BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its effic...BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its efficacy in recurrent liver cancer remains unclear.AIM To investigate the clinical effect of TACE combined with RFA in the treatment of recurrent liver cancer.METHODS Ninety patients with recurrent liver cancer were divided into 2 groups according to treatment plan:Control(RFA alone);and experimental[TACE combined with RFA(TACE+RFA)].The incidence of increased alanine aminotransferase levels,complications,and other indices were compared between the two groups before and after the procedures.RESULTS One month after the procedures,the short-term efficacy rate and Karnofsky Performance Status scores of the experimental group were significantly higher than those of the control group(P<0.05).Alpha-fetoprotein(AFP)and total bilirubin levels were lower than those in the control group(P<0.05);The overall response rate was 82.22%and 66.67%in the experimental and control groups,respectively;The disease control rate was 93.33%and 82.22%in the experimental and control groups,respectively,the differences are statistically significant(P<0.05).And there were no statistical differences in complications between the two groups(P>0.05).CONCLUSION TACE+RFA was effective for the treatment of recurrent liver cancer and significantly reduced AFP levels and improved various indices of liver function.展开更多
Objective: To investigate the potential and early effect of hypertonic saline resuscitation on T-lymphocyte sub- populations in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was es...Objective: To investigate the potential and early effect of hypertonic saline resuscitation on T-lymphocyte sub- populations in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was established in 18 Sprague-Dawley (SD) rats. The rats were randomly divided into Sham group, HTS group (hypertonic saline resuscitation group) and NS group (normal saline resuscitation group). Each group contained 6 rats. The CD4+ and CD8+ subpopulations of T-lymphocytes in peripheral blood were detected respectively before shock and after resuscitation by double antibody labelling and flow cytometry. Results: In the early stage after hemorrhagic shock, fluid resuscitation and emergency treatment, the CD4+ lymphocytes of peripheral blood in HTS and NS groups markedly increased. Small volume resuscitation with HTS also induced peripheral CD8+ lymphocytes to a certain extent, whereas NS resuscitation showed no effect in this respect. Consequently, compared with Sham and HTS groups, CD4+/CD8+ ratio of peripheral blood in NS group was obviously increased, and showed statistically differences. Conclusion: In this model of rat with severe hemorrhagic shock, small volume resuscitation with HTS is more effective than NS in reducing immunologic disorders and promoting a more balanced profile of T-lymphocyte subpopula- tions regulating network.展开更多
Objective: To investigate the early effects of hypertonic and isotonic saline solutions on apoptosis of intestinal mucosa in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was estab...Objective: To investigate the early effects of hypertonic and isotonic saline solutions on apoptosis of intestinal mucosa in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was established in 21 Sprague-Dawley (SD) rats. The rats were randomly divided into the sham group, normal saline resuscitation (NS) group, and hypertonic saline resuscitation (HTS) group, with 7 in each group. We detected and compared the apoptosis in small intestinal mucosa of rats after hemorrhagic shock and resuscitation by terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL), FITC (fluo- rescein-iso-thiocyanate)-Annexin V/PI (propidium iodide) double staining method, and flow cytometry. Results: In the early stage of hemorrhagic shock and resuscitation, marked apoptosis of small intestinal mucosa in the rats of both NS and HTS groups was observed. The numbers of apoptotic cells in these two groups were significantly greater than that in the sham group (P<0.01). In the HTS group, the apoptic cells significantly decreased, compared with the NS group (P<0.01). Conclusion: In this rat model of severe hemorrhagic shock, the HTS resuscitation of small volume is more effective than the NS resuscitation in reducing apoptosis of intestinal mucosa in rats, which may improve the prognosis of trauma.展开更多
To compare the early effects of hypertonic and isotonic saline resuscitation on heme oxygenase-1 （HO-1） expression in organs of rats with hemorrhagic shock. Rats were randomly divided into hypertonic saline resuscit...To compare the early effects of hypertonic and isotonic saline resuscitation on heme oxygenase-1 （HO-1） expression in organs of rats with hemorrhagic shock. Rats were randomly divided into hypertonic saline resuscitation （HTS）, normal saline resuscitation （NS） and sham groups. HO-1 mRNA, protein expression and apoptosis were evaluated in organs. In the HTS group, significant difference was noted in HO-1 protein in small intestinal mucosa and liver compared with the NS and sham groups, and in HO-1 mRNA in liver and kidney compared with the sham group. The apoptosis of small intestinal mucosa, liver, heart, and lung was significantly lower in the HTS group than that in the NS group. In this study, small volume resuscitation with HTS can efficiently up-regulate the expression level of HO-1 in small intestinal mucosa and liver, which may be one of the mechanisms alleviating organ damage.展开更多
