Radiotherapy is one of the most common countermeasures for treating a wide range of tumors.However,the radioresistance of cancer cells is still a major limitation for radiotherapy applications.Efforts are continuously...Radiotherapy is one of the most common countermeasures for treating a wide range of tumors.However,the radioresistance of cancer cells is still a major limitation for radiotherapy applications.Efforts are continuously ongoing to explore sensitizing targets and develop radiosensitizers for improving the outcomes of radiotherapy.DNA double-strand breaks are the most lethal lesions induced by ionizing radiation and can trigger a series of cellular DNA damage responses(DDRs),including those helping cells recover from radiation injuries,such as the activation of DNA damage sensing and early transduction pathways,cell cycle arrest,and DNA repair.Obviously,these protective DDRs confer tumor radioresistance.Targeting DDR signaling pathways has become an attractive strategy for overcoming tumor radioresistance,and some important advances and breakthroughs have already been achieved in recent years.On the basis of comprehensively reviewing the DDR signal pathways,we provide an update on the novel and promising druggable targets emerging from DDR pathways that can be exploited for radiosensitization.We further discuss recent advances identified from preclinical studies,current clinical trials,and clinical application of chemical inhibitors targeting key DDR proteins,including DNA-PKcs(DNA-dependent protein kinase,catalytic subunit),ATM/ATR(ataxia–telangiectasia mutated and Rad3-related),the MRN(MRE11-RAD50-NBS1)complex,the PARP(poly[ADP-ribose]polymerase)family,MDC1,Wee1,LIG4(ligase IV),CDK1,BRCA1(BRCA1 C terminal),CHK1,and HIF-1(hypoxia-inducible factor-1).Challenges for ionizing radiation-induced signal transduction and targeted therapy are also discussed based on recent achievements in the biological field of radiotherapy.展开更多
Objective： To observe the clinical efficacy of artificial skin combined with vacuum sealing drainage （VSD） in treating large-area skin defects. Methods： Totally 18 patients with skin defects, treated with artific...Objective： To observe the clinical efficacy of artificial skin combined with vacuum sealing drainage （VSD） in treating large-area skin defects. Methods： Totally 18 patients with skin defects, treated with artificial skin combined with VSD from September 2008 to May 2009 in our hospital, were retrospectively analyzed in this study. There were 15 males and 3 females, aged 7-66 years, 34.3 years on average. Among them, 10 cases had skin laceration caused by traffic accidents （7 with open fractures）, 1 mangled injury, 1 blast injury, 1 stump infection combined with skin defects after amputation and 5 heel ulcers. Results： All skin grafts in 16 cases survived afterbeing controlled by VSD for one time. For the rest 2 patients, one with skin avulsion on the left foot was given median thickness skin grafts after three times of VSD, the other with open fractures in the left tibia and fibula caused by a traffic accident was given free flap transplantation. Skin grafts of both patients survived, with normal color and rich blood supply. Conclusion： Skin grafting in conjunction with artificial skin and VSD is much more effective than traditional dress- ing treatment and worth wide application in clinic.展开更多
Objective: To find out the optimal approach to decompress externally the severe injured brain and to avoid possible complications caused by external decompression. Methods: 68 patients who underwent external decompres...Objective: To find out the optimal approach to decompress externally the severe injured brain and to avoid possible complications caused by external decompression. Methods: 68 patients who underwent external decompression after traumatic brain injury were admitted into Tianjin Medical University General Hospital for cranioplasty from 1995 to 2001. Complications were retrospectively investigated and analyzed in all patients. The findings were compared between the patients who accepted the decompressive craniectomy in our hospital and in local hospitals. χ 2-test was employed for statistical analysis and complication evaluation. Results: Large craniectomy definitely caused some side effects to patients. Among various complications, several of them showed significantly high incidence (P< 0.05) in patients who underwent the decompressive operation in local hospitals such as shunt-dependent hydrocephalous, subdural fluid collection, and CSF leakage from scalp incision. The rest of the complications had no remarkable difference (P> 0.05) between the two groups including dilation or/and migration of lateral ventricle underlying the cranial defect, skin flap concavity, encephalomalacia of the decompressive area, seizure and infection. Conclusions: To reduce the incidence of iatrogenic side effects, surgical craniectomy should be performed according to the strict indication and standard and any abuse should be avoided.展开更多
