Bouveret's syndrome is an extremely rare type of gallstone-induced ileus with atypical clinical manifestations,such as abdominal distension and pain,nausea and vomiting,fever or even gastrointestinal bleeding,whic...Bouveret's syndrome is an extremely rare type of gallstone-induced ileus with atypical clinical manifestations,such as abdominal distension and pain,nausea and vomiting,fever or even gastrointestinal bleeding,which may easily be misdiagnosed. In the present case,a 55-year-old male was admitted to the hospital with upper gastrointestinal obstructive symptoms but without pain,fever,jaundice or melena. At first,gastrolithiasis and peptic ulcer combined with pyloric obstruction were suspected after gastroscopy revealed a large,hard stone in the duodenal bulb. A revised diagnosis of Bouveret's syndrome was made following abdominal computed tomography. Subsequently,the patient exhibited a good postoperative recovery after laparoscopic duodenotomy for gallstone removal and subtotal cholecystectomy. The condition of the patient remained stable after being followed up for 6 mo. The successful application of laparoscopic therapy to treat Bouveret's syndrome has seldom been reported. Laparoscopic enterolithotomy is safe and effective,with good patient tolerability,rapid postoperative recovery and few wound-related complications. The laparoscopic treatment of Bouveret's syndrome is worth exploring.展开更多
Context: Endometriosis is a pathology that directly affects the daily lives of women with frequent impairment of their quality of life. In our environment, medical, socio-cultural, financial factors and factors relate...Context: Endometriosis is a pathology that directly affects the daily lives of women with frequent impairment of their quality of life. In our environment, medical, socio-cultural, financial factors and factors related to the organization of the health care system greatly delay its diagnosis. The objectives of the present study were to determine the diagnosis delay and to assess the quality of life before surgery of women with endometriosis using the specific Endometriosis Health Profile 5 (EHP-5) questionnaire. Methods: We carried out a descriptive, observational, retrospective study in 8 medical centers in the City of Kinshasa, from January 2019 to October 2022. A total of 80 women with endometriosis confirmed by laparoscopy (16 diagnostic and 64 operative laparoscopies) and histopathology were interviewed. We used the revised American Society for Reproductive Medicine (rASMR) classification, the Endometriosis Fertility Index (EFI) score was calculated for infertile women and the EHP-5 questionnaire to assess quality of life. Our data was entered and analyzed using Statistical Analysis Software 16.1 (STATA 16.1). Results: Diagnosis delay of endometriosis was on average 12 ± 4.3 years. The overall mean EHP-5 score of all patients showed a severe deterioration in quality of life (604 ± 235). A negative relationship was observed between the age of the patient, the diagnostic delay, and the alteration of the quality of life in patients over 36 years old and those with about 11 years of diagnostic delay presenting the slight alteration. Patients with a high social level had very severe quality impairment. Women on hormonal treatment, those with a history of pregnancy, childbirth, miscarriage and abortion had a slight and significant deterioration in quality of life (p 0.05). Conclusion: Despite some limitations, our preliminary study highlights that in sub-Saharan Africa, the diagnosis of endometriosis is delayed and associated with a severe alteration in quality of life. Moreover, diagnosis of endometriosis seems to be restricted to women with high social levels. Therefore, further efforts are required to develop a health policy to decrease delay for diagnosis with potential benefits on symptoms, quality of life, fertility while limiting stigma and psychological effects of this debilitating pathology.展开更多
Summary： To isolate and culture the purified monoclonal neural stem cells from the cerebral cortex of new born mice, new-born mice cerebral cortex was isolated and dissociated to single-cell suspension by mechanical ...Summary： To isolate and culture the purified monoclonal neural stem cells from the cerebral cortex of new born mice, new-born mice cerebral cortex was isolated and dissociated to single-cell suspension by mechanical trituration. The dissociated single cells were cultured in serum-free medium. After the formation of neurospheres, single-cell clone culture was performed by limiting dilution and the proliferated single-cell clones were harvested for subculture. Immunocytochemistry was used to detect the specific marker of neuroepithelial stem cells （Nestin） of the primary and monoclonal neurospheres. In the differentiated cells we detected the specific antigen of NF-200 and GFAP. Our results showed that the primary neurospheres expressed Nestin antigen positively. By limiting dilution, we cultured the cell lines from single-cell clone and the monoclonal neurospheres expressed Nestin and had capabilities of self-renewal, proliferation and the potentiality of differentiation into neurons and glial cells. It is concluded that monoclonal neural stem cells which have the ability of proliferation and multi-directional differentiation can be isolated and cultured from the cerebral cortex of new-born mice by limiting dilution.展开更多
