Pub Date : 2014-01-07DOI: 10.3760/CMA.J.ISSN.1673-4203.2008.05.012
Yan Zeng, Hao Liang
Objective To study the clinical features, diagnosis and treatment of small intestinal stromal tumor (SIST). Methods Clinical data of 45 SIST patients admitted to our hospital from July 2007 to December 2013 were analyzed retrospectively. The diagnosis was confirmed pathologically in all the patients. Results The clinical manifestations of SIST were non-specific, and the most common manifestations were as follows: gastrointestinal bleeding in 29 patients (64.4 %), abdominal pain in 15 (33.3%) and abdominal mass in 4 (8.9%). The most common predilection sites of SIST were jejunum (n=21, 46.7%), duodenum (n=13, 28.9%) and ileum (n=9, 20.0%). The tumor was located at the jejunoileal junction in 2 patients (4.4%). The diagnostic rate of SIST by spiral CT was 73.7% (28/38), and it was the most accurate among all the examinations. Surgical operation was the most effective therapeutic method for SIST. All the 45 patients received surgical treatment, and according to Fletcher's criteria, there were 6 patients (13.3%) at very low-risk, 16 (35.6%) at low-risk, 8 (17.8%) at moderate-risk and 15 (33.3%) at highrisk of SIST. The postoperative immunohistochemistry showed that the positive rate of CD117 was 100%, while the positive rate of CD34 was 67.0% (30/45). Imatinib mesylate was helpful for patients who had palliative operation and for preventing postoperative recurrence. Reoperation could prolong the survival of patients who had a local recurrence or distant metastasis. Conclusions Clinical manifestations of SIST are non-specific, and its early diagnosis is difficult. However, spiral CT has a high diagnostic value for SIST. The surgical operation is the main method for treatment of SIST, and long-time oral imatinib mesylate medication after surgery can attain a better result for a long duration. DOI: 10.11855/j.issn.0577-7402.2014.07.11
{"title":"Diagnosis and treatment of small intestinal stromal tumor: an analysis of 45 cases","authors":"Yan Zeng, Hao Liang","doi":"10.3760/CMA.J.ISSN.1673-4203.2008.05.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4203.2008.05.012","url":null,"abstract":"Objective To study the clinical features, diagnosis and treatment of small intestinal stromal tumor (SIST). Methods Clinical data of 45 SIST patients admitted to our hospital from July 2007 to December 2013 were analyzed retrospectively. The diagnosis was confirmed pathologically in all the patients. Results The clinical manifestations of SIST were non-specific, and the most common manifestations were as follows: gastrointestinal bleeding in 29 patients (64.4 %), abdominal pain in 15 (33.3%) and abdominal mass in 4 (8.9%). The most common predilection sites of SIST were jejunum (n=21, 46.7%), duodenum (n=13, 28.9%) and ileum (n=9, 20.0%). The tumor was located at the jejunoileal junction in 2 patients (4.4%). The diagnostic rate of SIST by spiral CT was 73.7% (28/38), and it was the most accurate among all the examinations. Surgical operation was the most effective therapeutic method for SIST. All the 45 patients received surgical treatment, and according to Fletcher's criteria, there were 6 patients (13.3%) at very low-risk, 16 (35.6%) at low-risk, 8 (17.8%) at moderate-risk and 15 (33.3%) at highrisk of SIST. The postoperative immunohistochemistry showed that the positive rate of CD117 was 100%, while the positive rate of CD34 was 67.0% (30/45). Imatinib mesylate was helpful for patients who had palliative operation and for preventing postoperative recurrence. Reoperation could prolong the survival of patients who had a local recurrence or distant metastasis. Conclusions Clinical manifestations of SIST are non-specific, and its early diagnosis is difficult. However, spiral CT has a high diagnostic value for SIST. The surgical operation is the main method for treatment of SIST, and long-time oral imatinib mesylate medication after surgery can attain a better result for a long duration.\u0000 \u0000 DOI: 10.11855/j.issn.0577-7402.2014.07.11","PeriodicalId":18660,"journal":{"name":"Medical Journal of Chinese People's Liberation Army","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69909936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01DOI: 10.11855/J.ISSN.0577-7402.2014.12.02
Hongling Liu, S. You, Chen Li, Wanshu Liu, Z. Wan, H. Zang, B. Zhu, Y. Rong, Fangfang Liu, S. Nyberg, S. Xin
