Biological Therapy ; Carcinoma, Neuroendocrine ; Thyroid Neoplasms ; therapy

Hepatic Encephalopathy ; classification ; diagnosis ; therapy ; Humans ; Terminology as Topic

BACKGROUND: Transplantation of the human umbilical cord blood mononuclear cells (HUCBCs) have received increasing attention, as a promising candidate for the cellular transplantation, but the majority of the existing studies are basic research.OBJECTIVE: To report a patient of extensive anterior-wall acute myocardial infarction with cardiogenic shock and severe heart failure, after treatment of HUCBCs transplantation. METHODS: A 73-year-old female patient with cardiogenic shock and severe heart failure after extensive anterior-wall acute myocardial infarction was treated with percutaneous coronary intervention (three scaffolds implantation) and medications, and she still appeared the symptoms of congestive heart failure, such as severe recurrent dyspnea. 2.4 × 108 HUCBCs (50 mL cell suspension) was injected into the infarcted myocardium through the left anterior descending artery by using coronary micro-guide catheter.RESULTS AND CONCLUSION: The patient reported profound clinical benefit including improvement of heart-failure-associated symptoms after the transplantation. Notably the patient did not experience the cell transplant-related side effects during 4 months of follow-up. The ejection fraction increased from 22% before the transplantation to 53% at 21 days after the transplantation. The B-type natriuretic peptide decreased from 1 730 ng/L before the transplantation, 854 ng/L after the transplantation to 264 ng/L at 21 days after the transplantation. The patient did not appear the symptoms of congestive heart failure, including dyspnea, chest distress and hypodynamia, she returned to daily activity at 4 months of follow-ups. Experimental findings indicate that the HUCBCs transplantation is an effective and safe means for patients cardiogenic shock and severe heart failure after acute myocardial infarction.

Exosome is a sort of vesicle structure attached to cell membrane and released by cells, which contains numerous bioactive molecules, such as proteins, lipids, mRNA, microRNA and DNA fragments. These bioactive molecules are involved in the regulation of many biological processes, not only the participation in the occurrence and development of diverse diseases, but also the close relationship with the invasion and metastasis of tumors. The recent study has indicated that lots of exosomes released from cancer cells participate in a variety of pathological processes as a messenger of cell functions. This article will elaborate the function and application of exosomes in some malignant cancers.

Objective This study was designed to evaluate the short-term effect and safety of 80 mg/d atorvastatin treating on ACS patients with interventional therapy in China. Methods From August 2002 to March 2014,1746 ACS patients accepting 80mg/d atorvastatin treatment were enrolled from three province hospital. All patients were divided into three groups, 886 patients in group A with 80mg/d atorvastatin treating for 4 weeks, 562 patients in group B with 80mg/d atorvastatin treating for 8 weeks, and 298 patients in group C with 80mg/d atorvastatin treating for 12 weeks after discharge. Blood lipid level, hepatic function, renal function and creatine kinase level were tested on 4th, 8th, 12th week. Results The percentage of patients reacting lipid levels was 85.0%in group A, 86.1%in group B, 94.0%in group C and 86.9%in total. The rate of ALT/AST exceed two times of normal upper level in group A was 1.6%, in group B was 1.8%and in group C was 1.0%.The symptom of joint and muscle pain in group A was 6.3%, group B was 1.4%, group C was 2.7%. The elevation of creatine kinase in group A was 0.8%, in group B was 0.5%, and 0%in group C. The symptom of abdomen discomfort in group A was 2.3%, group B was 2.5%and group C was 4.0%. The complaint of other symptoms was 3.2%in group A, 2.1%in group B, 1.7%in group C. Conclusions Accepting 80 mg/d atorvastatin treating for ACS patients with interventional therapy is effective and safe in short term.

