BACKGROUND: In vivo animal experiments have found that magnesium al oy stents can be completely degraded in a slow, orderly and non-toxic manner fol owing the vascular remodeling. OBJECTIVE: To investigate the applied effect and biocompatibility of a new type of magnesium al oy stent in blood vessels. METHODS: Forty-two crossbreed dogs were implanted with absorbable magnesium al oy stents via the coronary artery or left femoral artery. At days 1, 3, 5 and weeks 1, 2, 3, 4 after implantation, coronary or femoral artery angiography, inflammatory factor detection and morphological analysis targeting intimal hyperplasia were performed. RESULTS AND CONCLUSION: At 1 day after implantation, the stents had the complete shape and were ful y extended; at 3 days after implantation, the stents were degraded partial y; at 1 week after implantation, the stents were degraded completely. Within 1-3 weeks after implantation, the levels of tumor necrosis factor α, interleukin-6 and interleukin-8 continued to decrease. At 2 and 3 weeks after implantation, the target vessels presented with mild intimal hyperplasia. As time went on, the hyperplasia area increased gradual y, and the percentage of intimal hyperplasia increased gradual y. Blood magnesium concentration remained unchanged before and after stent implantation. The results show that the new absorbable magnesium al oy stent can be completely degraded within 1 week after stent implantation and has good biocompatibility.

Objective To investigate the efficacy and safety of intraarterial or intravenous recombinant tissue plasminogen activator(rtPA) for patients with acute cerebral infarction.Methods 60 patients consistent with the inclusion criteria were divided into intra-arterial thrombolysis group, intravenous thrombolysis group and control group. rtPA of 10～20 mg was infused over the course of 30 minutes in intra-arterial thrombolysis group. rtPA was administered in a dose of 0.7～0.8 mg/kg(maximum dose 50 mg),with 100% as a constant infusion over a period of 90 minutes in intravenous thrombolysis group.24 hours late, both groups were followed by subcutaneous injection of low molecular weight heparin(0.4 ml,twice daily) for 7 days. The control group received only routine treatment. European Stroke Scale(ESS) and Barthel Index(BI) were used to evaluate the recovery of neurological functions.Results The efficacy in both thrombolysis groups was significantly higher than that in the control group(all P 0.05).But in intraarterial group, the stenosis of intracranial arteries or extracranial arteries could be found, and new thrombosis could be prevented by transluminal stent-assistant angioplasty. One case of intracerebral hemorrhage and one case of asymptomatic hemorrhage occurred in intraarterial thrombolysis group. One case of asymptomatic hemorrhage was found in intravenous thrombolysis group and control group respectively. No dead case was found in the three groups.Conclusion Thrombolytic therapy of intra-arterial and intravenous rtPA can be performed safely and efficaciously in patients with acute cerebral infarction within 6 hours from the onset.

Objectives:To study the impact of nutritional support in non operative management of severe acute pancreatitis. Methods:Sixteen patients with severe acute pancreatitis were provided with stage nutritional support. Results:Fourteen cases fully recovered and 2 cases died. Stage of maintenance equilibration was (57.0?12.5)hours,TPN was (12.1?4.2)days and PN+EN was (12.2?3.5)days. Conclusions:Stage nutritional support might be favourable in improving prognosis and survival rate of severe acute pancreatitis.

To study the identification of Gentianaceae Mongolian medicine Digeda with spectroscopy techniques, near infrared spectroscopy and differential scanning calorimetry techniques were applied to study on the identification of 4 kinds of Gentianaceae Mongolian medicine Digeda, and characteristic spectrums obtained were systematically analyzed. In NIR study, the four species of Digeda exist some differences in 4 250-4 400 cm(-1) and 5 650-5 800 cm(-1) of one-dimensional spectra, and show significant differences in 4 100- 4 400 cm(-1), 4 401-4 900 cm(-1) and 5 400-5 800 cm(-1) of the second derivative spectra. DSC curves of them present distinct topological pattern, characteristic peak and peak temperature. Using near infrared spectroscopy and differential scanning calorimetry analysis can realize efficient and accurate identification of four kinds of Mongolian medicine Digeda, and provide scientific basis for the efficient and accurate identification of other Gentianaceae Mongolian medicine Digeda.
Calorimetry, Differential Scanning ; methods ; China ; Gentianaceae ; chemistry ; classification ; Medicine, Mongolian Traditional ; Spectroscopy, Near-Infrared ; methods

