ObjectiveTo investigate the risk factors for survival after transjugular intrahepatic portosystemic shunt （TIPS） in patients with liver cirrhosis and esophagogastric variceal bleeding （EGVB）， and to establish a predictive model for survival after TIPS. MethodsClinical data were collected from 352 patients with liver cirrhosis and EGVB who underwent TIPS in Department of Gastroenterology， Affiliated Drum Tower Hospital of Nanjing University Medical School， from January 2015 to December 2018， and the patients were randomly divided into training group （n=248） and validation group （n=104） at a ratio of 7∶3. The Cox regression analysis was used to identify the independent risk factors for survival after TIPS， and a nomogram predictive model was established. The index of concordance （C-index） and the receiver operating characteristic （ROC） curve were used to assess the discriminatory ability of the model， and the calibration curve was used to assess the predictive value of the model. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier analysis was used to calculate cumulative survival rate. ResultsFor the patients in the training group， the 1-，3-， and 5-year cumulative survival rates were 91.1%，79.5%， and 77.0%， respectively. The multivariate Cox regression analysis showed that age （hazard ratio ［HR］=1.047， 95% confidence interval ［CI］：1.032‍ ‍—‍ ‍1.092，P<0.001）， MELD score （HR=1.127，95%CI：1.003‍ ‍—‍ ‍1.268，P=0.045）， and serum sodium （Na） （HR=0.928，95%CI：0.878‍ ‍—‍ ‍0.981，P=0.008） were independent influencing factors for survival， and a predictive model and a nomogram were established based on these factors. The predictive model had a C-index of 0.760 in the training group and 0.757 in the validation group. In the training group， the nomogram had an area under the ROC curve of 0.807，0.788， and 0.787， respectively， in predicting 1-，3-， and 5-year cumulative survival rates. The calibration curve showed relatively high consistency between the results predicted by the nomogram and the actual results. ConclusionA nomogram model is established based on age， MELD score， and Na for predicting survival after TIPS in patients with liver cirrhosis and EGVB， and this model has good discriminatory ability and accuracy.

Objective To observe the effect of abdominal electrical stimulation combined with high-frequency chest wall oscillation on airway clearance ability in critical ill patients with tracheostomy. Methods From January to June, 2021, a total of 84 critical ill patients with tracheostomy in the department of Critical Care Medicine, Zhongda Hospital, Southeast University, were randomly divided into control group (n = 28),experimental group A (n = 28) and experimental group B (n = 28). All the groups received routine therapy and early activities; while high-frequency chest wall oscillation was added to experimental group A, and abdominal electrical stimulation combined with high-frequency chest wall oscillation were added to experimental group B, for two weeks. Their involuntary cough peak flow (ICPF), Clinical Pulmonary Infection Score (CPIS), diaphragmatic excursion (DE), diaphragmatic thickness fraction (DTF) and thickness of abdominal muscle (Tab) were measured before and after treatment. Results The improvement of CPIS, ICPF and Tab were better in the experimental group B than in the other two groups (P < 0.05). The improvement of DE and DTF were slightly better in experimental group B, however, there was no significant difference among groups (FDE = 0.514, FDTF = 1.582, P > 0.05). The thickness d-values of rectus abdominis, musculi obliquus internus abdominis and musculus transversus abdominis were positively correlated with the d-value of ICPF in the exprimental group B (r > 0.415, P < 0.05). ICPF was highly negatively correlated with CPIS before treatment for all the patients (r = -0.702, P < 0.001). No adverse events occurred during the intervention period. Conclusion Abdominal electrical stimulation combined with high-frequency chest wall oscillation could improve airway clearance ability in critical ill patients with tracheostomy.