Objective:To investigate the effect of GRP94 gene expression down-regulation on the proliferation in human lung carcinoma A549 cells and possible mechanism.Methods:Expression of GRP94 was examined in 4 lung carcinoma cells and two lung bronchial epithelial cells by qRT-PCR and Western blot.Chemically synthesized siRNA targeting GRP94 gene and transfected into A549 cells used by Lipofectamine2000.The mRNA and protein expression levels of GRP94,c-myc and cyclinD1 were detected by qRT-PCR and Western blot.CCK8 assay and Colony formation assay were used to detect the effect of specific GRP94 siRNA on cell proliferation.Results:The levels of GRP94 expression in the four lung carcinoma cells were significantly higher than that in two lung bronchial epithelial cells (P<0.05).GRP94 siRNA significantly downregulated the levels of GRP94 mRNA and protein in A549 cells, and the downregulation evidently suppressed cell proliferation.However, The c-myc and cyclinD1 expression levels in A549 cells in siRNA-GRP94 group was significantly lower than that in siRNA-NC group (P<0.05).Conclusion:The levels of GRP94 expression in lung carcinoma cells were significantly higher than that in normal lung epithelial cells.Knockdown GRP94 expression significantly inhibit the level of lung carcinoma A549 cells proliferation,which may act via influencing the expression of c-myc,cyclinD1.

BACKGROUND:Myocardial infarction patients commonly appear to have left ventricular remodeling and heart failure. Because of physical characteristics, these two complications are more likely to occur in elderly patients with myocardial infarction. In recent years, stem celltransplantation in the treatment of acute myocardial infarction and heart failure has become a hot topic, and the feasibility and safety has been confirmed, but its long-term outcomes in elderly patients are stil unclear.
OBJECTIVE:To assess the long-term effect of transplantation of autologous peripheral blood stem cells on the left ventricular remodeling and heart function in the old patients with myocardial infarction.
METHODS:Thirty old patients (age ≥ 60 years) with myocardial infarction were randomly assigned to receive intracoronary transplantation of peripheral blood stem cells fol owing bone marrow cells mobilization by granulocyte colony-stimulating factor ( 300-600μg per day) subcutaneously for 5 days in addition to conventional therapy (standard drug therapy and percutaneous coronary intervention;transplantation group, n=15) or standard therapy (standard drug therapy and percutaneous coronary intervention;control group, n=15) . Complications during intervention, left ventricular function and left ventricular remodeling at baseline and 6, 12, 24, 60 months after treatment were monitored.
RESULTS AND CONCLUSION:Left ventricular function, left ventricular end diastolic volume, and left ventricular end-systolic volume were significantly improved 6,12, 24, 60 months after autologous peripheral blood stem celltransplantation compared to baseline, while these parameters remained unchanged in the control group. These parameters had statistical difference between the two groups after treatment. During the fol ow-up, no severe side effects were observed. These findings indicate that autologous peripheral blood stem celltransplantation leads to significant and longstanding improvements in left ventricular performance of old patients with myocardial infarction, and shows good safety.

Thyroid cancer is the most common malignant tumor of the human endocrine system. A papillary thyroid microcarci-noma (PTMC) is usually defined as a papillary thyroid tumor that is less than 10 mm in diameter. The incidence of thyroid cancers has obviously increased in recent years. The surgical treatment of PTMC differs in China and overseas. Aside from conventional surgery, novel surgical methods, such as ultrasound-guided percutaneous ablation, have been used for the surgical treatment of PTMC. This arti-cle mainly discusses the research progress in the surgical treatment of PTMC.

