Objective To investigate the effects of genistein with different concentration on proliferation and apoptosis of cultured human retinal pigment epithelial (RPE) cells in vitro. Methods The effect of genistein with the concentration of 5，10，25，50，75，and 100 mg·L-1on the proliferation of cultured RPE was examined by tetrazolium salt (MTT) assay and AgNORs staining. The cell apoptosis was detected by terminal deoxynucleotidyl transferase-mediated deoxyuridine 5-triphosphate nick-end labeling (TUNEL) methods, in the mean time, the morphologic changes of cell apoptosis were observed by light microscopy and transmission electronic microscopy, the results of which were compared with the normal RPE cells. Results Genistein with the concentration of 25, 50, 75, and 100 mg·L-1had a dose-dependent and time-dependent antiproliferative effects on RPE cells with the inhibitory rate of 12.0%-64.6% (P＜0.05). The results of AgNORs staining showed that the number of AgNORs in the nucleolus decreased when treated by genistein. In TUNEL staining, the median of percent of apoptotic RPE cells was 7.6%, 9.8%, 13.7% when treated with 50 mg·L-1genistein, 10.3%, 16.4%, 23.4% when treated with 75 mg·L-1genistein, and 15.4%, 21.2%, 35.8% when treated with 100 m g·L-1genistein respectively for 24, 48, and 72 hours. After the treatme nt with 50 mg·L-1genistein for 48 hours, the apoptosis in the nucleolus of RPE cells was found. Conclusions Genistein with different concentrations has a dose-dependent and time-dependent antiproliferative effect on RPE cells. Genistein can induce the apoptosis of RPE cells when it reaches a certain extent of concentration. (Chin J Ocul Fundus Dis，2004，20：241-244)
摘要:目的:探讨急诊医疗过程中意外死亡的原因,以引起广大同道的重视。方法:对急诊就诊过程中24 h内死亡且符合入选标准的68例患者进行死亡原因分析,分析意外死亡常见的病因并探讨死亡原因与就诊之初临床特征的关系。结果:68例意外死亡患者占同期死亡人数的4.39％,其中主动脉夹层31例,占同期死亡2％,占意外死亡的45.6％;心脏性猝死(急性心肌梗塞9例,心肌炎4例,)13例占同期死亡病人的0.84％,占意外死亡总数的191％;急性脑血管病(小脑出血5例,小脑梗塞8例)13例,占同期死亡人数的0.84％,占意外死亡总数的19.1％;重症哮喘3例;不明原因死亡5例。临床特征多为胸痛、胸背痛、头痛、上腹痛、眩晕等为首发症状。结论:急诊就诊过程意外死亡发生取决于多种因素,由于这些病例症状多不典型,病情复杂多样,临床医师极易忽视,临床极易漏诊、误诊,一旦发生,都将引起较大的医疗纠纷,耗费大量的人力物力。因此对急诊就诊过程中的不典型特征高度重视及时考虑主动脉夹层、心脏性猝死、急性脑血管病,早期治疗,避免意外死亡的发生。Abstract: Objective: To explore the character of accidental death during treatment in emergency department, and get more attention of other emergent doctors to avoid death in emergent treatment.Methods: To analysis death causes of 68 qualified patients, who died within 24 hours after they went to hospital; To analysis familiar accidental death causes and the relationship between them and initial clinical signs. Results:These 68 accidental dead patients occupied 4.39% in all dead patients during the same period, including 31 cases of aortic dissecting hematoma(2% in all dead patients vs 45.6% in accidental dead patients); 13 cases of sudden cardiac death(0.84% in all dead patients vs 19.1% in accidental dead patients), which included 9 cases of acute myocardial infaction, 4 cases of myocarditis; 13 cases of acute cerebravascular diseases(0.84% in all dead patients vs 19.1% in accidental dead patients),which included 5 cases of cerebella hemorrhage and 8 cases of cerebella infarction; 3 severe asthma and other 5 cases without exact reasons. Clinical initial showed frequently the pain of breast, breast and back, head and upper belly, and dizzling. Conclusion: The happening of accidental death during treatment in emergent department was decided by many complicated factors. Because being nontypical and complicated, these factors always were ignored by clinical doctors, resulting wrong diagnosis or leaked diagnosis, which brought many clinical dissensions. Clinical dissensions cost much money and energy. So to know and pay more attention to these nontypical signs is very important to diagnosis aortic dissecting hematoma, sudden cardiac death and acute cerebravascular diseases, and is helpful to treat in time, and consequently the death was avoided.
