Objective To systematically review the effectiveness and safety of implanting sustained-release 5-fluorouracil during hepatectomy in patients with primary liver cancer (PLC). Methods We electronically searched the following databases including CENTRAL, MEDLINE, EMbase, WanFang Data, CBM, CNKI and VIP to collect randomized controlled trials (RCTs) on the effectiveness and safety of implanting sustained-release 5-fluorouracil during hepatectomy vs. hepatectomy alone for PLC from inception to October, 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of the included studies. Then, meta-analysis was performed using RevMan 5.0 software. Results A total of 6 RCTs involving 951 patients were included. The results of meta-analysis showed that, implanting sustained-release 5-fluorouracil during hepatectomy significantly decreased the total recurrence rates of 1-year and 3-year (1 year: RR=0.48, 95%CI 0.36 to 0.65, Plt;0.000 01; 3 years: RR=0.69, 95%CI 0.50 to 0.96, P=0.03). However, the two groups were alike in decreasing the surem levels of AFP. Besides, the commonly-seen adverse reaction of implanting sustained-release 5-fluorouracil during hepatectomy included abdominal pain and bile leakage. Conclusion Implanting sustained-release 5-fluorouracil during hepatectomy can decrease the 1-year and 3-year recurrence rates of PLC patients, especially for HCC at the early stage. But this conclusion should be interpreted with caution and needs more strictly-designed RCTs with large sample size and enough long follow-up to verify.
Objective To review the role of mTOR signal pathway in chemo-resistance of gastric cancer. Methods Domestic and international publications related mTOR signal pathway in chemo-resistance of gastric cancer in recent years were collected and reviewed. Results mTOR was a central signaling molecule of mTOR signal pathway， which regulated key cellular processes such as cell growth， cell proliferation， cell metabolism， and angiogenesis. Signaling molecules of mTOR signal pathway were overexpressed in gastric cancer. Moreover， mTOR signal pathway might play an important role in chemo-resistance of gastric cancer， and tumor stem cells were involved in it too. Conclusion As mTOR signal pathway plays an important role in chemo-resistance of gastric cancer， the combination of mTOR inhibitors and chemotherapy drugs may overcome the chemo-resistance of gastric cancer.
Objective To study the p-mammalian target of rapamyein(p-roTOR)expression and its prognostic significance in non-small cell lung cancer(NSCLC)．Methods Immunohistochemical staining of EnVision was applied to investigate the expression of p-roTOR in lung specimens from 59 cases with NSCLC and 10 cases with benign pulmonary diseases(3 pulmonary tuberculosises and 7 inflammatory pseudotumors 1．Results The positive rate of p-mTOR was 40．7％ in NSCLC which was significantly higher than that in the benign pulmonary diseases(x =6．237，P=0．013)．The expression of p-mTOR was closely correlated with age，sex and pTNM stage．Kaplan-Meire survival analysis revealed that the expression of p-mTOR was not correlated significantly with survival days(Log rank test P =0．055)．Conclusion P-mTOR might be a biomark for differential diagnosis of malignant lung disease，but has poor prognostic value．
Objective To investigate the extent intravenously transplantation of mesenchymal stem cells (MSCs) mediated by magnetic targeting material arrive in the myocardial infarction region and its effects on the recovery of myocardial infarction. Methods Identify the phenotype of the fourth genet of ex vivo expanded MSCs, stain with DAPI after inducing with 10μmol/L 5-aza, then preserve the MSCs for transplantation. 28 SD rats were divided into three groups: group A (n=10), delivered MSCs combined with magnetic targeting material for 30 minutes to rats through tail vein,and kept on raising after placing magnets on the corresponding skin region to myocardial infarction area for 30min; group B (n=9), administration MSCs not conjuncted with magnetic targeting material through tail vein; group C (n=9), direct intramyocardial transplantation of MSCs. Two days after transplantation, evaluate the aggregation state of MSCs in the area of myocardial infarction; 30d later, estimate the functional and morphological changes in myocardial infarction region. Results We observed that each MSCs had 3-5 molecules of magnetic targeting material attached to its membrane under transmission electron microscope. The homing rates of MSCs respectively were group A 38%, group B 6%, group C 53%.The number of aggregating MSCs of group A and group C was apparently more than that of group B（Plt;0.01）. After transplantation, the contraction indices of left ventricle in group A and group C had significant improvement as compared with that of pretransplantation (LVEF 46%±6% vs. 38%±8%, 51%±5% vs. 35%±4%; LVFS 28%±6% vs. 20%±7%, 32%±4% vs. 20%±5%, Plt;0.05) and administrated cells stained with DAPI could be detected in infarction region under optical microscope. After transplantation, the contraction indices of left ventricle in group B hadn’t conspicuous improvement, and the transplanted cells labeled with DAPI could not be identified in infarction region under optical microscope (homing rate of MSCs 38%). There was no statistically difference of results between group A and group C, but in experiment process, there was a high mortality in group C. Conclusion The method that intravenously delivery of MSCs mediated by magnetic targeting material could accumulate much more MSCs in infarction region, reduce infarction size, and effectively improve the cardiac function after infarction.
Objective To review the possible mechanisms of the mammal ian target of rapamycin (mTOR) in theneuronal restoration process after nervous system injury. Methods The related l iterature on mTOR in the restoration ofnervous system injury was extensively reviewed and comprehensively analyzed. Results mTOR can integrate signals fromextracellular stress and then plays a critical role in the regulation of various cell biological processes, thus contributes to therestoration of nervous system injury. Conclusion Regulating the activity of mTOR signaling pathway in different aspects cancontribute to the restoration of nervous system injury via different mechanisms, especially in the stress-induced brain injury.mTOR may be a potential target for neuronal restoration mechanism after nervous system injury.
Objective To investigate the mechanism of adenosine-tri phosphate (ATP) activated mammal ian target of rapamycin (mTOR)/signal transducer and activator of transcription 3 (STAT3) signal pathway in the physiology and pathology of spinal cord injury (SCI). Methods Ninety-six adult healthy female Sprague-Dawley rats were randomly divided into 4 groups (groups A, B, C and D, n=24). In groups A, B and C, the rats were made the SCI models at T8-10 levels by using a modified Allen’ s stall, and in group D, rats were given laminectomy without SCI. The rats were subjected to the administration of ATP (40 mg/kg) for 7 days in group A, to the administration of physiological sal ine (equal-volume) for 7 days in group B, to the administration of ATP (40 mg/kg) and rapamycin (3 mg/kg) for 7 days in group C, and to the administration of physiological sal ine (equal-volume) for 7 days in group D. Locomotor activity was evaluated using the Basso-Beattie-Bresnahan rating scale at the postoperative 1st, 2nd, 3rd, and 4th weeks. Then, the expressions of spinal cord cell marker [Nestin, neuron-specific enolase (NSE), gl ial fibrillary acidic protein (GFAP)] and the mTOR/STAT3 pathway factors (mTOR, STAT3) were detected at the postoperative 1st, 2nd, 3rd, and 4th weeks by immunohistochemistry analysis, Western blot assay, and real-time fluorescence PCR analysis. Results The BBB scores in group A showed a steady increase in the postoperative 1st-4th weeks and were significantly higher than those in groups B and C (P lt; 0.01), but were lower than that in group D (P lt; 0.01). Real-time fluorescence PCR results showed that the mRNA expressions of mTOR, STAT3, NSE of group A steadily increased, however, the Nestin mRNA expression gradually decreased in the postoperative 1st-4th weeks, which were all significantly higher than those of groups B, C, and D (P lt; 0.01). The mRNA expression of GFAP showed a steady increase in group A and was significantly less than those of groups B and C, but was higher than that of group D (P lt; 0.01). There were significant differences (Plt; 0.01) in all markers between groups B, C, and group D; there were significant differences in mTOR, P-mTOR, STAT3, and P-STAT3 mRNA between groups B and C at 1st-4th weeks (P lt; 0.05). The similar changes were found by Western blot assay. Conclusion ATP can activate the mTOR/STAT3 pathway to induce endogenic NSCs to prol iferate and differentiate into neurons in rats, it enhances the heal ing of SCI.
