目的系统评价腹主动脉球囊封堵治疗凶险性前置胎盘(PPP)伴植入的有效性及安全性。方法计算机检索PubMed、Cochrane Library、Web of Science、EMbase数据库获取文献,检索时间均为数据库建库至2018年3月。由2名评价员按纳入与排除标准独...目的系统评价腹主动脉球囊封堵治疗凶险性前置胎盘(PPP)伴植入的有效性及安全性。方法计算机检索PubMed、Cochrane Library、Web of Science、EMbase数据库获取文献,检索时间均为数据库建库至2018年3月。由2名评价员按纳入与排除标准独立进行文献筛选、数据提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果最终纳入6项回顾性队列研究,共515例患者(球囊组342例,对照组173例)。Meta分析结果显示:球囊组术中出血量少于对照组(SMD=-0.51,95%CI:-0.80～-0.23,P=0.000 4);球囊组子宫切除率低于对照组(OR=0.40,95%CI:0.21～0.74,P=0.003);而2组间红细胞输注量(SMD=-0.23,95%CI:-0.54～0.07,P=0.13)和术后住院时间(SMD=-0.23,95%CI:-0.12～0.58,P=0.20)差异无统计学意义;腹主动脉球囊封堵相关不良反应主要为穿刺点血肿和动/静脉血栓形成,对症治疗后均缓解。结论腹主动脉球囊封堵治疗PPP伴植入可减少术中出血量,降低子宫切除率,且无严重相关并发症报道。但上述结论仍需更多高质量、大样本的研究进一步予以验证。展开更多
Background This study aimed to investigate multi-slice CT contrast-enhanced presentation of gastric cancer and its correlation with histo-differentiation and p53 and P-glycoprotein （P-gp） expression. Methods Sixty-s...Background This study aimed to investigate multi-slice CT contrast-enhanced presentation of gastric cancer and its correlation with histo-differentiation and p53 and P-glycoprotein （P-gp） expression. Methods Sixty-six patients with gastric cancer in the present study underwent a multi-slice CT preoperative routine and dual-phase contrast-enhanced examination of the upper abdomen; postoperative specimens were used to determine histo-differentiation and the expression of p53 and P-gp. The correlation of multi-slice CT contrast-enhanced presentation with histo-differentiation and expression of p53 and P-gp was analyzed. Results The dual-phase contrast-enhanced ratio （CER） was not correlated with the histo-differentiation of gastric cancer （P 〉0.05）. Positive expression of p53 and P-gp was significantly higher in the cases of layered or heterogeneous enhancement than in the cases of homogenous enhancement （P 〈0.05）. Positive expression of p53 was also correlated with the arterial phase CER, tumor size and lymph node metastasis （P 〈0.05）, but not with infiltration thickness of the gastric wall, nor was it correlated with the portal phase CER （P 〉0.05）. Positive expression of P-gp was only correlated with the portal phase CER （P=0.005）. Conclusions Differently enhanced pattern and CER of the arterial and portal phase in gastric cancer correlate with its different histo-differentiation and expression of p53 and P-gp respectively. In addition, tumor size and lymph node metastasis of gastric cancer relate to the expression of p53.展开更多
Deep venous thrombosis(DVT)poses a major challenge to public health worldwide.Endothelial cell injury evokes inflammatory and oxidative responses that contribute to thrombus formation.Tea polyphenol(TP)in the form of ...Deep venous thrombosis(DVT)poses a major challenge to public health worldwide.Endothelial cell injury evokes inflammatory and oxidative responses that contribute to thrombus formation.Tea polyphenol(TP)in the form of epigallocatechin-3-gallate(EGCG)has anti-inflammatory and oxidative effect that may ameliorate DVT.However,the precise mechanism remains incompletely understood.The current study was designed to investigate the anti-DVT mechanism of EGCG in combination with warfarin(an oral anticoagulant).Rabbits were randomly divided into five groups.A DVT model of rats was established through ligation of the inferior vena cava(IVC)and left common iliac vein,and the animals were orally administered with EGCG,warfarin,or vehicle for seven days.In vitro studies included pretreatment of human umbilical vein endothelial cells(HUVECs)with different concentrations of EGCG for 2 h before exposure to hydrogen peroxide.Thrombus weight and length were examined.Histopathological changes were observed by hematoxylin-eosin staining.Blood samples were collected for detecting coagulation function,including thrombin and prothrombin times,activated partial thromboplastin time,and fibrinogen levels.Protein expression in thrombosed IVCs and HUVECs was evaluated by Western blot,immunohistochemical analysis,and/or immunofluorescence staining.RT-qPCR was used to determine the levels of AGTR-1 and VEGF mRNA in IVCs and HUVECs.The viability of HUVECs was examined by CCK-8 assay.Flow cytometry was performed to detect cell apoptosis and ROS generation was assessed by 2′,7ʹ-dichlorofluorescein diacetate reagent.In vitro and in vivo studies showed that EGCG combined with warfarin significantly reduced thrombus weight and length,and apoptosis in HUVECs.Our findings indicated that the combination of EGCG and warfarin protects HUVECs from oxidative stress and prevents apoptosis.However,HIF-1αsilencing weakened these effects,which indicated that HIF-1αmay participate in DVT.Furthermore,HIF-1αsilencing significantly up-regulated cell apoptosis and ROS generation,and enhanced VEGF expression and the activation of the PI3K/AKT and ERK1/2 signaling pathways.In conclusion,our results indicate that EGCG combined with warfarin modifies HIF-1αand VEGF to prevent DVT in rabbits through anti-inflammation via the PI3K/AKT and ERK1/2 signaling pathways.展开更多
文摘Background This study aimed to investigate multi-slice CT contrast-enhanced presentation of gastric cancer and its correlation with histo-differentiation and p53 and P-glycoprotein （P-gp） expression. Methods Sixty-six patients with gastric cancer in the present study underwent a multi-slice CT preoperative routine and dual-phase contrast-enhanced examination of the upper abdomen; postoperative specimens were used to determine histo-differentiation and the expression of p53 and P-gp. The correlation of multi-slice CT contrast-enhanced presentation with histo-differentiation and expression of p53 and P-gp was analyzed. Results The dual-phase contrast-enhanced ratio （CER） was not correlated with the histo-differentiation of gastric cancer （P 〉0.05）. Positive expression of p53 and P-gp was significantly higher in the cases of layered or heterogeneous enhancement than in the cases of homogenous enhancement （P 〈0.05）. Positive expression of p53 was also correlated with the arterial phase CER, tumor size and lymph node metastasis （P 〈0.05）, but not with infiltration thickness of the gastric wall, nor was it correlated with the portal phase CER （P 〉0.05）. Positive expression of P-gp was only correlated with the portal phase CER （P=0.005）. Conclusions Differently enhanced pattern and CER of the arterial and portal phase in gastric cancer correlate with its different histo-differentiation and expression of p53 and P-gp respectively. In addition, tumor size and lymph node metastasis of gastric cancer relate to the expression of p53.
基金supported by the National Nature Science Foundation of China(No.81871463)Nanjing Health Science and Technology Development Special Fund Project(No.YKK19086).
文摘Deep venous thrombosis(DVT)poses a major challenge to public health worldwide.Endothelial cell injury evokes inflammatory and oxidative responses that contribute to thrombus formation.Tea polyphenol(TP)in the form of epigallocatechin-3-gallate(EGCG)has anti-inflammatory and oxidative effect that may ameliorate DVT.However,the precise mechanism remains incompletely understood.The current study was designed to investigate the anti-DVT mechanism of EGCG in combination with warfarin(an oral anticoagulant).Rabbits were randomly divided into five groups.A DVT model of rats was established through ligation of the inferior vena cava(IVC)and left common iliac vein,and the animals were orally administered with EGCG,warfarin,or vehicle for seven days.In vitro studies included pretreatment of human umbilical vein endothelial cells(HUVECs)with different concentrations of EGCG for 2 h before exposure to hydrogen peroxide.Thrombus weight and length were examined.Histopathological changes were observed by hematoxylin-eosin staining.Blood samples were collected for detecting coagulation function,including thrombin and prothrombin times,activated partial thromboplastin time,and fibrinogen levels.Protein expression in thrombosed IVCs and HUVECs was evaluated by Western blot,immunohistochemical analysis,and/or immunofluorescence staining.RT-qPCR was used to determine the levels of AGTR-1 and VEGF mRNA in IVCs and HUVECs.The viability of HUVECs was examined by CCK-8 assay.Flow cytometry was performed to detect cell apoptosis and ROS generation was assessed by 2′,7ʹ-dichlorofluorescein diacetate reagent.In vitro and in vivo studies showed that EGCG combined with warfarin significantly reduced thrombus weight and length,and apoptosis in HUVECs.Our findings indicated that the combination of EGCG and warfarin protects HUVECs from oxidative stress and prevents apoptosis.However,HIF-1αsilencing weakened these effects,which indicated that HIF-1αmay participate in DVT.Furthermore,HIF-1αsilencing significantly up-regulated cell apoptosis and ROS generation,and enhanced VEGF expression and the activation of the PI3K/AKT and ERK1/2 signaling pathways.In conclusion,our results indicate that EGCG combined with warfarin modifies HIF-1αand VEGF to prevent DVT in rabbits through anti-inflammation via the PI3K/AKT and ERK1/2 signaling pathways.
