Objective To explore the effects of early adminstering various doses of atorvastatin on serum sCD40L level and prognosis in patients with acute coronary syndrome (ACS). Methods One hundred and sixty-eight patients with ACS were randomly divided into three groups, which were administered atorvastatin at the dose of 10mg/d (low-dose group, n=56), 40mg/d (middle-dose group, n=55) and 80mg/d (high-dose group, n=57), respectively. Levels of serum sCD40L and lipid before and after treatment were measured. The major adverse cardiovascular events (MACE) were followed up for mean 7.6?3.2 months. Results The levels of serum sCD40L had no significant changes before and after treatment in low-dose group, but significantly reduced 52.4% and 52.2% in high-dose group and middle-dose group after treatment (P

AIM:To evaluate the efficacy and safety of the regimen based on platinum compound plus docetaxel in the treatment of advanced esophageal carcinoma as first-line drug,and to further explore prognostic factors of advanced esophageal carcinoma by survival analysis.METHODS:From August 2006 to October 2008,36 patients with advanced esophageal carcinoma were enrolled in the study,and non-randomly assigned to docetaxel 75 mg/m2 in the first day every 3 weeks,combined with cisplatin 25 mg/m2 in the first day to third day or in the first day to forth day(DT,n=27),or with carboplatin AUC=5 on day 1(CT,n=9).RESULTS:The curative and toxic side effects were evaluated to the 36 patients.There were 1 complete respone,17 partial respone,11 no changes and 7 progressive disease in 36 patients with total response rate of 50.00%.The response rates of DT,CT regimen were 59.26% and 22.22%(P=0.121).The major side effects were nausea-vomiting,all side effects were reversible by symptomatic treatment.After a median follow-up of 8.70 months,the overall median survival was 10.50 months(95% CI 7.36 to 13.64 months).The COX univariate regression analysis suggested there was no correlation with sex,age and the hemoglobin of before chemotherapy with existence.But there was statistical significance between the behavior state of chemotherapy and the existence(P=0.036).CONCLUSION:The regimen based on platinum compound plus docetaxel is tolerable and more effective as a first-line treatment for advanced esophageal carcinoma.Patients with good performance status before chemotherapy indicates good prognosis and it is an independent factor affecting survival for advanced esophageal carcinoma.

Objective To evaluate the therapeutic effetive,toxicity and survial rate of non-operation esophageal carcinoma patients treated by tegafur plus cisplatin combined with three-dimensional conformal radiotherapy (3D-CRT).Methods 184 cases of non-operation patients with esophageal carcinoma were divided into two groups.The cases of treatment group were treated by cisplatin and tegafur.The cases of control group were treated by cisplatin and 5-Fu.All patients received 3D-CRT,and the total radiation dose was 50-70 Gy.Each group had 14 cases treated with primary chemotherapy for 1 course,28 cases for 2 courses,and 50 cases without any chemotherapy.Results The recent effect rate was 69.57 ％ (64/92) in treatment group and 67.39 ％ (62/92) in control group,there was no statistical difference (x2 =0.101,P =0.874).Radioactive esophagitis and leukopenia were the main side effect of treatment.The treatment group was significantly lower than that of the control group,the difference had statistical significance.The 1-,2-and 3-year survival rates were 74.9 ％,61.6 ％,52.8 ％,respectively in treatment group and 75.8 ％,56.9 ％,48.0 ％,respectively in control group.The control group survival rates were significantly higher than the treatment group,the difference had statistical significance (x2 =7.325,P =0.007).Conclusions Cisplatin plus tegafur or 5-Fu combined with 3D-CRT is effective way of treatment for non-operation of esophageal carcinoma.The toxicity of cisplatin plus tegafur group is significantly lower than cisplatin plus 5-Fu group,therefor it can improve the quality of life of the patients obviously.

