Objective To explore the expression of survivin gene in gastric cancerous tissue and its relationship with gastric cancer prognosis. Methods All the samples were obtained from patients with gastric cancer who underwent surgery in Zhongshan Hospital from July 1995 to June 1996.“ Envision two steps”of immunochemistry was used to detect survivin expression in the resected gastric cancerous tissue.TNM stages were determined by pathological diagnosis and clinical status.All the cases were followed up at least 5 year or until death.The discrepancy of survivin expression was compared in different pathological types and TNM stages.Survivial curves were compared in the two groups with or without survivin expression. Results Totally 96 cases(male/female:59/37;age:29-84 years old,mean age 56) were recruited and survivin expression rate was 70.8%(68/96).Among pathological types,78 cases were adenocarcinoma,18 were non-adenocarcinoma.Survivin expression was similar in different pathological types (69.7% in adenocarcinoma vs.60.0% in non-adenocarcinoma,P=0.369).Among adenocarcinoma,survivin expression rate was higher in poorly differentiated group than that in well differentiated one(82.1% vs. 62.5%,P=0.053).As the infiltration denoted in adenocarcinoma,the expression rates of survivin were 33.3% in cases limited to mucosa and submucosa,81.3% in cases limited to muscularis layer and 75.9% in cases infiltrated to whole layers (P= 0.020).Expression rate of survivin was not related with lymph node metastasis(68.1% vs.70.8%,P= 0.771).Five-year survival rate in 68 survivin positive cases was 42.93%,lower than 52.93% of 28 survivin negative cases,but no statistical difference was observed. Conclusions Survivin is highly expressed in gastric cancer.Survivin expression is closely related with differentiation status of adenocarcinoma and degree of infiltration.Further studies are needed to evaluate its role in the prognosis of gastric cancer.

OBJECTIVE:To study the in vitro dissolution of Enalapril maleate and folic acid tablet. METHODS:HPLC was performed on the column of Agilent HC-C18 with mobile phase A of acetonitrle-phosphate buffer solution(70:30,V/V) and mobile phase B of acetonitrle-phosphate buffer solution(5:95,V/V)(gradient elution) at a flow rate of 1.0 ml/min,detection wavelength was 215 nm,column temperature was 50 ℃,and volume injection was 80 μl. Media were water,hydrochloric acid solution(pH 1.2),phosphate buffer solution(pH 5.0)and phosphate buffer solution(pH 6.8),medium volume was 900 ml and rotation speed was 50 r/min. The dissolution behavior of enalapril maleate in Enalapril maleate and folic acid tablet in 4 media were studied and compared with the dissolution behavior in vitro in original preparation of Enalapril maleate tablet,meanwhile,the dissolution behar-ior of folic acid in Enalapril maleate and folic acid tablet in phosphate buffer solution(pH 5.0)were studied and compared with dis-solution data of folic acid preparation in Japanese Orange Book to evaluate the intrinsic quality. RESULTS:The linear range was 0.561-14.03μg/ml for enalapril maleate(r=0.999 9)and 0.043-1.085μg/ml for folic acid(r=0.999 9),respectively;RSDs of pre-cision and stability tests were lower than 2.0%;recoveries of enalapril maleate in 4 media were 100.63%-102.33%(RSD=0.72%, n=9),99.27%-100.44%(RSD=0.41%,n=9),99.71%-100.29%(RSD=0.15%,n=9)and 96.74%-99.19%(RSD=0.79%,n=9),respectively. Recoveries of folic acid were 100.18%-101.63%(RSD=0.48%,n=9),97.73%-101.81%(RSD=1.32%,n=9),99.60%-102.24%(RSD=0.74%,n=9)and 100.00%-102.76%(RSD=0.90%,n=9),respectively. In 15 min,the dissolution of enalapril maleate of 2 preparations in 4 dissolution media were more than 85%;dissolution speed of folic acid in Enalapril male-ate and folic acid tablet was faster than that in folic acid preparation in phosphate buffer solution(pH 5.0). CONCLUSIONS:The method is suitable to determine the dissolution of Enalapril maleate and folic acid tablet;the in vitro dissolution curve of enalapril maleate in Enalapril maleate and folic acid tablet is similar to Renitec,and the in vitro dissolution of folic acid is better than folic acid preparation.

Objective To explore antiviral efficacy, safety and blocking of mother-to-infant transmission by administrating telbivudine in pregnant patients with chronic hepatitis B (CHB) throughout pregnancy. Methods Sixty-four cases of female patients were enrolled. The study participants were divided into the telbivudine treatment group (n = 31) and the control group (n = 33). Data were recorded from beginning of administration to ending pregnancy, as well as notation of any adverse reactions. The neonates and infants were evaluated in HBV infection, parameters of growth and development. Results The recovery rates of ALT, respectively, were 90.32% vs. 57.58% (P = 0.003), 93.55% vs. 62.50% (P = 0.003) at 24 weeks and ante partum and the HBVDNA-negative conversion rates, respectively, were 48.39% vs. 3.03% (P = 0.000), 83.87%vs. 6.06% (P = 0.000), 90.32% vs. 6.25% (P = 0.000) respectively, at 12, 24 weeks of pregnancy and at ante partum between the treatment and control groups. The HBsAg-positive and HBVDNA-positive rates of the infants, respectively, were 12.90% vs. 37.50% (P = 0.025) and 0 vs. 21.88% (P = 0.018) at birth, and respectively, were all 0 vs. 18.75% (P = 0.035) and 0 vs. 18.75% (P = 0.035) at 1, 6, 12 months old between the treatment and control groups. The treatment group showed lower incidence of intrauterine HBV infection (0 vs. 18.75%, P = 0.035). The gestational ages, fetal weights and Apgar scores were not significant different in the children born in the mothers from the two groups. Conclusions Telbivudine administration showed a good antiviral curative effect and effectively blocked mother-to-infant transmission in women with CHB. The treatment was safe and caused no obvious adverse reaction.

Objective To explore the application value of VCT 64-row with 128-layer spiral extremities arterial imaging techniques and methods in the double lower limb artery.Methods 60 patients on lower limbs MSCTA angiography after Saul,flat on intravenous regiment note contrast agents CT angiography,image the maximum intensity projection(MIP),curved planner reconstruction(CPR),volume rendering(VR)after-treatment technology reconstructed vessels.Results All 60 patients showed the lower limb arterial and main branch.Conclusion 64-row helical VCT angiographic with 128-layer could clearly show that lower limb artery and pathological changes,and become main methods of preoperative evaluation and selection for the lower limb artery disease.

OBJECTIVETo explore the antiviral efficacy, safety and protective ability against mother-to-infant transmission of telbivudine in pregnant patients with chronic hepatitis B (CHB) during the first trimester.

METHODSEighty four gravid women who were diagnosed with CHB, in their first trimester of pregnancy, and had refused to terminate their pregnancies were enrolled; all study participants were clinically classified as active hepatitis cases with positivity for both hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg), HBV DNA more than or equal to 107 copies/mL and serum level of alanine aminotarnsferase (ALT) of more than or equal to 4 ULN.Patients with YMDD mutations were excluded from the study. The study participants were divided into a telbivudine treatment group (n=43; administered in the first trimester of pregnancy) and a control group (n=41, consisting of patients who refused to take antivirals). All babies bom to the women in both groups of the study received standard immune prevention (anti-hepatitis B immunoglobulin plus hepatitis B vaccine) and artificial feeding.Data recorded for the women during pregnancy included clinical findings for tests of hepatic and renal function, myocardial enzymes, blood and urine clinical parameters, hepatitis B virus makers and HBV DNA, as well as notation of any adverse reactions. The neonates were evaluated for presence of HBV infection, parameters of growth and development, presence of complications, and Apgar score. At 6 and 12 months old, all infants were evaluated for HBV DNA level and HBsAg presence.

RESULTSThe genetic variant rtM204I was detected in one of the women in the treatment group at 36 weeks of pregnancy. One woman in the control group developed severe hepatitis at 28 weeks of pregnancy and was put on the telbivudine treatment The treatment group showed greater recovery rates of ALT than the control group at 12 weeks of pregnancy (62.8% vs.29.3%, P=0.002), 24 weeks of pregnancy (76.7% vs.46.3%, P=0.000), and at ante partum (88.1% vs.60.0%, P=0.004). The treatment group also showed greater HBV DNA-negative conversion rates at 12 weeks of pregnancy (20.9% vs.0, P=0.006), at 24 weeks of pregnancy (37.2% vs.0, P=0.001) and at ante partum (78.6% vs.0, P=0.000), and greater HBeAg seroconversion rates at 12 weeks of pregnancy (2.3% vs.0, P=1.000), at 24 weeks of pregnancy (9.3% vs.0, P=0.116) and at ante partum (2 1.4% vs.0, P=0.002). The HBsAg-positive rates and HBV DNA-positive rates among the infants born to the mothers in the treatment and control groups, respectively, were 2.4% vs.17.5% (P=0.027) at birth, 0 vs.17.5% (P=0.005)at 6 months old and 0 vs.17.5% (P=0.005) at 12 months old. The Apgar scores were not significantly different for the children born to the mothers from the two groups, and all the children showed parameters of growth development within normal limits.

CONCLUSIONTelbivudine administration in the first trimester had a good antiviral curative effect and effectively blocked mother-to-infant transmission in women with CHB. The treatment was safe, causing no obvious adverse reaction in the gravid women or developmental effects on the infants.

Antiviral Agents ; DNA, Viral ; Female ; Hepatitis A Vaccines ; Hepatitis B Vaccines ; Hepatitis B e Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Infant ; