Somatostatin as a mediator of the effect of neurotensin on pentagastrin-stimulated acid secretion in rats

Neurotensin and somatostatin have both been shown to inhibit gastric acid secretion, but no interaction between these peptides has been demonstrated. To determine whether somatostatin might be a mediator of neurotensin's effect on pentagastrin-stimulated gastric acid secretion, we performed the following three experiments. First, we collected 0.2-ml samples of portal venous blood as frequently as every 5 min, and we confirmed a significant release of somatostatin-like immunoreactivity into portal venous blood during neurotensin-induced inhibition of acid secretion. This release of somatostatin-like immunoreactivity and inhibition of acid secretion were only seen in pentobarbital-anesthetized rats, but no sustained release of somatostatin-like immunoreactivity or inhibition of acid secretion occurred in urethane-anesthetized animals. In the second experiment, we analyzed portal plasma by high pressure liquid chromatography, and found that portal somatostatin-like immunoreactivity in blood collected during neurotensin infusion was composed of a single peak corresponding to somatostatin-14. In the third experiment, we found that infusion of antibody to somatostatin prevented neurotensin from inhibiting pentagastrin-stimulated acid secretion. Taken together, these data show that somatostatin, possibly from the stomach itself, is a necessary mediator of neurotensin's inhibitory effect in pentobarbital-anesthetized rats.     

Dosimetric performance of continuous EPID imaging in stereotactic treatment conditions

PurposeThis study aims at investigating the dosimetric characteristics of a Varian aS1000 EPID, focusing on its continuous acquisition mode under the challenging conditions that can be met in stereotactic radiotherapy verification.MethodsAn aS1000 EPID installed on a Varian TrueBeamSTx was irradiated with 6 and 10 MV unflattened and flattened photon beams. In order to avoid detector saturation, the source-to-detector distance (SDD) was set to 150 or 180 cm depending on the dose rate. EPID image sets were acquired in continuous mode (CM) and also in the commonly used integrated mode (IM) for comparison, to evaluate dose linearity (including dose rate dependence), repeatability, reproducibility, stability, ghosting effect and field size dependence.ResultsCM response linearity was found to be within 0.8% of IM and independent of dose rate. Response repeatability was slightly better for IM and FF beams, being in all cases within 0.9%. Reproducibility was within 0.6% for both modes and all beam qualities. Response stability between continuous frames varied within 1% for dynamic and static irradiations and for all the beam qualities, showing its independence from these parameters. Ghosting effect was not significant, being comparable to signal variations between continuous frames (±1%). Field size dependence in both modes agreed within 1%.ConclusionsThe dosimetric response of the aS1000 EPID in CM with FFF beams and high dose rates is comparable to that in IM and for flattened beams provided that the appropriate SDD is used. aS1000 EPID in continuous acquisition mode is therefore suitable for stereotactic applications.     

Experimental infections of Orchitophrya stellarum (Scuticociliata) in American blue crabs (Callinectes sapidus) and fiddler crabs (Uca minax)

Outbreaks of an unidentified ciliate have occurred on several occasions in blue crabs from Chesapeake Bay held during winter months in flow-through systems. The parasite was initially thought to be Mesanophrys chesapeakensis, but molecular analysis identified it as Orchitophyra stellarum, a facultative parasite of sea stars (Asteroidea). We investigated the host-parasite association of O. stellarum in the blue crab host. Crabs were inoculated with the ciliate, or they were held in bath exposures after experimentally induced autotomy of limbs in order to determine potential mechanisms for infection. Crabs inoculated with the ciliate, or exposed to it after experimental autotomy, rapidly developed fatal infections. Crabs that were not experimentally injured, but were exposed to the ciliate, rarely developed infections; thus, indicating that the parasite requires a wound or break in the cuticle as a portal of entry. For comparative purposes, fiddler crabs, Uca minax, were inoculated with the ciliate in a dose-titration experiment. Low doses of the ciliate (10 per crab) were sometimes able to establish infections, but high intensity infections developed quickly at doses over 500 ciliates per crab. Chemotaxis studies were initiated to determine if the ciliate preferentially selected blue crab serum (BCS) over other nutrient sources. Cultures grown on medium with BCS or fetal bovine serum showed some conditioning in their selection for different media, but the outcome in choice experiments indicated that the ciliate was attracted to BCS and not seawater. Our findings indicate that O. stellarum is a facultative parasite of blue crabs. It can cause infections in exposed crabs at 10–15 °C, but it requires a portal of entry for successful host invasion, and it may find injured hosts using chemotaxis.     