This project aimed to explore the protective effect of ginsenoside Rg_1 on hypoxia/reoxygenation(H/R)-induced H9 c2 cardiomyocyte injury and its underlying signaling pathway. The H/R model of H9 c2 cardiomyocytes was established and then the cells were divided into different treatment groups. CCK-8(cell counting kit-8) was used to detect the activity of cardiomyocytes; Brdu assay was used to detect the proliferation of H9 c2 cells; the caspase-3 activity was tested, and then the protein expression was assessed by Western blot. Flow cytometry was used to evaluate the apoptosis level of cardiomyocytes. Ginsenoside Rg_1 inhibited H/R-induced cardiomyocyte apoptosis and caspase-3 activity, promoted nuclear transcription of nuclear factor erythroid-2 related factor 2(Nrf2), and enhanced the expression of the downstream heme oxygenase-1(HO-1). Ginsenoside Rg_1 could increase Nrf2 nuclear transcription and HO-1 expression with the increase of concentration(10, 20, 40, 60 μmol·L~(-1)). However, the protective effect of ginsenoside Rg_1 on cardiomyocytes was significantly weakened after the transfection of Nrf2-siRNA. Ginsenoside Rg_1 could protect cardiomyocytes by activating the Nrf2/HO-1 pathway.
Apoptosis ; Ginsenosides/pharmacology* ; Heme Oxygenase-1/genetics* ; Humans ; Hypoxia ; Myocytes, Cardiac ; NF-E2-Related Factor 2/genetics*

Objective: To investigate the clinical features of cases with emergency thyroid surgery. Methods: Nineteen cases treated with emergency thyroid surgery from May 2014 to May 2019 were analysed retrospectively, including 9 males and 10 females, aged from 24-79 years old. Among them, 6 cases had nodular goitres and 13 cases had thyroid malignancies. One case underwent tracheal stenting before operation. Emergency thyroid surgery was due to severe dyspnea in all cases. Treatment outcomes and prognoses of patients were evaluated. Results: All the 19 patients underwent general anesthesia with endotracheal intubation. One patient underwent extracorporeal membrane oxygenation(ECMO) and two patients underwent cardiopulmonary bypass. Six cases of nodular goitres underwent proximal thyroidectomy. Eight cases of malignant tumors underwent total thyroidectomy, six cases with invading the trachea underwent tracheal end-end anastomosis after partial tracheal resection, one case underwent tumor resection with sternal sternum approach, cervical and mediastinal lymph node dissection, total laryngectomy and tracheal low ostomy. Two cases with extensive involvement of malignant tumors were given a definite diagnosis and tracheostomy. Of three cases with malignant lymphoma, one underwent total thyroidectomy, and two were only given a definite diagnosis and tracheostomy. No complications such as hemorrhage, recurrent laryngeal nerve or parathyroid injury occurred after operation in all patients. With followed up for 6-50 months, except 2 cases died due to tumor progression, the rest were alive. Conclusions: Patients with obvious dyspnea caused by thyroid tumors have a high mortality rate and should be treated actively. Emergency surgery not only relieves respiratory obstruction and saves the lives of patients, but some patients can get a radical cure as well.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms/surgery* ; Thyroidectomy ; Trachea/surgery* ; Young Adult

Objective:To investigate the synergistic effect and mechanism of the combined application of recombinant human bone morphogenetic protein-2(rhBMP-2) and basic fibroblast growth factor (bFGF).Methods:24KM male mice were randomly divided into6 groups with4 mice in each group, namely,GroupA(control group),GroupB(only treated with collagen),GroupC(treated with 2 ng bFGF+collagen),GroupD(treated with4 μg rhBMP-2+collagen),GroupE(treated with4 μg rhBMP-2+2 ng bFGF+collagen) andGroupF(treated with4 μg rhBMP-2+4 ng bFGF+collagen). The composites were implanted into the intermuscular septum of hind legs mice; whereas in control group, intermuscular septum of mice was separated and no implantation was performed. General observation, detection of concentration of calcium content, micro computed tomography (Micro-CT), three-dimensional reconstruction scan, measurement of bone mineral density(BMD), bone volume fraction(BVF) and trabecular thickness(Tb.Th), as well as histological observation withHE staining andALP andCD34 immumohistochemical staining were performed.Results:Ectopic osteogenesis was found inGroupsD,E andF mice.The difference in concentration of calcium contentswas statistically significant betweenGroupsD andE(P<0.05), but insignificant betweenGroupsE andF(P>0.05).Micro-CT and three-dimensional reconstruction revealed continuous newborn bone substance in external surface of ectopic bone formation, and the center of bone formation did not show obvious substantial filling by bone substance.The differences in BMD,BVF andTb.Th were statistically significant betweenGroupsD andE orF(P<0.01 or <0.05). HE staining showed that inGroupsD,E andF, newborn bone substance was mainly located at the edge of ectopic bone formation, and the bone formation inGroupsE andF was better than that in GroupD.ALP andCD34 immumohistochemical staining revealed the positive expression mainly at the edge of ectopic bone formation, and area of positiveexpression inGroupsE andF was larger than that inGroupsD.Conclusions:rhBMP-2 possesses the capacity to induce ectopic osteogenesis independently, but bFGF does not have this ability; the combined application of rhBMP-2 and bFGF can enhance the synergetic effect on inducing ectopic osteogenesis.

