加速康复外科理念在根治性子宫切除术患者中的应用研究

目的:探讨加速康复外科理念对行根治性子宫切除术的宫颈癌患者的围手术期应用价值。方法:选取2013年1月至2018年7月在我院行因宫颈癌行根治性子宫切除术的66例患者作为研究对象。将入院患者随机分为观察组及对照组,观察组接受加速康复外科理念治疗(30例),对照组为常规治疗组(36例)。比较两组患者的肠鸣音恢复时间、肛门排气时间、下床行走时间、术后住院时间以及术后并发症的发生情况。结果:观察组与对照组肠鸣音恢复时间分别为(35.9±3.4)h及(39.6±3.0)h,术后首次排气时间分别为(50.7±2.7)h及(54.8±3.2)h,下床行走时间分别为(49.9±2.6)h及(53.6±3.2)h。术后住院时间分别为(7.6±1.7)d及(9.2±1.8)d,观察组以上指标均显著短于对照组(P0.01)。观察组与对照组的术后并发症总发生率分别为10.11%及23.44%,观察组显著低于对照组(P0.05)。两组拔除尿管后尿潴留的发生情况比较差异无统计学意义(P0.05)。结论:加速康复外科理念用于宫颈癌根治术患者的围手术期可有效加速患者的康复,且安全性较高。     

Multiparametric magnetic resonance imaging-guided salvage radiotherapy in prostate cancer

AimTo analyse the efficacy and toxicity of postprostatectomy SRT in patients with a BCR evaluated with mpMRI.BackgroundMultiparametric magnetic resonance imaging (mpMRI) has the ability to detect the site of pelvic recurrence in patients with biochemical recurrence (BCR) after radical prostatectomy (RP). However, we do not know the oncological outcomes of mpMRI-guided savage radiotherapy (SRT).ResultsLocal, lymph node, and pelvic bone recurrence was observed in 13, 4 and 2 patients, respectively. PSA levels were significantly lower in patients with negative mpMRI (0.4 ng/mL [0.4]) vs. positive mpMRI (2.2 ng/mL [4.1], p = 0.003). Median planning target volume doses in patients with visible vs. non-visible recurrences were 76 Gy vs. 70 Gy. Overall, mean follow-up was 41 months (6–81). Biochemical relapse-free survival (bRFS) at 3 years was 82.3% and 82.5%, respectively, for the negative and positive mpMRI groups (p = 0.800). Three-year rates of late grade ≥2 urinary and rectal toxicity were 14.8% and 1.9%, respectively; all but one patient recovered without sequelae.ConclusionSRT to the macroscopic recurrence identified by mpMRI is a feasible and well-tolerated option. In this study, there were no differences in bRFS between MRI-positive and MRI-negative patients, indicating effective targeting of MRI-positive lesions.     

Changes in prostate cancer incidence,mortality and survival in relation to prostate specific antigen testing in New South Wales,Australia

BackgroundTo examine changes in prostate cancer incidence and mortality rates, and 5-year relative survival, in relation to changes in the rate of prostate specific antigen (PSA) screening tests and the use of radical prostatectomy (RP) in the Australian population.MethodsProstate cancer stage-specific incidence rates, 5-year relative survival and mortality rates were estimated using New South Wales Cancer Registry data. PSA screening test rates and RP/Incidence ratios were estimated from Medicare Benefits Schedule claims data. We used multiple imputation to impute stage for cases with “unknown” stage at diagnosis. Annual percentage changes (APC) in rates were estimated using Joinpoint regression.ResultsTrends in the age-standardized incidence rates for localized disease largely mirrored the trends in PSA screening test rates, with a substantial ‘spike’ in the rates occurring in 1994, followed by a second ‘spike’ in 2008, and then a significant decrease from 2008 to 2015 (APC −6.7, 95% CI −8.2, −5.1). Increasing trends in incidence rates were observed for regional stage from the early 2000s, while decreasing or stable trends were observed for distant stage since 1993. The overall RP/Incidence ratio increased from 1998 to 2003 (APC 9.6, 95% CI 3.8, 15.6), then remained relatively stable to 2015. The overall 5-year relative survival for prostate cancer increased from 58.4% (95% CI: 55.0–61.7%) in 1981–1985 to 91.3% (95% CI: 90.5–92.1%) in 2011–2015. Prostate cancer mortality rates decreased from 1990 onwards (1990–2006: APC −1.7, 95% CI −2.1, −1.2; 2006–2017: APC −3.8, 95% CI −4.4, −3.1).ConclusionsOverall, there was a decrease in the incidence rate of localized prostate cancer after 2008, an increase in survival over time and a decrease in the mortality rate since the 1990s. This seems to indicate that the more conservative use of PSA screening tests in clinical practice since 2008 has not had a negative impact on population-wide prostate cancer outcomes.     