Objective To review the recent studies about human umbilical cord mesenchymal stem cells （hUCMSCs） and advances in the treatment of spinal cord injury. Data sources Published articles （1983-2007） about hUCMSCs and...Objective To review the recent studies about human umbilical cord mesenchymal stem cells （hUCMSCs） and advances in the treatment of spinal cord injury. Data sources Published articles （1983-2007） about hUCMSCs and spinal cord injury were selected using Medline. Study selection Articles selected were relevant to development of mesenchymal stem cells （MSCs） for transplantation in spinal cord injury therapy. Of 258 originally identified articles 51 were selected that specifically addressed the stated purpose. Results Recent work has revealed that hUCMSCs share most of the characteristics with MSCs derived from bone marrow and are more appropriate to transplantation for cell based therapies. Conclusions Human umbilical cord could be regarded as a source of MSCs for experimental and clinical needs. In addition, as a peculiar source of stem cells, hUCMSCs may play an important role in the treatment of spinal cord injury. Chin Med J 2009;122（2）：225-231展开更多
Objective: To study the effect of hyperbaric oxygen (HBO) treatment of severe brain injury. Methods: Fifty-five patients were divided into a treatment group (n=35 receiving HBO therapy) and a control group (n=20 recei...Objective: To study the effect of hyperbaric oxygen (HBO) treatment of severe brain injury. Methods: Fifty-five patients were divided into a treatment group (n=35 receiving HBO therapy) and a control group (n=20 receiving dehydrating, cortical steroid and antibiotic therapy) to observe the alteration of clinic GCS (Glasgow Coma Scale), brain electric activity mapping (BEAM), prognosis and GOS (Glasgow Outcome Scale) before and after hyperbaric oxygen treatment. Results: In the treatment group GCS,BEAM and GOS were improved obviously after 3 courses of treatment, GCS increased from 5.1 to 14.6 (P< 0.01- 0.001),the BEAM abnormal rate reduced from 94.3% to 38% (P< 0.01- 0.001),the GOS good-mild disability rate was 83.7%, and the middle-severe disability rate was 26.3% compared with the control group. There was a statistic significant difference between the two groups (P< 0.01- 0.001). Conclusions: Hyperbaric oxygen treatment could improve obviously GCS, BEAM and GOS of severe brain injury patients, and effectively reduce the mortality and morbidity. It is an effective method to treat severe brain injury.展开更多
基金supported by the National Natural Science Foundation of China(Grant Nos.U1803124,81530085,and 31870847)the Natural Science Foundation of Hunan Province(Grant No.2019JJ40396).
文摘Radiotherapy is one of the most common countermeasures for treating a wide range of tumors.However,the radioresistance of cancer cells is still a major limitation for radiotherapy applications.Efforts are continuously ongoing to explore sensitizing targets and develop radiosensitizers for improving the outcomes of radiotherapy.DNA double-strand breaks are the most lethal lesions induced by ionizing radiation and can trigger a series of cellular DNA damage responses(DDRs),including those helping cells recover from radiation injuries,such as the activation of DNA damage sensing and early transduction pathways,cell cycle arrest,and DNA repair.Obviously,these protective DDRs confer tumor radioresistance.Targeting DDR signaling pathways has become an attractive strategy for overcoming tumor radioresistance,and some important advances and breakthroughs have already been achieved in recent years.On the basis of comprehensively reviewing the DDR signal pathways,we provide an update on the novel and promising druggable targets emerging from DDR pathways that can be exploited for radiosensitization.We further discuss recent advances identified from preclinical studies,current clinical trials,and clinical application of chemical inhibitors targeting key DDR proteins,including DNA-PKcs(DNA-dependent protein kinase,catalytic subunit),ATM/ATR(ataxia–telangiectasia mutated and Rad3-related),the MRN(MRE11-RAD50-NBS1)complex,the PARP(poly[ADP-ribose]polymerase)family,MDC1,Wee1,LIG4(ligase IV),CDK1,BRCA1(BRCA1 C terminal),CHK1,and HIF-1(hypoxia-inducible factor-1).Challenges for ionizing radiation-induced signal transduction and targeted therapy are also discussed based on recent achievements in the biological field of radiotherapy.