2,4-dinitrophenol （DNP）, an organic compound which frequently used in industry, is considered to have high toxicity. This study aimed to investigate the early changes of lymphocyte subpopulations in patients with oc...2,4-dinitrophenol （DNP）, an organic compound which frequently used in industry, is considered to have high toxicity. This study aimed to investigate the early changes of lymphocyte subpopulations in patients with occupational 2,4-DNP poisoning. Totally 9 patients with acute occupational 2,4-DNP poisoning and 30 healthy volunteers as control were enrolled. The patients received immediately comprehensive supportive treatments, including large-dose glucocorticoid and repeated hemoperfusion （HP）. The ratio of CD4＋/CD8＋ T cells were significantly higher in patients upon admission compared to healthy controls （P 〈 0.01）; however, counts of total lymphocytes, CD3＋, CD3＋CD4＋, CD3＋CD8＋, B （CD19＋）, and natural killer （NK） cells （CD16＋CD56＋） were significantly reduced （all P 〈 0.001）. The NK cell count was negatively correlated with initial plasma 2,4-DNP concentration （r = -0.750, P = 0.026）. Thus, acute occupational 2,4-DNP poisoning was accompanied by immediate complex immune cell reactions, especially NK cells might play important role in severe 2,4-DNP poisoning.展开更多
Objective: To observe the effects of three fluid resuscitation methods on apoptosis of visceral organs in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock and active bleeding was esta...Objective: To observe the effects of three fluid resuscitation methods on apoptosis of visceral organs in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock and active bleeding was established in 32 SD (Sprague-Dawley) rats. The rats were randomly divided into control group, no fluid resuscitation group (NF group), controlled fluid resuscitation group (NS40 group) and rapid large scale fluid resuscitation group (NS80 group). Each group contained 8 rats. The curative effects were compared. At the same time, the apoptosis in liver, kidney, lung and small intestinal mucosa of survivors after hemorrhage and resuscitation was detected by light microscopy in HE (hematoxylin and eosin) stained tissue sections, flow cytometry and terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL). Results: The survival rate of early fluid resuscitation (14/16) was markedly higher than that of NF group (3/8). There was some apoptosis in liver, kidney, lung and small intestinal mucosa of all survivors. Compared with NF and NS40 groups, the apoptosis of liver, kidney and small intestinal mucosa of NS80 group was obviously increased. Conclusions: Among three fluid resuscitation methods, controlled fluid resuscitation can obviously improve the early survival rate and the apoptosis of liver, kidney and small intestinal mucosa in rats with severe and uncontrolled hemorrhagic shock, and may benefit improvement of prognosis.展开更多
S To provide evidences for exploiting tissue microarray (TMA) technology, we reviewed advantages and applications of TMA on tumor research. TMA has many advantages, including (1) section from TMA blocks can be utili...S To provide evidences for exploiting tissue microarray (TMA) technology, we reviewed advantages and applications of TMA on tumor research. TMA has many advantages, including (1) section from TMA blocks can be utilized for the simultaneous analysis of up to 1,000 different tumors at DNA, RNA or protein level; (2) TMA is highly representative of their donor tissues; (3) TMA can improve conservation of tissue resources and experimental reagents, improve internal experimental control, and increase sample numbers per experiment, and can be used for large-scale, massively parallel in situ analysis; (4) TMA facilitates rapid translation of molecular discoveries to clinical applications. TMA has been applied to tumor research, such as glioma, breast tumor, lung cancer and so on. The development of novel biochip technologies has opened up new possibilities for the high-throughput molecular profiling of human tumors. Novel molecular markers emerging from high-throughput expression surveys could be analyzed on tumor TMA. It is anticipated that TMA, a new member of biochip, will soon become a widely used tool for all types of tissue-based research. TMA will lead to a significant acceleration of the transition of basic research findings into clinical applications.展开更多
Primary clear cell carcinoma of the nasopharynx is a rare and locally invasive minor salivary gland neoplasm,only two cases have been reported yet in the literature.Now a 57-year man,with primary nasopharyngeal clear ...Primary clear cell carcinoma of the nasopharynx is a rare and locally invasive minor salivary gland neoplasm,only two cases have been reported yet in the literature.Now a 57-year man,with primary nasopharyngeal clear carcinoma,received radiotherapy and chemotherapy.After treatment,the mass of nasopharynx visibly reduced.Follow-up two months and repeated MRI,CT,abdominal B-ultrasonograpy,electronic nasopharyngoscopy,no tumor recurrence or metastasis.展开更多
Tumor cachexia is widely seen in patients with various stages of cancer,manifested by inadequate intake or abnormal hypermetabolism resultingin negative nitrogen and energy balance. Early intervention of nutritionalth...Tumor cachexia is widely seen in patients with various stages of cancer,manifested by inadequate intake or abnormal hypermetabolism resultingin negative nitrogen and energy balance. Early intervention of nutritionaltherapy and penetrate it into other anti-cancer treatment processes cansignificantly benefit cancer patients who receiving palliative treatment.Nutritional therapy for cancer is a process of planning, implementing, evaluatingand nutritional intervention to treat cancer and its complications orphysical condition, to improve the prognosis of cancer patients, includingnutritional diagnosis (screening/evaluation), nutritional intervention, efficacyevaluation (including follow-up) three stages. In practice, we shouldchoose appropriate nutritional risk assessment tools and interventionmethods according to the actual situation of patients, avoid over-treatment,reduce complications, and maximize patients'interests as far as possible.Nutritional support therapy for cancer involves ethics, morality and thewishes of patients and their families, and needs further exploration andimprovement. The best nutritional support strategy often requires the jointparticipation of many disciplines, including clinicians, nurses, nutritionistsand psychosocial workers. Nutritional support group and multidisciplinarycollaboration group on cancer are gradually becoming a trend. With theaccumulation of experience in cancer nutrition therapy, the developmentand application of drugs and nutritional preparations, and the deepening ofmulti-disciplinary collaboration, more cancer patients will benefit in clinicalwork.展开更多