血清白介素8基因多态性与食管鳞癌根治术后的相关性分析

摘要 目的：探讨与分析血清白细胞介素8（IL-8）基因多态性与食管鳞癌（ESCC）根治术后的相关性。方法：2017年8月到2020年6月选择在本院诊治的食管鳞癌患者98例作为研究对象,检测血清IL-8表达水平。所有患者都给予根治手术治疗,随访患者的预后并进行相关性分析。结果：所有患者术后随访到2021年7月,平均随访时间为25.69±2.58个月,死亡28例,死亡率为28.6 %（死亡组）。两组血清IL-8表达水平表达具有差异（P<0.05）。所有患者的基因型频率均符合Hardy-Weinberg这一平衡法则,表明本文所选取的样本均具有群体代表性。IL-8基因启动子rs4073A/T的AA基因型较死亡组高,TT基因型较死亡组低,两组A、T等位基因频率分布对比有差异（P<0.05）。直线相关性分析显示：IL-8基因启动子rs4073A/T的AA基因型、A等位基因、血清IL-8表达水平与预后死亡率存在相关性（P<0.05）。多因素logistic回归分析显示：IL-8基因启动子rs4073A/T的AA基因型、A等位基因、血清IL-8表达水平为导致患者随访死亡的主要因素（OR=2.051,3.094,P<0.05）。结论：食管鳞癌根治术后患者依然存在一定的死亡率,患者死亡与血清IL-8基因多态性存在相关性,同时多伴随有IL-8的高表达。IL-8基因启动子rs4073A/T的AA基因型、A等位基因、血清IL-8表达水平为导致患者死亡的主要因素。     

Catechol thioethers with physiologically active fragments: Electrochemistry,antioxidant and cryoprotective activities

A number of asymmetrical thioethers based on 3,5-di-tert-butylcatechol containing sulfur atom bonding with physiologically active groups in the sixth position of aromatic ring have been synthesized and the electrochemical properties, antioxidant, cryoprotective activities of new thioethers have been evaluated. Cyclic voltammetry was used to estimate the oxidation potentials of thioethers in acetonitrile. The electrooxidation of compounds at the first stage leads to the formation of o-benzoquinones. The antioxidant activities of the compounds were determined using 2,2′-diphenyl-1-picrylhydrazyl radical (DPPH) assay, experiments on the oxidative damage of the DNA, the reaction of 2,2′-azobis(2-amidinopropane hydrochloride) (AAPH) induced glutathione depletion (GSH), the process of lipid peroxidation of rat liver (Wistar) homogenates in vitro, and iron(II) chelation test. Compounds 1–9 have greater antioxidant effectiveness than 3,5-di-tert-butylcatechol (CatH₂) in all assays. The variation of physiologically active groups at sulfur atom allows to regulate lipophilic properties and antioxidant activity of compounds. Thioethers 3, 4 and 7 demonstrate the combination of radical scavenging, antioxidant activity and iron(II) binding properties. The researched compounds 1–9 were studied as possible cryoprotectants of the media for cryopreservation of the Russian sturgeon sperm. Novel cryoprotective additives in cryomedium reduce significantly the content of membrane-permeating agent (DMSO). A cryoprotective effect of an addition of the catechol thioethers depends on the structure of groups at sulfur atom. The cryoprotective properties of compounds 3, 4 and 7 are caused by combination of catechol fragment, bonded by a thioether linker with a long hydrocarbon chain and a terminal ionizable group or with a biologically relevant acetylcysteine residue.     

