Lu X.C.,Zhejiang Hospital
Zhonghua yi xue za zhi | Year: 2016
OBJECTIVE: To evaluate the efficacy of tigecycline for treatment of ventilator-associated pneumonia in critically ill elderly patients.METHODS: Data of critically ill elderly patients with ventilator-associated pneumonia treated with tigecycline in the intensive care unit was collected from June 2011 to March 2014 in this retrospective study, to evaluated the clinical efficacy of tigecycline.RESULTS: A total of 79 patients (83.5% male) were included, the mean age was 84 years old (rang, 65 years to 100 years old). Acinetobacter baumannii (39.1%), Pseudomonas aeruginosa (35.0%) and Klebsiella pneumonia (23.8%) were the most common pathogens.All patients were treated with tigecycline, 54.4% combined with other antimicrobial agents, 35.4% treated with double dose of tigecycline, and the mean course of antibiotic treatment was 9 days (range, 2 days to 22 days). After treatment, clinical success were recorded in 44 patients (55.7%), clinical failure were recorded in 29 patients, clinical uncertainty were recorded in 6 patients.28 days after treatment, patients' overall mortality was 39.0%.The clinical success rates were associated with acute physiology and chronic health evaluation (APACHE) Ⅱ score less than 15 (the clinical success rates were 72.2% and 41.9% in patients with APACHE Ⅱ score<15 and APACHE Ⅱ score≥15, respectively; P=0.007); treated with double dose of tigecycline (71.4% vs 47.1%, P=0.037) or combination regimens were also had significant difference (67.4% vs 41.7%, P=0.022).CONCLUSIONS: Treatment of tigecycline combined with other antimicrobial agents and double dose of tigecycline may both can improve clinical efficacy in critically ill elderly patients with ventilator-associated pneumonia.
Sun X.-D.,Zhejiang Provincial Peoples Hospital |
Liu X.-E.,Zhejiang Hospital |
Huang D.-S.,Zhejiang Provincial Peoples Hospital
Oncology Reports | Year: 2013
Curcumin, a phenolic compound extracted from Zingiberaceae turmeric, has strong anti-inflammatory, antioxidant and antitumor properties. However, the anti carcinogenic mechanism of curcumin has yet to be fully elucidated. Epithelial-mesenchymal transition (EMT) induced by transforming growth factor-β1 (TGF-β1) is involved in the promotion of tumor invasion and metastasis, and is closely related to the drug resistance of tumor cells. The abnormal activation of Hedgehog signaling also plays an important role in tumorigenesis and metastasis. In order to investigate whether curcumin can reverse the TGF-β1-stimulated EMT of pancreatic cancer PANC-1 cells, and its possible mechanism, the pancreatic cancer cell line PANC-1 was stimulated with TGF-β1 (5 ng/ml) for 7 days to induce formation of EMT, and the TGF-β1-stimulated PANC-1 cells were treated with different concentrations of curcumin (10, 20 and 30 μmol/ml) for 48 h. The growth inhibition rate of the cells was measured by MTT assay, apoptosis was detected by flow cytometry, the expression levels of Shh, GLI1, E-cadherin and vimentin were detected by western blot analysis, and cell invasion and migration ability were examined by Transwell cell invasion assay and wound healing assay. Following stimulation with TGF-β1, the expression levels of Shh, GLI1 and vimentin in the TGF-β1-stimulated group were significantly increased, compared with those in the control group (P<0.01, respectively). The expression levels of E-cadherin in the TGF-β1-stimulated group were significantly decreased, compared with those in the control group (P<0.01). The TGF-β1-stimulated PANC-1 cells were treated with curcumin and the results showed that curcumin significantly inhibited TGF-β1-stimulated PANC-1 cell proliferation and induced apoptosis, compared with other groups (P<0.01), and expression levels of Shh, GLI1 and vimentin in the curcumin-treated group were significantly decreased compared with those in the control group (P<0.01, respectively). The expression level of E-cadherin in the curcumin-treated group was significantly increased compared with that in the control group (P<0.01). Cell invasion in the curcumin-treated group (30μmol/ml) was significantly decreased compared with that in the control group (P<0.01). The scratch wounds in the curcumin-treated group healed slower compared with those in the control group (P<0.01). Curcumin significantly inhibited the invasion and migration of TGF-β1-stimulated PANC-1 cells. These results indicate that curcumin can inhibit the proliferation of TGF-β1-stimulated PANC-1 cells, it can induce apoptosis, and reverse the EMT. The possible underlying molecular mechanisms are through inhibition of the Shh-GLI1 signaling pathway.
Chen S.,Zhejiang University |
Zhao Y.,University of Sydney |
Zhang Y.,Zhejiang Hospital |
Zhang D.,University of Canberra
PLoS ONE | Year: 2014
p Conclusion/Significance: Fucoidan exerts its anti-tumor function by modulating ER stress cascades. Contribution of ER stress to the fucoidan-induced cell apoptosis augments our understanding of the molecular mechanisms underlying its antitumour activity and provides evidence for the therapeutic application of fucoidan in cancer.
