Purpose:To investigate the safety and feasibility of radical total gastrectomy without postoperative gastrointestinal decompression in elderly patients with gastric cancer.Methods:Elderly patients(65e80 years of age)h...Purpose:To investigate the safety and feasibility of radical total gastrectomy without postoperative gastrointestinal decompression in elderly patients with gastric cancer.Methods:Elderly patients(65e80 years of age)hospitalized with gastric cancer from May 2009 to August 2012 were selected to receive radical total gastrectomy with(controls,n=39)or without(n=37)postoperative gastrointestinal decompression.Postoperative recovery conditions and associated complications were observed and compared.Results:In the group without decompression,the first passage of flatus post-operation was significantly earlier,and scores of nausea,pharyngitis,insomnia,and postoperative ambulation limitation were significantly reduced compared to controls(all p<0.01).However,there were no differences in the degree of abdominal distension,time to first anal defecation,or incidence of postoperative complications between the groups.Conclusion:Gastrointestinal decompression is not necessary after total gastrectomy in elderly gastric cancer patients,and may improve patient comfort and recovery.展开更多
Multiple endocrine neoplasia type 2A （MEN2A）, a subtype of MEN2, is characterized by medullary thyroid cancer, pheochromocytoma, and primary hyperparathyroidism. A Han Chinese pedigree with MEN2A was investigated fo...Multiple endocrine neoplasia type 2A （MEN2A）, a subtype of MEN2, is characterized by medullary thyroid cancer, pheochromocytoma, and primary hyperparathyroidism. A Han Chinese pedigree with MEN2A was investigated following confirmation of the proband＇s diagnosis by pathological findings and DNA/biochemical screening. DNA samples from 4 other family members were collected and exon 5, 8, 10, 11, 13, 16 and 18 of the RET proto-oncogene were sequenced and then analyzed. A missense mutation of TGG （Trp） to TGC （Cys） at codon 634 （the classic MEN2A mutation） in exon 11 of the RET gene was detected in 3 family members, including the proband. Sequencing data were compared with the human gene mutation database. Elevated serum calcitonin level was detected initially; medullary thyroid carcinoma was revealed in the 3 cases and adrenal pheochromocytoma was also found in the proband. Elective operations were successfully performed on the adrenal and thyroid glands because of pheochromocytoma and medullary thyroid carcinoma. Our case study confirms that integrated DNA-based/biochemical screening is crucial for early diagnosis of MEN2A and is helpful in the screening of their relatives. In addition, DNA-based screening may occasionally uncover a previously unknown RET sequence.展开更多
BACKGROUND Angioimmunoblastic T-cell lymphoma(AITL), a unique subtype of peripheral Tcell lymphoma, has relatively poor outcomes. High-dose chemotherapy with autologous stem cell transplantation(ASCT) can achieve comp...BACKGROUND Angioimmunoblastic T-cell lymphoma(AITL), a unique subtype of peripheral Tcell lymphoma, has relatively poor outcomes. High-dose chemotherapy with autologous stem cell transplantation(ASCT) can achieve complete remission and improve outcomes. Unfortunately, subsequent T-cell lymphoma-triggered hemophagocytic lymphohistiocytosis(HLH) has a worse prognosis than B-cell lymphoma-triggered HLH.CASE SUMMARY We here report a 50-year-old woman with AITL who achieved a favorable outcome after developing HLH 2 mo after receiving high-dose chemotherapy/ASCT. The patient was initially admitted to our hospital because of multiple enlarged lymph nodes. The final pathologic diagnosis, made on biopsy of a left axillary lymph node was AITL(Stage Ⅳ, Group A). Four cycles of the following chemotherapy regimen were administered: Cyclophosphamide 1.3 g, doxorubicin 86 mg, and vincristine 2 mg on day 1;prednisone 100 mg on days 1-5;and lenalidomide 25 mg on days 1-14. The interval between each cycle was 21 d. The patient received a conditioning regimen(busulfan, cyclophosphamide, and etoposide) followed by peripheral blood stem cell infusion. Unfortunately, she developed sustained fever and a low platelet count 17 d after ACST, leading to a diagnosis of HLH after ASCT. During treatment, she experienced thrombocytopenia and Pneumocystis carinii pneumonia. The patient was successfully treated with etoposide and glucocorticoids.CONCLUSION It is possible that development of HLH is related to immune reconstitution after ASCT.展开更多