Objective To investigate the antimicrobial activity of fosfomycin combined with other antibiotics against carbapenem-resistant enterobacteriaceae(CRE).Methods A total of 233 non-repititive CRE isolates were collected from January 2010 to December 2014 from 4 hospitals, including Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou Traditional Chinese Medicine Hospital, Zhejiang Provincial People's Hospital and Second Hospital of Jiaxing.Antimicrobial susceptibility of fosfomycin, imipenem, meropenem, cefepime, ceftazidime, ceftriaxone, cefperazone-sulbactam, piperacillin-tazobactam, ciprofloxacin, amikacin, tobramycin, polymyxin B and tigecycline were determined by agar dilution method.Synergistic effect between fosfomycin and other antibiotics, including meropenem, cefepime, ceftazidime, cefperazone-sulbactam, ciprofloxacin, amikacin, tobramycin and tigecycline against 30 CRE isolates was determined by chequerboard assay.Chi-Square test was used for statistical analysis, and the difference was statistical significant when P<0.05.Results An overall 45.1%(105/233) of 233 CRE isolates were resistant to fosfomycin.Among which, Klebsiella spp.possessed the highest resistance rate (61.9%,73/118), followed by Enterobacter spp.(50%,15/30), Serratia marcescens (25%,7/28), and Escherichia coli (8.2%,4/49).Fosfomycin in combination with tigecyclin showed best activity against CRE isolates with a synergy rate of 76.7%(23/30).Fosfomycin and aminoglycosides also presented good activity against CRE isolates with synergy rate of 53.3%(16/30) to 70.0%(21/30).Synergism was observed only in 30%(9/30) of CRE isolates for the combination of fosfomycin and ciprofloxacin.As for the combination of fosfomycin and β-lactam antibiotics, even less synergism was observed ( 0%-3.3%) ( 1/30 ).No antagonism was demonstrates among all of the combinations.Conclusions Fosfomycin demonstrates certain in vitro activity against CRE isolates.A combination of fosfomycin and tigecyclin or aminoglycosides shows good activity, which suggests a new strategy in the campaign against serious infections caused by CRE.

ObjectiveTo assess cost-effectiveness of pramipexole and levodopa/benseraside in the hospitalized Parkinson's disease (PD) patient.Methods81 PD patients were divided into group A(levodopa/benserazide group) and group B( pramipexole combined with levodopa/benserazide group) according to different pharmacotherapy.The curative effects and costs of hospitalized PD patients were evaluated.The curative effects were evaluated by unified Parkinson's disease rating scale (UPDRS).ResultsThere were 44 patients in group A and 37 patients in group B.Although B group in drug costs and treatment costs were increased more significantly than A group ( P ＜0.01),but declined markedly UPDRS after treatment ( P ＜ 0.05 ) than A group.Pramipexole can be applied in all kinds of Hoehn and Yahr states in PD.ConclusionAlthough the combination of pramipexole would increase drug costs and treatment costs,but could improve the clinical symptoms of PD,and can be applied to different stages of PD.It should be individualized recommendation in the Parkinson's patients.

Objective To evaluate the effects of Aidi injection on the short-term curative effect,pain level,quality of life and the survival time for the elderly and infirm patients with advanced cancer.Methods A total of 143 elderly patients with advanced cancer were randomly divided into two groups,71 patients in control group were treated with routine support therapies,and 72 patients in treatment group were injected with 50-60 ml Aidi injection infused in NS 250 ml by i.v drip every day combined with routine medicines,each cycle was 21 days,all patients were received for 2 cycles.Results After treatment the short-term curative effect rate (CR+PR) was 2.8 ％ (2/72) only compared with no effect of control group.But the effective and stabilization rate (CR+PR+SD) was 66.7 ％ (48/72),it was 31.0 ％ (22/71) in control group.There was significant difference between the two groups (P ＜ 0.05).The overall effective rate of easement of pain was 67.7 ％ (48/72) in treatment group versus 36.1％ (13/36) in control group (P ＜ 0.05).The median survival time (MST) was 6.2 months in treatment group versus 5.1 months in control group (P ＞ 0.05).The quality of life in treatment group was improved obviously (P ＜ 0.05).The side effects of patients in treatment group were very slight.Conclusions Aidi injection can reduce the cancer pain,improve the quality of life and prolong the survival time of the elderly and infirm patients with advanced cancer.It is safe,and effective to inhibit growth of tumor.It can be recommended widely to clinical use.

Objective:To investigate the status quo of pain management for cancer patients in hospice care wards of community health service centers.Methods:The electronic medical records of 373 cancer patients admitted in hospice wards of Kangjian Community Health Center of Xuhui District and Jinshanwei Town Community Health Center of Jinshan District from January 2015 to July 2021 were collected. The characteristics of cancer pain, the use of analgesic drugs, the effects of analgesic drugs and its influencing factors were analyzed.Results:The incidence of cancer pain in 373 patients was 93.0% (347/373), and the proportion of moderate to severe cancer pain was 55.6% (193/347). Analgesics were used in 304 patients, among whom 233 (76.6%) patients used oral analgesics, 297 (97.7%) used on time, 97.6%(285/292) used sustained-release opioids, and 94 (30.9%) used combinedly. Breakout pain occurred in 100 cases (32.9%), all of which was controlled with immediate-release morphine. Cancer pain was not relieved in 132 cases (43.42%), and multivariate logistic regression analysis showed that the pain degree on admission (moderate: OR=3.69, 95 %CI:2.09-6.49; severe: OR=5.52, 95 %CI:2.43-12.53), the presence of burst pain ( OR=3.28, 95 %CI:1.77-6.06), the type of analgesics used (non-steroidal+weak opioids: OR=0.39, 95 %CI:0.20-0.76; nonsteroidal+strong opioids: OR=0.20, 95 %CI:0.08-0.51) and the adverse reactions ( OR=1.92, 95 %CI:1.03-3.60) were the influencing factors of pain relief in cancer pain patients (all P<0.05). Conclusion:The pain of cancer patients admitted to community palliative care wards cannot be ignored. Although most cancer pain patients use analgesic drugs in a standard way, there are still a high proportion of patients whose pain is not controlled. Various factors affect the effect of analgesic treatment.

