Cisplatin is a first-line anticancer drug widely used in clinic. However, its resistance reduces its efficacy. With a non-specific cell cycle, cisplatin's main targets are nucleophilic protein, DNA and RNA in cells. Among cisplatin's multi-factorial resistance mechanisms, abnormal expression of transport protein, intracellular detoxification enhancement, DNA repair capacity increase and apoptosis blocking are the main mechanisms. Because traditional Chinese medicines (TCMs) have unique advantages in cancer treatment, their combination with cisplatin can improve the efficacy. In this paper, the authors summarized the advance in studies on cisplatin's resistance and the combination of TCMs and cisplatin in recent years.
Antineoplastic Agents ; administration & dosage ; pharmacology ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cisplatin ; administration & dosage ; pharmacology ; Drug Resistance, Neoplasm ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Medicine, Chinese Traditional ; methods ; trends ; Neoplasms ; drug therapy ; pathology ; therapy

Objective To compare the effects of target-controlled infusion(TCI) of remifentanil in three different doses in thoracic patients undergoing total intravenous anesthesia.Methods Forty-five ASA Ⅰ～Ⅱ patients aged 40～60yr undergoing thoracic surgery were randomly divided into three groups.The patients were given midazolam 0.05mg/kg and artropine 0.5 mg/kg i.m.before anesthesia.Anesthesia was induced with remifentanil and propofol both given by TCI simultaneously.The target concentration of propofol was set at 3?g/ml and remifentanil at 4,6,8ng/ml(groupⅠ,Ⅱ,Ⅲ).When the patients lost conscionsness,rocuronium 0.6mg/kg was given i.v.to facilitate intubation.Anesthesia was maintained with TCI of propofol-remifentanil and intermittent i.v.boluses of rocuronium.Remifentanil target concentration maintained unchanged during anesthesia.BIS index was controlled at 45～55 by modify propofol target concentration.SBP,DBP,MAP,HR and BIS index was recorded in baseline(T0),before intubation(T1),intubation(T2),skin incision(T3),the opening of the chest(T4),skin closuer(T5),extubation(T6).Vein blood samples were taken for determination of plasma concentration of epinephrine(E) and norepinephrine(NE) by ELASA.Results SBP,DBP,MAP,HR and plasma NE concentration at T2,T3,T4,T5 were higher than T0 in group Ⅰ(P

The latest developments of techniques that prolong the half-life of protein drugs were reviewed.The therapeutic potential of several proteins is limited by their rapid clearance from the body,resulting in the need for frequent treatment of individuals to maintain drug levels.Several techniques including chemical modification,protein fusion,microsphere,glycosylation,and protease-resistant variants,and so on,prevent rapid degradation of such drugs and prolong their half-lives in vivo.Several successful protein drugs with prolonged half-life have already been on the market or on clinical trials.The principles,efficiencies and scopes of application of these techniques were described,compared and discussed.

Adolescent ; Adult ; Cholecystitis ; complications ; drug therapy ; surgery ; Cholecystolithiasis ; complications ; drug therapy ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis ; drug therapy ; etiology ; surgery ; Phytotherapy ; Postoperative Period ; Sphincterotomy, Endoscopic