PTVE 与TIPS治疗肝硬化门静脉高压合并食管胃底静脉曲张破裂出血 的疗效比较

目的:研究经皮胃底曲张静脉栓塞术(PTVE)和经颈静脉肝内门体分流术(TIPS)治疗肝硬化门静脉高压合并食管胃底静脉曲张破裂出血的临床疗效,为临床治疗提供依据。方法:选取2001年4月到2015年4月我院肝硬化门静脉高压合并食管胃底静脉曲张破裂患者169例,根据手术方式分为PTVE组(行PTVE治疗)141例和TIPS组(行TIPS治疗)28例,比较两组术前、术后门静脉压力,术前、术后3个月、6个月以及1年两组Child-Pugh评分、白蛋白以及直接胆红素,并比较两组再出血和肝性脑病发生率。结果:TIPS组术后门静脉压力较术前显著降低,比较差异具有统计学意义(P0.05),术后PTVE组及TIPS组组间比较差异具有统计学意义(P0.05);两组术前和术后各时间直接胆红素无统计学意义(P0.05);PTVE组术后1年白蛋白水平显著升高,与术前和TIPS组比较差异具有统计学意义(P0.05),TIPS组术后白蛋白有所升高,但各时间比较差异无统计学意义(P0.05),PTVE组术后各时间Child-Pugh评分较术前明显改善,比较差异具有统计学意义(P0.05),TIPS组术后3个月和术后6个月Child-Pugh评分较术前明显改善,比较差异具有统计学意义(P0.05);两组术后再出血发生率比较无统计学意义(P0.05),PTVE组肝性脑病发生率显著低于TIPS组,比较差异具有统计学意义(P0.05)。结论:PTVE和TIPS治疗肝硬化门静脉高压合并食管胃底静脉曲张破裂出血效果相当,TIPS能显著降低门静脉压,PTVE能降低肝性脑病的发生率,改善患者Child-Pugh评分。     

实时影像融合的超声虚拟导航技术联合射频消融术治疗原发性肝癌合并门静脉癌栓患者的疗效及对血清Bax、Cyfra21-1的影响

摘要 目的：探讨实时影像融合的超声虚拟导航技术联合射频消融术治疗原发性肝癌合并门静脉癌栓患者的疗效及对血清BCL-2同源的水溶性相关蛋白（Bax）、细胞角蛋白19片段（Cyfra21-1）的影响。方法：选择本院2017年1月到2021年4月收治的原发性肝癌合并门静脉癌栓患者82例作为研究对象,根据1：1随机数字表法将患者分为虚拟导航组与对照组各41例,虚拟导航组给予实时影像融合的超声虚拟导航技术联合射频消融术治疗,对照组给予单纯超声引导联合射频消融术治疗。结果：虚拟导航组的进针次数、融合时间、布针时间少于对照组（P<0.05）;虚拟导航组治疗后3个月的胆汁瘤、肝脓肿、膈肌损伤、肺部感染等并发症发生率为4.9 %,低于对照组的29.3 %（P<0.05）。虚拟导航组治疗后3个月的总有效率为82.9 %,高于对照组的51.2 %（P<0.05）。两组治疗后3个月的血清谷丙转氨酶（ALT）、谷草转氨酶（AST）水平低于治疗前,虚拟导航组低于对照组（P<0.05）。两组治疗后的血清Bax、Cyfra21-1含量低于治疗前,虚拟导航组低于对照组（P<0.05）。结论：实时影像融合的超声虚拟导航技术联合射频消融术治疗原发性肝癌合并门静脉癌栓能降低血清Bax、Cyfra21-1含量,改善患者的肝功能,提高消融效率,还可减少并发症的发生,最终提高患者的总体治疗效果。     

Portal hemodynamic changes after hepatocyte transplantation in acute hepatic failure

Hepatocyte transplantation has been proposed as an alternative for rescuing patients with acute hepatic failure. However, portal hemodynamic changes and issues of safety after hepatocyte transplantation in acute hepatic failure have not been systemically evaluated because of the lack of a suitable experimentation system. In this study, we created a novel spring-guidewire introducer needle to simplify the technique for long-term portal cannulation in F-344 rats. The portal cannula was capable of being used for blood sampling, infusion of hepatocytes, and measurement of portal hemodynamic changes. One week after portal cannulation, rats were injected withD-galactosamine (1.35 g/kg, i.p.) to induce hepatic failure. Hepatocytes (2×10⁷) were infused intraportally 24–26 h after induction of liver injury. Portal pressures were recorded for up to 60 min after hepatocyte transplantation. Intraportal infusion of 2×10⁷ hepatocytes caused an instantaneous onset of portal hypertension. The magnitude of the rise in portal pressure was similar in both normal rats and rats with acute hepatic failure (33.0±7.1 vs. 37.7±0.5 mm Hg; p=0.23). However, the resolution rate of portal hypertension was remarkably delayed in rats with acute hepatic failure, and the portal pressure was significantly higher than that in normal rats 60 min after hepatocyte transplantation (25.0±2.8 vs. 14.5±2.4 mm Hg; p=0.007). In conclusion, we have established a simple new technique for long-term portal cannulation of rats. Our studies provide critical insights into the delayed resolution of portal hemodynamics after hepatocyte transplantation in subjects with acute hepatic failure.     

