ObjectiveTo elucidate the mechanism of evolimus (EVR) and its application, efficacy and common adverse reactions in hepatocellular carcinoma (HCC) patients after liver transplantation.MethodRelevant literatures in recent years were searched through websites such as Wanfang, CNKI and PubMed, and the results were read, analyzed and summarized.ResultsCurrently, there are a wide variety of immunosuppressive agents for HCC patients after liver transplantation, and immunosuppressive treatment options are also diverse and there is no unified standard. Today is more widely used clinically used for transplantation immune inhibitors of calcineurin inhibitors (CNIs), but because of its renal toxicity and side effects and recurrence of HCC risk increases, CNIs in HCC patients after liver transplantation using gradually is restricted, and mammalian target of rapamycin (mTOR) inhibitors are valued, gradually into clinical immunosuppression after liver transplantation for treatment provides a new way of thinking. As an mTOR inhibitor, EVR is gradually being applied to HCC patients after liver transplantation.ConclusionAs an mTOR inhibitor only approved for use in HCC patients after liver transplantation in recent years, relevant literature studies have shown that EVR plays an important role in improving the success rate of transplantation, protecting renal function and inhibiting HCC recurrence.
Objective To summarize the research progress of immunotherapy for metastatic breast cancer. Method Literatures about immunotherapy for metastatic breast cancer were reviewed by searching the literatures in domestic and foreign database. Results In recent years, immunotherapy had been initially attempted in patients with metastatic breast cancer and showed its unique value. It provided a new way to improve the therapeutic effect and prolong the survival time of patients with metastatic breast cancer. ConclusionsImmunotherapy is the most effective in triple-negative metastatic breast cancers. The immuno-oncology needs to be developed to improve the clinical benefits of immunotherapy for breast cancer.
Objective To assess the efficacy and safety of acupuncture for patients with hiccups after stroke. Methods The randomized controlled trials (RCTs) of acupuncture for patients with hiccups after stroke were collected by searching PubMed, The Cochrane Library, CNKI, VIP, and WangFang databases. The quality of the included studies was evaluated and the data were retrieved according to the methods recommended by the Cochrane Collaboration. Meta-analyses were conducted by using RevMan software. Results Three trials involving 143 patients were included. All of them were open-label controlled without observing the effective rate and mortality rate (or dependence rate) at the end of follow-up visit lasting for at least three months. The result of meta-analyses showed that the group of acupuncture plus drug was more effective for hiccup after stroke than the drug group at the end of the treatment, and the difference was significant (OR=9.05, 95%CI 3.17 to 25.82, Plt;0.000 01). The three studies did not report any adverse reactions. Conclusion Although the acupuncture has the short-term improvement trend without adverse events for hiccups after stroke, the confirmed conclusion of long-term effectiveness has not yet been reached because both the methodological quality and the quantity of all included studies are poor, and especially the long-term outcome measures are insufficient. There is no enough evidence to recommend acupuncture as a routine treatment for hiccups after stroke. So more high-quality multi-center RCTs in large scale are required.
ObjectiveTo summarize progress of immune response in severe acute pancreatitis (SAP) and to provide a basis for appropriate immunotheraphy.MethodThe relevant literatures about the effect of immune response in the SAP with infectious complications in recent years were reviewed.ResultsThe inflammatory cascade reaction occurred in the early stage of SAP. Subsequently, the compensatory anti-inflammatory response syndrome (CARS) arised and immune response of the organism was suppressed. At this stage, the rate of infection was higher than before.ConclusionsCARS is one of major reasons in SAP with infectious complications. At present, fluid infusion, fasting, parenteral nutrition and like are major therapies in SAP. If corresponding immunotherapy could be carried out according to immune mechanism of SAP infection, that is, early appropriate immunosuppressive therapy and dynamic monitoring of body’s immune system state should be performed, when it is found that immunosuppression is present, appropriate immunostimulus therapy will be possible to reduce mortality of SAP and improve its prognosis.
ObjectiveTo summarize the research progress of diagnosis and treatment in hypertriglyceridemia pancreatitis in recent years.MethodsThrough the retrieval of relevant literatures, the progress of diagnosis and treatment in hypertriglyceridemia pancreatitis were reviewed.ResultsHypertriglyceridemia pancreatitis is a rare acute pancreatitis, but with the improvement of living standard and the change of diet structure, the incidence of this disease in recent years was increasing, and more likely to lead to complications, causing serious consequences. The treatment of hypertriglyceridemia pancreatitis in addition to the routine treatment of pancreatitis, attention should also be paid to the rapid reduction of blood triglyceride levels, including plasma exchange, the use of low molecular weight heparin and insulin, and the use of lipid-lowering drugs.ConclusionsHypertriglyceridemia pancreatitis is more severe than acute pancreatitis caused by other causes, and the incidence of complications is higher. Maintaining a lower level of blood triglycerides is of great significance for the improvement of this pancreatitis and the prevention of the recurrence of pancreatitis.