Objective： The aim of this study is to establish the methods of four facio-cervical fields＇ conformal radiotherapy （4F-CRT） for nasopharyngeal carcinoma （NPC）, and to optimize the methods for clinical practice. ...Objective： The aim of this study is to establish the methods of four facio-cervical fields＇ conformal radiotherapy （4F-CRT） for nasopharyngeal carcinoma （NPC）, and to optimize the methods for clinical practice. Methods and Materials： 40 patients with untreated NPC of T1-T4 （1997AJCC Staging System） were rolled into this study. Conventional and four ratio-cervical fields conform plans were designed for each patient using Pinnacle 8.0 three-dimension treatment planning system （3D-TPS）： 1） Improved plan, four ratio-cervical fields＇conform plans, anterior, posterior ratio-cervical and 2 lateral opposing facio-eervical fields; 2） Conventional plan, two lateral opposing facio-cervical fields only with the same dose delivered to the target in each plan, close volume histograms （DVHs） of the targets and normal organs, brain stem, spinal cord, parotid glands, and temporal mandibular joints （TMJs） were compared and the dose distribution were evaluated. Results： 1） The dose distribution of the improved plan could meet the requirements for the target volume. 2） There was not any significant difference in the dose of spinal cord between the two plans. The mean doses of Dmax for brain stem in conventional plan were much lower than those in the improved plan, though both were within safety limits. 3） Compared with the conventional plans, the improved plan significantly decreased the hotspot areas in the target volume and had better parotid glands and temporal mandibular joints sparing effect. Conclusion： Compared with the conventional plan, the improved plan provides satisfactory dose coverage to the tumor volume and better sparing of the parotid gland, TMJs and other normal tissues in external beam radiotherapy of NPC.展开更多
Background Hemorrhagic shock induces immune dysfunction. Regulatory T cells （Tregs）, T-helper （Th） cells, and cytotoxic T-lymphocytes （CTLs） can execute many crucial actions in immune and inflammatory responses....Background Hemorrhagic shock induces immune dysfunction. Regulatory T cells （Tregs）, T-helper （Th） cells, and cytotoxic T-lymphocytes （CTLs） can execute many crucial actions in immune and inflammatory responses. This study was conducted to investigate the early pathophysiological changes of CD4＋CD25＋Foxp3＋ Treg and Th1/Th2, Tc1/Tc2 profiles in the peripheral blood of rats with controlled hemorrhagic shock and no fluid resuscitation. Methods A rat model of controlled hemorrhagic shock with no fluid resuscitation was established. Peripheral blood samples were taken before and four hours after hemorrhagic shock with no fluid resuscitation. Three color flow cytometry was used to detect Tregs, Thl, Th2, Tcl and Tc2 ceils in the samples. Results In the peripheral blood of rats, the percentage of Tregs four hours after hemorrhagic shock was significantly lower than before hemorrhagic shock （P=0.001）. The ratios of Th1/Th2 and Tc1/Tc2 were changed from （23.08±8.98）% to （23.91±15.36）%, and from （40.40±21.56）% to （65.48±23.88）%, respectively. Conclusions At an early stage, the advent of hemorrhagic shock is related to an early decrease of Tregs, and a mild shift in the Th1/Th2, Tc1/Tc2 balance toward Thl and Tcl dominance. These changes are part of a hyper-inflammatory state of the host, and will deteriorate the maintenance of immune balance. Further influences and detailed mechanisms need to be investigated.展开更多
Hemorrhagic shock is a common clinical emergency case. Successful treatment is usually accomplished by surgical control of hemorrhage and restoration of tissue perfusion. The fluid resuscitation method in the presurgi...Hemorrhagic shock is a common clinical emergency case. Successful treatment is usually accomplished by surgical control of hemorrhage and restoration of tissue perfusion. The fluid resuscitation method in the presurgical care of the hypotensive trauma patients is controversial. Current guidelines for presurgical treatment of patients with hemorrhagic shock recommend rapid volume resuscitation to normal blood pressure as quickly as possible.展开更多
Objective： To investigate the effect and clinical significance of Xuebijing injection on peripheral T-lymphocyte subpopulations in patients with severe trauma. Methods： Thirty-three patients with severe trauma were...Objective： To investigate the effect and clinical significance of Xuebijing injection on peripheral T-lymphocyte subpopulations in patients with severe trauma. Methods： Thirty-three patients with severe trauma were randomly divided into a control group （n=16） and a treatment group （n=17）. The patients of two groups were all treated conventionally, and the only difference was that Xuebijing injection was given to patients of the treatment group. The CD4^＋ and CD8^＋ subpopulations of T-lymphocyte in the peripheral blood were detected respectively on admission, 3rd and 5th days after trauma by double antibody labeling and flow cytometry. Results： The CD4^＋ T-lymphocytes and CD4^＋/CD8^＋ ratio of peripheral blood in patients with severe trauma decreased markedly on the 3rd and 5th days after trauma. Furthermore, compared with control group, the peripheral CD4^＋ T-lymphocytes and CD4^＋/CD8^＋ ratio of treatment group renewed obviously on the 5th day after trauma, and showed statistical differences （P〈0.05）. Conelusion： In the treatment of patients with severe trauma, the early use of Xuebijing injection is effective in correcting disorder or suppression of T-lymphocyte subpopulations regulating network, and promoting a more balanced profile of immunologic function.展开更多