Objective:To induce pluripotent stem(IPS)cells from fibrocytes that are separated from liver cancer patients.Methods:The fibrocytes were reprogrammed to IPS cells by lentiviral vector,stained and identified by immunoh...Objective:To induce pluripotent stem(IPS)cells from fibrocytes that are separated from liver cancer patients.Methods:The fibrocytes were reprogrammed to IPS cells by lentiviral vector,stained and identified by immunohistochemistry.Results:The IPS cells were successfully established from fibrocytes after infection,and IPS cell clones formed in round shape under a microscopy.The induction rate was 0.013%±0.007%.No tumor formed at the back of nude mice within 8 weeks after the inoculation of cell clone.However,tetatoma appeared in nude mice within 1 week after IPS inoculation.A few tumors formed in nude mice within 4 weeks after the inoculation of cell clones.However,subcutaneous tumors formed within 1 week after IPS inoculation.The induced IPS cells showed three germ layers in tetatoma.Nanog and OCT4 in the induced IPS cells showed hypomethylation.SSEA-A,TRA-1-6-,TRA-1-81 and Nanog were highly expressed in the induced IPS cells,indicating the IPS cells possessed the similar ability as the stem cells.Conclusion:The IPS cells of liver cancer patients can be established effectively from fibrocytes and can be cultured stably in vitro,which provides an approach for the treatment of intermediate or advanced stage liver cancer.展开更多
Lactoferrin is a multifunctional protein that exhibits anti-inflammatory,immune regulating and anti-infective properties.One of its receptor sites is located on severe acute respiratory syndrome coronavirus 2.The bind...Lactoferrin is a multifunctional protein that exhibits anti-inflammatory,immune regulating and anti-infective properties.One of its receptor sites is located on severe acute respiratory syndrome coronavirus 2.The binding of lactoferrin with heparin sulfate proteoglycans may prevent the first contact between the virus and host cells,thus preventing subsequent infection.Given that lactoferrin may act as a natural mucosal barrier,an intranasal treatment together with its oral intake can be hypothesized to prevent the spread,infection and inflammation caused by coronavirus disease 2019(COVID-19).Moreover,the literature reports that vitamin D plays an essential role in promoting immune response.With its antiinflammatory and immunoregulatory properties,vitamin D is critical for activating the immune system’s defenses,improving immune cell function.Different studies also demonstrate that lactoferrin is a potential activator of the vitamin D receptor.In this sense,the combined use of lactoferrin(through an association of oral intake and a nasal spray formulation)and vitamin D could represent a valuable therapy for COVID-19 treatment and prevention.However,further randomized clinical trials are needed before recommending/prescribing them.展开更多
Background What benefits and toxicities patients acquire from the use of bevacizumab combined with first-line chemotherapy remains controversial.This study was performed to evaluate the efficacy and safety of first-li...Background What benefits and toxicities patients acquire from the use of bevacizumab combined with first-line chemotherapy remains controversial.This study was performed to evaluate the efficacy and safety of first-line chemotherapy plus bevacizumab in patients with metastatic colorectal cancer （mCRC）.Methods Several databases,including PubMed,Embase,and Cochrane Library,were searched up to April 30,2013.Eligible studies were only randomized,controlled trials （RCTs） with a direct comparison between mCRC patients treated with and without bevacizumab.Overall risk ratio （RR）,hazard ratio （HR）,odds ratio （OR）,and 95％ confidence intervals （CO were calculated employing fixed or random-effects models depending on the heterogeneity of the included trials.Results Six RCTs,including 1582 patients in chemotherapy plus bevacizumab group and 1484 patients in chemotherapyalone group,were included.Overall,the addition of bevacizumab to first-line chemotherapy increased overall response rate （ORR） by 4.5％,prolonged both progression-free survival （PFS） and overall survival （OS）,and increased the rate of total Grades 3 or 4 adverse events （G3/4AEs） by 6.9％.Significant differences were found in ORR （RR=1.22 （95％ CI 1.01-1.46）,P=0.03）,PFS （HR=0.60 （95％ Cl 0.47-0.77）,P ＜0.0001）,OS （HR=0.83 （95％ Cl 0.70-0.97）,P=0.02）,and any G3/4AEs （OR=1.56 （95％ Cl 1.29-1.89）,P ＜0.00001）.Conclusion Bevacizumab is a valuable addition to the current first-line chemotherapy regimens used in patients with mCRC,because of conferring a significant improvement in ORR,PFS,and OS,even though it increased adverse events.展开更多
The key to successful gene therapy is tofind a suitable method and carrier for transfection to allow a gene to be transferred into a cell and integrated into the target gene.The aim of this study was to determine wheth...The key to successful gene therapy is tofind a suitable method and carrier for transfection to allow a gene to be transferred into a cell and integrated into the target gene.The aim of this study was to determine whether biomagnetic material could be combined with the nucleic acid for gene transfection.Dextran-coated iron oxide nanoparticles(DCIONPs)were prepared and mixed with the plasmid pGenesil-1 containing the test gene,which expresses enhanced greenfluorescent protein(eGFP).PGenesil-1 empty vector was used as a control.The binding ability was assessed by electrophoresis of the DNA on agarose gels and quantification using BANDS-CAN software.Using different gene carriers,Lipofecta-mine 2000,Sofast,and DCIONPs,the large intestine cancer(Lovo)cell line was transfected in vitro with or without a magneticfield.The expression of eGFP was observed byfluorescence microscopy,and the transfection efficiency was compared.The results showed there was a rapid increase in combining rate when the quality ratio of DCIONPs and pGenesil-1 ascended from 1∶1 to 5∶1.However,the combining rate increased less rapidly as the quality ratio continued ascending.The expression of eGFP showed that the early transfection rate could be improved by applying a magneticfield.In conclusion,the DCIONPs we synthesized are able to carry plasmid DNA and enhance the early transfection efficiency when using a magneticfield.展开更多
Background Alveolar echinococcosis （AE） is caused by the metacestode stage of Echinococcus multilocularis （E. multilocularis） and is a rare but life-threatening disease. This disease commonly is characterized by a...Background Alveolar echinococcosis （AE） is caused by the metacestode stage of Echinococcus multilocularis （E. multilocularis） and is a rare but life-threatening disease. This disease commonly is characterized by an infiltrative, tumor-like growth of the E. multilocularis metacestode in the liver of human. Liver transplantation is an effective therapy for end-stage of hepatic AE, but the characteristics of host immunity associated with E. multilocularis infection with organ transplantation are poorly defined. We hereby aimed to study the immunological status and allograft heart survival in inbred rats with E. multilocularis infection. Methods Rat models of AE were established by injecting the E. multilocularis suspension made from E. multilocularis infected tissues into the abdomen of Lewis （LEW） rats. Three months later, in the experimental group, allograft heart transplantation was performed from Brown-Norway （BN） rats to the E. multilocularis infected LEW rats. In the control group, we transplanted hearts from BN rats to healthy LEW rats. The influence of the disturbed immune system in E. multilocularis infected rats on the heart transplantation was assessed, including observation of allograft heart survival time, histopathological examination of grafts and immunohistochemical examination of infiltrating cells （CD4＋ T cells, CD8＋ T cells and eosinophile granulocytes）, measurement of interleukin （IL）-4 and interferon （IFN）-γ in the serum by enzyme-linked immunosorbent assay （ELISA） and analysis of CD4＋CD25＋ regulatory T cells in peripheral blood by fluorescence activated cell sorting （FACS） flow cytometric analysis. Results The survival time of recipients in the experimental group was prolonged compared with those in the control group. The numbers of graft infiltrating CD8＋ T cells were decreased whereas the graft infiltrating eosinophil granulocytes （CD15＋） were increased in grafts in the experimental group （P 〈0.05）. Furthermore, the proportion of CD4＋CD25＋regulatory T cells in the peripheral blood was 10.8% on average in the experimental group, which was significantly higher than that in the control group （6.1%）. In addition, the level of serum IL-4 in E. multilocularis infected rats was higher than that in the control group rats, whereas the level of serum IFN-γ in experimental group was lower than that in the control group when graft rejection occurred （P 〈0.05）. Conclusions This study suggests that E. multilocularis infection could prolong the allograft survival time through the polarization of Th1/Th2-type cells and induction of CD4＋CD25＋ regulatory T cells. This strategy may provide a new idea for establishing transplantation tolerance.展开更多
文摘Bouveret's syndrome is an extremely rare type of gallstone-induced ileus with atypical clinical manifestations,such as abdominal distension and pain,nausea and vomiting,fever or even gastrointestinal bleeding,which may easily be misdiagnosed. In the present case,a 55-year-old male was admitted to the hospital with upper gastrointestinal obstructive symptoms but without pain,fever,jaundice or melena. At first,gastrolithiasis and peptic ulcer combined with pyloric obstruction were suspected after gastroscopy revealed a large,hard stone in the duodenal bulb. A revised diagnosis of Bouveret's syndrome was made following abdominal computed tomography. Subsequently,the patient exhibited a good postoperative recovery after laparoscopic duodenotomy for gallstone removal and subtotal cholecystectomy. The condition of the patient remained stable after being followed up for 6 mo. The successful application of laparoscopic therapy to treat Bouveret's syndrome has seldom been reported. Laparoscopic enterolithotomy is safe and effective,with good patient tolerability,rapid postoperative recovery and few wound-related complications. The laparoscopic treatment of Bouveret's syndrome is worth exploring.
文摘Context: Endometriosis is a pathology that directly affects the daily lives of women with frequent impairment of their quality of life. In our environment, medical, socio-cultural, financial factors and factors related to the organization of the health care system greatly delay its diagnosis. The objectives of the present study were to determine the diagnosis delay and to assess the quality of life before surgery of women with endometriosis using the specific Endometriosis Health Profile 5 (EHP-5) questionnaire. Methods: We carried out a descriptive, observational, retrospective study in 8 medical centers in the City of Kinshasa, from January 2019 to October 2022. A total of 80 women with endometriosis confirmed by laparoscopy (16 diagnostic and 64 operative laparoscopies) and histopathology were interviewed. We used the revised American Society for Reproductive Medicine (rASMR) classification, the Endometriosis Fertility Index (EFI) score was calculated for infertile women and the EHP-5 questionnaire to assess quality of life. Our data was entered and analyzed using Statistical Analysis Software 16.1 (STATA 16.1). Results: Diagnosis delay of endometriosis was on average 12 ± 4.3 years. The overall mean EHP-5 score of all patients showed a severe deterioration in quality of life (604 ± 235). A negative relationship was observed between the age of the patient, the diagnostic delay, and the alteration of the quality of life in patients over 36 years old and those with about 11 years of diagnostic delay presenting the slight alteration. Patients with a high social level had very severe quality impairment. Women on hormonal treatment, those with a history of pregnancy, childbirth, miscarriage and abortion had a slight and significant deterioration in quality of life (p 0.05). Conclusion: Despite some limitations, our preliminary study highlights that in sub-Saharan Africa, the diagnosis of endometriosis is delayed and associated with a severe alteration in quality of life. Moreover, diagnosis of endometriosis seems to be restricted to women with high social levels. Therefore, further efforts are required to develop a health policy to decrease delay for diagnosis with potential benefits on symptoms, quality of life, fertility while limiting stigma and psychological effects of this debilitating pathology.
基金This project was supported by a grant from the National Natural Science Foundation of China (No.30371397)
文摘Summary： To isolate and culture the purified monoclonal neural stem cells from the cerebral cortex of new born mice, new-born mice cerebral cortex was isolated and dissociated to single-cell suspension by mechanical trituration. The dissociated single cells were cultured in serum-free medium. After the formation of neurospheres, single-cell clone culture was performed by limiting dilution and the proliferated single-cell clones were harvested for subculture. Immunocytochemistry was used to detect the specific marker of neuroepithelial stem cells （Nestin） of the primary and monoclonal neurospheres. In the differentiated cells we detected the specific antigen of NF-200 and GFAP. Our results showed that the primary neurospheres expressed Nestin antigen positively. By limiting dilution, we cultured the cell lines from single-cell clone and the monoclonal neurospheres expressed Nestin and had capabilities of self-renewal, proliferation and the potentiality of differentiation into neurons and glial cells. It is concluded that monoclonal neural stem cells which have the ability of proliferation and multi-directional differentiation can be isolated and cultured from the cerebral cortex of new-born mice by limiting dilution.
基金supported by Science and Technology Project of Henan Provincial Department of Health(NO:2011020038)
文摘Objective:To induce pluripotent stem(IPS)cells from fibrocytes that are separated from liver cancer patients.Methods:The fibrocytes were reprogrammed to IPS cells by lentiviral vector,stained and identified by immunohistochemistry.Results:The IPS cells were successfully established from fibrocytes after infection,and IPS cell clones formed in round shape under a microscopy.The induction rate was 0.013%±0.007%.No tumor formed at the back of nude mice within 8 weeks after the inoculation of cell clone.However,tetatoma appeared in nude mice within 1 week after IPS inoculation.A few tumors formed in nude mice within 4 weeks after the inoculation of cell clones.However,subcutaneous tumors formed within 1 week after IPS inoculation.The induced IPS cells showed three germ layers in tetatoma.Nanog and OCT4 in the induced IPS cells showed hypomethylation.SSEA-A,TRA-1-6-,TRA-1-81 and Nanog were highly expressed in the induced IPS cells,indicating the IPS cells possessed the similar ability as the stem cells.Conclusion:The IPS cells of liver cancer patients can be established effectively from fibrocytes and can be cultured stably in vitro,which provides an approach for the treatment of intermediate or advanced stage liver cancer.
文摘Lactoferrin is a multifunctional protein that exhibits anti-inflammatory,immune regulating and anti-infective properties.One of its receptor sites is located on severe acute respiratory syndrome coronavirus 2.The binding of lactoferrin with heparin sulfate proteoglycans may prevent the first contact between the virus and host cells,thus preventing subsequent infection.Given that lactoferrin may act as a natural mucosal barrier,an intranasal treatment together with its oral intake can be hypothesized to prevent the spread,infection and inflammation caused by coronavirus disease 2019(COVID-19).Moreover,the literature reports that vitamin D plays an essential role in promoting immune response.With its antiinflammatory and immunoregulatory properties,vitamin D is critical for activating the immune system’s defenses,improving immune cell function.Different studies also demonstrate that lactoferrin is a potential activator of the vitamin D receptor.In this sense,the combined use of lactoferrin(through an association of oral intake and a nasal spray formulation)and vitamin D could represent a valuable therapy for COVID-19 treatment and prevention.However,further randomized clinical trials are needed before recommending/prescribing them.
文摘Background What benefits and toxicities patients acquire from the use of bevacizumab combined with first-line chemotherapy remains controversial.This study was performed to evaluate the efficacy and safety of first-line chemotherapy plus bevacizumab in patients with metastatic colorectal cancer （mCRC）.Methods Several databases,including PubMed,Embase,and Cochrane Library,were searched up to April 30,2013.Eligible studies were only randomized,controlled trials （RCTs） with a direct comparison between mCRC patients treated with and without bevacizumab.Overall risk ratio （RR）,hazard ratio （HR）,odds ratio （OR）,and 95％ confidence intervals （CO were calculated employing fixed or random-effects models depending on the heterogeneity of the included trials.Results Six RCTs,including 1582 patients in chemotherapy plus bevacizumab group and 1484 patients in chemotherapyalone group,were included.Overall,the addition of bevacizumab to first-line chemotherapy increased overall response rate （ORR） by 4.5％,prolonged both progression-free survival （PFS） and overall survival （OS）,and increased the rate of total Grades 3 or 4 adverse events （G3/4AEs） by 6.9％.Significant differences were found in ORR （RR=1.22 （95％ CI 1.01-1.46）,P=0.03）,PFS （HR=0.60 （95％ Cl 0.47-0.77）,P ＜0.0001）,OS （HR=0.83 （95％ Cl 0.70-0.97）,P=0.02）,and any G3/4AEs （OR=1.56 （95％ Cl 1.29-1.89）,P ＜0.00001）.Conclusion Bevacizumab is a valuable addition to the current first-line chemotherapy regimens used in patients with mCRC,because of conferring a significant improvement in ORR,PFS,and OS,even though it increased adverse events.