Background Dyslipidemia caused by liver injury is a significant risk factor for cardiovascular complications.Previous studies have shown that hydrogen sulfide （H2S） protects against multiple cardiovascular disease s...Background Dyslipidemia caused by liver injury is a significant risk factor for cardiovascular complications.Previous studies have shown that hydrogen sulfide （H2S） protects against multiple cardiovascular disease states in a similar manner as nitric oxide （NO）,and NO/endothelial nitric oxide synthase （eNOS） pathway is the key route of NO production.The purpose of this study was to investigate whether H2S can ameliorate the high blood pressure and plasma lipid profile in Nw-nitro-L-argininemethyl ester （L-NAME）-induced hypertensive rats by NO/eNOS pathway.Methods Thirty-six 4-week old Sprague-Dawley （SD） male rats were randomly assigned to 6 groups （n=6）：control group,L-NAME group,control ＋ glibenclamide group,control ＋ NaHS group,L-NAME ＋ NaHS group,and L-NAME ＋ NaHS ＋ glibenclamide group.Measurements were made of plasma triglycerides （TG）,low-density lipoprotein （LDL）,high-density lipoprotein （HDL）,total cholesterol （CHO）,glutamic-pyruvic transaminase （ALT） levels after 5 weeks.Then measurements of NO level and proteins expression of eNOS,P-eNOS,AKT,P-AKT were made in liver tissue.Results After 5 weeks of L-NAME treatment,the blood pressure,plasma TG （（1.22±0.12） mmol/L in L-NAME group vs.（0.68±0.09） mmol/L in control group; P ＜0.05） and LDL （（0.54±0.04） mmol/L in L-NAME group vs.（0.28±0.02） mmol/L in control group; P ＜0.05） concentration were significantly increased,and the plasma HDL （（0.26±0.02） mmol/L in L-NAME group vs.（0.69±0.07） mmol/L in control group; P ＜0.05） concentration significantly decreased.Meanwhile the rats treated with L-NAME exhibit dysfunctional eNOS,diminished NO levels （（1.36±0.09） mmol/g protein in L-NAME group vs.（2.34±0.06） mmol/g protein in control group; P ＜0.05） and pathological changes of the liver.H2S therapy can markedly decrease the blood pressure （（37.25±4.46） mmHg at the fifth week; P ＜0.05）,and ameliorate the plasma TG （（0.59±0.06） mmHg）,LDL （（0.32±0.04） mmHg）,and HDL （（0.46±0.03） mmHg） concentration in L-NAME ＋ NaHS group （all P ＜0.05）.H2S therapy can also restore eNOS function and NO bioavailability and attenuate the pathological changes in the liver in L-NAME-induced hypertensive rats.Conclusion H2S protects the L-NAME-induced hypertensive rats against liver injury via NO/eNOS pathway,therefore de.creases the cardiovascular risk.展开更多
Objective To review the advances of studies on vitamin D receptor and its role in the pathogenesis of diabetic nephropathy.Data sources A comprehensive search of the PubMed literatures without restriction on the publi...Objective To review the advances of studies on vitamin D receptor and its role in the pathogenesis of diabetic nephropathy.Data sources A comprehensive search of the PubMed literatures without restriction on the publication date was carried out using keywords such as vitamin D receptor and diabetic nephropathy.Study selection Articles related to vitamin D receptor and diabetic nephropathy were selected and carefully analyzed.Results The ligands as well as construction and tissue distribution of vitamin D receptor were summarized.Pathogenesis of diabetic nephropathy was analyzed.The mechanisms underlying the renoprotective role of vitamin D receptor including inhibition of renin-angiotensin system,anti-inflammation,anti-fibrosis and the reduction of proteinuria were reviewed.Mounting evidences from animal and clinical studies have suggested that vitamin D therapy has beneficial effects on the renal systems and the underlying renoprotective mechanisms of the vitamin D receptor-mediated signaling pathways is a hot research topic.Conclusion Our study suggests that vitamin D receptor has a great potential for preventing the progression of diabetic nephropathy via multiple mechanisms.展开更多
基金This project was supported by the Natural Science Foundation of Anhui Province,China(1408085MH154).
