Asian Pacific Journal of Tropical Medicine

12-16

Authors: Lan-fang Du, Hong-xia Ge, Qing-bian Ma, Bao-lan Ge, Jian-zhong Yang, Yu-hong Mi, Yi-xiong Zhang

Objective: To investigate the current practice of extracorporeal cardiopulmonary resuscitation (ECPR) for Chinese cardiac arrest patients after the publication of 2015 American Heart Association guidelines for cardiopulmonary resuscitation. Methods: A questionnaire was distributed to healthcare providers of emergency departments (EDs) and/or Intensive Care Units (ICUs) across 52 hospitals in China from August to November 2016. Data collection ended in February 2017. The questionnaire included three parts: (1) characteristics of the departments and the respondents; (2) knowledge about ECPR; (3) practice of ECPR in cardiac arrest patients (case volume, inclusion/exclusion criteria, ECPR procedure). The characteristics of the departments/hospitals were only answered by the head of the department. Results: A total of 1 952 (86.8%) respondents fulfilled the survey. Only 2.5% of the respondents from 3 of 52 hospitals performed ECPR. Among the three hospitals, the case number of ECPR were ≤5 per year and none of them had written ECPR procedures. Only one hospital had formal inclusion/exclusion criteria. The inclusion criteria included age between 18 to 60 years, suspected cardiogenic cardiac arrest, beginning of cardiopulmonary resuscitation <5 min after cardiac arrest and duration of cardiopulmonary resuscitation >10 min. The top three reasons for the nonuse of ECPR were unknown fields (31.2%), potential ECMO-related side effects (26.9%) and cost (18.7%). Conclusions: ECPR for cardiac arrest patients are not well understood by healthcare providers in the emergency department or ICUs and its application is still in the early stage in China. Educational training and other interventions are needed to promote the clinical practice.

25-31

Authors: Zao-xi Sun, Yong-mei Shen, Zheng-ke Sun, Kai Li, Emmanuel CM, Yan Yang, Yong-jiang Zhou, Hai-rong Huang

Objective: To explore the survival status and prognostic factors of patients with pancreatic cancer in Hainan. Methods: Clinical data of patients who were diagnosed as pancreatic cancer and visited the First and Second Affiliated Hospital of Hainan Medical University and Haikou People's Hospital from 2013 to 2017 were collected based on electronic medical records. Basic information was collected by a self-designed questionnaire. Data about admission examinations including blood routine examination, blood biochemistry tests, tumour markers tests, imaging examination and other clinical tests were also collected. The date of follow-up via telephone was 30 June 2018. The survival rate was analyzed by the Kaplan–Meier method and the logrank test. Univariate and multivariate analyses were performed with COX regression model. Results: A total of 198 patients were included in the study. Kaplan–Meier results showed that the overall survival (OS) in 6 months and 1, 2, 3 and 5 years was 47.4%, 26.8%, 16.4%, 13.2%, and 8.7%, respectively. The median OS was 5.8 months. Log-rank test analysis found that there were significant differences in OS among patients with different age, surgery status, distant metastasis or absolute number of neutrophils, percentage of neutrophils, absolute number of lymphocytes, neutrophil-to-lymphocyte ratio (NLR), CA199 and carcino-embryonic antigen (P<0.1). COX multivariate analysis showed that age, surgical presence, presence or absence of distant metastasis and NLR were significantly associated OS (P<0.05). Conclusions: Older age, higher NLR and liver or lung metastasis are independent risk factors, while surgical treatment is an independent protective factor for patients with pancreatic cancer.

41-53

Authors: Pan-li Ni, Shu-hong Tian, Zhao-xin Yang, Jun-qing Zhang, Fan Yang, Li-fan Zhong, Lian-fang Gan, Mian-qing Huang, Ling Huang

Objective: To explore the effect of Feng-liao-chang-wei-kang (FLCWK) on acute and chronic gastroenteritis, synergistic effect on the growth inhibitory effect with 5-fluorouracil (5-FU) on colorectal cancer and its underlying mechanisms. Methods: In the in vitro study, HT-29 cells were divided into 5-FU alone, FLCWK alone and coadministration groups. The MTT assay was used to analyze the proliferation of HT-29 cells at 24 h. Flow cytometry was used to observe the apoptosis, cycle of colorectal cancer HT- 29 cells at 24 h. In the in vivo experiment, The subcutaneous transplantation tumor model of colorectal cancer HT-29-Luc was established with nude mice. All mice were randomly divided into 5-FU alone, FLCWK alone and coadministration groups according to body weight. During administration, the Interactive Video Information System small animal live imaging system was used to monitor the growth of subcutaneous transplantation in nude mice. The model of colitisassociated colorectal cancer (CACC) was established with BALB/c mice. BALB/c mice were randomly divided into the normal control group, the model control group, and the FLCWK group. At the end of the administration, the pathological status was detected by HE staining. Cell apoptosis of tumor tissue tumor and colon tissues were observed by TUNEL staining and TUNEL green fluorescence. The protein expression of Caspase 3, p-STAT3, Bcl-2, Bax and P-gp in tumor tissues tumor and colon tissues were tested by using immunohistochemical assay. Results: FLCWK and 5-FU coadministration suppressed HT-29 cell viability and induced S phase arrest and apoptosis compared to treatment with 5-FU alone. Furthermore, compared to treatment with 5-FU alone, coadministration of FLCWK and 5-FU obviously reduced tumor volume and weight and induced apoptosis through decreasing p-STAT3 and P-gp and increasing Caspase 3 protein expression in a murine xenograft tumor model. Moreover, the result revealed decreased number and size of tumors following FLCWK protective administration, downregulated p-STAT3 and Bcl-2 levels and upregulated Bax and Caspase 3 expression in mice with CACC. Conclusions: FLCWK has synergistic effects with 5-FU on colorectal cancer by suppressing the STAT3 pathway and downregulating P-gp expression. Furthermore, FLCWK administration suppresses CACC tumorigenesis by inhibiting the STAT3 pathway.

59-68

Authors: Wei Wu, Rui Wang, Yong-mei Fu, Jie Zhou, Hai-chao Huang, Wei-wang Gu

Objective: To investigate the effect of memantine on Parkinson’s disease cell models. Methods: Parkinson’s disease cell models were established using PC12 cells incubated with 6-hydroxydopamine (6-OHDA). Flow cytometry and microscopy were used to investigate the apoptotic process and the percentage of different apoptotic stages. PC12 cells were infected with lentiviral vectors to knockdown Nur77. Western blotting was used to detect the expression of Nur77 and caspase -3, -8, -9, -12 in PC12 cells withdifferent concentrations of 6-OHDA or 6-OHDA+memantine. Results: 6-OHDA led to apoptosis PC12 cells, and increased the expression of Nur77 and caspases. Memantine significantly inhibited 6-OHDA-induced apoptosis of PC12 cells. Meanwhile, memantine could mitigate apoptosis of PC12 cells by regulating the Nur77 and caspase pathway. Conclusions: Memantine has a protective effect on the PC12 cell model via regulating the Nur77 and caspases pathway.