Objective To review the research progress of the treatment of osteosarcoma, and to thoroughly understand its current state of research and prospect so as to lay a sol id foundation for the cl inical treatment. Methods The cl inical and experimental research l iteratures about treatment of osteosarcoma were extensively reviewed and analyzed. Results The present treatment of osteosarcoma is still need to comprehensive therapy which combine chemotherapy and surgical treatment. There are some progresses in gene therapy and molecular targeting therapy which can improve survival rate. Furthermore, well-designed studies and cl inical trials are needed to evaluate the potential therapeutic impact before they are used in cl inical. Conclusion Advancement in chemotherapeutic regimens has improved survival and l imb-sparing surgery in the treatment of osteosarcoma, but the progress of gene therapy and molecular targeting therapy gives new hope for osteosarcoma patients.
Objective To explore the facilitative effects of different allogenic cells injected into the denervated muscles on the nerve regeneration, the protection of the myoceptor degeneration, and the promotion for rehabilitation of the muscular function. Methods Schwann cells, myoblast cells, and renal endothelial cells were prepared from 400 SD rats aged 7 days and weighing 20.0±2.3 g. Thirty-six adult female SD rats weighing 120-150 g were randomly divided into 4 groups(n=9). Under the asepsis condition, the left ischiadic nerves of all the SD rats were cut off, and the primary suture of the epineurium was performed. After operation, the different corresponding cells were injected into the triceps muscles of the rat calf in each group once per week for 4 times in all. One ml of Schwann cells (1×106/ml) was injected into the rats in Group A; 1 ml of the mixed cells of Schwann cells and myoblast cells (1×106/ml) was injected into the rats in Group B; 1 ml of the extract from the mixed cells of Schwann cells, myoblast cells, and renal endothelial cells (1×106/ml) was injected into the rats in Group C; 1 ml of the culture medium without any serum was injected into the rats in Group D as a control. After operation, observation was made for the general condition of the rats; 3 months after operation, enzymohistochemistry and the CJun expression were performedin the ventricornual motor neuron. At the proximal and the distal ends of the nerve suture, the density of neurilemma cells in the unit area and the area size of the regenerated nerve fibers were observed and measured. Results The affected limbs of the rats in Groups A, B and C improved 13 months after operation. The ulcers and swelling at the ankles gradually relieved and the rats could move normally 3 months after operation. However, the affected limbsof the rats in Group D still had ulcers and swelling, with an obvious contracture of the toes and a difficult movement. Three months after operation, the number of the target muscle myoceptor, the number of the Actin positive cells, the activity of the various enzymes in the denervated muscles, and the histological changes of the regenerated nerves were better in Group C than in Groups A and B (P＜0.01); and they were all better in Groups A, B and C than in Group D（Plt;0.01）. Conclusion Schwann cells, the mixture of Schwann cells and myoblast cells, and the extract from the mixture of Schwann cells, myoblast cells and renal endothelial cells can all promote neurotization and rehabilitation of the muscular function, and protect against the myoceptor degeneration. However, the effect of the extract is superior to that of Schwann cells or the mixed cells.
