腹腔热灌注化疗治疗胃肠癌

腹腔热灌注化疗是防治腹腔恶性肿瘤,尤其胃肠癌术后腹腔复发和肝转移的一项重要措施．其综合利用局部化疗、热疗和大容量化疗液对腹腔的机械灌洗作用,具有药代动力学及流体动力学优势,能有效清除游离癌细胞及微小癌灶,防治术后腹腔复发和肝转移．我们就腹腔热灌注化疗治疗胃肠癌加以综述．     

世界华人消化杂志和World Journal of Gastroenterology2006年工作总结

世界胃肠病学杂志社于2006-12-22在北京鹭鹭酒家东方店举行了第三次工作会议,总结了2006年《世界华人消化杂志》和《World Journal of Gastroenterology》各项编辑出版工作,国家自然科学基金委员会杂志部祖广安主     

猝死型胰腺炎误诊分析3例

本文通过3例猝死型胰腺炎的发病过程及病理特点,分析了猝死型胰腺炎临床特征:(1)发病至死亡时间短暂;(2)无明显诱发因素;(3)无胰腺炎特异性体征;(4)胰腺病理改变比较轻微;(5)胰头部胰腺坏死与呼吸骤停可能相关.     

64层螺旋CT冠状动脉造影CPR/MPR评价心肌桥-壁冠状动脉

目的采用西门子64层螺旋CT冠状动脉造影对心肌桥-壁冠状动脉进行诊断,评价血管狭窄程度。方法对198例临床有或无胸闷患者进行64层螺旋CT冠状动脉造影,MPR/CPR对血管进行重建,分析血管在收缩期甚或是舒张期血管狭窄程度。结果MPR/CPR重建更有利于心肌桥-壁冠状动脉的显示。8例合并软斑块,5例合并钙化斑块,5例合并冠状动脉起源异常。22例发生在前降支,13例发生在回旋支。结论MPR/CPR重建可以对心肌桥-壁冠状动脉明确显示,为临床冠心病诊断提供明确影像学依据。     

氯代正丁苯酞在大鼠肝微粒体中的代谢研究

用大鼠肝微粒体体外温孵方法进行了氯代正丁苯酞(CBP)代谢转化研究,优化了温孵体系的组成,建立了反相HPLC-DAD在线同时分离检测CBP及其4个体外代谢产物的分析方法,并比较了在苯巴比妥(PB)与3-甲基胆蒽(3-MC)诱导的微粒体中代谢差别。利用TLC、柱色谱与制备HPLC分离纯化了3个主要代谢产物,并进行了NMR,MS,UV等光谱鉴定,确定了其主要代谢产物为γ-羟基氯代正丁苯酞与β-羟基氯代正丁苯酞及它们的立体异构体。     

Bone marrow-derived macrophage contributes to fibrosing steatohepatitis through activating hepatic stellate cells

The role of macrophages in fibrosing steatohepatitis is largely unclear. We characterized the origin and molecular mechanisms of macrophages and its targeted therapy of fibrosing steatohepatitis. Fibrosing steatohepatitis was established in Alms1 mutant (foz/foz) and C57BL/6J wildtype mice fed high-fat/high-cholesterol or methionine- and choline-deficient diet. Bone marrow transplantation was performed to track the macrophage origin in fibrosing steatohepatitis. Macrophages were depleted using liposomal clodronate. Primary macrophages were isolated from bone marrow for adoptive transfer into mice. We found that macrophage infiltration is induced in two mouse models of fibrosing steatohepatitis and human nonalcoholic steatohepatitis-fibrosis patients. Bone marrow-derived macrophages (BMMs) contribute to the hepatic macrophage accumulation in experimental fibrosing steatohepatitis. Depletion of hepatic BMMs by liposomal clodronate during liver injury attenuated fibrosing steatohepatitis, whilst BMMs depletion after liver injury delayed the regression of fibrosing steatohepatitis. The pro-fibrotic effect of macrophages was associated with reduced activation of hepatic stellate cells (HSCs), collagen deposition and hepatic expression of key pro-fibrotic factors (TIMP1, TIMP2, and TGFβ1) and endoplasmic reticulum stress markers (GRP78, IRE1α, and PDI). Conversely, adoptive transfer of BMMs significantly aggravated fibrosing steatohepatitis. Moreover, macrophage-conditioned medium directly promoted the phenotypic transition of primary quiescent HSCs to activated HSCs; it enhanced activation and proliferation but decreased apoptosis of HSC cell lines (LX-2 and HSC-T6). The effect of BMMs in promoting fibrosing steatohepatitis was mediated by inducing key pro-fibrosis factors and signaling pathways including cytokine/chemokine, TGFβ and complement cascade as assessed by cDNA expression array. Complement 3a receptor (C3ar1) was a predominant effector of macrophage mediated fibrosing steatohepatitis. Knockout of C3ar1 in mice blunted development of fibrosing steatohepatitis. In conclusion, BMMs promoted the progression of fibrosing steatohepatitis during injury, whereas macrophages reduced fibrosing steatohepatitis in the recovery phase of liver injury. Increasing anti-fibrotic macrophages and decreasing pro-fibrotic macrophages are promising approaches for fibrosing steatohepatitis. © 2019 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.     

Efficacy of low-dose nebulized epinephrine as treatment for croup: A randomized,placebo-controlled,double-blind trial

ObjectiveCroup treatment usually involves a single dose of systemic dexamethasone combined with nebulized epinephrine. However, the optimal dose of l-epinephrine remains unclear. We examined whether a low dose (0.1 mg/kg) was inferior to the conventional dose (0.5 mg/kg) of 1:1000 nebulized l-epinephrine in patients with moderate to severe croup.MethodsThis randomized double-blind clinical non-inferiority trial was conducted in three pediatric emergency departments from May 2015 to October 2017. Children 6 months to 5 years old with moderate to severe croup (Westley scale scores 3–11) were eligible. Subjects were randomly assigned to the conventional dose (0.5 mg/kg: maximum 5 mg) or low dose (0.1 mg/kg; maximum 1 mg) group. All subjects received 0.6 mg/kg dexamethasone. Croup scores and other vital signs were measured before and at 30, 60, 90, and 120 min after nebulized l-epinephrine administration. The primary outcome was the change in croup score after 30 min.ResultsThe final analysis included 84 patients. The groups did not differ significantly in terms of demographic parameters. At 30 min after treatment with nebulized l-epinephrine, the croup scores in both groups were significantly reduced from the baseline values (p < 0.05) and did not differ between the two groups (p = 0.42). Neither blood pressure nor heart rate differed between the two groups.ConclusionsLow-dose 1:1000 l-epinephrine was not inferior in croup score reduction to the conventional dose in patients with moderate to severe croup.Clinical trial No: NCT01664507, KCT0002318.