Objective To compare the neonatal outcomes of different gestational age at which elective cesarean sections at term were performed. Methods All the cases of cesarean section registered in Peking Union Medical College Hospital from September 2002 to November 2009 were collected. Women with viable singleton pregnancies delivered before the onset of labor and without recognized indications for cesarean section after 37 weeks at term were included and their general information and outcomes were compared with one-way ANOVA. All the maternal data and neonatal adverse events were compared with Cochran-Armitage test among different gestational weeks, including respiratory complications (respiratory distress syndrome or transient tachypnea of the newborn), infections, admission to the neonatal intensive care unit (NICU), and hospitalization in NICU＞5 d. Results Of 8122 primary cesarean sections and 594 repeat cesarean sections at term, 4565 and 409 cases were performed electively as the primary or repeat cesarean section. Among the 4565 women underwent primary elective cesarean sections, 2194 (48.1%) were before 39 gestational weeks,and 1828 (40.0%) at 39-39+6 weeks. While, among the 409 repeat elective cesareans sections, these figures were 275 (67.2%) and 120 (29.3%), respectively. No fetal or neonatal death occurred during perinatal period. Compared with births at 39-39+6 weeks, births at 37-37+6 weeks or 38-38+6 weeks were associated with increased risk of the neonatal adverse events. For the primary cesarean section cases, the odds ratio (OR) for births at 37-37+6 weeks and 38-38+6 weeks was 1.4 (95% CI: 0.9-2.0) and 1.1 (95% CI: 0.9-1.4), respectively. For the repeat cesarean section cases, OR for births at 37-37+6 weeks and 38-38+6 weeks was 2.5 (95% CI: 1.1-5.8) and 1.3 (95% CI: 0.6-2.7) respectively. Conclusions Elective cesarean section before 39 weeks of gestation is popular and associated with adverse neonatal outcomes. Elective cesarean section performed after 39-39+6 gestational weeks might decrease the risk of adverse neonatal outcomes.

As the head transplant program“Heaven Surgery” was put forward, there was birth to many bioethi-cal confusion, clinical-medical ethical confusion and other questions of ethical confusion. Face with various ethi-cal confusions, clinician need rational return of humanism, and the public need pay more attention to the essence of life and the concept of life and death.

Objective To study the feasibility of cerebral state index(CSI)modulating the depth of general anesthesia in the elderly with laryngeal mask anesthesia.Methods Tmenty-four ASA physical status of Ⅱ-Ⅲ patients undergoing selective lower abdominal surgery were divided two groups with 12 cases.The anesthesia was induced by sufentanil、 propofuland maintained with TCI propofol.The depth of anesthesia was modulated by CSI index in group I or by hemodynamics in group Ⅱ.HR、SBP、DBP、MAP and CSI were recorded.The time of awakening form anesthesia(the time when OAA/S reached 4 score after the drawal of propofol)and the dosage of propofol and fentanyl were recored.Results The time of awakening from anesthesia was 16?5min in group Ⅱ,which was significantly longer than that in group I(P

A fungus that is capable of producing EPA and DHA was isolated from seawater. A fast extraction and methyl esterification of microbial lipid were established as well as their content determination by capillary gas chromatography using external calibration method. The results showed that the methyl ester prepared directly form the wet mycelia treated with CHCl 3 KOH CH 3OH is less time consuming and the method fits for the fast determination. To determine its EPA and DHA content,the wet mycelia was hydrolyzed according to Weibul’s method and the lipid obtained was methyl esterified with KOH MeOH,the results obtained by capillary gas chromatography using external calibration method were 7.32% and 7.58% respectively.

Neurotrophic factor activates signal pathways of intracellular phosphoinositide 3-kinase and extracellular signal-regulated kinase after acting on Trk receptor tyrosine kinase.It promotes the survival and differentiation of neurons.The development of small molecule Trk agonists of non-peptides and neurotrophic factor simulants can avoid a number of shortcomings of neurotrophic factors while agitating trk receptor signal transduction.It may provide a novel therapeutic approach for the treatment of nervous system diseases.

Objective To investigate the expression pattern of tropomyosin receptor kinase(Trk)after focal cerebral ischemia in rat,and to explore the relationship between ischemia and the pattern of Trk expression. Methods(The model) of focal cerebral ischemia was built by middle cerebral artery occlusion.Immunocytochemistry staining was used to observe the dynamic changes of Trk expression at different time of acute stage of ischemia,and the patterns at different regions of the striate and hippocampal were detected. Results Trk immuno-positive neurons widely expressed in the normal brain.The number of Trk immuno-positive neurons was decreased abruptly in the necrosis core of the focal cerebral of ischemia,while increased obviously in the penumbra region and the DG area after 6 h of occlusion(P