OBJECTIVE: To evaluate the efficacy and safety of magnesium sulfate in the treatment of acute severe asthma in adults. METHODS: Literature searches were conducted on PubMed, Cochrane, CNKI, VIP and Wanfang databases to screen randomized controlled trial (RCT) of magnesium sulfate in the treatment of acute severe asthma in adults, starting from the establishment of the database and ending on May 22, 2024. The control group received conventional treatment. The observation group was given intravenous magnesium sulfate on the basis of routine treatment. The outcome indexes included total effective rate, peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and other pulmonary function indexes, and incidence of adverse reactions. The selection of relevant literature, the collection of data needed for the study and the risk assessment of bias in the included study were all conducted independently by 2 researchers. Stata 12.0 software was used for Meta-analysis, and funnel plot was used to evaluate publication bias. RESULTS: Sixteen RCT studies with a total of 2 601 patients were included. Meta-analysis results showed that the total effective rate in the observation group was significantly higher than that in the control group [risk ratio (RR) = 1.11, 95% confidence interval (95%CI) was 1.03-1.20, P = 0.008]. In pulmonary function examination, PEF [weighted mean difference (WMD) = 0.70, 95%CI was 0.24-1.15, P = 0.003], FEV1 (WMD = 0.48, 95%CI was 0.29-0.68, P = 0.000) and FVC (WMD = 0.72, 95%CI was 0.47-0.97, P = 0.000) were significantly better than those in the control group. There was no significantly difference in the incidence of adverse reactions between the two groups (RR = 0.51, 95%CI was 0.17-1.55, P = 0.419). The funnel plot was drawn for the total effective rate, which showed that each study presented a symmetrical distribution, and the Begg's test (Z = 1.31, P = 0.189) and Egger's test (t = 1.18, P = 0.261) were combined to consider the small possibility of publication bias. CONCLUSIONS Current evidence shows that the use of magnesium sulfate in the treatment of acute severe asthma in adults increases the total response rate and improves lung function without increasing the incidence of adverse reactions. Due to the limited number and quality of included studies, the above conclusions need to be verified by more high-quality studies high-quality studies.
Humans ; Magnesium Sulfate/administration & dosage* ; Asthma/drug therapy* ; Adult ; Randomized Controlled Trials as Topic ; Forced Expiratory Volume ; Peak Expiratory Flow Rate/drug effects* ; Treatment Outcome

While neuroblastoma accounts for 15% of childhood tumor-related deaths, treatments against neuroblastoma remain scarce and mainly consist of cytotoxic chemotherapeutic drugs. Currently, maintenance therapy of differentiation induction is the standard of care for neuroblastoma patients in clinical, especially high-risk patients. However, differentiation therapy is not used as a first-line treatment for neuroblastoma due to low efficacy, unclear mechanism, and few drug options. Through compound library screening, we accidently found the potential differentiation-inducing effect of AKT inhibitor Hu7691. The protein kinase B (AKT) pathway is an important signaling pathway for regulating tumorigenesis and neural differentiation, yet the relation between the AKT pathway and neuroblastoma differentiation remains unclear. Here, we reveal the anti-proliferation and neurogenesis effect of Hu7691 on multiple neuroblastoma cell lines. Further evidence including neurites outgrowth, cell cycle arrest, and differentiation mRNA marker clarified the differentiation-inducing effect of Hu7691. Meanwhile, with the introduction of other AKT inhibitors, it is now clear that multiple AKT inhibitors can induce neuroblastoma differentiation. Furthermore, silencing AKT was found to have the effect of inducing neuroblastoma differentiation. Finally, confirmation of the therapeutic effects of Hu7691 is dependent on inducing differentiation in vivo, suggesting that Hu7691 is a potential molecule against neuroblastoma. Through this study, we not only define the key role of AKT in the progression of neuroblastoma differentiation but also provide potential drugs and key targets for the application of differentiation therapies for neuroblastoma clinically.