Objective To optimize conditions for hypothermic preservation of rat hepatocyte spheroids without freezing in order to facilitate the application of biological artificial liver. Methods Rat hepatic cells were isolated by a two-step perfusion method, and hepatocyte spheroids formed after 48 hours of rocking culture in serum free medium (SFM). Spheroids were then maintained in rocking culture at 37℃ (control condition), or cold stored at 4℃ for 24 or 48 hours in four different cold storage solutions: SFM alone; SFM+1mmol/L deferoxamine (Def ); SFM+1μmol/L cyclosporin A (CsA); and SFM+1mmol/L Def+1μmol/L CsA. After culturing for another 4 or 5 days, survival rate, changes in ultrastructure, and the production of albumin and urea were observed. Results Cold-induced injury could be reduced significantly by the addition of the iron chelators Def and CsA. The function and structure of hepatocyte spheroids stored in SFM+Def+CsA or SFM+Def for 24 hours were similar to those in control conditions. But the function was significantly reduced after hypothermic preservation in SFM alone. After cold storage for 48 hours, the ultrastructure of hepatocyte spheroids obviously changed and the number of dead cells increased. The survival rate of hepatocyte spheroids stored in SFM+Def+CsA or SFM+Def was significantly higher than that stored in SFM or SFM+CsA(P 0.05). Conclusions Hepatocyte spheroids tolerate 24 hours of cold storage with stable viability and function. Hypothermic preservation increases the availability of cell-based therapy for liver diseases. DOI: 10.11855/j.issn.0577-7402.2014.12.02
{"title":"Primary exploration of conditions for hypothermic preservation of rat hepatocyte spheroids","authors":"Hongling Liu, S. You, Chen Li, Wanshu Liu, Z. Wan, H. Zang, B. Zhu, Y. Rong, Fangfang Liu, S. Nyberg, S. Xin","doi":"10.11855/J.ISSN.0577-7402.2014.12.02","DOIUrl":"https://doi.org/10.11855/J.ISSN.0577-7402.2014.12.02","url":null,"abstract":"Objective To optimize conditions for hypothermic preservation of rat hepatocyte spheroids without freezing in order to facilitate the application of biological artificial liver. Methods Rat hepatic cells were isolated by a two-step perfusion method, and hepatocyte spheroids formed after 48 hours of rocking culture in serum free medium (SFM). Spheroids were then maintained in rocking culture at 37℃ (control condition), or cold stored at 4℃ for 24 or 48 hours in four different cold storage solutions: SFM alone; SFM+1mmol/L deferoxamine (Def ); SFM+1μmol/L cyclosporin A (CsA); and SFM+1mmol/L Def+1μmol/L CsA. After culturing for another 4 or 5 days, survival rate, changes in ultrastructure, and the production of albumin and urea were observed. Results Cold-induced injury could be reduced significantly by the addition of the iron chelators Def and CsA. The function and structure of hepatocyte spheroids stored in SFM+Def+CsA or SFM+Def for 24 hours were similar to those in control conditions. But the function was significantly reduced after hypothermic preservation in SFM alone. After cold storage for 48 hours, the ultrastructure of hepatocyte spheroids obviously changed and the number of dead cells increased. The survival rate of hepatocyte spheroids stored in SFM+Def+CsA or SFM+Def was significantly higher than that stored in SFM or SFM+CsA(P 0.05). Conclusions Hepatocyte spheroids tolerate 24 hours of cold storage with stable viability and function. Hypothermic preservation increases the availability of cell-based therapy for liver diseases. DOI: 10.11855/j.issn.0577-7402.2014.12.02","PeriodicalId":18660,"journal":{"name":"Medical Journal of Chinese People's Liberation Army","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65624853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is a higher sepsis rate in the intensive care unit (ICU) patients, which is one of the most important causes for patient death, but the sepsis lacks specific clinical manifestations. Exploring sensitive and specific molecular markers for infection that accurately reflect infection severity and prognosis is very clinically important. In this article, based on our previous study, we introduce some new biomarkers with high sensitivity and specificity for the diagnosis and predicting the prognosis and severity of sepsis. Increase of serum soluble(s) triggering receptor expressed on myeloid cells-1 (sTREM-1) suggests a poor prognosis of septic patients, and changes of locus rs2234237 of sTREM-1 may be the one of important mechanisms. Additionally, urine sTREM-1 can provide an early warning of possible secondary acute kidney injury (AKI) in sepsis patients. Serum sCD163 level was found to be a more important factor than procalcitonin (PCT) and C-reactive protein (CRP) in prognosis of sepsis, especially severe sepsis. Moreover, urine sCD163 also shows excellent performance in the diagnosis of sepsis and sepsis-associated AKI. Circulating microRNAs, such as miR-150, miR-297, miR-574-5p, miR -146a , miR-223, miR -15a and miR-16, also play important roles in the evaluation of status of septic patients. In the foreseeable future, newly-emerging technologies, including proteomics, metabonomics and trans-omics, may exert profound effects on the discovery of valuable biomarkers for sepsis.