BACKGROUND:Number of experimental and clinical studies have shown that stem celltransplantation can establish new blood vessels and improve heart function instead of necrotic myocardium, to significantly improved clinical symptoms and prognosis of cardiovascular disease patients.
OBJECTIVE:To observe the safety of human umbilical cord blood mononuclear cells transplantation in patients with coronary heart disease and heart failure.
METHODS:A total of 12 patients with coronary heart disease and heart failure (acute myocardial infarction and heart failure in six cases, old myocardial infarction and heart failure in six cases) were enrol ed in this study. Patients were treated on the basis of standard medication and percutaneous coronary intervention. The coronary pathway was established via a percutaneous catheter, and suspension of cord blood mononuclear cells was injected through microcatheter into the distal artery. Routine blood test was carried out at 1 week after celltransplantation, blood routine, liver function, kidney function, C-reactive protein, IgA, IgG were compared preoperatively and postoperatively.
RESULTS AND CONCLUSION:The incidence of adverse reactions in cord blood stem celltransplantation was 8.3%, including one case of fever. No micro-embolism occurred. During 1-week fol ow-up, no graft-versus-host disease appeared. After celltransplantation, there were no significant changes in blood routine, liver function, kidney function, C-reactive protein, IgA, IgG. These findings indicate umbilical cord blood monomuclear cells transplantation is safe in a short term for patients with coronary heart disease and heart failure.

Current Issue Archive 15 December 2020, Volume 11 Issue 4 Previous Issue Improving antibiotic prescribing in the emergency department for uncomplicated community-acquired pneumonia Rebekah Shaw, Erica Popovsky, Alyssa Abo, Marni Jacobs, Nicole Herrera, James Chamberlain, Andrea Hahn World Journal of Emergency Medicine. 2020, 11(4): 199-205. doi:10.5847/wjem.j.1920-8642.2020.04.001 Asbtract HTML PDF (151KB) Outcome prediction value of National Early Warning Score in septic patients with community-acquired pneumonia in emergency department: A single-center retrospective cohort study Hai-jiang Zhou, Tian-fei Lan, Shu-bin Guo World Journal of Emergency Medicine. 2020, 11(4): 206-215. doi:10.5847/wjem.j.1920-8642.2020.04.002 Asbtract HTML PDF (255KB) Effects of fluid balance on prognosis of acute respiratory distress syndrome patients secondary to sepsis Yu-ming Wang, Yan-jun Zheng, Ying Chen, Yun-chuan Huang, Wei-wei Chen, Ran Ji, Li-li Xu, Zhi-tao Yang, Hui-qiu Sheng, Hong-ping Qu, En-qiang Mao, Er-zhen Chen World Journal of Emergency Medicine. 2020, 11(4): 216-222. doi:10.5847/wjem.j.1920-8642.2020.04.003 Asbtract HTML PDF (107KB) BACKGROUND: Fluid management is crucial to acute respiratory distress syndrome (ARDS) secondary to sepsis. However, choices of fluid resuscitation strategies and fluid input volumes remain a thorny problem. Our study aimed to elucidate the relationship between fluid balance and prognosis of ARDS patients secondary to sepsis. METHODS: Our study included 322 sepsis patients from Ruijin Hospital between 2014 and 2018, and 84 patients were diagnosed as ARDS within 72 hours after onset of sepsis according to Berlin ARDS Definition. RESULTS: Among the 322 sepsis patients, 84 (26.1%) were complicated with ARDS within 72 hours. ARDS patients had a lower oxygenation index (PaO2/FiO2 166.4±71.0 vs. 255.0±91.2, P<0.05), longer duration of mechanical ventilation (11 [6-24] days vs. 0 [0-0] days, P<0.05) than those without ARDS. Sepsis patients with ARDS showed daily positive net fluid balance during seven days compared with those without ARDS who showed daily negative net fluid balance since the second day with significant statistical differences. Among the 84 sepsis patients with ARDS, 58 (69.0%) died. Mean daily fluid input volumes were much lower in survivors than in non-survivors (43.2±16.7 mL/kg vs. 51.0±25.2 mL/kg, P<0.05) while output volumes were much higher in survivors (45.2±19.8 mL/kg vs. 40.2±22.7 mL/kg, P<0.05). Using binary logistic regression analysis, we found that the mean daily fluid balance was independently associated with mortality of sepsis patients complicating with ARDS (P<0.05). CONCLUSIONS: Early negative fluid balance is independently associated with a better prognosis of sepsis patients complicated with ARDS.