Objective:To explore the long-term effect of endoscopic radiofrequency ablation for the treatment of unresectable ampullary carcinoma.Methods:Clinical data of patients with ampullary carcinoma who received endoscopic radiofrequency ablation in the Third Affiliated Hospital of Naval Medical University from January 2012 to May 2019 were retrospectively collected, including basic information, frequency of radiofrequency ablation, the type of biliary stent, postoperative complications, and follow-up. Kaplan-Meier method was used to analyze the survival of patients after endoscopic radiofrequency ablation. Relationship between frequency of radiofrequency ablation, type of biliary stent and overall survival time was analyzed.Results:A total of 50 patients were enrolled, including 31 males and 19 females, aged 73.0±9.7 years. Twenty-five patients (50.0%) underwent 1 radiofrequency ablation treatment, while 25 patients (50.0%) underwent radiofrequency ablation treatments more than twice. Postoperative complications occurred in 6 patients (12.0%), all of which were mild symptoms. The average follow-up was 22.3 months, with a total of 39 (78.0%) deaths, 5 (10.0%) lost to follow-up, and 6 (12.0%) surviving. The median overall survival time was 16.9 (95% CI: 9.1-24.8) months, with cumulative survival rates of 62.0%, 38.5%, 27.0%, and 12.6% at 1, 2, 3, and 5 years, respectively. The median overall survival time of those treated with radiofrequency ablation ≥2 times showed a trend of prolongation compared to patients treated once, but the difference was not statistically significant [26.7 (95% CI: 9.7-43.7) months VS 12.6 (95% CI: 4.9-20.3) months, χ2=3.049, P=0.081]. Plastic stents were used in 32 patients (64.0%) and metal stents in 18 patients (36.0%). There was no significant difference in median overall survival time between patients using metal and plastic stents [17.1 (95% CI: 6.1-28.0) months VS 15.9 (95% CI: 6.9-24.9) months， χ2=0.029， P=0.865]. Conclusion:Endoscopic radiofrequency ablation is a safe treatment for unresectable ampullary carcinoma, and multiple consecutive treatments may increase the survival benefit.

Objective:To investigate the efficacy of endoscopic stent placement for patients with Bismuth type Ⅳ hilar cholangiocarcinoma.Methods:Data of 229 patients with unresectable Bismuth type Ⅳ hilar cholangiocarcinoma who successfully underwent endoscopic stent placement at the Department of Endoscopy, the Third Affiliated Hospital of Naval Medical University from January 2002 to January 2019 were retrospectively analyzed. Outcomes included clinical success rate, complication incidence, stent patency period and overall survival time. The patency of stents and overall survival time of patients were estimated by using the Kaplan-Meier method. The independent predictors for stent patency and overall survival of patients were analyzed by a multivariate Cox proportional regression model.Results:The overall clinical success rate was 78.2% (179/229). The incidence of early cholangitis after endoscopic retrograde cholangiopancreatography was 20.5% (47/229). The median stent patency and overall survival time were 5.7 (95% CI: 4.8-6.7) months and 5.1 (95% CI: 4.2-6.0) months, respectively. Further multivariate Cox regression analysis showed that metal stent ( P<0.001, HR=0.452, 95% CI: 0.307-0.666) and bilateral stents with bilateral angiography ( P=0.036, HR=0.644, 95% CI: 0.427-0.971) were independent predictors of stent patency; total bilirubin>200 μmol/L ( P=0.001, HR=1.627, 95% CI: 1.208-2.192), metal stent ( P=0.004, HR=0.636, 95% CI: 0.467-0.866) and antitumor therapy ( P<0.001, HR=0.439, 95% CI:0.308-0.626) were independent predictors of overall survival. Conclusion:There is high incidence of cholangitis in patients with unresectable Bismuth type Ⅳ hilar cholangiocarcinoma treated with endoscopic stenting. Longer stent patency can be achieved with metal stent placement and bilateral drainage. In addition, metal stent for drainage and antitumor therapy can also help increase the survival benefit.