Background Massive blood loss due to trauma is the leading cause of death in trauma patients and military combatants. The fluid category of resuscitation for hypotensive trauma patients is open to debate. This study w...Background Massive blood loss due to trauma is the leading cause of death in trauma patients and military combatants. The fluid category of resuscitation for hypotensive trauma patients is open to debate. This study was conducted to investigate the early effects of hypertonic and isotonic saline solutions on heme oxygenase-1 （HO-1） mRNA expression and apoptosis in the intestinal mucosa of rats with hemorrhagic shock. Methods A model of severe hemorrhagic shock was established in 21 Sprague-Dawley rats. The rats were randomly divided into sham, normal saline resuscitation （NS）, and hypertonic saline resuscitation （HTS） groups, with 7 in each group. We assessed and compared the HO-1 mRNA expression and apoptosis in the small intestinal mucosa of rats after hemorrhagic shock and resuscitation using the SYBR Green I fluorescence quantitative reverse transcriptase polymerase chain reaction, fluorescein-iso-thiocyanate-annexin V/propidium iodide double staining, and flow cytometry. Results In the early stage of hemorrhagic shock and resuscitation, marked apoptosis occurred in the small intestinal mucosa from both the NS and HTS groups. The apoptotic rate in the NS group was higher than that in the HTS group （P 〈0.01）. Among the three groups, HO-1 mRNA mucosa from the HTS group had the highest level of expression; however, the differences were not significant. There was a significant negative correlation between HO-1 mRNA expression and apoptosis in the small intestinal mucosa from the NS and HTS groups after hemorrhagic shock and resuscitation. Conclusions In this rat model of severe hemorrhagic shock, HTS resuscitation with a small volume is more effective than NS resuscitation in reducing apoptosis of the intestinal mucosa. Further, HO-1 mRNA over-expression in the intestinal mucosa may be one of the molecular mechanisms of HTS in the resuscitation of hemorrhagic shock.展开更多
Objective： To investigate the effects of resuscitation with normal saline（NS）, hypertonic saline（HTS）, and hydroxyethyl starch（HES） on regulatory T cells（Tregs）, helper T 1（Th1）/Th2 and cytotoxic T 1（Tc1）...Objective： To investigate the effects of resuscitation with normal saline（NS）, hypertonic saline（HTS）, and hydroxyethyl starch（HES） on regulatory T cells（Tregs）, helper T 1（Th1）/Th2 and cytotoxic T 1（Tc1）/Tc2 profiles in the treatment of hemorrhagic shock. Methods： Rats subjected to severe hemorrhagic shock were resuscitated for 30 min with NS（n=8）, HTS（n=8）, or HES（n=8）; sham（n=8） and naive control（n=8） groups were used for comparison. Following fluid resuscitation, the whole shed blood was reinfused for 30 min, and the rats were observed with continuous hemodynamic monitoring for 120 min. CD4^＋CD25^＋Foxp3^＋ Treg proportions, Th1/Th2 and Tc1/Tc2 profiles in spleen were analyzed by three-color flow cytometry. Results： The proportion of CD4^＋CD25^＋Foxp3^＋ Tregs and ratios of Th1/Th2 and Tc1/Tc2 did not differ among control, sham, and HTS groups, but were significantly lower in NS and HES groups（both P0.05 vs. sham）; NS and HES levels were similar. The level of Tc1 was significantly increased in HTS（P0.05 vs. sham）, and levels of Tc2 were increased in NS, HES, and HTS groups compared to sham（all P0.05）, but did not differ from each other. Conclusions： HTS resuscitation has a greater impact on immune system recovery than NS or HES by preserving the proportion of Tregs and maintaining the balance between Th1/Th2 and Tc1/Tc2 cells in the spleen. Thus, HTS resuscitation provides potential immunomodulatory activity in the early stage after hemorrhagic shock.展开更多
Objective:To observe the clinical efficacy of point application with De Huang(Rhizome Rhei Crude)powder at Shenque(CV 8)plus moxa-salt hot compress on the umbilicus for preventing gastrointestinal adverse reactions af...Objective:To observe the clinical efficacy of point application with De Huang(Rhizome Rhei Crude)powder at Shenque(CV 8)plus moxa-salt hot compress on the umbilicus for preventing gastrointestinal adverse reactions after chemotherapy for non-Hodgkin lymphoma(NHL).Methods:A total of 60 cases with NHL under chemotherapy were divided into two groups by hospitalization order,with 30 cases in each group.The control group was treated with routine nursing and the observation group was additionally given point application with Da Hueng(Rhizome Rhei Crude)powder plus moxa-salt hot compress on the umbilicus,to compare the effect in preventing gastrointestinal adverse reactions after chemotherapy between the two groups.Results:The occurrence rates of constipation,nausea,vomiting and poor appetite on the second day and fifth day after chemotherapy were obviously lower in the observation group than those in the control group,with statistically significant differences between the two groups(all P〈0.05).Conclusion;The point application with De Hueng(Rhizome Rhei Crude)powder at Shenque(CV 8)plus maxa-salt hot compress on the umbilicus can produce more significant efficacy in preventing the gastrointestinal adverse reactions after chemotherapy for NHL than routine nursing.Moreover,it is simple and easy to be used and popularized.展开更多
Objective: The aim of this study is to establish the methods of four facio-cervical field's conformal radiotherapy(4F-CRT) for nasopharyngeal carcinoma(NPC), and to optimize the methods for clinical practice. Mate...Objective: The aim of this study is to establish the methods of four facio-cervical field's conformal radiotherapy(4F-CRT) for nasopharyngeal carcinoma(NPC), and to optimize the methods for clinical practice. Materials and Methods:40 patients with untreated NPC of T1-T4(1997 AJCC Staging System) were rolled into this study.Conventional and four facio-cervical fields conform plans were designed for each patient using Pinnacle 8.0 three-dimension treatment planning system(3D-TPS)as follows: 1. Improved plan, four facio-cervical field's conform plan, anterior, posterior facio-cervical and two lateral opposing facio-cervical fields; 2. Conventional plan, two lateral opposing facio-cervical fields delivered to the target in each plan, only with the same dose dose volume histograms(DVHs) of the targets and normal organs, brain stem,spinal cord, parotid glands, and temporal mandibular joints(TMJs) were compared and the dose distribution were evaluated. Results: 1.The dose distribution of the improved plan could meet the requirements for the target volume. 