This study was purposed to investigate the effects of magnetic nanoparticle of Fe3O4 (Fe3O4-MNPs) on murine immune system. ICR mice were assigned randomly into four groups which were treated with normal saline, low, middle and high dose of MNP-Fe3O4 respectively. The mice were killed after being exposed by intragastric administration for 2 weeks. The ratios of spleen weight to body weight, lymphocyte transformation rate in spleen suspension and phagocytic index of macrophage in abdominal cavity were detected. The results showed that the ratios of spleen weight to body weight in Fe3O4-MNP groups were not significantly different in comparison with the control (p > 0.05). The lymphocyte transformation rate in spleen suspension in Fe3O4-MNP groups were all higher than that in control group (-0.1775 +/- 0.0246), especially in the middle dose group (0.1833 +/- 0.0593) (p < 0.05), and the phagocytic index of macrophages in abdominal cavity of middle dose group (0.2051 +/- 0.0213) was higher than that of control group and other two Fe3O4-MNP group (low dose 0.1538 +/- 0.0100, high dose 0.1511 +/- 0.0184) (p < 0.05). It is concluded that suitable dose of Fe3O4-MNP can enhance the cellular immune activity and phagocytic function of macrophages of mice.
Animals ; Immunity, Cellular ; Lymphocytes ; drug effects ; Macrophages ; drug effects ; Magnetite Nanoparticles ; administration & dosage ; Mice ; Mice, Inbred ICR ; Phagocytosis

This study was purposed to investigate the reversal effect of glucosylceramide synthase (GCS) inhibitor D, L-threo-1-phenyl-2-decanoylamino-3-morpholino-1-propanol (PDMP) hydrochloride, on multidrug resistance in K562/A02 cells and its mechanism. The IC(50) (the half maximal inhibitory concentration) of PDMP was measured by MTT method. Cell apoptosis and intracellular daunorubicin (DNR) concentration were detected by flow cytometry. The expression of GCS and mdr1 genes were assayed by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) and Western blot. The results showed that the IC(50) of DNR in K562 and K562/A02 cells were 0.23 +/- 0.02 and 7.15 +/- 0.24 microg/ml respectively. When the concentration of PDMP was equal to or less than 20 micromol/L ( < / = 20 micromol/L), the obviously inhibitory effect on proliferation of K562 and K562/A02 cells was not observed, but both 20 micromol/L and 10 micromol/L PDMP could enhance the sensitivity of K562/A02 cells to DNR (p < 0.01) and the reversal multiples were 2.59 and 1.69 respectively. After treating with 20 micromol/L and 10 micromol/L PDMP for 48 hours, the concentration of DNR in K562/A02 cells increased (p < 0.05) and the apoptotic rate also was elevated (p < 0.01). The expressions of GCS and mdr1 genes were down-regulated at mRNA and protein levels after treating K562/A02 cells with 20 micromol/L PDMP for 48 hours. It is concluded that PDMP can enhance the sensitivity of K562/A02 cells to DNR by increasing cell apoptosis rate and accumulation concentration of DNR in cells, which may be related to down-regulated expressions of GCS and mdr1 genes.
Daunorubicin ; pharmacology ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Enzyme Inhibitors ; pharmacology ; Humans ; Inhibitory Concentration 50 ; K562 Cells ; Morpholines ; pharmacology