Objective To investigate the clinical effects and safety differences of endoscopic hormone injection by tympanic membrane puncture and eustachian tube in the treatment of patients with chronic secretory otitis media.Methods From January 2015 to September 2016,90 patients with chronic secretory otitis media in Zhoushan Hospital were chosen.They were randomly divided into two groups according to the digital table.The tympanic membrane puncture group (65 patients) was treated with hormone injection by tympanic membrane puncture and the eustachian tube group(65 patients) was treated with endoscopic hormone injection by eustachian tubeThe total clinical effective rate,the bone conduction threshold value in 1 kHz,2kHz,4kHz and 8kHz,the ETDQ-7 score and the levels of laboratory index before and after treatment,the secondary tympanic effusion rate and the recurrence rate with follow-up of both groups were compared.Results The total clinical effective rate of the tympanic membrane puncture group and eustachian tube group were 77.78％ and 93.33％,respectively.The total clinical effective rate of the eustachian tube group were significant higher than that of the tympanic membrane puncture group (x2 =9.84,P ＜ 0.05).The bone conduction threshold value in l kHz,2kHz,4kHz and 8kHz of the tympanic membrane puncture group after treatment were (10.42 ± 1.60) kHz,(12.86 ± 2.50) kHz,(16.09 ± 2.81) kHz,(15.26 ± 2.68) kHz,respectively.The bone conduction threshold value in 1kHz,2kHz,4kHz and 8kHz of the eustachian tube group after treatment were (9.75 ± 1.36) kHz,(11.13 ± 2.02) kHz,(14.82 ± 2.44) kHz,(13.78 ± 2.11) kHz,respectively.The bone conduction threshold value in 1kHz,2kHz,4kHz and 8kHz of the eustachian tube group after treatment were significant lower than those of the tympanic membrane puncture group and those before treatment(t =3.10,3.56,3.29,3.96,2.87,3.15,2.91,3.28,2.67,2.81,2.78,2.50,all P ＜ 0.05).The ETDQ-7 scores of the eustachian tube group after treatment were significant lower than those of the tympanic membrane puncture group and those before treatment(t =3.31,3.87,2.89,all P ＜ 0.05).The levels of laboratory index of the eustachian tube group after treatment were significant higher than those of the tympanic membrane puncture group and those before treatment (t =3.36,3.77,3.71,4.02,2.83,3.06,all P ＜ 0.05).The secondary tympanic effusion rate and the recurrence rate with follow-up of the eustachian tube group were significant lower than those of the tympanic membrane puncture group(x2 =9.87,12.33,10.67,all P ＜ 0.05).Conclusion Compared with endoscopic hormone injection by tympanic membrane puncture,endoscopic hormone injection by eustachian tube in the treatment of patients with chronic secretory otitis media possess the advantages including relieve the clinical symptoms,improve the bone conduction threshold and eustachian tube function,regulate the laboratory indexes and reduce the risk of recurrence and effusion.

Curcumae Rhizoma comes from Curcuma genus,functional breaking blood stasis,detumescence and acesodyne for treatment of Zhengjia accumulation,amenorrhea,traumatic injury and bruising pain.Modem pharmacological studies have shown that the main monomer composition of zedoary turmeric has a good anti-inflammatory and anti-tumor effects.The main monomer composition of zedoary turmeric copies of curcumol,beta etemene,curcumin anti-inflammatory anti-tumor mechanism of review,provide the basis for the further research progress and clinical application of zedoary turmeric.

Objective:To study the mechanism of ginsenoside Rh2 inhibiting HepG2 cells migration.Methods:HepG2 cells in logarithmic growth phase were cultured in 96-well plates,which were induced by different concentration Rh2,respectively for 24,48,72 hours.The cell inhibition was detected by Cell Counting Kit.Transwell chambers was used to checked HepG2 cell migration ability;luciferase was tested by Luciferase Reporter Assay system reagent;The expressions of P-ERK,ERK,P-P38,P-38,P-JUK,JUK,MMP3 proteins were detect by Western blot;the expression of AP1,MMP3 gene were detected by Quantitative PCR;The expression of AP1, MMP3 fluorescence protein were observed by fluorescence microscopy.Results:Administrated with different concentration of Rh2 after 24 ,48 ,72 h,the proliferation of HepG2 cells were inhibited ( P<0.05) ,and in dose-and time-dependent manner.Transwell assay showed Rh2 could significantly inhibited migration of HepG2 cells.The expressions of P-ERK , MMP3 proteins were significantly decreased,the expressions of P-JUK, P-P38 proteins were significantly increased, expression levels of ERK, P-38, JUK were no significant difference.Expression of AP1,MMP3 gene were significantly decreased,the expressions of AP1,MMP3 fluorescence proteins were significantly decreased.Conclusion:Ginsenoside Rh2 can activate MAPK pathway to inhibit the migration of HepG2 cells.

