Journal of Nanjing Medical University最新文献

Objective

To observe the efficacy and safety of topical imiquimod 5% cream in the treatment of uncomplicated infantile hemangiomas (IHs).

Methods

A total of 68 IHs were treated with topical imiquimod 5% cream. Among them, 36 were superficial, 22 were mixed, and 10 were deep. The size of IHs ranged from 1.0 cm, × 1.5 cm to an area of a whole forearm. All the hemangiomas were in a proliferative stage. Imiquimod was applied 3 times weekly in 44 patients and 5 times weekly in 24 patients for up to 36 weeks.

Results

All superficial IHs improved, and 18 achieved complete clinical resolution, 10 had excellent improvement, 5 showed moderate improvements, and 3 patients displayed minimal improvement. Two mixed IHs showed excellent improvement, 3 showed moderate improvement and 5 manifested minimal improvements. The remaining 12 mixed IHs and all deep IHs did not respond to the therapy. The total incidence of local adverse events was 58.82%(40/68), which included erythema or edema, local itching, incrustation or peeling, erosion or ulceration, although most of these were mild to moderate reactions and did not affect the treatment. Scarring occurred in 2 mixed IHs. No systemic side effects developed.

Conclusion

Imiquimod 5% cream may be a safe and effective alternative for the treatment of superficial IHs and some mixed IHs in which the superficial component predominates. An appropriate treatment duration for proliferative IHs treated with this therapy may be 24 weeks. Some local adverse events, such as crusting and erosion with possible scarring potential may occur and should be addressed by prompt, but temporary, discontinuation of the imiquimod. Topical imiquimod 5% cream can be prudently used in the treatment of IHs larger than 5.0 cm, × 5.0 cm in newborns and infants less than 6 months of age. To our knowledge, this is the largest IH group treated with imiquimod that has been reported in the literature to date.

Objective

To identify and isolate CD133 positive cancer stem-like cells (CD133⁺ cells) from the highly invasive human hepatocellular carcinoma cell line(MHCC97H), and examine their potential for clonogenicity and tumorigenicity.

Methods

CD133⁺ and CD133⁻ cells were isolated from MHCC97H cell line by magnetic bead cell sorting(MACS), and the potentials of CD133⁺ cells for colony formation and tumorigenicity were evaluated by soft agar cloning and tumor formation following nude mice inoculation.

Results

CD133⁺ cells represent a minority(0.5-2.0%) of the tumor cell population with a greater colony-forming efficiency and greater tumor production ability. The colony-forming efficiency of CD133⁺ cells in soft agar was significantly higher than CD133⁻ cells(36.8 ± 1.4 vs 12.9 ± 0.8, P < 0.05). After 6 weeks, 3/5 mice inoculated with 1 × 10³ CD133⁺ cells, 4/5 with 1 × 10⁴ CD133⁺ cells and 5/5 with 1 × 10⁵ CD133⁺ cells developed detectable tumors at the injection site, while only one tumor was found in mice treated with same numbers of CD133⁻ cells.

Conclusion

CD133 may be a hallmark of liver cancer stem cells (CSC) in human hepatocellular carcinoma(HCC), because the CD133⁺ cells identified and isolated with anti-CD133 labeled magnetic beads from MHCC97H cell line exhibit high potentials for clonogenicity and tumorigenicity. These CD133⁺ cells might contribute to hepatocarcinogenesis, as well as the growth and recurrence of human HCC, and therefore may be a useful target for anti-cancer therapy.

Objective

To assess the effects of lightwand and laryngoscopic intubation techniques in patients undergoing laparoscopic cholecystectomy (LC).

Methods

300 ASA physical status I and II patients, undergoing LC, were randomly assigned to two groups, with 150 cases in each group. Patients in the LS group underwent endotracheal intubation using a standard direct-suspension laryngoscopic technique. Patients in the LW group were intubated by using transillumination with a lightwand. Mean arterial pressure and heart rate were recorded before induction, and at 1, 3 and 5 min after intubation. The incidence and of sore throat, hoarseness, and dysphagia was assessed twenty-four hours after surgery.

Results

This study demonstrated no clinically significant difference in cardiovascular variables between the two techniques. Patients had a significantly lower incidence of sore throat, hoarseness, and dysphagia when the lightwand was used for intubation.

Conclusion

This study suggests that lightwand intubation may decrease the incidence of postoperative sore throat, hoarseness, and dysphagia, thereby potentially increasing satisfaction in surgical patients. Therefore, more frequent use of the lightwand is recommended for endotracheal intubation.

Objective

The use of a combination of tumor markers may be an important tool in the early diagnosis of pancreatic cancer, which is the key to improving prognosis. The study aim was to investigate the diagnostic value of carbohydrate antigen 19-9(CA 19-9) and carcinoembryonic antigen(CEA) levels in patients with pancreatic cancer.

Methods

An immunoradiometric assay was used to homochronously measure the serum CA19-9 and CEA levels in 78 pancreatic cancer cases and 64 healthy examinees in hospital. The normal reference values were CA19-9(0-39 U/ml) and CEA(0-3.4 ng/ml).