This study was purposed to investigate the effect of a hypoxia-inducible factor inhibitor (YC-1) on expression of hypoxia-inducible factor 1alpha (HIF-1alpha) and vascular endothelial growth factor (VEGF) as well as induction of apoptosis in leukemic cell lines. RT-PCR was used to determine the levels of HIF-1alpha mRNA and VEGF mRNA in K562, U937 and Jurkat cells. After treatment of U937 cell with 4 micromol/L YC-1, cell apoptosis was assayed by DAPI staining under fluorescent microscope and flow cytometry with Annexin V-FITC/PI staining; the expression levels of HIF-1alpha mRNA and VEGF mRNA were measured with RT-PCR; the expression levels of HIF-1alpha, VEGF, BAX, BCL-2 and caspase-3 proteins were measured by Western blot. The results showed that HIF-1alpha mRNA and VEGF mRNA were expressed in all three leukemia cell lines. After treatment of U937 cell with 4 micromol/L YC-1 for 0, 8, 16 and 24 hours, the changes of morphologic features of U937 cells could be observed under fluorescent microscope and the apoptotic rates significantly increased in time-dependent manner, they were (4.87 +/- 0.70)%, (27.27 +/- 2.00)%, (51.53 +/- 2.81) and (60.5 +/- 3.20)% respectively, the expression levels of VEGF mRNA reduced, while the expression levels of HIF-1alpha mRNA had no obviously changes.Furthermore, the expression of HIF-1alpha, VEGF and BCL-2 decreased, while the expression of BAX and caspase-3 increased, the ratio of BAX/BCL-2 increased in time-dependent manner (r = 0.973, p < 0.01). It is concluded that HIF-1alpha mRNA and VEGF mRNA are all expressed in in K562, U937 and Jurkat cells, YC-1 has significant effect on down-regulating the protein expression of HIF-1alpha and VEGF, and induces the apoptosis in U937. The mechanism of apoptosis in leukemic cells may involve in up-regulating BAX/BCL-2 ratio and expression of protein caspase-3.
Apoptosis ; drug effects ; Cell Hypoxia ; Gene Expression Regulation, Leukemic ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; antagonists & inhibitors ; metabolism ; Indazoles ; pharmacology ; Jurkat Cells ; K562 Cells ; U937 Cells ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo study the effect of tetrandrine (Tet) in combination with droloxifen (DRL) on the expression of nuclear factor kappa B (NF-kappaB) in K562 and K562/A02 cell lines and its reversal mechanism.

METHODSThe activation of NF-kappaB in K562 and K562/A02 cell lines and the effect of Tet or DRL alone or in combination on NF-kappaB protein expression were determined with immunocytochemistry and Western blotting respectively.

RESULTS(1) K562/A02 cells displayed higher level of NF-kappaB protein expression than K562 cells. (2) The application of Tet or DRL alone or in combination had no effect on NF-kappaB expression in K562 cells at 6 h and 12 h (P > 0.05). (3) Tet and DRL alone or in combination could significantly down-regulate NF-kappaB protein expression in nuclei of K562/A02 cells. The effect was more significant in combination than either alone. This effect was more significant at 12 h than at 6 h.

CONCLUSIONS(1) Activation of NF-kappaB may be involved in the mechanism of MDR of K562/A02 cell line. (2)Inhibition of NF-kappaB activation may be involved in the reversal of multidrug resistance in K562/A02 cells by Tet and DRL.

Benzylisoquinolines ; pharmacology ; Drug Resistance, Multiple ; Humans ; K562 Cells ; NF-kappa B ; metabolism ; Tamoxifen ; analogs & derivatives ; pharmacology

Prostate-specific membrane antigen (PSMA), the research of which has flourished in recent years, is a specific prostate cancer marker. PSMA plays a more and more important role in the early diagnosis, gene treatment and prognosis of the disease course of prostate cancer. This review focuses on the progress in researches of the structure, function, expression traits and gene expression of the PSMA protein, prostate cancer radioimmunoimaging, DNA vaccines and suicide gene therapy based on PSMA, as well as the role of PSMA in the clinical diagnosis and treatment of prostate cancer.
Antigens, Surface ; genetics ; Gene Expression Regulation, Neoplastic ; Glutamate Carboxypeptidase II ; genetics ; Humans ; Male ; Prostate-Specific Antigen ; genetics ; Prostatic Neoplasms ; diagnosis ; genetics ; therapy ; RNA, Messenger ; genetics ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction