Pulmonary metastasectomy for soft tissue sarcoma – Report from a dual institution experience at the Medical University of Vienna

BackgroundPulmonary metastasectomy when possible has become therapeutic standard in soft tissue sarcoma patients. However, published reports frequently describe mixed series of patients with bone or soft tissue sarcoma. We report the outcome of 46 soft tissue sarcoma (STS) patients who underwent pulmonary metastasectomy (PM).MethodsThis current analysis includes retrospective survival data from 46 consecutive STS patients with pulmonary metastases who underwent PM at the Medical University of Vienna between January 2003 and December 2013.ResultsIn total 72 pulmonary metastasectomies were performed. 322 metastatic nodules were resected with a median number of four nodules per intervention and the R0 resection rate was 97.2%. The postoperative complication rate as documented was low. Median follow-up (mFU) was 31.8 months (range 3.7–127.4). Median overall survival as calculated from first detection of metastatic disease was 47.1 months (95% confidence interval (CI) = 36.2–58.1 months) and 45.3 months (95% CI = 33.3–57.4 months) when calculated from first PM until death or last follow-up (n = 46). Five-year overall survival calculated from primary diagnosis was 62% and 32% when estimated from first PM. Previous disease free interval (DFI) as calculated from date of surgery of the primary tumour until the date of diagnosis of lung metastasis was 12.2 months (range 0–140.1 months). Median relapse-free survival (mRFS) after first PM to the date of recurrence of lung metastasis, death or last follow-up was 13.4 months (95% CI = 3–23.8 months).ConclusionMedian overall survival in this selected patient cohort is 45.3 months. Despite the lack of prospective randomised controlled trials, PM is a reasonable treatment strategy in selected patients.     

Curcumin-3,4-Dichloro Phenyl Pyrazole (CDPP) overcomes curcumin's low bioavailability,inhibits adipogenesis and ameliorates dyslipidemia by activating reverse cholesterol transport

BackgroundAdipocyte dysfunction, obesity and associated metabolic disorders are of prime healthcare concern worldwide. Among available medications, natural products and inspired molecules hold 40% space in clinically prescribed medicines. In queue, this study overcomes the drawback of curcumin's low bioavailability with potent anti-adipogenic and anti-dyslipidemic activity.MethodsTo evaluate the role of CDPP on adipocyte differentiation, 3T3-L1 adipocytes were used as an in-vitro model. Flow cytometry was performed for cell cycle analysis. Syrian golden hamsters were used to study pharmacokinetic profile and dyslipidemic activity exhibited by CDPP.ResultCDPP was found to be a potent inhibitor of adipogenesis in-vitro. It blocked mitotic clonal expansion by causing cell cycle arrest. CDPP showed marked improvement in gastrointestinal stability and bioavailability in-vivo as compared to curcumin. Administration of CDPP (100 mg/kg) significantly improved HFD induced dyslipidemic profile in hamsters and activated reverse cholesterol transport machinery.ConclusionCDPP could be used as a potential drug candidate against adipogenesis and dyslipidemia with enhanced gastrointestinal stability and bioavailability.     

颈部推拿对兔颈动脉粥样硬化重度狭窄病变的#br# 血管拉伸力学特性的影响 颈部推拿对兔颈动脉粥样硬化重度狭窄病变的血管拉伸力学特性的影响

目的　探讨颈部推拿手法对兔颈动脉粥样硬化（CAS）重度狭窄的血管拉伸力学特性的影响。 方法　45只新西兰兔随机分为颈椎旋转组（n=12）、推桥弓组（n=12）、模型对照组（n=12）和空白对照组（n=9），在颈椎旋转组、推桥弓组和模型对照组建立左侧CAS模型，并分别接受颈椎旋转手法、推桥弓手法干预3周，模型对照组和空白对照组不作手法干预。取左侧颈动脉进行单轴拉伸试验和病理观察，比较四组兔颈动脉的拉伸力学特性。 结果　（1）26只兔造模成功，其中颈椎旋转组、推桥弓组、模型对照组兔颈动脉的最大载荷显著高于空白对照组，同时最大应变显著低于空白对照组(P<0.05)；（2）颈椎旋转组兔颈动脉的弹性模量显著高于模型对照组、推桥弓组和空白对照组（P<0.05），而推桥弓组兔颈动脉的弹性模量与模型对照组相比差异无统计学意义(P>0.05)。 结论　动脉粥样硬化病变可致兔颈动脉血管拉伸力学特性下降，而颈部旋转推拿治疗可导致严重粥样硬化病变并重度狭窄的兔颈动脉弹性下降，为临床安全应用颈部推拿手法提供了参考。     

综合心理护理在神经病理性疼痛治疗中的应用

目的观察综合心理护理对神经病理性疼痛(neuropathic pain,NP)患者疼痛、不良心理、服药依从性以及生存质量的影响,从而探讨心理护理措施在NP治疗中的作用。方法选择2018年1月—2018年8月就诊于西南医科大学附属中医医院疼痛科的NP患者60例,随机分为心理护理组和常规护理组各30例。心理护理组在常规护理的基础上,实施综合心理护理方案。于T0~T3时间点分别评价疼痛视觉模拟评分(VAS)、焦虑评分(SAS)、抑郁评分(SDS)、Morisky服药依从性评分;同时在T3时间点评价SF-36生活质量评分。结果两组患者均完成试验与随访,治疗前两组患者VAS、SAS、SDS评分及服药依从性评分差异无统计学意义(P>0.05)。各组VAS、SAS、SDS评分随治疗进展降低,于T1~T3时间点均低于T0时间点,差异有统计学意义(P<0.05);此外,心理护理组VAS、SAS、SDS评分于T1~T3时间点均低于常规护理组,差异有统计学意义(P<0.05);同时,心理护理组服药依从性评分于T1~T3时间点均高于常规护理组,差异有统计学意义(P<0.05);于T3时间点心理护理组生活质量评分高于常规护理组,差异有统计学意义(P<0.05)。结论综合心理护理措施能够明显改善NP,减轻焦虑、抑郁的不良心理,提高患者生活质量及服药依从性。     

IL-7/IL-7 receptor axis stimulates prostate cancer cell invasion and migration via AKT/NF-κB pathway

IL-7, acting via IL-7 receptor (IL-7R), plays an important role in tumor progression. Elevated IL-7 expression has been reported to be observed in prostate cancer tissues and closely associated with poor prognosis. However, the biological functions of IL-7 and its receptor in prostate cancer cell invasiveness remain unclear. In our study, we found that the expressions of IL-7 and IL-7R were both upregulated in prostate cancer cells. IL-7 dose-dependently promoted the invasion and migration of prostate cancer cells, whereas knockdown of IL-7R attenuated the effect of IL-7. Further, IL-7/IL-7R axis induced the activation of AKT and NF-κB, whereas blocking of AKT suppressed IL-7-mediated NF-κB activity. Moreover, IL-7/IL-7R axis increased MMP-3 and MMP-7 expression of prostate cancer cells, whereas inhibition of NF-κB as well as MMPs activity suppressed IL-7-mediated cell invasion and migration. Together, these data identify IL-7/IL-7R axis to be involved in prostate cancer cell invasion and migration, probably via activating AKT/NF-κB pathway and upregulating MMP-3 and MMP-7 expression. Therefore, blocking IL-7/IL-7R axis may provide a potential therapeutic strategy to treat prostate cancer.     

高甘油三酯腰围表型与急性胰腺炎病情程度及预后的相关性分析

目的探讨高甘油三酯腰围表型(HTGW)与急性胰腺炎(AP)病情程度及预后的相关性。方法选取西南医科大学附属医院2018年9月-2019年8月收治的356例AP患者为研究对象,将患者分为甘油三酯和腰围正常组(NWNT)、单纯高甘油三酯组(NWET)、单纯腹型肥胖组(EWNT)、高甘油三酯腰围表型组(HTGW)4个组,对比4组患者的临床特点,包括年龄、性别、实验室指标、病情分级、并发症等。符合正态分布的计量资料组间比较采用one-way ANOVA检验,组内两两比较采用LSD-t检验;不符合正态分布的计量资料组间及组内两两比较均采用Kruskal-Wallis H检验。计数资料二分类变量组间及组内两两比较均采用χ2检验,有序多分类变量组间比较采用Kruskal-Wallis H检验,组内两两比较采用Mann-Whitney U检验。患者发生器官衰竭和胰腺感染坏死的影响因素采用单因素及多因素logistic回归分析。结果HTGW组中性粒细胞计数水平高于NWNT组,CRP水平高于NWNT、NWET组,肌酐水平高于NWNT组,总胆固醇、TG、低密度脂蛋白水平高于NWNT、EWNT组,高密度脂蛋白水平低于NWNT、EWNT组,血糖水平高于NWNT组,差异均有统计学意义(P值均<0.05)。HTGW组重型急性胰腺炎发生率高于其他3组,差异有统计学意义(χ2=189.519,P<0.001)。HTGW组感染性胰腺坏死和器官衰竭并发症比例均高于其他3组,差异均有统计学意义(χ2值分别为11.770、19.457,P值分别为0.008、<0.001)。单因素logistic回归分析显示性别、复发史是感染性胰腺坏死的危险因素,校正危险因素后,HTGW组发生感染性胰腺坏死的风险为NWNT的3.347倍[95%可信区间(95%CI):1.538~7.283,P=0.002];BMI、腰围甘油三酯指数、吸烟、糖尿病、HTGW是器官衰竭的危险因素(P<0.05),校正危险因素后,HTGW组发生器官衰竭的风险为NWNT的4.143倍(95%CI:1.299~13.219,P=0.016)。结论HTGW是重型急性胰腺炎发生的独立危险因素,影响患者的病情程度及并发症的发生,应早期识别和诊断此型患者,积极改善脂代谢紊乱,改善患者的病情及预后。