Results

Mean serum CA19-9 and CEA levels in patients with pancreatic cancer(406.55 ± 60.18 U/ml, 12.43 ± 1.25 ng/ml) were significantly higher(P < 0.01) than those in healthy examinees(16.54 ± 1.95 U/ml, 2.37 ± 0.17 ng/ml). The sensitivity of the combined detection of CA19-9 and CEA (92.31%) was significantly higher(P < 0.05) than that of either marker alone (79.49%, 71.79%, respectively). In addition, the sensitivity to diagnose pancreatic cancer by detecting the serum CA19-9 and CEA levels was higher(P < 0.05) in stage, II B + III + IV(87.04%, 79.23%) than stage I + II, A(62.50%, 54.17%).

Conclusion

The combined detection of CA19-9 and CEA could overcome the deficiency of using single marker detection by improving the sensitivity to diagnose pancreatic cancer. At the same time, CA19-9 and CEA detection could be used to assess mesenteric artery invasion and the metastasis of lymphatics and distant organs in pancreatic cancer.

Objective

To investigate the expression of herg1 gene in tumor tissues from gastric carcinomas and gastric carcinoma cell lines, and study the relationship between HERG K+ channel expressions and tumor cell proliferation and apoptosis.

Methods

RT-PCR and PCR assays were used to detect the expression of herg1 gene in 64 gastric carcinomas and the gastric cancer cell line SGC-7901. Blocking the HERG K+ channels was used to evaluate their effects on tumor cell proliferation and apoptosis.

Results

The statistically significant expression of herg1 gene was detected in all the gastric cancers and SGC-7901 cells, but not in normal tissues. The HERG K+ channel blocker, E-4031, increased the cell population in G0/G1(P < 0.05) and the number of apoptotic tumor cells(P < 0.05).

Conclusion

HERG K+ channels were expressed in all gastric carcinomas tested and these channels appear to modulate tumor cell proliferation and apoptosis.

Objective

To investigate the efficacy and safety of the second generation argon plasma coagulation(VIO APC) in the ablation of Barrett's Esophagus.

Methods

A total of 35 patients with uncomplicated Barrett's esophagus entered into a prospective, randomized, unblinded study comparing the treatment VIO APC combined with a proton pump inhibiter with a proton pump inhibiter administered alone. VIO APC was performed at a power setting of 40W, and argon gas flow at 1.5-2.0 L/min, and, “forced” mode. Ablative treatment was repeated until either no Barrett's epithelium remained or a maximum of 5 treatment sessions occurred.

Results

In the ablation group, macroscopic complete ablation was achieved in 14 of 18 patients, and complete ablation confirmed by histology in 12 of 18 patients (P < 0.01). Buried glands were observed in 2 patients who had achieved macroscopic ablation. The Barrett's mucosa averaged a reduction of 65%(range 50-75%) in the remaining 4 patients. In the control group, only 2 patients had partial regression, median 30%(range 20-40%). In the ablation group, post-treatment 4 patients had transient retrosternal pain, and 3 patients had mild epigastric discomfort. One patient had a small hemorrhage during the procedure, which ceased after norepinephrine and thrombosin were administered through the endoscope biopsy channel. No adverse events were observed in the control group. During 11.8(4-15) months follow-up, patients who had achieved the complete ablation have no evidence of relapse of Barrett's esophagus.

Conclusion

VIO APC with a relatively low power setting can effectively ablate the Barrett's mucosa. No severe adverse events were observed. Long-term follow-up is needed to assess cancer prevention and the durability of the neo-squamous epithelium.

Spinal cord injury(SCI) is a severe trauma to the central nervous system(CNS). This article reviews recent advances in cellular transplantation to treat SCI. Transplanted cells can supply new neurons to replace injured ones, promote regeneration of axons and myelin sheath, modulate the inflammatory response, and thus promote recovery from traumatic injury of the CNS. Cellular transplantation is a promising potential method for the treatment of SCI.

Tako-tsubo cardiomyopathy(TC) is a recently described acute cardiac syndrome, which the latest cardiomyopathy classification of the European Society of Cardiology describes as an unclassified cardiomyopathy. TC mimics acute myocardial infarction(AMI) and is characterised by ischaemic chest symptoms, an elevated electrocardiogram ST-segment, and moderately increased levels of cardiac disease markers. However, patients with TC have no coronary angiogram-detectable or non-obstructive coronary arterial disease(CAD), and left ventriculography documents transient left apical and middle ventricular wall dysfunction. In this review, we describe TC and evaluate epidemiological, clinical and instrumental features, pathophysiological mechanisms, therapy and prognosis of this syndrome, with a view to raising awareness of the disease.

Objective

To explore a new natural antibiotic.

Methods

The chemical composition of the essential oil from Ganoderma japonicum (G. japonicum) mycelia was analyzed by gas chromatography-mass spectrometry(GC-MS). The antimicrobial activity of the oil was evaluated against eighteen microorganisms, including bacteria, mildew and yeast by using a disc diffusion method. Furthermore, the minimum inhibitory concentrations(MIC) and the minimum bactericidal concentrations(MBC) of the essential oil against twelve clinical pathogens were determined.

Results

The main components of the oil were nerolidol, decadienal, linalool and benzyl alcohol. The antimicrobial results indicated that the oil inhibited all the tested bacterium, especially Methicillin-resistant Staphylococcus aureus (MRSA) in which the antibacterial activity exhibited a MBC of 1.03 mg/ml.

Conclusion

The essential oil of G. japonicum mycelium has significant inhibitory activity. It is a potential medicinal resource that can be used as a natural antibiotic.