Objective To investigate protective effect of apocynin, the inhibitor of NADPH oxidase Ⅱ (NOX2), on lung injury induced by acute necrotic pancreatitis (ANP) in rat. Methods Forty SPF adult male Wistar rats were randomly divided into 4 groups: shame operation group (SO group, n=10), ANP model group (ANP group, n=12), apocynin treated group (APO group, n=10), and apocynin control group (APO-CON group, n=8). The ANP models were induced by the retrograde injection of 5% sodium taurocholate through the biliopancreatic duct in the ANP group and the APO group. The apocynin was injected at 30 min before the induction of ANP models in the APO group. The pancreas and duodenum of rats were just flipped and the apocynin and the 10% DMSO (2 mL/kg) were injected in the APO-CON group and SO group respectively. All the rats were sacrificed at 12 h after the operation. The blood samples were collected by the inferior vena cava puncture, and the levels of serum amylase and lipase were measured by the auto-chemistry analyzer. The lung tissues were harvested and the integrated optical densities (IODs) of the nuclear factor-κB (NF-κB), tumor necrosis factor-α (TNF-α), and NOX2 were detected by the immunohistochemistry assay. The IODs of the myeloperoxidase (MPO), Toll like receptor 4 (TLR4), and CD68 were detected by the immunofluorescence assay. The concentration of malondialdehyde (MDA) and activity of superoxide dismutase (SOD) were tested by the ELISA method. Results The levels of the serum amylase and lipase and the IODs of the NF-κB, TNF-α, NOX2, MPO, TLR4, CD68, and concentration of MDA of the lung tissues in the ANP group were significantly increased as compared with the SO group (P<0.05), these indices in the APO group were significantly decreased as compared with the ANP group (P<0.05). The SOD activity of the lung tissue in the ANP group was significantly decreased as compared with the SO group (P<0.05), which in the APO group was significantly increased as compared with the ANP group (P<0.05). Conclusion Apocynin can ameliorate lung injury induced by ANP through inhibiting activity of NOX2.
Objective To evaluate safety, efficacy, and indications of laparoscopic bile duct reexploration in treatment of bile duct stones. Methods Fifty-seven patients with bile duct stones who underwent laparoscopic common bile duct reexploration (laparoscope group) and 62 patients with bile duct stones who underwent open common bile duct reexploration (laparotomy group) were included into this study from February 2013 to February 2017 in the Renmin Hospital of Wuhan University. The intraoperative and postoperative data of the patients were documented and analyzed. Results All the operations were performed successfully and all the patients had no extra-damage during the operation. One case was converted to the laparotomy due to the intraabdominal serious adhesion in the laparoscope group. Compared with the laparotomy group, the amount of intraoperative blood loss was less, the first time of anal exhaust was earlier, the rates of postoperative analgesia and incision infection were lower, and the length of hospital stay was shorter in the laparoscope group, there were significant differences (P<0.05). There were no significant differences in the operative time, the hospitalization expense, primary suture rate of common bile duct, and the rates of postoperative complications such as the bile leakage, bile duct stricture, and residual stone between the laparoscope group and the laparotomy group (P>0.05). Conclusion With experienced skills and strict surgical indications, laparoscopic common bile duct reexploration is safe and effective in treatment of bile duct stones, and it has some advantages including less bleeding, rapid recovery, and shorter hospitalization time.
Objective To explore effects of macrophage migration inhibitory factor (MIF) inhibitor ISO-1 on intestinal injury in acute necrotic pancreatitis in pregnancy (ANPIP) rat. Methods Twenty-four pregnant SD rats were randomly averagely divided into three groups: a sham operation (SO) group, an ANP group, and an ANP model plus ISO-1 treatment group (ISO-1 group). A rat model of ANP was induced by the retrograde injection of 5% sodium taurocholate into the biliopancreatic duct. The rats were killed and the inferior vena cava blood and the tissues of pancreas and jejunum were harvested at 12 h after the operation. The serum amylase (AMY), lipase (LIP), diamine oxidase (DAO), interleukin (IL)-1β, and IL-6 levels were measured. The pancreatic and jejunal tissues were taken for the pathological examination scoring. The immunohistochemical method was used to detect the expression of the MIF, nuclear factor (NK)-κB, or tumor necrosis factor (TNF)-α protein. Results ① Compared with the SO group, the serum AMY, LIP, DAO, IL-1β, and IL-6 levels were increased in the ANP group (P<0.050), which in the ISO-1 group were decreased as compared with the ANP group, the DAO, IL-1β, and IL-6 levels had significant differences (P<0.050), but the AMY and LIP levels had no significant differences (P>0.050). ② The pathological points of the pancreas and jejunum tissues were increased in the ANP group as compared with the SO group, which were significantly decreased in the ISO-1 group as compared with the ANP group (P<0.050). ③ The average integrated optical density divide by area of the NF-κB,TNF-α, and MIF were significantly increased in the ANP group as compared with the SO group, which were significantly decreased in the ISO-1 group as compared with the ANPgroup (P<0.050). Conclusions MIF inhibitor ISO-1 could protect intestinal injury in ANPIP rat. It is suggested that MIF is one of mechanisms in ANPIP with intestinal injury and might be correlated with activities of TNF-α and NF-κB.
Objective To investigate the protective effect of castanospermine (CS) on renal injury induced by severe acute pancreatitis (SAP) in rats and its possible mechanism. Methods Twenty-four SPF adult male Sprague Dawley rats were randomly divided into three groups: shame operation group (SO group, n=8), SAP group (n=8), and CS group (n=8). SAP models were induced by retrograde injection of 5% sodium taurocholate (1 mL/kg) in biliopancreatic duct in the SAP group and the CS group. CS solution (200 mg/kg) was immediately administered via intraperitoneal injection after the induction of pancreatitis in the CS group. Rats in the SO group were subjected to a sham surgery that the pancreas and duodenum were flipped a number of times. All rats were sacrificed at 12 h after modeling. Blood samples were collected by inferior vena cava puncture, and serum activities of amylase (AMY), levels of blood urea nitrogen (BUN) and creatinine (Cr) were measured by using a fully automatic chemistry analyzer. The head of pancreas and renal tissues were harvested and pathological change was observed under the light microscope. Expressions of nuclear factor-κB (NF-κB), tumor necrosis factor-α (TNF-α), intercellular adhesion molecule-1 (ICAM-1), and Caspase-3 in renal tissues were evaluated by immunohistochemistry assay. Results ① Compared with the SO group, the damages of the pancreas and kidney tissues were significantly worse in the SAP group, and the above damages in the CS group were significantly decreased when comparing with the SAP group. ② Compared with the SO group, the serum activities of AMY, levels of BUN and Cr were significantly increased in the SAP group (P<0.05). The serum activities of AMY, levels of BUN and Cr in the CS group were significantly lower than those of the SAP group (P<0.05). ③ Compared with the SO group, the integrated optical density (IOD) of NF-κB, TNF-α, ICAM-1, and Caspase-3 in renal tissues were significantly increased in the SAP group (P<0.05), and the above indicators in kidney tissues of the CS group were significantly decreased when comparing with the SAP group (P<0.05). Conclusions CS can mitigate severe acute pancreatitis-induced renal injuries in rats, it ameliorates renal injury and improves renal function. The mechanism for the above improvements is that CS can widely inhibit the activation of NF-κB, and then downregulate the expressions of TNF-α, ICAM-1, and Caspase-3.
ObjectiveTo explore the change of expression of oxygen-regulated protein 150 (ORP150) in pancreatic injury of rats with severe acute pancreatitis. MethodsForty male Wistar rats were randomly allocated into two groups: sham operation group (SO group， n=10) and severe acute pancreatitis model group （SAP group， 3 h, 6 h， and 12 h after modeling, each time n=10）. SO group rats were only turned over the pancreas, and the SAP group rats were induced by retrogradely infusing 5% sodium taurocholate into the biliopancreatic duct. SO group rats were killed at 12 h after sham operation, and the SAP group rats were killed at 3 h, 6 h, and 12 h after modeling. Blood samples were obtained for detecting the amylase (AMY) and alanine transarninase (ALT) levels. The quantity of ascites were collected and measured. Pancreatic tissue samples were stained with hematoxylin and eosin for histopathological evaluation. Pancreatic tissue was collected to detect the expressive quantity of ORP150 mRNA by RT-PCR. ResultsThe quantity of ascites, AMY and ALT levels, and histopathological evaluation were significantly higher in SAP group than those in SO group (Plt;0.05). AMY and ALT levels, histopathological detection, and expression of ORP150 mRNA in pancreatic rats among 3 h, 6 h, and 12 h after modeling were significantly different from each other (Plt;0.05), except for ascites. The ascites were not significantly different between 3 h and 6 h after modeling (Pgt;0.05), while 12 h were significantly higher than those at 3 h and 6 h (Plt;0.05). The expression of ORP150 mRNA was low in SO group, and were rise in subgroup SAP 12 h, 6 h, and 3 h gradually. Subgroup was statistical difference (Plt;0.05). ConclusionThe expressive quantity of ORP150 mRNA is high in pancreatic tissues with SAP rats, prompting that ORP150 may play a role in pancreatic injury with SAP.