2. There was not any significant difference in the dose of spinal cord between the two plans.The mean doses of Dmaxfor brain stem in conventional plan were much lower than those in the improved plan,though both were within safety limits. 3. Compared with the conventional plans, the improved plan significantly decreased the hotspot areas in the target volume and had better parotid glands and temporal mandibular joints sparing effect. Conclusion:Compared with the conventional plan, the improved plan provides satisfactory dose coverage to the tumor volume and better sparing of the parotid gland, TMJs and other normal tissues in external beam radiotherapy of NPC.展开更多
文摘BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its efficacy in recurrent liver cancer remains unclear.AIM To investigate the clinical effect of TACE combined with RFA in the treatment of recurrent liver cancer.METHODS Ninety patients with recurrent liver cancer were divided into 2 groups according to treatment plan:Control(RFA alone);and experimental[TACE combined with RFA(TACE+RFA)].The incidence of increased alanine aminotransferase levels,complications,and other indices were compared between the two groups before and after the procedures.RESULTS One month after the procedures,the short-term efficacy rate and Karnofsky Performance Status scores of the experimental group were significantly higher than those of the control group(P<0.05).Alpha-fetoprotein(AFP)and total bilirubin levels were lower than those in the control group(P<0.05);The overall response rate was 82.22%and 66.67%in the experimental and control groups,respectively;The disease control rate was 93.33%and 82.22%in the experimental and control groups,respectively,the differences are statistically significant(P<0.05).And there were no statistical differences in complications between the two groups(P>0.05).CONCLUSION TACE+RFA was effective for the treatment of recurrent liver cancer and significantly reduced AFP levels and improved various indices of liver function.
文摘Objective: To investigate the potential and early effect of hypertonic saline resuscitation on T-lymphocyte sub- populations in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was established in 18 Sprague-Dawley (SD) rats. The rats were randomly divided into Sham group, HTS group (hypertonic saline resuscitation group) and NS group (normal saline resuscitation group). Each group contained 6 rats. The CD4+ and CD8+ subpopulations of T-lymphocytes in peripheral blood were detected respectively before shock and after resuscitation by double antibody labelling and flow cytometry. Results: In the early stage after hemorrhagic shock, fluid resuscitation and emergency treatment, the CD4+ lymphocytes of peripheral blood in HTS and NS groups markedly increased. Small volume resuscitation with HTS also induced peripheral CD8+ lymphocytes to a certain extent, whereas NS resuscitation showed no effect in this respect. Consequently, compared with Sham and HTS groups, CD4+/CD8+ ratio of peripheral blood in NS group was obviously increased, and showed statistically differences. Conclusion: In this model of rat with severe hemorrhagic shock, small volume resuscitation with HTS is more effective than NS in reducing immunologic disorders and promoting a more balanced profile of T-lymphocyte subpopula- tions regulating network.
基金Project (No. 20061420) supported by the Education and Research Foundation of Zhejiang Province, China
文摘Objective: To investigate the early effects of hypertonic and isotonic saline solutions on apoptosis of intestinal mucosa in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock was established in 21 Sprague-Dawley (SD) rats. The rats were randomly divided into the sham group, normal saline resuscitation (NS) group, and hypertonic saline resuscitation (HTS) group, with 7 in each group. We detected and compared the apoptosis in small intestinal mucosa of rats after hemorrhagic shock and resuscitation by terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL), FITC (fluo- rescein-iso-thiocyanate)-Annexin V/PI (propidium iodide) double staining method, and flow cytometry. Results: In the early stage of hemorrhagic shock and resuscitation, marked apoptosis of small intestinal mucosa in the rats of both NS and HTS groups was observed. The numbers of apoptotic cells in these two groups were significantly greater than that in the sham group (P<0.01). In the HTS group, the apoptic cells significantly decreased, compared with the NS group (P<0.01). Conclusion: In this rat model of severe hemorrhagic shock, the HTS resuscitation of small volume is more effective than the NS resuscitation in reducing apoptosis of intestinal mucosa in rats, which may improve the prognosis of trauma.
基金supported by the Zhejiang Provincial Natural Science Foundation of China (No.Y2100430)the Zhejiang Provincial Education and Research Foundation of China (No. Y201019154)
文摘To compare the early effects of hypertonic and isotonic saline resuscitation on heme oxygenase-1 （HO-1） expression in organs of rats with hemorrhagic shock. Rats were randomly divided into hypertonic saline resuscitation （HTS）, normal saline resuscitation （NS） and sham groups. HO-1 mRNA, protein expression and apoptosis were evaluated in organs. In the HTS group, significant difference was noted in HO-1 protein in small intestinal mucosa and liver compared with the NS and sham groups, and in HO-1 mRNA in liver and kidney compared with the sham group. The apoptosis of small intestinal mucosa, liver, heart, and lung was significantly lower in the HTS group than that in the NS group. In this study, small volume resuscitation with HTS can efficiently up-regulate the expression level of HO-1 in small intestinal mucosa and liver, which may be one of the mechanisms alleviating organ damage.