文摘Purpose:To investigate the safety and feasibility of radical total gastrectomy without postoperative gastrointestinal decompression in elderly patients with gastric cancer.Methods:Elderly patients(65e80 years of age)hospitalized with gastric cancer from May 2009 to August 2012 were selected to receive radical total gastrectomy with(controls,n=39)or without(n=37)postoperative gastrointestinal decompression.Postoperative recovery conditions and associated complications were observed and compared.Results:In the group without decompression,the first passage of flatus post-operation was significantly earlier,and scores of nausea,pharyngitis,insomnia,and postoperative ambulation limitation were significantly reduced compared to controls(all p<0.01).However,there were no differences in the degree of abdominal distension,time to first anal defecation,or incidence of postoperative complications between the groups.Conclusion:Gastrointestinal decompression is not necessary after total gastrectomy in elderly gastric cancer patients,and may improve patient comfort and recovery.
基金supported by grant 81170747 from the National Natural Sciences Foundation of Chinagrant H201106 from Health Promotion Foundation of Jiangsu Provincegrant from the Office of Human Resources and Social Security of Jiangsu Province (Peak of the Six Personnel in Jiangsu Province) to Hongwen Zhou
文摘Multiple endocrine neoplasia type 2A （MEN2A）, a subtype of MEN2, is characterized by medullary thyroid cancer, pheochromocytoma, and primary hyperparathyroidism. A Han Chinese pedigree with MEN2A was investigated following confirmation of the proband＇s diagnosis by pathological findings and DNA/biochemical screening. DNA samples from 4 other family members were collected and exon 5, 8, 10, 11, 13, 16 and 18 of the RET proto-oncogene were sequenced and then analyzed. A missense mutation of TGG （Trp） to TGC （Cys） at codon 634 （the classic MEN2A mutation） in exon 11 of the RET gene was detected in 3 family members, including the proband. Sequencing data were compared with the human gene mutation database. Elevated serum calcitonin level was detected initially; medullary thyroid carcinoma was revealed in the 3 cases and adrenal pheochromocytoma was also found in the proband. Elective operations were successfully performed on the adrenal and thyroid glands because of pheochromocytoma and medullary thyroid carcinoma. Our case study confirms that integrated DNA-based/biochemical screening is crucial for early diagnosis of MEN2A and is helpful in the screening of their relatives. In addition, DNA-based screening may occasionally uncover a previously unknown RET sequence.
基金Supported by the Jinan Clinical Medical Science and Technology Innovation Plan,No.202019141Norman Bethune Foundation-Feifan Iron Supplement Project,No.ffbt-C-2022-010.
文摘BACKGROUND Angioimmunoblastic T-cell lymphoma(AITL), a unique subtype of peripheral Tcell lymphoma, has relatively poor outcomes. High-dose chemotherapy with autologous stem cell transplantation(ASCT) can achieve complete remission and improve outcomes. Unfortunately, subsequent T-cell lymphoma-triggered hemophagocytic lymphohistiocytosis(HLH) has a worse prognosis than B-cell lymphoma-triggered HLH.CASE SUMMARY We here report a 50-year-old woman with AITL who achieved a favorable outcome after developing HLH 2 mo after receiving high-dose chemotherapy/ASCT. The patient was initially admitted to our hospital because of multiple enlarged lymph nodes. The final pathologic diagnosis, made on biopsy of a left axillary lymph node was AITL(Stage Ⅳ, Group A). Four cycles of the following chemotherapy regimen were administered: Cyclophosphamide 1.3 g, doxorubicin 86 mg, and vincristine 2 mg on day 1;prednisone 100 mg on days 1-5;and lenalidomide 25 mg on days 1-14. The interval between each cycle was 21 d. The patient received a conditioning regimen(busulfan, cyclophosphamide, and etoposide) followed by peripheral blood stem cell infusion. Unfortunately, she developed sustained fever and a low platelet count 17 d after ACST, leading to a diagnosis of HLH after ASCT. During treatment, she experienced thrombocytopenia and Pneumocystis carinii pneumonia. The patient was successfully treated with etoposide and glucocorticoids.CONCLUSION It is possible that development of HLH is related to immune reconstitution after ASCT.