基金supported by the National High Technology Research and Development Program of China(Nos.2001AA218051 and 2007AA022001).
文摘The key to successful gene therapy is tofind a suitable method and carrier for transfection to allow a gene to be transferred into a cell and integrated into the target gene.The aim of this study was to determine whether biomagnetic material could be combined with the nucleic acid for gene transfection.Dextran-coated iron oxide nanoparticles(DCIONPs)were prepared and mixed with the plasmid pGenesil-1 containing the test gene,which expresses enhanced greenfluorescent protein(eGFP).PGenesil-1 empty vector was used as a control.The binding ability was assessed by electrophoresis of the DNA on agarose gels and quantification using BANDS-CAN software.Using different gene carriers,Lipofecta-mine 2000,Sofast,and DCIONPs,the large intestine cancer(Lovo)cell line was transfected in vitro with or without a magneticfield.The expression of eGFP was observed byfluorescence microscopy,and the transfection efficiency was compared.The results showed there was a rapid increase in combining rate when the quality ratio of DCIONPs and pGenesil-1 ascended from 1∶1 to 5∶1.However,the combining rate increased less rapidly as the quality ratio continued ascending.The expression of eGFP showed that the early transfection rate could be improved by applying a magneticfield.In conclusion,the DCIONPs we synthesized are able to carry plasmid DNA and enhance the early transfection efficiency when using a magneticfield.
基金This study was supported by grants from the National Natural Science Foundation of China （No. 30760239 and No. 81160201）. Conflicts of interest： none.
文摘Background Alveolar echinococcosis （AE） is caused by the metacestode stage of Echinococcus multilocularis （E. multilocularis） and is a rare but life-threatening disease. This disease commonly is characterized by an infiltrative, tumor-like growth of the E. multilocularis metacestode in the liver of human. Liver transplantation is an effective therapy for end-stage of hepatic AE, but the characteristics of host immunity associated with E. multilocularis infection with organ transplantation are poorly defined. We hereby aimed to study the immunological status and allograft heart survival in inbred rats with E. multilocularis infection. Methods Rat models of AE were established by injecting the E. multilocularis suspension made from E. multilocularis infected tissues into the abdomen of Lewis （LEW） rats. Three months later, in the experimental group, allograft heart transplantation was performed from Brown-Norway （BN） rats to the E. multilocularis infected LEW rats. In the control group, we transplanted hearts from BN rats to healthy LEW rats. The influence of the disturbed immune system in E. multilocularis infected rats on the heart transplantation was assessed, including observation of allograft heart survival time, histopathological examination of grafts and immunohistochemical examination of infiltrating cells （CD4＋ T cells, CD8＋ T cells and eosinophile granulocytes）, measurement of interleukin （IL）-4 and interferon （IFN）-γ in the serum by enzyme-linked immunosorbent assay （ELISA） and analysis of CD4＋CD25＋ regulatory T cells in peripheral blood by fluorescence activated cell sorting （FACS） flow cytometric analysis. Results The survival time of recipients in the experimental group was prolonged compared with those in the control group. The numbers of graft infiltrating CD8＋ T cells were decreased whereas the graft infiltrating eosinophil granulocytes （CD15＋） were increased in grafts in the experimental group （P 〈0.05）. Furthermore, the proportion of CD4＋CD25＋regulatory T cells in the peripheral blood was 10.8% on average in the experimental group, which was significantly higher than that in the control group （6.1%）. In addition, the level of serum IL-4 in E. multilocularis infected rats was higher than that in the control group rats, whereas the level of serum IFN-γ in experimental group was lower than that in the control group when graft rejection occurred （P 〈0.05）. Conclusions This study suggests that E. multilocularis infection could prolong the allograft survival time through the polarization of Th1/Th2-type cells and induction of CD4＋CD25＋ regulatory T cells. This strategy may provide a new idea for establishing transplantation tolerance.