Objective: To investigate the inhibitory effect of Rh2 on HepG2 cells and explore the underlying mechanism.Methods: We used lentivirus carrying β-catenin to infect HepG2 cell, and detected expression of β-catenin using fluorescence microscopy.The effect of Rh2 on proliferation of HepG2-β-catenin and HepG2 cells was measured by CKK-8 assay,and flow cytometry was used to detect cell cycle and apoptosis.The activity of Gsk-3βwas checked by ELISA kit.The expression of Gsk-3β,β-catenin,Bax,Bcl2,CyclinD1,MMP3 genes were measured by qRT-PCR.In order to checked the relationship between β-catenin and TCF4,CHIP assay kit was used,the expression of Bax,Bcl2,CyclinD1,MMP3 genes were measured by PCR.The expressions of Gsk-3β,β-catenin,Bax,Bcl2,CyclinD1,MMP3 proteins were examined by Western blot.Results:HepG2 cells were successfully infected by pLOV-EF1a-MCS-3FLAG-β-catenin lentivirus,named HepG2-β-catenin.CCK-8 showed that ginsenoside Rh2 could effectively inhibit the proliferation of HepG2 and HepG2-β-catenin cells in vitro,which exhibits a dose-dependent manner at range of 10-160 μmol/L Rh2.The IC50 of Rh2 exposure on HepG2 cell for 48,72 h were 100 μmol/L and 58.12 μmol/L,but the IC50 of Rh2 exposure on HepG2-β-catenin for 48,72 h were 129.2 μmol/L,83.33 μmol/L,respectively.The IC50 of Rh2 exposure on HepG2-β-catenin cell was higher than HepG2 cell, compared with HepG2 group the differences was statistically significant ( P<0.01 ).Flow cytometry indicated that Rh2 could arrest HepG2 and HepG2-β-catenin cells in G0/G1 phase;the cell population in G0/G1 phase of HepG2+Rh2 group was(64.57±0.65)%,HepG2-β-catenin+Rh2 group was(58.61±2.01)%.Flow cytometry indicated that Rh2 could induced early apoptosis in HepG2 and HepG2-β-catenin cells.The apoptosis rate of HepG2 +Rh2 group was (17.27 ±2.77)%,HepG2-β-catenin +Rh2 group(9.02 ±1.76)%.The ELISA results indicated that HepG2 cells was induced by Rh2 for 12,24,48,72 h,the activity of Gsk-3βgradually increased,peak in 48 h,then decreased.Compared with control group,Rh2 induced HepG2 and HepG2-β-catenin cells for 48 hours, Gsk-3βactivity were increased, and their activity reduced after adding Bio, there were no significant differences between HepG2+Rh2 and HepG2-β-catenin+Rh2 groups.The PCR,CHIP and WB results showed that the expression of Gsk-3β,Bax gene and proteins increased,while theβ-catenin,CyclinD1,Bcl2,MMP3 gene and proteins down-regulation in HepG2 and HepG2-β-catenin cell induced by Rh2.Compared with HepG2-β-catenin +Rh2 group, the expression of other gene and proteins changed significantly,however,Gsk-3βwas no significant difference.Conclusion:Over-expression of β-catenin may weaken the phar-macological effects of ginsenoside Rh2 on HepG2 cells.The activity of Gsk-3βwas increased by ginsenoside Rh2 to degradeβ-catenin, affecting the expression of downstream genes,promoting apoptosis of liver cancer cells and inhibiting metastasis.

