Objectives. To investigate the association between inflammatory mediators, matrix degrading enzymes and acute coronary syndrome (ACS) and the impact of early reperfusion therapy on circulating ...biomarkers. Design. Peripheral serum levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinase-9 (MMP-9) were determined in 134 patients with ACS. These biomarkers were serially monitored in ten patients with intravenous thrombolytic therapy (IVT). Results. Serum levels of IL-6, hs-CRP and MMP-9 were higher in unstable angina (UA) and myocardial infarction (MI) groups than in control or SA group (p<0.05). Peripheral IL-6 level in patients with MI was greater after percutaneous coronary intervention (PCI) (p<0.01) or IVT (p<0.05). Serial concentration determination revealed marked elevation of serum IL-6 and MMP-9 levels, both reaching peak values (like creatine kinase-MB). Conclusions. Elevated levels of IL-6, hs-CRP and MMP-9 provide a link between inflammation, matrix degradation and the development and progression of ACS. IL-6 and MMP-9 appear to be released mainly from vulnerable plaque or necrotic myocardium during the acute phase of MI.
Testicular germ cell tumors (TGCT) are the most common cancer among men aged 15 to 39 years. Previous studies have considered factors related to TGCT survival rate and race/ethnicity, but ...histological type of the diagnosed cancer has not yet been thoroughly assessed.
The data came from 42,854 eligible patients from 1992 to 2015 in the Surveillance Epidemiology and End Results 18. Frequencies and column percent by seminoma and nonseminoma subtypes were determined for each covariates. We used Cox proportional hazard regression to assess the impact of multiple factors on post-diagnostic mortality of TGCT.
Black males were diagnosed at a later stage, more commonly with local or distant metastases. The incidence of TGCT in black non-seminoma tumors increased most significantly. The difference in survival rates between different ethnic and histological subtypes, overall survival (OS) in patients with non-seminoma was significantly worse than in patients with seminoma. The most important quantitative predictor of death was the stage at the time of diagnosis, and older diagnostic age is also important factor affecting mortality.
Histological type of testicular germ cell tumor is an important factor in determining the prognosis of testicular cancer in males of different ethnic groups.
AIM:To evaluate the application of bipolar coagulation(BIP)in hepatectomy by comparing the efficacy of BIP alone,cavitron ultrasonic surgical aspirator(CUSA)+BIP and conventional clamp ...crushing(CLAMP).METHODS:Based on our database of patient records,a total of 380 consecutive patients who underwent hepatectomy at our hospital were retrospectively studied for the efficacy of BIP alone,CUSA+BIP and CLAMP.Of all the patients,75 received saline-coupled BIP(Group A),53 received CUSA+BIP(Group B),and252 received CLAMP(Group C).The pre-,mid-,and postoperative clinical manifestations were compared,and the effects of those maneuvers were evaluated.RESULTS:There was no obvious difference among the preoperative indexes between the different groups.The operative time was longer in Groups A and B than in Group C(P<0.001 for both).The amount of bleeding and the rate of transfusion during the operation were significantly higher in Group C than in Groups A and B(P<0.001 for all).The incidence of postoperative complications in Group C(46.43%)was higher than that in Groups A(30.67%,P=0.015)and B(28.30%,P=0.016).The patients’liver function recovery and postoperative hospital stay were not significantly different.BIP could decrease intraoperative hemorrhage and postoperative complications compared to CLAMP.CONCLUSION:Simple saline-coupled BIP should be considered a safe and reliable technique for liver resection to decrease intraoperative hemorrhage and postoperative complications.
AIM:To explore a prophylactic procedure to prevent splenic artery steal syndrome(SASS),as well as a therapeutic intervention to correct it.METHODS:Forty-three liver transplant patients were enrolled ...in a non-randomized controlled trial,with the eligible criterion that the diameter of the splenic artery is more than 5 mm and/or 1.5 times of the diameter of the hepatic artery.The procedure of splenic artery banding was performed in 28 of the 43 patients,with the other 15 patients studied as a control group.SASS and other complications were compared between these two groups.A new therapeutic intervention,temporary incomplete blockade of the splenic artery with a balloon,was performed to treat SASS in this study.RESULTS:The incidence of SASS was decreased by banding the splenic artery(0/28 vs 5/15,P = 0.006),and the same result was observed in total complications associated with prophylactic procedures(2/28 vs 6/15,P = 0.014).Five patients in the control group developed SASS within 5 d after OLT,2 of whom were treated by coil embolization of the splenic artery,whereas the other 3 by temporary blockade of the splenic artery.Reappeared or better hepatic arteries with improved systolic amplitude and increased diastolic flow were detected by Doppler ultrasonography in all the 5 patients.Local splenic ischemic necrosis and nonanastomotic biliary stricture were diagnosed respectively in one patient treated by coil embolization,and no collateral complication was detected in patients treated by temporary blockade of the splenic artery.CONCLUSION:SASS should be avoided during the operation by banding the splenic artery.Temporary blockade of the splenic artery is a new safe and effective intervention for SASS.
