A risk prediction model for contrast-induced nephropathy associated with gadolinium-based contrast agents

ObjectiveThis is the first study to explore the risk factors for nephropathy caused by gadolinium-based contrast agents and establish a prediction model to identify high-risk patients.MethodsA total of 1404 patients who received gadolinium-based contrast agents in our hospital were included. The participants were randomly assigned in a 7:3 ratio to the modeling and validation groups. The modeling group was divided into a contrast-induced nephropathy group and a non-contrast-induced nephropathy group. The clinical characteristics before the use of contrast agents were compared between the two groups. The risk factors for contrast-induced nephropathy were analyzed by logistic regression. A nomogram that could predict the incidence of contrast-induced nephropathy was plotted. The validation group was used to verify the predictive model.ResultsThe incidence of contrast-induced nephropathy caused by gadolinium-based contrast agents was 3.92% (55/1404). The logistic stepwise regression analysis showed that sex, systolic pressure (SBP), absolute neutrophil count, albumin, fasting blood glucose level, and furosemide use were significant predictors of contrast-induced nephropathy caused by gadolinium-based contrast agents. The above predictors were then included in the nomogram construction. The area under the receiver operating characteristic (ROC) curve was 0.82 (p < 0.001). The specificity and sensitivity corresponding to the optimal cutoff point (0.039) based on the area under the ROC curve were 71.9% and 80.5%, respectively.ConclusionSex, SBP, absolute neutrophil count, albumin, fasting blood glucose levels, and furosemide use are significant predictors of contrast-induced nephropathy caused by gadolinium-based contrast agents. Therefore, the incidence of contrast-induced nephropathy may be estimated by the prediction model established in this study before the use of contrast agents.     

Subtoxic concentration of doxorubicin enhances TRAIL-induced apoptosis in human prostate cancer cell line LNCaP

Most tumor cells are sensitive to tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-induced apoptosis but sparing to normal cells, thus providing therapeutic potential for clinical use. Some tumor cells are resistant to TRAIL-induced cell death while the sensitivity could be recruited with the existence of some chemical agents. In this study, human prostatic cancer cell line LNCaP was found to be resistant to TRAIL-induced apoptosis while it could be restored to TRAIL sensitivity with combination treatment of low concentration of doxorubicin. TRAIL receptor-1 (DR4) and TRAIL receptor-2 (DR5) were upregulated under the treatment of doxorubicin and verified to be responsible for TRAIL-mediated signal transduction. Furthermore, caspase-8 and caspase-3 were activated and drove their autocleavage into programmed cell death. Interestingly, apoptosis-inhibitory protein c-FLIP, but not Bcl-2 and XIAP was downregulated after doxorubicin treatment. Taken together, these findings suggested that the pathway of cell apoptosis induced by TRAIL was intact but under negative control. Subtoxic concentration of doxorubicin effectively boosted TRAIL sensitivity via depletion of antiapoptotic protein. These findings support the new strategies for killing tumors with TRAIL and chemical agents.     

过表达或抑制IL-18对大鼠深静脉血栓形成的影响

目的 :探讨白介素(interleukin,IL)-18对大鼠深静脉血栓(deep vein thrombosis,DVT)模型血栓形成的影响。方法 :构建IL18-p CDH-GFP、IL18-LMP-sh RNAmir1病毒载体。SD大鼠(n=27)随机均分为3组。过表达组:尾静脉注入IL-18慢病毒过表达载体(IL18-p CDH-GFP,100μl);抑制组:注入IL-18逆转录病毒抑制载体(IL18-LMP-sh RNAmir1,100μl);对照组:注入无菌生理盐水(100μl)。注射24 h后,SD大鼠行狭窄法下腔静脉(inferior vena cava,IVC)血栓造模,造模后24 h解剖观察IVC血栓形成情况,并取材称量血栓重量及长度;血栓静脉管壁行实时荧光定量PCR检测IL-18表达情况。结果:IL18-p CDH-GFP、IL18-LMPsh RNAmir1病毒载体的体外细胞实验具备理想的过表达率及抑制率。各组大鼠造模后24 h可见稳定血栓形成。IL-18过表达组的平均成栓长度和重量较IL-18抑制组、对照组明显增加(P<0.05),real-time PCR结果显示过表达组中IL-18在大鼠静脉壁表达量明显增加(F=3.784,P<0.05)。结论:IL-18表达量增加,对大鼠DVT造模后IVC血栓形成有促进作用,而表达减少亦对成栓有影响,其表达状况与深静脉血栓的发生、发展有关,IL-18介导的促炎反应在静脉血栓疾病发病机制中可能起重要作用。     

