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Chen P.,Liaoning Medical University | Pang X.,Liaoning Medical University | Zhang Y.,Liaoning Medical University | He Y.,Jinhua Municipal central hospital
Oncology Reports

Adrenomedullin (AM), a potent vasodilator peptide, is present in various types of tumors. Here, we constructed short hairpin RNA (shRNA) in order to target the AM gene in vitro using RNA interference (RNAi) technology. HO8910 ovarian cancer cells were transfected, and the effects of AM on proliferation and chemosensitivity of the cells were examined. RT-PCR, real-time PCR and western blot analysis were performed to detect the AM gene and protein expression. The MTT assay was used to observe the effect of AM on proliferation and chemosensitivity of the cells. Also, the protein levels of Bcl-2 and the extracellular regulated protein kinase (ERK) were evaluated by western blot analysis. We found that silencing of the AM gene inhibited the proliferation and increased the chemosensitivity of HO8910 cells, reduced the expression of AM mRNA and protein as well as downregulated Bcl-2 and p-ERK expression. We, therefore, conclude that silencing of the AM gene in HO8910 ovarian cancer cells inhibited the proliferation and increased the chemosensitivity of the cells through downregulation of ERK and Bcl-2 expression. Thus, anti-AM treatment together with suppression of ERK and Bcl-2 expression provides a novel research approach for ovarian cancer. Source

Wu X.,Jinhua Municipal central hospital | Jin Y.,Shanghai JiaoTong University | Zhang X.,Shanghai JiaoTong University
Journal of Craniofacial Surgery

Rupture of traumatic pseudoaneurysms of the middle meningeal artery (MMA) usually causes extradural hematoma. In rare cases, it may be a possible cause of intraparenchymal hematoma. We present 2 cases of intraparenchymal hematoma caused by rupture of traumatic pseudoaneurysms of MMA. Both patients had definite medical history of head trauma. Imaging examinations indicated temporal hematoma or frontal hematoma caused by rupture of pseudoaneurysm of MMA. After surgical management, both the patients had a favorable prognosis. The formation of the traumatic pseudoaneurysms, imaging findings, and the management were discussed, and we conclude that in the management of traumatic intraparenchymal hematoma, possibility of traumatic pseudoaneurysms must be considered. Surgery may be the prior choice for the treatment of traumatic pseudoaneurysms. © 2014 Mutaz B. Habal. Source

Zhang Z.,Zhejiang University of Science and Technology | Zhang Z.,Southern Medical University | Xue Y.,Jinhua Municipal central hospital | Xu X.,Zhejiang University of Science and Technology | Ni H.,Zhejiang University of Science and Technology
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Background and objectives: The prognostic role of B-type natriuretic peptide (BNP) in septic patients is controversial. The study aimed to investigate the prognostic value of BNP in critically ill septic patients. Furthermore, because BNP is primarily released from ventricles in response to myocardial stretch, the second aim of the study was to test whether the change in BNP was correlated to the amount of fluid balance.Methods: This was a prospective observational study conducted in a tertiary 18-bed ICU. Patients fulfilled criteria of sepsis were enrolled. Exclusion criteria included renal dysfunction on ICU entry, age < 18 or >80 years old. BNP was measured on entry (BNP0) and day 3 (BNP1) and daily fluid balance over the three days were recorded. Diagnostic performances of BNP0 and ΔBNP (BNP1-BNP0) were analyzed. The correlation between fluid balance and ΔBNP were tested using Spearman's correlation test.Results: A total of 67 subjects were eligible for the study during study period. BNP0 was significantly higher in non-survivors than in survivors (738 vs 550 pg/ml, p < 0.01). The area under curves (AUCs) of BNP0 in predicting mortality, duration of mechanical ventilation (MV) > 7 d, length of stay in ICU (LOSICU) > 7 d and hospital (LOShospital) > 12 d were 0.71, 0.79, 0.66 and 0.71, respectively. The AUCs of ΔBNP in predicting duration of MV > 7 d, LOSICU > 7 d and LOShospital > 12 d were 0.80, 0.84 and 0.85, respectively. The amount of fluid balance was correlated to ΔBNP (Spearman's rho = 0.63, p < 0.01), and the correlation remained statistically significant in multivariate model.Conclusions: BNP measured on ICU entry is associated with mortality, duration of MV, LOSICU and LOShospital. ΔBNP is able to predict the LOSICU and LOShospital with satisfactory sensitivity and specificity. ΔBNP is closely correlated to the amount of fluid balance during resuscitation period. However, this could only be considered as a hypothesis-generating pilot study due to its small sample size and the observational nature. © 2012 Zhang et al.; licensee BioMed Central Ltd. Source

Shao M.-J.,Jinhua Municipal central hospital | Hu M.-X.,Jinhua Municipal central hospital | Hu M.,Jinhua Municipal central hospital
Journal of Minimally Invasive Gynecology

Study Objective: To describe temporary bilateral uterine artery occlusion with titanium clips in combination with vasopressin as an effective surgical intervention to control hemorrhage during laparoscopic management of cesarean scar pregnancies (CSPs). Design: Retrospective study (Canadian Task Force classification III). Setting: University hospital in an obstetrics and gynecology department. Interventions: Five patients with CSPs underwent removal of gestational ectopic masses via laparoscopy. At the beginning of the procedure, all 5 women had temporary bilateral uterine artery occlusion with titanium clips, and vasopressin 6 U was injected into the myometrium. Measurements and Main Results: Clinical data, serum β-human chorionic gonadotropin levels, operative times, and operative blood loss levels were recorded. The mean gestational age at the time of CSP diagnosis was 9.2 ± 1.9 weeks. The mean serum β-hCG level on the day of surgery was 14262 ± 12870 IU/L. The mean operative time was 86 ± 21.6 minutes, the mean uterine artery occlusion time was 58 ± 13.8 minutes, and the mean blood loss was 144 ± 79.6 mL. No cases were converted to laparotomy, no blood transfusions were required, and there were no complications. Conclusions: Laparoscopy combined with titanium clip occlusion of the uterine arteries bilaterally with vasopressin injection is an effective, minimally invasive procedure to preserve the uterus in patients with a CSP. © 2013 AAGL. Source

Zhang Z.,Jinhua Municipal central hospital | Xu X.,Jinhua Municipal central hospital | Ni H.,Jinhua Municipal central hospital
Critical Care

Introduction: Small-study effects refer to the fact that trials with limited sample sizes are more likely to report larger beneficial effects than large trials. However, this has never been investigated in critical care medicine. Thus, the present study aimed to examine the presence and extent of small-study effects in critical care medicine.Methods: Critical care meta-analyses involving randomized controlled trials and reported mortality as an outcome measure were considered eligible for the study. Component trials were classified as large (≥100 patients per arm) and small (<100 patients per arm) according to their sample sizes. Ratio of odds ratio (ROR) was calculated for each meta-analysis and then RORs were combined using a meta-analytic approach. ROR<1 indicated larger beneficial effect in small trials. Small and large trials were compared in methodological qualities including sequence generating, blinding, allocation concealment, intention to treat and sample size calculation.Results: A total of 27 critical care meta-analyses involving 317 trials were included. Of them, five meta-analyses showed statistically significant RORs <1, and other meta-analyses did not reach a statistical significance. Overall, the pooled ROR was 0.60 (95% CI: 0.53 to 0.68); the heterogeneity was moderate with an I2of 50.3% (chi-squared = 52.30; P = 0.002). Large trials showed significantly better reporting quality than small trials in terms of sequence generating, allocation concealment, blinding, intention to treat, sample size calculation and incomplete follow-up data.Conclusions: Small trials are more likely to report larger beneficial effects than large trials in critical care medicine, which could be partly explained by the lower methodological quality in small trials. Caution should be practiced in the interpretation of meta-analyses involving small trials. © 2013 Zhang et al.; licensee BioMed Central Ltd. Source

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