Chen X.,Zhejiang Hospital |
Mao G.,Zhejiang Hospital |
Leng S.X.,Johns Hopkins University
Clinical Interventions in Aging | Year: 2014
Frailty is a common and important geriatric syndrome characterized by age-associated declines in physiologic reserve and function across multiorgan systems, leading to increased vulnerability for adverse health outcomes. Two major frailty models have been described in the literature. The frailty phenotype defines frailty as a distinct clinical syndrome meeting three or more of five phenotypic criteria: weakness, slowness, low level of physical activity, self-reported exhaustion, and unintentional weight loss. The frailty index defines frailty as cumulative deficits identified in a comprehensive geriatric assessment. Significant progress has recently been made in understanding the pathogenesis of frailty. Chronic inflam-mation is likely a key pathophysiologic process that contributes to the frailty syndrome directly and indirectly through other intermediate physiologic systems, such as the musculoskeletal, endocrine, and hematologic systems. The complex multifactorial etiologies of frailty also include obesity and specific diseases. Major clinical applications include risk assessment and stratification. This can be applied to the elderly population in the community and in a variety of care settings. Frailty may also be useful for risk assessment in surgical patients and those with cardiovascular diseases, cancer, or human immunodeficiency virus infection, as well as for assessment of vaccine effectiveness in older adults. Currently, exercise and comprehensive geriatric interdisciplinary assessment and treatment are key interventions for frailty. As understanding of the biologic basis and complexity of frailty further improves, more effective and targeted interventional strategies and innovative geriatric-care models will likely be developed. © 2014 Chen et al.
Si C.-J.,Zhejiang Hospital
European Journal of Cancer Prevention | Year: 2016
Previous studies have attempted to assess the relation between different dietary patterns and the risk of endometrial cancer (EC); however, a consistent perspective has not been established to date. Therefore, we carried out this meta-analysis to evaluate the associations between dietary patterns and the risk of EC. The most common dietary patterns with high loadings of foods and/or nutrients were selected. A total of 27 studies fulfilled the inclusion criteria and were included in the present meta-analysis. There was evidence of a decreased risk of EC in the highest compared with the lowest categories of healthy dietary pattern [odds ratio (OR)=0.74; confidence interval (CI): 0.62–0.88; P=0.008]. An increased risk of EC was shown for the highest compared with the lowest category of a western-style dietary pattern (OR=1.37; CI: 1.15–1.64; P=0.0005). No significant association with the risk of EC was found in the highest compared with the lowest category of alcohol-drinking pattern (OR=0.98; CI: 0.73–1.30; P=0.87). The results of this meta-analysis indicate that some dietary patterns may be associated with the risk of EC. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Lixin X.,Zhejiang Hospital
Quintessence international (Berlin, Germany : 1985) | Year: 2010
OBJECTIVE: This retrospective study evaluated the success rate of a fixed retrievable prosthesis based on an electroforming technique combining the advantages of screw- and cement-retained principles. METHOD AND MATERIALS: Forty patients (17 men and 23 women) with a mean age of 62.2 years were treated. A total of 353 implants were placed in the edentulous maxilla, mandible, or both jaws to allow prosthetic rehabilitations with 55 fixed prostheses. Clinical success of the implants was based on the criteria of Buser. Technical complications monitored throughout the wearing period are described. Retrievability of the restoration with a conventional crown remover was checked at 6, 12, and 36 months. The cumulative survival rate of the implants was measured. RESULTS: After a mean observation period of 4.08 years (range 22 to 62 months), a cumulative survival rate of 99.15% was recorded for the 234 maxillary implants (234 Camlog RootLine, Camlog) and for the 119 mandibular implants (72 Camlog RootLine, 47 Camlog ScrewLine). Three implants failed before prosthetic loading. Monitored technical complications were seen in 10.91% of the restorations; they comprised ceramic chip-off and relining. CONCLUSIONS: This fixed implant-retained prosthesis based on electroforming indicates a comparable clinical efficacy to other techniques and allows scheduled retrieval.
Feng Y.-L.,Zhejiang Hospital
European Journal of Cancer Prevention | Year: 2016
The analysis of dietary patterns has recently drawn considerable attention as a method of investigating the association between the overall whole diet and the risk of colorectal cancer. However, the results have yielded conflicting findings. Here, we carried out a meta-analysis to identify the association between dietary patterns and the risk of colorectal cancer. A total of 40 studies fulfilled the inclusion criteria and were included in this meta-analysis. The highest category of ‘healthy’ dietary pattern compared with the lowest category was apparently associated with a decreased risk for colorectal cancer [odds ratio (OR)=0.75; confidence interval (CI): 0.68–0.83; P<0.00001]. An increased risk of colorectal cancer was shown for the highest compared with the lowest category of a ‘western-style’ dietary pattern (OR=1.40; CI: 1.26–1.56; P<0.00001). There was an increased risk of colorectal cancer in the highest compared with the lowest category of ‘alcohol-consumption’ pattern (OR=1.44; CI: 1.13–1.82; P=0.003). The results of this meta-analysis indicate that a ‘healthy’ dietary pattern may decrease the risk of colorectal cancer, whereas ‘western-style’ and ‘alcohol-consumption’ patterns may increase the risk of colorectal cancer. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Zhan J.,Zhejiang University |
Han Q.,Zhejiang Hospital |
Wang K.,Chinese Academy of Sciences
Expert Opinion on Investigational Drugs | Year: 2013
Introduction: Small cell lung cancer (SCLC) is one of most aggressive cancers and only modest improvements have been achieved in overall survival over last 30 years. In recent years, antibody therapeutics has been actively studied and shown promise in treatment of SCLC. Areas covered: A comprehensive literature search through Medline and the registry database of clinical trials (ClinicalTrials.gov) was performed to collect all relevant preclinical and clinical data. The diverse antibody therapeutics which target against different antigens including VEGE-A, CEA, IGF-1R, CD56, EpCAM, CTLA-4, gangliosides GD2 and GD3, Lewis Y and tenascin-C are now under clinical investigation for therapeutic effects in SCLC. Expert opinion: During the last few decades, progresses have been made in antibody therapy for SCLC, however great challenges still remain. The major reasons are the complexity of SCLC and a lack of understanding of cancer immunology. The profound studies of signaling pathways involved in carcinogenesis, proliferation, metastasis and apoptosis in SCLC are crucial for the identification of new therapeutic targets and biomarkers. Moreover, a better understanding of the interplay between cancer and the immune system is a new direction for the design of more effective antibody therapeutics. © 2012 Informa UK, Ltd.
Xu Q.H.,Zhejiang Hospital
Zhonghua nei ke za zhi [Chinese journal of internal medicine] | Year: 2012
To investigate the effects of ω-3 fish oil lipid emulsion via vein on the inflammatory response, immune and organ function in patients with severe acute pancreatitis. A total of 53 patients with severe acute pancreatitis were randomized into conventional therapy plus fish oil group (FO group) and conventional therapy group (CON group). The patients in FO group were treat with ω-3 fish oil lipid emulsion (0.2 g×kg(-1)×d(-1), 10%) based on conventional therapy for 14 days. The level of C-reactive protein (CRP), TG and TC were detected before treatment and at day 7 and day 14 after treatment. CD(4)(+), CD(4)(+)/CD(8)(+) and C(3), C(4) were also detected at day 1 and day 14 after treatment. At the same time, acute physiology and chronic health evaluation II score (APACHEII score), intra-abdominal pressure, negative fluid balance time, enteral nutrition start-time and ICU stay time were observed and recorded. Forty-five out of 53 patients were finally recruited into results statistics. The level of CD(4)(+), CD(4)(+)/CD(8)(+) and C(3) at day 14 after treatment in FO groups improved significantly than that in the CON group (P < 0.05). The levels of CRP, intra-abdominal pressure and APACHE II score at day 7 and day 14 in FO group descended more obviously than that in the CON group (P < 0.05). The negative liquid balance time in FO group (3.55 ± 0.86)days was obvious shorter than that in CON group (4.61 ± 1.12) days, while enteral nutrition start-time (3.86 ± 1.17) days was significantly earlier compared with CON group (5.30 ± 1.61) days (P < 0.05), however ICU stay time and 28 days mortality rate had no significant difference between the two groups. ω-3 fish oil lipid emulsion can decrease the inflammatory response and the negative liquid balance time, improve the immune function and restore bowel function in severe acute pancreatitis patients. Therefore, it maybe provide a new and effective means for severe acute pancreatitis.
Jin Y.,Zhejiang Cancer Hospital |
Zhao L.,Zhejiang Hospital |
Peng F.,Zhejiang Hospital
Clinics | Year: 2013
OBJECTIVE: Patients with stage I non-small cell lung cancer who have undergone complete surgical resection harbor a 30% risk for tumor recurrence. Thus, the identification of factors that are predictive for tumor recurrence is urgently needed. The aim of this study was to test the prognostic value of serum albumin levels on tumor recurrence in patients with stage I non-small cell lung cancer. METHODS: Stage I non-small cell lung cancer patients who underwent complete surgical resection of the primary tumor at Zhejiang Hospital were analyzed in this study. Serum albumin levels were measured before surgery and once again after surgery in 101 histologically diagnosed non-small cell lung cancer patients. Correlations between the pre- and post-operative serum albumin levels and various clinical demographics and recurrence-free survival rates were analyzed. RESULTS: Patients with pre-operative hypoalbuminemia (<3.5 g/dl) had a significantly worse survival rate than patients with normal pre-operative serum albumin levels (≥3.5 g/dl) (p = 0.008). Patients with post-operative hypoalbuminemia had a worse survival rate when compared with patients with normal post-operative serum albumin levels (p = 0.001). Cox multivariate analysis identified pre-operative hypoalbuminemia, post-operative hypoalbuminemia and tumor size over 3 cm as independent negative prognostic factors for recurrence. CONCLUSION: Serum albumin levels appear to be a significant independent prognostic factor for tumor recurrence in patients with stage I non-small cell lung cancer who have undergone complete resection. Patient pre-treatment and post-treatment serum albumin levels provide an easy and early means of discrimination between patients with a higher risk for recurrence and patients with a low risk of recurrence. © 2013 CLINICS.