基金This study was supported by the grants from the National Natural Science Foundation of China （No. 31171098）, the Program for New Century Excellent Talents in University from the Education Ministry of China （No. NCET-07-0252）, Hebei Province Funds for Distinguished Young Scientists （No. 2010000471）, Innovation Talents Support plan of Hebei Province （No. LJRC017）, the Specialized Research Fund for the Doctoral Program of Higher Education （No. 20121323110008）.
文摘Background Dyslipidemia caused by liver injury is a significant risk factor for cardiovascular complications.Previous studies have shown that hydrogen sulfide （H2S） protects against multiple cardiovascular disease states in a similar manner as nitric oxide （NO）,and NO/endothelial nitric oxide synthase （eNOS） pathway is the key route of NO production.The purpose of this study was to investigate whether H2S can ameliorate the high blood pressure and plasma lipid profile in Nw-nitro-L-argininemethyl ester （L-NAME）-induced hypertensive rats by NO/eNOS pathway.Methods Thirty-six 4-week old Sprague-Dawley （SD） male rats were randomly assigned to 6 groups （n=6）：control group,L-NAME group,control ＋ glibenclamide group,control ＋ NaHS group,L-NAME ＋ NaHS group,and L-NAME ＋ NaHS ＋ glibenclamide group.Measurements were made of plasma triglycerides （TG）,low-density lipoprotein （LDL）,high-density lipoprotein （HDL）,total cholesterol （CHO）,glutamic-pyruvic transaminase （ALT） levels after 5 weeks.Then measurements of NO level and proteins expression of eNOS,P-eNOS,AKT,P-AKT were made in liver tissue.Results After 5 weeks of L-NAME treatment,the blood pressure,plasma TG （（1.22±0.12） mmol/L in L-NAME group vs.（0.68±0.09） mmol/L in control group; P ＜0.05） and LDL （（0.54±0.04） mmol/L in L-NAME group vs.（0.28±0.02） mmol/L in control group; P ＜0.05） concentration were significantly increased,and the plasma HDL （（0.26±0.02） mmol/L in L-NAME group vs.（0.69±0.07） mmol/L in control group; P ＜0.05） concentration significantly decreased.Meanwhile the rats treated with L-NAME exhibit dysfunctional eNOS,diminished NO levels （（1.36±0.09） mmol/g protein in L-NAME group vs.（2.34±0.06） mmol/g protein in control group; P ＜0.05） and pathological changes of the liver.H2S therapy can markedly decrease the blood pressure （（37.25±4.46） mmHg at the fifth week; P ＜0.05）,and ameliorate the plasma TG （（0.59±0.06） mmHg）,LDL （（0.32±0.04） mmHg）,and HDL （（0.46±0.03） mmHg） concentration in L-NAME ＋ NaHS group （all P ＜0.05）.H2S therapy can also restore eNOS function and NO bioavailability and attenuate the pathological changes in the liver in L-NAME-induced hypertensive rats.Conclusion H2S protects the L-NAME-induced hypertensive rats against liver injury via NO/eNOS pathway,therefore de.creases the cardiovascular risk.
文摘Objective To review the advances of studies on vitamin D receptor and its role in the pathogenesis of diabetic nephropathy.Data sources A comprehensive search of the PubMed literatures without restriction on the publication date was carried out using keywords such as vitamin D receptor and diabetic nephropathy.Study selection Articles related to vitamin D receptor and diabetic nephropathy were selected and carefully analyzed.Results The ligands as well as construction and tissue distribution of vitamin D receptor were summarized.Pathogenesis of diabetic nephropathy was analyzed.The mechanisms underlying the renoprotective role of vitamin D receptor including inhibition of renin-angiotensin system,anti-inflammation,anti-fibrosis and the reduction of proteinuria were reviewed.Mounting evidences from animal and clinical studies have suggested that vitamin D therapy has beneficial effects on the renal systems and the underlying renoprotective mechanisms of the vitamin D receptor-mediated signaling pathways is a hot research topic.Conclusion Our study suggests that vitamin D receptor has a great potential for preventing the progression of diabetic nephropathy via multiple mechanisms.