{"title":"New Biomarkers for Sepsis","authors":"L. Xie","doi":"10.5772/50197","DOIUrl":"https://doi.org/10.5772/50197","url":null,"abstract":"There is a higher sepsis rate in the intensive care unit (ICU) patients, which is one of the most important causes for patient death, but the sepsis lacks specific clinical manifestations. Exploring sensitive and specific molecular markers for infection that accurately reflect infection severity and prognosis is very clinically important. In this article, based on our previous study, we introduce some new biomarkers with high sensitivity and specificity for the diagnosis and predicting the prognosis and severity of sepsis. Increase of serum soluble(s) triggering receptor expressed on myeloid cells-1 (sTREM-1) suggests a poor prognosis of septic patients, and changes of locus rs2234237 of sTREM-1 may be the one of important mechanisms. Additionally, urine sTREM-1 can provide an early warning of possible secondary acute kidney injury (AKI) in sepsis patients. Serum sCD163 level was found to be a more important factor than procalcitonin (PCT) and C-reactive protein (CRP) in prognosis of sepsis, especially severe sepsis. Moreover, urine sCD163 also shows excellent performance in the diagnosis of sepsis and sepsis-associated AKI. Circulating microRNAs, such as miR-150, miR-297, miR-574-5p, miR -146a , miR-223, miR -15a and miR-16, also play important roles in the evaluation of status of septic patients. In the foreseeable future, newly-emerging technologies, including proteomics, metabonomics and trans-omics, may exert profound effects on the discovery of valuable biomarkers for sepsis.","PeriodicalId":18660,"journal":{"name":"Medical Journal of Chinese People's Liberation Army","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5772/50197","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70926441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Feng, Sheng-yue Yang, Zi-qiang Yan, Wei He, Z. Tian, He Yin, Li-fu Ma, Zi-fu Shi, Qi-quan Zhou
Objective To assess the effects of physical labor on cardiac function of laborers at high altitude and changes in cardiac function after returning to lower altitude. Methods According to symptomatic scores on Chinese acute high altitude reaction (AHAR), 96 male officers and soldiers, who rapidly entered high altitude areas (3700m altitude)，and engaged in heavy physical work for 50 days, were be scored and graded. Levels of creatine kinase isoenzymes -MB (CK-MB) and lactic dehydrogenase isoenzyme -1 (LDH-1) in the serum, Tei index, left ventricular ejection fraction (LVEF), and left ventricular fractional shortening (LVFS) were measured in the 96 servicemen at the 50th day of residing at high altitude, and the 2nd and 15th day after returning to lower altitude (1500m altitude), and the results were compared with that of 50 healthy controls residing at 1500m. Results Among the 96 male servicemen, 71 developed AHAR, and 24 of them had severe AHAR, 47 mild to moderate AHAR, and the rest 25 had no AHAR. Levels of serum CK-MB, LDH-1 and Tei index were higher in the severe AHAR group than in the mild to moderate AHAR group, higher in the mild to moderate AHAR group than in the no AHAR group and higher in the no AHAR group than in the healthy group. As far as the values of LVEF and LVFS were concerned, the severe AHAR group < mild to moderate AHAR group < no AHAR group < control group. Significant difference was found in these levels between every two successive groups (P < 0.01). Linear correlation analysis showed that levels of CK-MB and LDH-1 of persons staying at 3700m altitude for 50 days were positively correlated with Tei index (r= 0.625, 0.598, respectively, P＜0.01), and negatively correlated with LVEF(r=－0.716, －0.658, respectively, P＜0.01), and also negatively correlated with LVFS (r=－0.639, －0.727, respectively, P＜0.01). Level of serum CK-MB, LDH-1 and Tei index at 3700m altitude for 50 days were significantly higher than those 2 days and 15 days after returning to 1500m altitude and those in control group (P＜0.01), and were significantly higher on the 2th day than on the 15th day. Moreover, the values of LVEF and LVFS were significantly lower than those at 2 and 15 days after returning to 1500m altitude and those in control group (P＜0.01), and significantly lower on the 2th day than on the 15th day. All parameters after 15 days returning to low altitude showed no significant difference compared with control group (P＞0.05). Conclusion Heavy physical work at high altitude could obviously impair human cardiac function. The impairment may aggravate along with increase in severity of AHAR. However, cardiac function may be improved significantly after returning to low altitude for 2 days, and recover to normal status 15 days later.