Ti-6Al-4V/Al7050 joints were fabricated by a method of insert molding and corresponding interfacial microstructure and mechanical properties were investigated. The interfacial thickness was sensitive ...to holding temperature during the first stage, and a good metallurgical bonding interface with a thickness of about 90 μm can be obtained at 750?C. X-ray diffraction, transmission electron microscopy, and thermodynamic analyses showed that the interface mainly contained intermetallic compound TiAl3 and Al matrix. The joints featured good mechanical properties, i.e., shear strength of 154 MPa, tensile strength of 215 MPa, and compressive strength of 283 MPa, which are superior to those of joints fabricated by other methods. Coherent boundaries between Al/TiAl3 and TiAl3/Ti were confirmed to contribute to outstanding interfacial mechanical properties and also explained constant fracture occurrence in the Al matrix. Follow-up studies should focus on improving mechanical properties of the Al matrix by deformation and heat treatment.
AIM: To determine whether the positive status of human epidermal growth receptor 2(HER2) can be regarded as an effective prognostic factor for patients with gastric cancer(GC) undergoing R0 ...resection.METHODS: A total of 1562 GC patients treated by R0 resection were recruited. HER2 status was evaluated in surgically resected samples of all the patients using immunohistochemical(IHC) staining. Correlations between HER2 status and clinicopathological characteristics were retrospective analyzed. Hazard ratios(HRs) and 95% confidence intervals(CIs) were estimated using Cox proportional hazard model, stratified by age, gender, tumor location and tumor-nodemetastasis(TNM) stage, with additional adjustment for potential prognostic factors.RESULTS: Among 1562 patients, 548(positive rate = 35.08%, 95%CI: 32.72%-37.45%) were HER2 positive. Positive status of HER2 was significantly correlated with gender(P = 0.004), minority(P < 0.001), tumor location(P = 0.001), pathological grade(P < 0.001), TNM stage(P < 0.001) and adjuvant radiotherapy(74.67% vs 23.53%, P = 0.011). No significant associations were observed between HER2 status and disease free survival(HR = 0.19, 95%CI: 0.96-1.46, P = 0.105) or overall survival(HR = 1.19, 95%CI: 0.96-1.48, P = 0.118) using multivariate analysis, although stratified analyses showed marginally statistically significant associations both in disease free survival and overall survival, especially among patients aged < 60 years or with early TNM stages(Ⅰ and Ⅱ). Categorical age, TNM stage, neural invasion, and adjuvant chemotherapy were, as expected, independent prognostic factors for both disease free survival and overall survival. CONCLUSION: The positive status of HER2 based on IHC staining was not related to the survival in patients with GC among the Chinese population.
BACKGROUNDWe present the case of a 72-year-old female patient with gallbladder cancer (GBC) who developed in situ recurrence and liver metastases 9 mo after irreversible electroporation ablation and ...oral tegafur (a fluoropyrimidine derivative) chemotherapy, which failed to control the progression of the disease. The patient further developed metastases in the lymph nodes around the head of the pancreas. The patient had severe anemia, requiring weekly blood transfusions. The gallbladder tumor invaded the descending part of the duodenum, causing intestinal leakage and hepatic colonic adhesion. CASE SUMMARYThe patient refused other treatments and began daily hydrogen inhalation therapy. After 1 mo of treatment, the gallbladder and liver tumors continued to progress, and intestinal obstruction occurred. After continuous hydrogen therapy and symptomatic treatments including gastrointestinal decompression and intravenous nutrition support, the intestinal obstruction was gradually relieved. Three months after hydrogen therapy, the metastases in the abdominal cavity gradually reduced in size, her anemia and hypoalbuminemia were corrected, lymphocyte and tumor marker levels returned to normal, and the patient was able to resume normal life. CONCLUSIONThis is the first report of an efficacy and safety study about hydrogen therapy in patient with metastatic GBC and a critical general condition, who has remained stable for more than 4 months.
Vascular integrity helps maintain brain microenvironment homeostasis, which is critical for the normal develop- ment and function of the central nervous system. It is known that neural cells can ...regulate brain vascular integrity. However, due to the high complexity of neurovaseular interactions involved, understanding of the neural regulation of brain vascular integrity is still rudimentary. Using intact zebrafish larvae and cultured rodent brain cells, we find that neurons transfer miR-132, a highly conserved and neuron-enriched microRNA, via secreting exosomes to endothelial cells （ECs） to maintain brain vascular integrity. Following translocation to ECs through exosome inter- nalization, miR-132 regulates the expression of vascular endothelial cadherin （VE-cadherin）, an important adherens junction protein, by directly targeting eukaryotic elongation factor 2 kinase （eef2k）. Disruption of neuronal miR-132 expression or exosome secretion, or overexpression of vascular eef2k impairs VE-cadherin expression and brain vas- cular integrity. Our study indicates that miR-132 acts as an intercellular signal mediating neural regulation of the brain vascular integrity and suggests that the neuronal exosome is a novel avenue for neurovascular communication.
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