Objective To investigate the influence of CO2 pneumoperitoneum on the adhesive and invasive ability of gastric cancer cells based on the expression of adhesive and invasive molecules. Methods With an artificial CO2 pneumoperitoneum model in vitro, human gastric cancer cells MKN-45, SGC-7901 and MKN-28 were exposed to 3 different CO2 gradients: 9 mm Hg, 15 mm Hg and control group (0 mm Hg). The expression of E-cadherin, ICAM-1, MMP-2 and VEGF-A were measured at 2 and 4 hours exposure by using RT-PCR, CytoMatrixTM kit and ECMatrixTM kit. The pretreated gastric cancer cells were injected into abdominal cavity of nude mice(2×106 cells per mouse). Five mice in each group were sacrificed 4 weeks later to record the number of tumor nodules in abdominal cavity. The remaining mice were kept for observation of survival time. Results The expression of E-cadherin (MKN-45: from 2.26 to 2.19, SGC-7901 :from 2.16 to 2.09、MKN-28 :from 2.06 to 1.99), ICAM-1 (MKN-45 : from 2.20 to 2.28、SGC-7901: from 2.10 to 2.18、MKN-28: from 2.00 to 2.08), MMP-2 (MKN-45:from 2.05 to 2.13、SGC-7901: from 1.95 to 2.03、MKN-28: from 1.85 to 1.93) and VEGF-A(MKN-45 : from 2.10 to 2.16、SGC-7901 :from 2.00 to 2.06、MKN-28: from 1.90 to 1.96) didn't change significantly with increasing pressure and time (P>0.05). The expression of adhesive and invasive molecules didn't change significantly between the experimental groups and the control group. There was no statistical significance of tumor metastasis in abdominal cavity of nude mice(MKN-45:from 22 to 23、SGC-7901 :from 20 to 22、MKN-28:from 21 to 22) and survival time(MKN-45 :from 23 to 21、SGC-7901 :from 22 to 21、MKN-28 :from 22 to 21) among all the groups. Conclusion Under low pressure and short time of CO2 exposure, the adhesive and invasive capacity of gastric cancer cells did not change significantly hence did not increase the possibility of neoplasm metastasis.

OBJECTIVE: To analyse the risk factors involved in local failure following radiotherapy and chemotherapy to nasopharyngeal carcinoma. METHOD: A retrospective analysis was carried out to review the histopathological data from 308 NPC patients who recieved medical treatment between 2004 and 2006. The incidence and the risk factor for local treatment failure were evaluated in a model that included the following factors: sex, age, T and N staging, histological grade of primary tumor, presence of cervical lymph node metastasis, size and laterals of positive neck nodes, levels involved, ways of radiation and condition of concurrent chemotherapy. Univariate chi2 test and multivariate stepwise logistic regression model were used for the analysis. Statistical analysis of survival of patients with local residues and recurrence was performed using Kaplan-Meier method. RESULT: Ninty-three cases (30.2%) presented local residues and recurrence in 308 patients of nasopharyngeal carcinomas. In the univariate analysis, it was confirmed that the following variables correlated to local failure, i. e., T staging (P < 0.01), N staging (P < 0.01), presence of cervical lymph node metastasis (P < 0.05), size and laterals of positive neck nodes (P < 0.05, respectively). In the multivariate analysis, the most ignificant risk factors for local failure were the T staging only. Kaplan-Meier analysis showed that overall survival rates of 71 NPC patients with local residues and recurrence who received re-treatment were 77.2% at 1 year, 40.4% at 3 years, 22.4% at 5 years, respectively. CONCLUSION T staging is the key risk factors in determining the development of local failure following radiotherapy or chemotherapy in NPC patients. Patients with primary tumor infiltrating bone have the higher risk of developing local residues and recurrence. Retreatment to the patients suffering from local failure can imrove survival rates.
Adult ; Aged ; Analysis of Variance ; Bone Neoplasms ; pathology ; Carcinoma ; Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; pathology ; radiotherapy ; Neck ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neoplasm, Residual ; Retrospective Studies ; Risk Factors ; Survival Rate ; Treatment Failure ; Tumor Burden

OBJECTIVE:To systematically review the efficacy and safety of lamivudine(LAM)combined with adefovir dipiv-oxil (ADV) versus entecavir (ETV)alone in the treatment of decompensated HBV-associated cirrhosis. METHODS:Retrieved from PubMed,Cochrane Library,CBM,CNKI,VIP and WangFang Database, randomized controlled trails (RCT) about LAM combined with ADV(combination group)versus ETV(control group)in the treatment of decompensated HBV-associated cirrhosis were collected. Meta-analysis was performed by using Stata 11.0 software after data extraction and quality evaluation. RESULTS:Totally 13 RCTs were included,involving 972 patients. Results of Meta-analysis showed,there were no significant differences in the serum alanine transaminase (ALT)[SMD=0.079,95%CI(-0.086,0.244),P=0.348],total bilirubin (TBIL) [SMD=0.056, 95%CI(-0.118,0.230),P=0.529],ALB[SMD=-0.020,95%CI(-0.494,0.454),P=0.935],HBV-DNA negative conversion rate [RR=1.012,95%CI(0.950,1.079),P=0.710],HBV e antigen(HBeAg)seroconversion rate [RR=1.181,95%CI(0.969,1.439), P=0.099],HBeAg negative conversion rate [RR=1.011,95%CI(0.860,1.189),P=0.893],follow-up 96 week liver function Child-Turcotte-Pugh score [SMD=-0.063,95%CI(-0.299,0.173),P=0.601],virological breakthrough rate [RR=1.562,95%CI (0.471,5.178),P=0.466],mortality rate [RR=1.198,95%CI(0.624,2.300),P=0.587] and the incidence of adverse reactions [RR=1.552,95%CI(0.618,3.900),P=0.349]in 2 groups;follow-up 48 week liver function CTP score in combination group was significantly higher than control group,the difference was statistically significant [SMD=0.352,95%CI(0.031,0.672),P=0.031]. CONCLUSIONS:LAM combined with ADV shows similar efficacy and safety to ETV in the treatment of decompensated HBV-as-sociated cirrhosis,but within short term(48 weeks),ETV is more likely to inhibit the development of liver fibrosis of the chronic HBV patients,and even can reverse liver fibrosis and cirrhosis.

Objective To investigate the expression and clinical significance of serum response factor (SRF) and vascular endothelial growth factor receptor (VEGFR2) in gastric carcinoma. Methods SABC immunohistochemical method was used to determine the expressions of SRF and VEGFR2 in 50 cases of gastric carcinoma, 50 cases of surgery incisal edges and 29 cases of lymph node metastasis focus. Results The detection positive rates of SRF and VEGFR2 in gastric carcinoma were 52.00 % (26/50) and 60.00 %(30/50), respectively, which were significantly higher than those in the normal gastric mucosa [16.00 % (8/50) and 10.00 % (5/50), respectively] (P< 0.05), with no statistical difference with metastiatic lymph node [65.52 % (19/29) and 72.41 % (21/29), respectively]. In the gastric carcinoma group, the expression of SRF was relevant with depth of invasion and lymph node metastasis (P<0.05). The expression of VEGFR2 was not related to age, gender and tumour size (P>0.05), but closely correlated to differentiation degree, invasion depth and lymph node metastasis (P<0.05). The expressions of SRF and VEGFR2 in the gastric carcinoma were positively correlated (r= 0.594, P< 0.05). Conclusion Overexpressions of SRF and VEGFR2 in gastric carcinoma can be regarded as the poorly prognostic markers and play an important role in invasion and metastasis of gastric carcinoma.

OBJECTIVE To explore the surgical approach for recurrent or residual nasopharyngeal carcinoma after radiotherapy failure. METHODS The clinical data of 12 patients with recurrent or residualnasopharyngeal carcinoma after radiotherapy failure for salvage surgery were retrospectively analyzed. The 12 patients were underwent salvage surgery via transcervico-mandibulo-palatal approach. The residual and recurrent tumors were found in 2 and 10 patients (included 2 recurrent patients after re- radiation) after radiotherapy respectively. RESULTS The paranasopharyngeal region defects were repaired with submandibular gland flaps in 10 patients and with free inferior turbinate mucosal graft in 2 patients. All of the 12 patients were followed up for more than 2 years. Seven patients survived with no evidence of disease and one patient survived with tumor. Three patients died of local recurrence and one died of distant metastasis. The 2-year survival rate was 75 %. CONCLUSION Resection of the local recurrent nasopharyngeal carcinoma via transcervico- mandibulo-palatal approach provides wide field exposure of the central skull base. The tumors located in paranasopharyngeal region can be resected en bloc and the internal carotid artery can be identified by palpation under direct vision. The surgical defects can be repaired with submandibular gland flap. The transcervico-mandibulo-palatal approach is the suitable procedure for local recurrent nasopharyngeal carcinoma with less mortality and complications.

OBJECTIVE To explore the indication and effect of primary repair of the defects for stomal recurrence after total laryngectomy. METHODS A total of 18 cases with stomal recurrence after total laryngectomy were performed operation.The defect of hypopharynx and cervical oesophagus was repaired with free forearm flap (n=5),free jejunual interposition(n=3),pectoralis major myocutaneous flap (n=1)and pharyngogastric anastomosis(n=2).The defect of skin was repaired with pectoralis major myocutaneous flap.RESULTS All pectoralis major myocutaneous flaps were viable. Pharyngeal fistula occurred in 4 cases,one of whom had been performed free jejunual interposition,2 had been performed free forearm flap,and one with fistula bleeding had been performed pharyngogastric anastomosis.All cases could swallow after operation. During follow-up for 6 to 74 months,swallow obstruction occurred in 3 cases.CONCLUSION The methods of repair for surgical defect of stomal recurrence after total laryngectomy should depend on the bound of stomal recurrence and therapeutic procedure of primary tumor.