{"title":"De-adaptation change in cardiac function of laborers engaged in physical labor at high altitude after returning to lower altitude","authors":"E. Feng, Sheng-yue Yang, Zi-qiang Yan, Wei He, Z. Tian, He Yin, Li-fu Ma, Zi-fu Shi, Qi-quan Zhou","doi":"10.1093/CVR/CVU091.128","DOIUrl":"https://doi.org/10.1093/CVR/CVU091.128","url":null,"abstract":"Objective To assess the effects of physical labor on cardiac function of laborers at high altitude and changes in cardiac function after returning to lower altitude. Methods According to symptomatic scores on Chinese acute high altitude reaction (AHAR), 96 male officers and soldiers, who rapidly entered high altitude areas (3700m altitude)，and engaged in heavy physical work for 50 days, were be scored and graded. Levels of creatine kinase isoenzymes -MB (CK-MB) and lactic dehydrogenase isoenzyme -1 (LDH-1) in the serum, Tei index, left ventricular ejection fraction (LVEF), and left ventricular fractional shortening (LVFS) were measured in the 96 servicemen at the 50th day of residing at high altitude, and the 2nd and 15th day after returning to lower altitude (1500m altitude), and the results were compared with that of 50 healthy controls residing at 1500m. Results Among the 96 male servicemen, 71 developed AHAR, and 24 of them had severe AHAR, 47 mild to moderate AHAR, and the rest 25 had no AHAR. Levels of serum CK-MB, LDH-1 and Tei index were higher in the severe AHAR group than in the mild to moderate AHAR group, higher in the mild to moderate AHAR group than in the no AHAR group and higher in the no AHAR group than in the healthy group. As far as the values of LVEF and LVFS were concerned, the severe AHAR group < mild to moderate AHAR group < no AHAR group < control group. Significant difference was found in these levels between every two successive groups (P < 0.01). Linear correlation analysis showed that levels of CK-MB and LDH-1 of persons staying at 3700m altitude for 50 days were positively correlated with Tei index (r= 0.625, 0.598, respectively, P＜0.01), and negatively correlated with LVEF(r=－0.716, －0.658, respectively, P＜0.01), and also negatively correlated with LVFS (r=－0.639, －0.727, respectively, P＜0.01). Level of serum CK-MB, LDH-1 and Tei index at 3700m altitude for 50 days were significantly higher than those 2 days and 15 days after returning to 1500m altitude and those in control group (P＜0.01), and were significantly higher on the 2th day than on the 15th day. Moreover, the values of LVEF and LVFS were significantly lower than those at 2 and 15 days after returning to 1500m altitude and those in control group (P＜0.01), and significantly lower on the 2th day than on the 15th day. All parameters after 15 days returning to low altitude showed no significant difference compared with control group (P＞0.05). Conclusion Heavy physical work at high altitude could obviously impair human cardiac function. The impairment may aggravate along with increase in severity of AHAR. However, cardiac function may be improved significantly after returning to low altitude for 2 days, and recover to normal status 15 days later.","PeriodicalId":18660,"journal":{"name":"Medical Journal of Chinese People's Liberation Army","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/CVR/CVU091.128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61005503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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