Objective To observe the histological changes and apoptosis of retinal cells in pigmented rabbits treated by transpupillary thermotherapy (TTT) with different laser power. Methods Fourteen pigmented rabbits (28 eyes) were divided averagely into seven groups（control group, 50, 70, 90, 110, 130, and 150 mW group）according to different laser power of TTT. Light microscopy was performed to observe the histological changes, and TDT-mediated biotin-dUTP nick-end labeling (TUNEL) technique and flow cytometry (FCM) examination were used to detect the apoptotic cells 24 and 48 hours after photocoagulation, respectively. Results The color of retinal burn speckles changed from offwhite to white and super white with the diameter enlarged gradually as the laser power of TTT increased. The results of light microscopy revealed that compared with the control group, the retinal tissue did not change much in 50-70 mW group; in 90-130 mW group, the retinal structure was integrated, but the cone and rod cells became swollen and condensed nuclei and cytoplasmic vacuolization were seen in the inner nuclear layer. The difference of retinal structure in 50-130 mW group 24 and 48 hours after photocoagulation and control group was not significant. In 150 mW group, tumefaction and degeneration were observed in each layer of retina and the inner and outer segments of photoreceptor cells lost 24 hours after photocoagulation, and obvious necrosis and cell loss of retinal tissues were detected hours after photocoagulation. The results of TUNEL examination indicated that positive cells were found in outer nuclear layer in each photocoagulation group which increased as the laser power of TTT was enhanced; the apoptosis gradually involved the inner nuclear layer and ganglion cell layer. The results of flow cytometry (FCM) examination showed the peak of apoptotic cells in each photocoagulation group 24 hours after photocoagulation. Conclusion Under certain subthreshold photocoagulation (50-70 mW), retinal tissue of rabbits does not change much but apoptosis of photoreceptor cells increase significantly. As the laser power of TTT increases, the retinal tissues become swollen, degenerated and even necrotic; cellular apoptosis gradually involves the inner nuclear layer and ganglion cell layer. (Chin J Ocul Fundus Dis, 2006, 22:249-252)
Objective To analyze the clinical features of immune checkpoint inhibitor-related pneumonia (CIP) in patients with lung cancer. Methods The case data of patients with CIP admitted to Zhongshan Hospital of Fudan University from January 2017 to December 2020 were retrospectively collected, and the basic data, clinical manifestations, imaging data, laboratory examination results, treatment and prognosis of the patients were analyzed. Results The ratio of male to female was 18:1, and the median age was 65 years (from 41 to 74 years). Fourteen patients received a programmed death protein-1 (PD-1) inhibitor and five patients received a programmed death protein-ligand-1 (PD-L1) inhibitor. The median time to CIP was 3.5 months. The respiratory symptoms of 15 patients were dyspnea in 11 cases, cough in 9 cases, chest tightness in 8 cases, fever in 4 cases, expectoration in 4 cases and hemoptysis in 2 cases. Chest CT findings mainly showed interstitial pneumonia, including 8 cases of implicit organizational pneumonia (COP), 7 cases of non-specific interstitial pneumonia (NSIP), 2 cases of acute interstitial pneumonia, and 2 cases of allergic pneumonia. C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase were higher in CIP than before, and the difference was statistically significant. Follow-up observation was performed in 3 patients alone, 14 patients were treated with glucocorticoid alone, 2 patients were treated with immunosuppressant therapy, 19 patients had stable or more absorption of pneumonia lesions, and 5 patients had restarted immunotherapy. There were no deaths from CIP. Conclusions CIP mainly occurs in men, with slow onset, lack of specificity in clinical manifestations, and increased inflammatory indicators. Imaging findings are mainly NSIP and COP changes. Early identification, diagnosis and rational application of glucocorticoid therapy have good effects.
ObjectiveTo evaluate the protective effect of estrogen on survival of retinal ganglion cells (RGCs) after transient retinal ischemia-reperfusion (RIR) in rats.MethodsRIR was induced in 60 ovariectomized adult rats (OVX) by increasing intraocular pressure via an intracameral catheter. All of the rats were divided into two groups randomly: in experimental group, the rats underwent a subcutaneous injection with 17β-estrodiol（100 μg/kg） 2 hours before retinal ischemia; and in the control group, saline water was injected correspondingly. The number of RGCs and the thickness of the inner retinal layers were mesured by HE staining method before and 12, 24, 48, and 72 hours after reperfusion. TdT-mediated biotin-dUTP nick end labelling (TUNEL) staining technique was used to examine the apoptosis of RGCs.ResultsTwenty-four and 48 hours after reperfusion, the number of apoptotic cells in experimental group was obvious lower than that in the control group(Plt;0.05), and the number of RGCs in experimental group was higher than that in the control group(Plt;0.05).ConclusionEstrogen can protect retinal neurons from transient RIR in ovariectomized rats.(Chin J Ocul Fundus Dis, 2005,21:177-179)
Objective To summarize the effect of lenvatinib + transarterial chemoembolization (TACE) + programmed cell death protein-1 (PD-1) antibody in the treatment of hepatocellular carcinoma with main portal vein tumor thrombus and cavernous transformation. Methods In this study, we reported the clinical data of four patients with hepatocellular carcinoma with main portal vein tumor thrombus and cavernous transformation who received conversion therapy with lenvatinib combined with TACE and PD-1 antibody in West China Hospital. Results Among the four patients, two patients achieved complete response and two achieved partial response; tumor markers were significantly decreased after combination treatment. However, all four patients failed to undergo hepatectomy. ConclusionsLenvatinib + TACE + PD-1 antibody is effective for hepatocellular carcinoma with main portal vein tumor thrombus and cavernous transformation. However, there are still many problems worthy of further discussion.