Geranyl chalcone derivatives with antifungal and radical scavenging properties from the leaves of Artocarpus nobilis

Antifungal activity guided fractionation of the n-butanol extract from the methanol extract of the leaves of Artocarpus nobilis furnished 2',4',4-trihydroxy-3'-geranylchalcone (1), 2 ',4',4-trihydroxy-3'-[6-hydroxy-3,7-dimethyl-2(E),7-octadienyl]chalcone (2), 2',4',4-trihydroxy-3'-[2-hydroxy-7-methyl-3-methylene-6-octaenyl]chalcone (3), 2',3,4,4'-tetrahydroxy-3'-geranylchalcone (4), 2',3,4,4'-tetrahydroxy-3'-[6-hydroxy-3,7-dimethyl-2(E),7-octadienyl]chalcone (5). The chalcones 3 and 5 are new natural products whereas 1 and 2 are reported first time from the family Moraceae. All these compounds showed good fungicidal activity against Cladosporium cladosporioides and high radical scavenging activity towards the 2,2'-diphenyl-1-picrylhydrazyl (DPPH) radical in TLC bio-autography method.     

Antioxidant activity of phenylpropanoid esters isolated and identified from Platycodon grandiflorum A. DC

Platycodon grandiflorum A. DC (Campanulaceae) is used as a traditional oriental medicine and also as a food in Korea. Here we investigated its antioxidant activity, and isolated and identified its active compounds. Petroleum ether extracts from the whole root of P. grandiflorum were fractionated by silica gel column chromatography using a solvent gradient (petroleum ether:diethyl ether, v/v; 9:1-5:5). The 8:2 fraction showed a higher radical scavenging activity than the other fractions, and active compounds were purified from this fraction by reversed-phased HPLC. Two active compounds were identified as coniferyl alcohol esters of palmitic and oleic acids by FAB-MS, UV, IR and NMR spectroscopy. The antioxidant activities of these two compounds, which were evaluated by 1,1-diphenyl-2-picrylhydrazyl (DPPH), superoxide and nitric oxide radical scavenging capacity, were found to be as high as those of BHT or BHA.     

Effects of pretreatment with a xanthine oxidase inhibitor on free radical levels during carotid endarterectomy

Objective: Free radicals contribute to the tissue damage caused by ischaemia-reperfusion. The aim of the present study was to investigate whether preoperative antioxidant therapy (allopurinol) affects free radical levels in cerebral venous blood in connection with surgery for carotid artery stenosis.

Materials and methods: Twenty-five patients were randomised into the study. Thirteen were controls and 12 were pretreated with allopurinol the day before surgery. Before, during and after surgery, blood samples were drawn from the ipsilateral jugular vein. Radical levels were measured using the spin trap technique ex vivo using OXANOH as the spin trap. Multivariate statistics were used with Principal Component Analysis and Partial Least Square regression analysis.

Results: Radical levels increased with diabetes, high leukocyte count, high creatinine and a high degree of contralateral stenosis. Radical levels decreased with high age, blood pressure, collateral circulation as well as operation for left-side carotid artery stenosis. After pretreatment with allopurinol, several of the relationships noted in the control group were eliminated, i.e. leukocyte count, side of operation, Betapred pretreatment and collateral circulation.

Conclusions: Radical levels can be determined in connection with surgery for carotid artery stenosis using an ex vivo spin trap method. With preoperative antioxidant therapy the relationships between enhanced radical levels and clinical data, as seen in control subjects, disappeared. This might indicate a beneficial effect of preoperative pretreatment with antioxidants.     

Change of Cu,Zn-superoxide dismutase activity of guinea pig lung in experimental asthma

Correlation between the level of reactive oxygen species (ROS) generated by airway inflammatory cells and superoxide dismutase (SOD) activity of pulmonary tissue during an asthma attach was investigated in a guinea pig model of allergic asthma. In addition, the influence of SOD inhibition by diethyldithiocarbamate (DDC, Cu-chelating agent) on the airway was investigated in terms of pulmonary function during an asthma attach. Relative to controls, the capacity of bronchoalveolar lavage fluid (BAL) cells to release ROS was significantly increased in guinea pigs sensitized with ovalbumin (OA) as the antigen, and significantly increased in guinea pigs with an asthma attack provoked by the inhalation of OA. SOD activity was increased significantly in the antigen-sensitized group. The asthma provocation group showed a tendency for increase in total SOD activity, compared with the sensitization group, whose increase was dependent on the increase in copper, zinc-SOD (Cu, Zn-SOD) activity. Pretreatment with DDC increased the severity and duration of the asthma attack. These results were indicated that Cu, Zn-SOD was closely involved in the asthma process, particularly in the scavenging of oxygen radicals secreted from BAL cells.