(H-L)was used to test the goodness-of-fit of the model,and another 30 patients were selected as the verification group,and the predictive effect of the model was verified by the receiver's operating characteristics(ROC)curve.Results The mean blood concentrations of the patients at 0.5,9 and 24 h were(12.54±4.38),(6.80±2.76),(4.13±2.16)μg·mL-1,and the mean AUC0-24h were(152.05±57.60)μg·mL-1·h.AUC0-24h was lower than the reference value(98 μg·mL-1·h)in two patients.The results of correlation analysis showed that gender showed a correlation with 0.5 h blood concentration(P＜0.05),and there was no correlation with the rest of the two time points blood concentration and AUC0-24h(P＞0.05).Body weight and albumin(Alb)concentration showed correlation with 0.5,9,24 h blood drug concentration and AUC0-24 h(P＜0.05),and the rest of the indicators showed no correlation with blood drug concentration and AUC0_24h at each time point(P＞0.05).The results of multifactorial analysis showed that the factors influencing the patients'0.5 h blood concentration were gender,Alb concentration and body weight,and the factors influencing the 9 and 24 h blood concentration and AUC0-24h were Alb concentration and body weight(P＜0.05).Correlation analysis showed that the daily dose was positively correlated with the plasma concentration of CPFG at 0.5,9 and 24 h and AUC0-24h(P＜0.05).The results of multivariate analysis showed that the daily dose was also one of the influencing factors of the plasma concentration of CPFG(P＜0.05).ROC curve shows that the model has good prediction ability.Conclusion Body weight and Alb are significantly associated with CPFG blood concentrations and area under the drug-time curve,which can be used as a basis for preventive risk avoidance.