Objective To survey the relations between the rural residents’ occupational satisfaction, the health policies and demographic factors in Henan province and then to confirm the health policy order and its key target populations. Methods The questionnaires were distributed to 1 117 rural residents in 156 villages among 44 townships in 19 counties (cities, districts). The frequency analysis, multivariate linear regression analysis and multiple comparisons were conducted. Results The average value of rural residents’ occupational satisfaction scored 68.23, among which the complete dissatisfaction scored 0 accounting for 1.9%, the complete satisfaction scored 100 accounting for 9.0%, the one scoring no more than 50 accounted for 20.9%, and the one scoreing equal 80 or more than 80 accounted for 37.5%. By regarding the occupational satisfaction as the dependent variable, the independent variables stayed in the model were as follows in order according to their influence from heavy to little on the dependent variable: new rural cooperative medical system (NRCMS), occupation, village general practitioner’s work, family formation, age, disease prevention and control efforts. The occupational satisfaction was much higher when there were the following conditions: the higher satisfaction with the NRCMS, the more financial burden relieved by the NRCMS, and the higher satisfaction with village general practitioners’ work. The occupational satisfaction was the highest when villagers lived with their spouses, while it was the lowest when villagers lived with their spouses and children, as well as they lived with their parents, spouses and children. The peasants’ occupational satisfaction was the lowest. The occupational satisfaction had significantly negative correlation with cultural level, and had positive correlation with age. Conclusion The occupational satisfaction is an important indicator for assessing the level of social harmony, and is the basis for policy decision-making, implementation, and evaluation. The overall occupational satisfaction of the rural residents in Henan is lower, so the social harmoniy and stability should be alerted. The priority order of the existing rural health policy should be the NRCMS policy, village general practitioner work policy, and village disease prevention and control policy. When we are formulating and implementing the rural health policy, the key target populations should be considered among the people whose families comprise two or three generations, whose occupations are farmers, whose cultural level is lower, and whose ages are younger.
摘要:目的:探讨联合应用激光汽化减压(percutaneous laser disc discompression,PLDD)、射频热凝靶点消融、臭氧注射治疗腰椎间盘突出症的的个体化选择。方法: 自2006年6月,在CT引导下选择性联合应用PLDD、射频和臭氧治疗腰椎间盘突出症患者267例,突出椎间盘的特点个体化选择穿刺路径和治疗方法;其中PLDD联合臭氧治疗92例(A组),射频联合臭氧治疗67例(B组),PLDD、射频和臭氧三者联合治疗108例(C组)。结果:所有患者均顺利完成手术,于术后1周、1个月,3个月及6个月随访记录VAS评分和Macanab优良率。三组患者VAS评分经方差分析,手术前、后有显著性差异(Plt;0.05),术后1周至6个月的VAS评分统计无显著性差异(Pgt;0.05);术后三组间VAS评分、Macanab优良率比较无显著性差异(Pgt;0.05)。结论: 选择性联合应用微创技术进行个体化的立体治疗,具有扩大微创手术适应症、提高手术疗效的优势,值得推广和利用。Abstract: Objective: To investigate the selectivity and individualization of using percutaneous laser disc discompression(PLDD) and ozone injection combined with radiofrequency thermocoagulation and target ablation curing lumbar intervertebral disc protrusion. Methods: From June 2006, 267 lumbar disc herniation cases were operated that guided by CT, the characteristic of the liable disc was confirmed by magnetic resonance imaging and CT before the procedure. 92 cases (A group) were treated by PLDD combined with ozone injection,67 case were treated by radiofrequency thermocoagulation and target ablation combined with ozone injection, 108 cases were treated by PLDD and ozone injection combined with radiofrequency thermocoagulation and target ablation. Results: All case been successfully operated, the theraptic effect was evaluated by comparing the value of VAS and excellent and good rate of therapy at preoperation and at 1 week, 1month,3 months, 6 months after operation. The value of VAS in three groups at postoperation were remarkably lower than preoperation (Plt;0.05). The excellent and good rate of therapy at 6 months was respectively 94.5％ in group A,94.0％ in group B and 95.4％ in group C,no significant difference was observed between the three groups(Pgt;0.05).Conclusion: The selectivity and individualization of using PLDD and ozone injection combined with radiofrequency thermocoagulation and target ablation curing lumbar intervertebral disc protrusion can enlarge the indication and improve the clinical curative effect, it should be spreaded in clinic.