OBJECTIVETo investigate the inhibitory effect of trichostatin A (TSA) on the proliferation of HepG2 cells and explore the underlying mechanism.

METHODSHepG2 cells exposed to different concentrations of TSA for 24, 48, or 72 h were examined for cell growth inhibition using a cell counting kit, changes in cell cycle distribution with flow cytometry, cell apoptosis with annexin V-FTIC/PI double staining, and cell morphology changes under inverted microscope. The expressions of beta-catenin, HDAC1, HDAC3, H3K9, cyclinD1 and Bax proteins in the exposed cells were detected by Western blotting, and the expressions of HDAC1 and HDAC3 mRNAs by quantitative fluorescent PCR.

RESULTSExposure to TSA caused significant dose- and time-dependent inhibition of HepG2 cell proliferation (P<0.05) and resulted in increased cell percentage in G0/G1 and G2/M phases and decreased cell percentage in S phase. The apoptotic index in the control group was (6.22 ± 0.25)%, which increased to (7.17 ± 0.20)% and (18.14 ± 0.42)% after exposure to 250 and 500 nmol/L TSA, respectively. Exposure to 250 and 500 nmol/L TSA also caused cell morphology changes with numerous floating cells. The expressions of beta-catenin, H3K9 and Bax proteins were significantly increased and CyclinD1, HDAC1, and HDAC3 protein expressions decreased in TSA-treated cells, but the expressions of HDAC1 and HDAC3 mRNAs showed no significant changes.

CONCLUSIONSTSA can inhibit the proliferation of HepG2 cells and induce cell cycle arrest and apoptosis by inhibiting HDAC activity, promoting histone acetylation, and activating Wnt/beta-catenin signaling pathway.

Acetylation ; Apoptosis ; Cell Cycle Checkpoints ; Cell Proliferation ; drug effects ; Cyclin D1 ; metabolism ; Hep G2 Cells ; drug effects ; Histone Deacetylase 1 ; metabolism ; Histone Deacetylases ; metabolism ; Histones ; metabolism ; Humans ; Hydroxamic Acids ; pharmacology ; Wnt Signaling Pathway ; bcl-2-Associated X Protein ; metabolism ; beta Catenin ; metabolism

Objective To explore the application value of five row of emotional nursing program in the patients suffering from gastrointestinal operation.Methods Totals of 228 patients suffering from gastrointestinal operation were randomly divided into the observation group and the control group, with 114 cases in each group. The observation group received five rows of emotional nursing program according to the three kinds of negative emotions, and the control group was implemented the general emotional nursing care.The symptom checklist was used to assess patients’ symptoms, the St.Mary’ s Hospital Sleep Questionnaire ( SMH) was used to evaluate the sleep quality of patients.Patients’ symptoms and sleep quality were compared at the second day after admission and the first day after intervention.Results The scores of symptom checklist and SMH were not significant (P>0.05).After the intervention, the total scores of somatization and SMH were (1.36 ±0.20) and (18.09 ±3.58) in the observation group.Those scores of the control group were (1.42 ±0.33) and (17.69 ±2.48).There were no significant differences between the two groups ( t =0.368, 0.985, respectively;P>0.05).Other aspects of the observation group were significantly better than those in the control group (t=2.896-4.023,P<0.05).The self-assessment lists and SMH of the observation group before and after the intervention had significant differences (t=3.012-7.362,P<0.05).After the intervention, the total scores of somatization and SMH of the control group were significantly improved ( t =3.026, -4.331, respectively;P<0.05).The rest of the aspects had no significant differences (t=0.639-0.942,P>0.05). Based on the five row emotional care programme, 112 patients in the observation group were satisfied and 2 patients were not satisfied.Those numbers of the control group were 91 and 23.There was a significant difference between the two groups (χ2 =19.726,P<0.01).Conclusions The five row emotional nursing program for patients suffering from gastrointestinal operation have a certain effect on negative emotional, and can improve the sleep quality and treatment satisfaction of the patients.