振动负荷前后家兔神经传导速度变化的实验研究

本文以５２只家兔为实验对象，按不同的接振剂量分为五个组（其中包括一对照组），采用后肢接振法来模拟人体局部振动作业状态，振动实验６０天，使用丹麦产Ｎｅｕｒｏｍａｔｉｃ２０００Ｃ型神经－肌动描记仪，在实验前、实验后１５天、３０天和６０天分别测定家兔在侧坐骨神经ＳＣＶ和ＭＣＶ。实验结果发现，接振组ＳＣＶ和ＭＣＶ均较对照组明显减慢，尤其是ＳＣＶ改变更为明显，与人体局部振动作业所致外周神经损伤检查结果有一致     

丹参川芎嗪联合疏血通治疗慢性脑供血不足30例临床研究

目的 观察丹参川芎嗪注射液联合疏血通注射剂治疗慢性脑供血不足(CCCI)的临床疗效及对患者血液动力学的影响.方法 在就诊患者中随机选取90例CCCI患者,随机分为3组,丹川组给予丹参川芎嗪注射液,疏血通组给予疏血通,联合组给予疏血通和丹参川芎嗪,3组均为1次/d,疗程14 d.在治疗前后分别对3组采用经颅多普勒超声(TCD)进行脑血流动力学检测;观察治疗前后患者头晕、头痛等临床症状改善情况等的变化.结果 疏血通注射液和丹参川芎嗪注射液均有改善头晕、头痛等症状及改善脑血流动力学的作用,但联合组治疗后头晕、头痛等临床症状减轻更明显,血液流变学改善更显著(P＜0.05).结论 丹参川芎嗪联合疏血通治疗CCCI比单独用药疗效更佳.     

应用TUR术治疗膀胱癌膀胱全切术后复发性尿道癌

目的：探讨膀胱癌行膀胱全切术后尿道复发的治疗方法.方法：回顾性分析膀胱癌行膀胱全切术患者216例,其中术后复发尿道癌15例（6.9％）,复发平均时间18（3-46）个月.15例患者术后因肉眼血尿（7例）、血性分泌物（3例）及排尿不畅（5例）再次就诊.均经尿道膀胱镜检查及尿道冲洗细胞学检查确诊.尿道镜活检报告为尿道尿路上皮癌,病理分期为Ta-T1.15例均行TUR术,术后辅以羟基喜树碱灌注治疗.结果：15例患者术后平均随访36（6-52）个月.其中12例患者健在,未见肿瘤复发及转移;1例术后14个月肿瘤复发,行全尿道切除＋尿液转流术,随访至今未见肿瘤再次复发及转移;1例术后8个月肿瘤复发,行全尿道切除＋阴道前壁、侧壁、子宫及附件切除＋盆腔淋巴结清扫术,术后9个月死于肿瘤多发转移;1例死于心肌梗死.结论：膀胱癌膀胱全切术后复发尿道癌可应用TUR术治疗,临床效果良好且生活质量较高.早期诊断与治疗是保证预后的关键.     

MicroRNA-93 promotes bladder cancer proliferation and invasion by targeting PEDF

Objective

MicroRNA-93 (miR-93) is upregulated in the urine of patients with bladder cancer (BC). Here, we investigated the role of miR-93 in BC progression and explored the underlying mechanism.