β-Arrestin-1 protects against endoplasmic reticulum stress/p53-upregulated modulator of apoptosis-mediated apoptosis via repressing p-p65/inducible nitric oxide synthase in portal hypertensive gastropathy

Portal hypertensive gastropathy (PHG) is a serious cause of bleeding in patients, and is associated with portal hypertension. β-Arrestins (β-arrestin-1 and β-arrestin-2) are well-established mediators of endocytosis of G-protein-coupled receptors (GPCRs), ubiquitination, and G-protein-independent signaling. The role of β-arrestin-1 (β-arr1) in mucosal apoptosis in PHG remains unclear. The aim of this study was to investigate the involvement of β-arr1 in PHG via its regulation of endoplasmic reticulum (ER) stress/p53-upregulated modulator of apoptosis (PUMA) apoptotic signaling. Gastric mucosal injury and apoptosis were studied in PHG patients and in PHG mouse models. The induction of β-arr1 and the ER stress/PUMA signaling pathway were investigated, and the mechanisms of β-arr1-regulated gastric mucosal apoptosis were analyzed in vivo and in vitro experiments. β-arr1 and ER stress/PUMA signaling elements were markedly induced in the gastric mucosa of PHG patients and mouse models. Blockage of ER stress demonstrably attenuated the mucosal apoptosis of PHG, while targeted deletion of β-arr1 significantly aggravated the injury and ER stress/PUMA-mediated apoptosis. β-arr1 limited the activation of p65 to repress TNF-α-induced inducible nitric oxide synthase (iNOS) expression and NO release, which could regulate ER stress/PUMA-mediated mucosal apoptosis in PHG. In vivo and in vitro experiments further demonstrated that β-arr1 protected against mucosal apoptosis by repressing TNF-α-induced iNOS expression via inhibiting the activation of p65. These results indicated that β-arr1 regulated ER stress/PUMA-induced mucosal epithelial apoptosis through suppression of the TNF-α/p65/iNOS signaling pathway activation and that β-arr1 is a potential therapeutic target for PHG.     

血S100B蛋白和尿乳酸/肌酐比值对门静脉高压症术后肝性脑病发生的早期预测价值

目的评价血S100B蛋白和尿乳酸/肌酐对乙肝肝硬化门脉高压症术后肝性脑病发生的早期预测价值。方法回顾性分析65例乙肝肝硬化门脉高压症患者的临床资料,动态检测术后24、48和72h的血S100B蛋白和尿乳酸/肌酐比值水平,根据是否发生术后肝性脑病将受试者分为肝性脑病组与非肝性脑病组,并对肝性脑病组患者进行临床分度。结果乙肝肝硬化门脉高压症患者术后发生肝性脑病组72h内血S100B蛋白含量和24 h内尿乳酸/肌酐比值水平明显高于非肝性脑病组(P<0.001);72h内血S100B蛋白含量和24 h内尿乳酸/肌酐比值之间及与肝性脑病的临床分度呈正相关(P<0.001);当血S100B水平在28ng/L,尿乳酸/肌酐比值在0.47时,单独检测72h血S100B蛋白的敏感度、特异度分别为91.2%、93.6%;尿乳酸/肌酐比值预测肝性脑病的敏感度和特异性度以术后24h最高,分别为89.3%和91.7%;如检测72h血S100B蛋白的同时监测术后24h尿乳酸/肌酐比值可显著提高肝性脑病诊断的准确性,联合应用两项指标进行检测,诊断的敏感度和特异度分别为95.7%和98.6%,较两种方法单独应用敏感度和特异度均提高。结论对门静脉高压症患者术后以临床表现为基础,同时监测72h内血S100B蛋白和24h尿乳酸/肌酐比值,对提高术后肝性脑病的早期诊断和临床分度具有一定应用价值。     

Anatomy-corresponding method of IMRT verification

Background

During a proper execution of dMLC plans, there occurs an undesired but frequent effect of the dose locally accumulated by tissue being significantly different than expected. The conventional dosimetric QA procedures give only a partial picture of the quality of IMRT treatment, because their solely quantitative outcomes usually correspond more to the total area of the detector than the actually irradiated volume.

Aim

The aim of this investigation was to develop a procedure of dynamic plans verification which would be able to visualize the potential anomalies of dose distribution and specify which tissue they exactly refer to.

Materials & methods

The paper presents a method discovered and clinically examined in our department. It is based on a Gamma Evaluation concept and allows accurate localization of deviations between predicted and acquired dose distributions, which were registered by portal as well as film dosimetry. All the calculations were performed on the self-made software GammaEval, the γ-images (2-dimensional distribution of γ-values) and γ-histograms were created as quantitative outcomes of verification.

Results

Over 150 maps of dose distribution have been analyzed and the cross-examination of the gamma images with DRRs was performed.

Conclusions

It seems, that the complex monitoring of treatment would be possible owing to the images obtained as a cross-examination of γ-images and corresponding DRRs.