ObjectiveImpaired breathing during and following seizures is an important cause of sudden unexpected death in epilepsy (SUDEP), but the network mechanisms by which seizures impair breathing have not been thoroughly investigated. Progress would be greatly facilitated by a model in which breathing could be investigated during seizures in a controlled setting. MethodRecent work with an acute Long-Evans rat model of limbic seizures has demonstrated that depression of brainstem arousal systems may be critical for impaired consciousness during and after seizures. We now utilize the same rat model to investigate breathing during partial seizures with secondary generalization. ResultBreathing is markedly impaired during seizures(P < 0.05;n=21), and that the severity of breathing impairment is strongly correlated with the extent of seizure propagation (Pearson R=-0.73;P < 0.001;n=30). ConclusionSeizure propagation could increase the severity of breathing impairment caused by seizures. Based on these results, we suggest that this animal model would help us to improve understanding of pathways involved in impairment of breathing caused by seizures and this is an important initial step in addressing this significant cause of SUDEP in people living with epilepsy.
Objective To investigate present status of health care in peri-brain-death and analyze its effectiveness and health economic characteristics. Method Retrospective analysis of case series was conducted and a total of 940 patients from surgical intensive care unit (SICU) were reviewed on treatment and part of direct medical expenditure. The patients admitted from Jun. 1999 to Dec. 2000 and Nov. 2001 to Jun. 2002 were included in this study. Data were processed by SPSS 10.0. Results Patients were included if they had two of the three symptoms for at least one hour: deep coma, pupillar light reflex disappear, and no autonomic respiratory. Ultimately 115 patients were included, with a total cost of ￥2 515.9 per day for each case, whereas mortality was 99.10%. Mortality increased with the state of peri-brain-death prolonged. Eighty percent of patients included were dead within 72 hours after admission. Conclusions Attempts to resuscitate patients of peri-brain-death have been the most widely applied in China, however, it resulted in great unnecessary consumption of health resources. It is of great importance to promote legislation of brain death in China.
Objective To analyze the death cause of residents in Zigong from 1985 to 2009, so as to provide the government with scientific information of health strategies, and disease prevention and control. Methods The death surveillance data in Zigong residents from 1985 to 2009 were collected, and the indexes such as all death mortality rate, infant mortality rate, maternal mortality rate, disease-specific mortality rate, age-specific mortality rate, and life expectancy were analyzed. Results The all death mortality rate had fluctuation of plus or minus 6‰, and the male mortality rate was higher than the female (χ2=8 059.769, P=0.000). The six main influencing factors of the death of Zigong residents were as follows: respiratory system diseases, circulatory system diseases, tumour, injury and poisoning regarded as external cause diseases, digestive system diseases, and infectious diseases and parasitic diseases. The mortality rates of different districts were statistically different (χ2=1 643.926, P=0.000), and Fushun County was the highest among them after standardization. The curve of mortality rate in different sex and age groups was changed alike letter “U”. The mortality rate was ascending with the age in the group of over 15 years old, the ascending trend was more evident especially after 50 years old. The infant mortality declined steadily and was well controlled. The maternal mortality declined obviously. The average life expectancy for the whole city was 74.72, which showed an ascending trend. Conclusion The chronic diseases are the main death cause of residents in Zigong. The prevention and controlling of acute infectious diseases and parasitic diseases should be persistently performed for declining both incidence rate and mortality rate. The Zigong city is gradually stepping into aging society, which requires the great development of senior work.
Objective To summarize and further investigate the initial experience of organ procurement process for organ donation after cardiac death （DCD）. Methods The clinical data，the selected standard，and the organ procurement process of 28 cases of DCD from July 2009 to January 2012 in the liver transplantation center of Guangzhou General Hospital were reviewed and analyzed. Results Twenty-eight cases of DCD all had donated organs successfully. Among these cases，there were 3 cases （10.7%） of the Maastricht Ⅲ， and one case （3.6%） of the Maastricht Ⅳ，and 24 cases （85.7%） of the organ donation after brain death plus cardiac death （DBCD）．Three cases of the Maastricht Ⅲ were practiced the organ procurement process of DCD．One case of the Maastricht Ⅳ was practiced the organ procurement process of DBCD without the extracorporeal membrane oxygenation （ECMO）．Twenty-four cases of DBCD were practiced the organ procurement process of DBCD with the ECMO．The donator warm ischemic time was zero min in DBCD，18 min in Maastricht Ⅳ，and mean 25 min （22-28 min） in MaastrichtⅢ．All the donated organs included 28 livers，40 kidneys，and 2 hearts．And all these organs had been practiced the liver transplantation，the kidney transplantation，and the heart transplantation. Conclusions The organ procurement process for organ DCD includes the DCD process and the DBCD process in China，and the later includes the organ procurement process with the ECMO and without the ECMO．The ECMO could well control the warm ischemia for protecting the donors just without ethics dispute. So，the using of the ECMO for the organ DCD of citizen in China has a very important contribution．