文摘Objective： To observe the clinical efficacy of artificial skin combined with vacuum sealing drainage （VSD） in treating large-area skin defects. Methods： Totally 18 patients with skin defects, treated with artificial skin combined with VSD from September 2008 to May 2009 in our hospital, were retrospectively analyzed in this study. There were 15 males and 3 females, aged 7-66 years, 34.3 years on average. Among them, 10 cases had skin laceration caused by traffic accidents （7 with open fractures）, 1 mangled injury, 1 blast injury, 1 stump infection combined with skin defects after amputation and 5 heel ulcers. Results： All skin grafts in 16 cases survived afterbeing controlled by VSD for one time. For the rest 2 patients, one with skin avulsion on the left foot was given median thickness skin grafts after three times of VSD, the other with open fractures in the left tibia and fibula caused by a traffic accident was given free flap transplantation. Skin grafts of both patients survived, with normal color and rich blood supply. Conclusion： Skin grafting in conjunction with artificial skin and VSD is much more effective than traditional dress- ing treatment and worth wide application in clinic.
文摘Objective: To find out the optimal approach to decompress externally the severe injured brain and to avoid possible complications caused by external decompression. Methods: 68 patients who underwent external decompression after traumatic brain injury were admitted into Tianjin Medical University General Hospital for cranioplasty from 1995 to 2001. Complications were retrospectively investigated and analyzed in all patients. The findings were compared between the patients who accepted the decompressive craniectomy in our hospital and in local hospitals. χ 2-test was employed for statistical analysis and complication evaluation. Results: Large craniectomy definitely caused some side effects to patients. Among various complications, several of them showed significantly high incidence (P< 0.05) in patients who underwent the decompressive operation in local hospitals such as shunt-dependent hydrocephalous, subdural fluid collection, and CSF leakage from scalp incision. The rest of the complications had no remarkable difference (P> 0.05) between the two groups including dilation or/and migration of lateral ventricle underlying the cranial defect, skin flap concavity, encephalomalacia of the decompressive area, seizure and infection. Conclusions: To reduce the incidence of iatrogenic side effects, surgical craniectomy should be performed according to the strict indication and standard and any abuse should be avoided.
基金This study was supported by the grants from National Natural Science Foundation of China （No. 30872603）, New Century Excellent Talents Programme of Ministry of Education of China （No. NCET060251） and Applied Basic Research Programmes of Science and Technology Commission Foundation of Tianjin （No. 07JCYBJC10200）.
文摘Objective To review the recent studies about human umbilical cord mesenchymal stem cells （hUCMSCs） and advances in the treatment of spinal cord injury. Data sources Published articles （1983-2007） about hUCMSCs and spinal cord injury were selected using Medline. Study selection Articles selected were relevant to development of mesenchymal stem cells （MSCs） for transplantation in spinal cord injury therapy. Of 258 originally identified articles 51 were selected that specifically addressed the stated purpose. Results Recent work has revealed that hUCMSCs share most of the characteristics with MSCs derived from bone marrow and are more appropriate to transplantation for cell based therapies. Conclusions Human umbilical cord could be regarded as a source of MSCs for experimental and clinical needs. In addition, as a peculiar source of stem cells, hUCMSCs may play an important role in the treatment of spinal cord injury. Chin Med J 2009;122（2）：225-231
文摘Objective: To study the effect of hyperbaric oxygen (HBO) treatment of severe brain injury. Methods: Fifty-five patients were divided into a treatment group (n=35 receiving HBO therapy) and a control group (n=20 receiving dehydrating, cortical steroid and antibiotic therapy) to observe the alteration of clinic GCS (Glasgow Coma Scale), brain electric activity mapping (BEAM), prognosis and GOS (Glasgow Outcome Scale) before and after hyperbaric oxygen treatment. Results: In the treatment group GCS,BEAM and GOS were improved obviously after 3 courses of treatment, GCS increased from 5.1 to 14.6 (P< 0.01- 0.001),the BEAM abnormal rate reduced from 94.3% to 38% (P< 0.01- 0.001),the GOS good-mild disability rate was 83.7%, and the middle-severe disability rate was 26.3% compared with the control group. There was a statistic significant difference between the two groups (P< 0.01- 0.001). Conclusions: Hyperbaric oxygen treatment could improve obviously GCS, BEAM and GOS of severe brain injury patients, and effectively reduce the mortality and morbidity. It is an effective method to treat severe brain injury.