基金supported by the grants from the Foundation of Science and Technology Department of Zhejiang Province for Beneficial Technology Research of Social Development(2011C23013)
文摘2,4-dinitrophenol （DNP）, an organic compound which frequently used in industry, is considered to have high toxicity. This study aimed to investigate the early changes of lymphocyte subpopulations in patients with occupational 2,4-DNP poisoning. Totally 9 patients with acute occupational 2,4-DNP poisoning and 30 healthy volunteers as control were enrolled. The patients received immediately comprehensive supportive treatments, including large-dose glucocorticoid and repeated hemoperfusion （HP）. The ratio of CD4＋/CD8＋ T cells were significantly higher in patients upon admission compared to healthy controls （P 〈 0.01）; however, counts of total lymphocytes, CD3＋, CD3＋CD4＋, CD3＋CD8＋, B （CD19＋）, and natural killer （NK） cells （CD16＋CD56＋） were significantly reduced （all P 〈 0.001）. The NK cell count was negatively correlated with initial plasma 2,4-DNP concentration （r = -0.750, P = 0.026）. Thus, acute occupational 2,4-DNP poisoning was accompanied by immediate complex immune cell reactions, especially NK cells might play important role in severe 2,4-DNP poisoning.
文摘Objective: To observe the effects of three fluid resuscitation methods on apoptosis of visceral organs in rats with hemorrhagic shock. Methods: A model of rat with severe hemorrhagic shock and active bleeding was established in 32 SD (Sprague-Dawley) rats. The rats were randomly divided into control group, no fluid resuscitation group (NF group), controlled fluid resuscitation group (NS40 group) and rapid large scale fluid resuscitation group (NS80 group). Each group contained 8 rats. The curative effects were compared. At the same time, the apoptosis in liver, kidney, lung and small intestinal mucosa of survivors after hemorrhage and resuscitation was detected by light microscopy in HE (hematoxylin and eosin) stained tissue sections, flow cytometry and terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL). Results: The survival rate of early fluid resuscitation (14/16) was markedly higher than that of NF group (3/8). There was some apoptosis in liver, kidney, lung and small intestinal mucosa of all survivors. Compared with NF and NS40 groups, the apoptosis of liver, kidney and small intestinal mucosa of NS80 group was obviously increased. Conclusions: Among three fluid resuscitation methods, controlled fluid resuscitation can obviously improve the early survival rate and the apoptosis of liver, kidney and small intestinal mucosa in rats with severe and uncontrolled hemorrhagic shock, and may benefit improvement of prognosis.
文摘S To provide evidences for exploiting tissue microarray (TMA) technology, we reviewed advantages and applications of TMA on tumor research. TMA has many advantages, including (1) section from TMA blocks can be utilized for the simultaneous analysis of up to 1,000 different tumors at DNA, RNA or protein level; (2) TMA is highly representative of their donor tissues; (3) TMA can improve conservation of tissue resources and experimental reagents, improve internal experimental control, and increase sample numbers per experiment, and can be used for large-scale, massively parallel in situ analysis; (4) TMA facilitates rapid translation of molecular discoveries to clinical applications. TMA has been applied to tumor research, such as glioma, breast tumor, lung cancer and so on. The development of novel biochip technologies has opened up new possibilities for the high-throughput molecular profiling of human tumors. Novel molecular markers emerging from high-throughput expression surveys could be analyzed on tumor TMA. It is anticipated that TMA, a new member of biochip, will soon become a widely used tool for all types of tissue-based research. TMA will lead to a significant acceleration of the transition of basic research findings into clinical applications.
文摘Primary clear cell carcinoma of the nasopharynx is a rare and locally invasive minor salivary gland neoplasm,only two cases have been reported yet in the literature.Now a 57-year man,with primary nasopharyngeal clear carcinoma,received radiotherapy and chemotherapy.After treatment,the mass of nasopharynx visibly reduced.Follow-up two months and repeated MRI,CT,abdominal B-ultrasonograpy,electronic nasopharyngoscopy,no tumor recurrence or metastasis.
文摘Tumor cachexia is widely seen in patients with various stages of cancer,manifested by inadequate intake or abnormal hypermetabolism resultingin negative nitrogen and energy balance. Early intervention of nutritionaltherapy and penetrate it into other anti-cancer treatment processes cansignificantly benefit cancer patients who receiving palliative treatment.Nutritional therapy for cancer is a process of planning, implementing, evaluatingand nutritional intervention to treat cancer and its complications orphysical condition, to improve the prognosis of cancer patients, includingnutritional diagnosis (screening/evaluation), nutritional intervention, efficacyevaluation (including follow-up) three stages. In practice, we shouldchoose appropriate nutritional risk assessment tools and interventionmethods according to the actual situation of patients, avoid over-treatment,reduce complications, and maximize patients'interests as far as possible.Nutritional support therapy for cancer involves ethics, morality and thewishes of patients and their families, and needs further exploration andimprovement. The best nutritional support strategy often requires the jointparticipation of many disciplines, including clinicians, nurses, nutritionistsand psychosocial workers. Nutritional support group and multidisciplinarycollaboration group on cancer are gradually becoming a trend. With theaccumulation of experience in cancer nutrition therapy, the developmentand application of drugs and nutritional preparations, and the deepening ofmulti-disciplinary collaboration, more cancer patients will benefit in clinicalwork.