Objective To investigate the constitutive characteristics and the change trend of gynecologic malignant tumors in hospitalized patients in Guangxi Zhuang Autonomous Region over the recent 20 years.Methods Clinical data of 8009 in-patients who suffered from gynecologic malignant tumors in 23 hospitals from 1985 to 2004 in Guangxi Zhuang Autonomous Region were analyzed,with respect to the tumor types and change trend.Results(1)The leading 4 types of malignant tumors were cervical cancers, ovarian cancers,endometrial cancers,and malignant trophoblastic tumors according to the constitutive ratios of the tumors.The constitutive ratio of cervical cancer patients rose year by year,from 17.48% during the 1985-1989 period to 49.25% during the 2000-2004 period(P0.05).(2)The occurring age of cervical cancers became younger obviously,from≥60 years old dropped to

Objective:To explore the incidence, clinical characteristics and prognosis of invasive pulmonary fungal infection(IPFI)in recipients of lung transplantation(LT)in southern China.Methods:From January 2003 to August 2019, retrospective analysis was performed for 300 recipients of lung transplantation at three hospitals in southern China. There were 254 males and 46 females with an average age of (54.98±14.2)years. Clinical data were collected from medical records, including symptoms and signs, imaging studies, bronchoscopy examination, pathogen separation and culture from deep sputum and bronchoalveolar lavage fluid(BALF), fungal-related laboratory tests and tissue pathology.Results:Among 300 cases, 93(31.0%)had at least one episode of IPFI. The most common pathogen was aspergillosis(60.2%), followed by candida(15 cases, 16.1%)and Pneumocystis jeroveci (13 cases, 14.0%). Kaplan Meier analysis indicated that all-cause mortality was significantly higher in IPFI group than that in non-IPFI(nIPFI)group with one-year mortality of 45.2% vs. 26.7% in IPFI and nIPFI groups respectively( P<0.05). Conclusions:IPFI is prevalent after LT in southern China. And aspergillosis is the most common pathogen and Candida comes the next. The median occurring time for aspergillosis is 6 months after LT. Candida infection occurs earlier at airway anastomosis. A higher incidence of invasive fungal disease(IFD)associated with a lower survival indicates that IPFI has a substantial mortality among recipients after LT. Prophylactic agents should be optimized based upon an epidemiologically likely pathogen.

BACKGROUND: The switch/sucrose nonfermentable chromatin-remodeling (SWI/SNF) complex is a pivotal chromatin remodeling complex, and the genomic alterations (GAs) of the SWI/SNF complex are observed in several cancer types, correlating with multiple biological features of tumor cells. However, their role in liver metastasis of non-small cell lung cancer (NSCLC) remains unclear. Our study aims to investigate the role and potential mechanisms underlying NSCLC liver metastasis induced by the GAs of SWI/SNF complex. METHODS: The GAs of SWI/SNF complex in NSCLC cell lines (H1299, H23 and H460) were identified by whole-exome sequencing (WES). ARID1A knockout H1299 cell was constructed with the CRISPR/Cas9 technology. The mouse model of liver metastasis from NSCLC was established to simulate lung cancer liver metastasis and observe the metastasis rate under different gene mutation conditions. RNA sequencing and Western blot were conducted for differential gene expression analysis. Immunohistochemistry (IHC) analysis was used to assess protein expression levels of SWI/SNF-regulated target molecules in mouse liver metastases. RESULTS: WES analysis revealed intracellular gene mutations. The animal experiments demonstrated a correlation between the GAs of SWI/SNF complex and a higher liver metastasis rate in immunodeficient mice. Transcriptome sequencing and Western blot analysis showed upregulated expression of ALDH1A1 and APOBEC3B in SWI/SNF-mut cells, particularly in ARID1A-deficient H460 and H1299 sgARID1A cells. IHC staining of mouse liver metastases further demonstrated elevated expression of ALDH1A1 in the H460 and H1299 sgARID1A group. CONCLUSIONS This study underscores the critical role of the GAs of SWI/SNF complex, such as ARID1A and SMARCA4, in promoting liver metastasis of lung cancer cells. The GAs of SWI/SNF complex may promote liver-specific metastasis by upregulating ALDH1A1 and APOBEC3B expression, providing novel insights into the molecular mechanisms underlying lung cancer liver metastasis.
Animals ; Mice ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Mutation ; Liver Neoplasms/genetics*