文摘Objective： The aim of this study is to establish the methods of four facio-cervical fields＇ conformal radiotherapy （4F-CRT） for nasopharyngeal carcinoma （NPC）, and to optimize the methods for clinical practice. Methods and Materials： 40 patients with untreated NPC of T1-T4 （1997AJCC Staging System） were rolled into this study. Conventional and four ratio-cervical fields conform plans were designed for each patient using Pinnacle 8.0 three-dimension treatment planning system （3D-TPS）： 1） Improved plan, four ratio-cervical fields＇conform plans, anterior, posterior ratio-cervical and 2 lateral opposing facio-eervical fields; 2） Conventional plan, two lateral opposing facio-cervical fields only with the same dose delivered to the target in each plan, close volume histograms （DVHs） of the targets and normal organs, brain stem, spinal cord, parotid glands, and temporal mandibular joints （TMJs） were compared and the dose distribution were evaluated. Results： 1） The dose distribution of the improved plan could meet the requirements for the target volume. 2） There was not any significant difference in the dose of spinal cord between the two plans. The mean doses of Dmax for brain stem in conventional plan were much lower than those in the improved plan, though both were within safety limits. 3） Compared with the conventional plans, the improved plan significantly decreased the hotspot areas in the target volume and had better parotid glands and temporal mandibular joints sparing effect. Conclusion： Compared with the conventional plan, the improved plan provides satisfactory dose coverage to the tumor volume and better sparing of the parotid gland, TMJs and other normal tissues in external beam radiotherapy of NPC.
基金This work was supported by a grant from the Medical and Health Science Foundation of Zhejiang Province, China （No. 2009B052）.
文摘Background Hemorrhagic shock induces immune dysfunction. Regulatory T cells （Tregs）, T-helper （Th） cells, and cytotoxic T-lymphocytes （CTLs） can execute many crucial actions in immune and inflammatory responses. This study was conducted to investigate the early pathophysiological changes of CD4＋CD25＋Foxp3＋ Treg and Th1/Th2, Tc1/Tc2 profiles in the peripheral blood of rats with controlled hemorrhagic shock and no fluid resuscitation. Methods A rat model of controlled hemorrhagic shock with no fluid resuscitation was established. Peripheral blood samples were taken before and four hours after hemorrhagic shock with no fluid resuscitation. Three color flow cytometry was used to detect Tregs, Thl, Th2, Tcl and Tc2 ceils in the samples. Results In the peripheral blood of rats, the percentage of Tregs four hours after hemorrhagic shock was significantly lower than before hemorrhagic shock （P=0.001）. The ratios of Th1/Th2 and Tc1/Tc2 were changed from （23.08±8.98）% to （23.91±15.36）%, and from （40.40±21.56）% to （65.48±23.88）%, respectively. Conclusions At an early stage, the advent of hemorrhagic shock is related to an early decrease of Tregs, and a mild shift in the Th1/Th2, Tc1/Tc2 balance toward Thl and Tcl dominance. These changes are part of a hyper-inflammatory state of the host, and will deteriorate the maintenance of immune balance. Further influences and detailed mechanisms need to be investigated.
文摘Hemorrhagic shock is a common clinical emergency case. Successful treatment is usually accomplished by surgical control of hemorrhage and restoration of tissue perfusion. The fluid resuscitation method in the presurgical care of the hypotensive trauma patients is controversial. Current guidelines for presurgical treatment of patients with hemorrhagic shock recommend rapid volume resuscitation to normal blood pressure as quickly as possible.
基金This study-was supported by the Traditional Chinese Medical Science Foundation of Zhejiang Province （No. 2005C052）.
文摘Objective： To investigate the effect and clinical significance of Xuebijing injection on peripheral T-lymphocyte subpopulations in patients with severe trauma. Methods： Thirty-three patients with severe trauma were randomly divided into a control group （n=16） and a treatment group （n=17）. The patients of two groups were all treated conventionally, and the only difference was that Xuebijing injection was given to patients of the treatment group. The CD4^＋ and CD8^＋ subpopulations of T-lymphocyte in the peripheral blood were detected respectively on admission, 3rd and 5th days after trauma by double antibody labeling and flow cytometry. Results： The CD4^＋ T-lymphocytes and CD4^＋/CD8^＋ ratio of peripheral blood in patients with severe trauma decreased markedly on the 3rd and 5th days after trauma. Furthermore, compared with control group, the peripheral CD4^＋ T-lymphocytes and CD4^＋/CD8^＋ ratio of treatment group renewed obviously on the 5th day after trauma, and showed statistical differences （P〈0.05）. Conelusion： In the treatment of patients with severe trauma, the early use of Xuebijing injection is effective in correcting disorder or suppression of T-lymphocyte subpopulations regulating network, and promoting a more balanced profile of immunologic function.
文摘Background Massive blood loss due to trauma is the leading cause of death in trauma patients and military combatants. The fluid category of resuscitation for hypotensive trauma patients is open to debate. This study was conducted to investigate the early effects of hypertonic and isotonic saline solutions on heme oxygenase-1 （HO-1） mRNA expression and apoptosis in the intestinal mucosa of rats with hemorrhagic shock. Methods A model of severe hemorrhagic shock was established in 21 Sprague-Dawley rats. The rats were randomly divided into sham, normal saline resuscitation （NS）, and hypertonic saline resuscitation （HTS） groups, with 7 in each group. We assessed and compared the HO-1 mRNA expression and apoptosis in the small intestinal mucosa of rats after hemorrhagic shock and resuscitation using the SYBR Green I fluorescence quantitative reverse transcriptase polymerase chain reaction, fluorescein-iso-thiocyanate-annexin V/propidium iodide double staining, and flow cytometry. Results In the early stage of hemorrhagic shock and resuscitation, marked apoptosis occurred in the small intestinal mucosa from both the NS and HTS groups. The apoptotic rate in the NS group was higher than that in the HTS group （P 〈0.01）. Among the three groups, HO-1 mRNA mucosa from the HTS group had the highest level of expression; however, the differences were not significant. There was a significant negative correlation between HO-1 mRNA expression and apoptosis in the small intestinal mucosa from the NS and HTS groups after hemorrhagic shock and resuscitation. Conclusions In this rat model of severe hemorrhagic shock, HTS resuscitation with a small volume is more effective than NS resuscitation in reducing apoptosis of the intestinal mucosa. Further, HO-1 mRNA over-expression in the intestinal mucosa may be one of the molecular mechanisms of HTS in the resuscitation of hemorrhagic shock.
基金supported by the National Natural Science Foundation of China(No.81272075)
文摘Objective： To investigate the effects of resuscitation with normal saline（NS）, hypertonic saline（HTS）, and hydroxyethyl starch（HES） on regulatory T cells（Tregs）, helper T 1（Th1）/Th2 and cytotoxic T 1（Tc1）/Tc2 profiles in the treatment of hemorrhagic shock. Methods： Rats subjected to severe hemorrhagic shock were resuscitated for 30 min with NS（n=8）, HTS（n=8）, or HES（n=8）; sham（n=8） and naive control（n=8） groups were used for comparison. Following fluid resuscitation, the whole shed blood was reinfused for 30 min, and the rats were observed with continuous hemodynamic monitoring for 120 min. CD4^＋CD25^＋Foxp3^＋ Treg proportions, Th1/Th2 and Tc1/Tc2 profiles in spleen were analyzed by three-color flow cytometry. Results： The proportion of CD4^＋CD25^＋Foxp3^＋ Tregs and ratios of Th1/Th2 and Tc1/Tc2 did not differ among control, sham, and HTS groups, but were significantly lower in NS and HES groups（both P0.05 vs. sham）; NS and HES levels were similar. The level of Tc1 was significantly increased in HTS（P0.05 vs. sham）, and levels of Tc2 were increased in NS, HES, and HTS groups compared to sham（all P0.05）, but did not differ from each other. Conclusions： HTS resuscitation has a greater impact on immune system recovery than NS or HES by preserving the proportion of Tregs and maintaining the balance between Th1/Th2 and Tc1/Tc2 cells in the spleen. Thus, HTS resuscitation provides potential immunomodulatory activity in the early stage after hemorrhagic shock.
文摘Objective:To observe the clinical efficacy of point application with De Huang(Rhizome Rhei Crude)powder at Shenque(CV 8)plus moxa-salt hot compress on the umbilicus for preventing gastrointestinal adverse reactions after chemotherapy for non-Hodgkin lymphoma(NHL).Methods:A total of 60 cases with NHL under chemotherapy were divided into two groups by hospitalization order,with 30 cases in each group.The control group was treated with routine nursing and the observation group was additionally given point application with Da Hueng(Rhizome Rhei Crude)powder plus moxa-salt hot compress on the umbilicus,to compare the effect in preventing gastrointestinal adverse reactions after chemotherapy between the two groups.Results:The occurrence rates of constipation,nausea,vomiting and poor appetite on the second day and fifth day after chemotherapy were obviously lower in the observation group than those in the control group,with statistically significant differences between the two groups(all P〈0.05).Conclusion;The point application with De Hueng(Rhizome Rhei Crude)powder at Shenque(CV 8)plus maxa-salt hot compress on the umbilicus can produce more significant efficacy in preventing the gastrointestinal adverse reactions after chemotherapy for NHL than routine nursing.Moreover,it is simple and easy to be used and popularized.
文摘Objective: The aim of this study is to establish the methods of four facio-cervical field's conformal radiotherapy(4F-CRT) for nasopharyngeal carcinoma(NPC), and to optimize the methods for clinical practice. Materials and Methods:40 patients with untreated NPC of T1-T4(1997 AJCC Staging System) were rolled into this study.Conventional and four facio-cervical fields conform plans were designed for each patient using Pinnacle 8.0 three-dimension treatment planning system(3D-TPS)as follows: 1. Improved plan, four facio-cervical field's conform plan, anterior, posterior facio-cervical and two lateral opposing facio-cervical fields; 2. Conventional plan, two lateral opposing facio-cervical fields delivered to the target in each plan, only with the same dose dose volume histograms(DVHs) of the targets and normal organs, brain stem,spinal cord, parotid glands, and temporal mandibular joints(TMJs) were compared and the dose distribution were evaluated. Results: 1.The dose distribution of the improved plan could meet the requirements for the target volume. 2. There was not any significant difference in the dose of spinal cord between the two plans.The mean doses of Dmaxfor brain stem in conventional plan were much lower than those in the improved plan,though both were within safety limits. 3. Compared with the conventional plans, the improved plan significantly decreased the hotspot areas in the target volume and had better parotid glands and temporal mandibular joints sparing effect. Conclusion:Compared with the conventional plan, the improved plan provides satisfactory dose coverage to the tumor volume and better sparing of the parotid gland, TMJs and other normal tissues in external beam radiotherapy of NPC.
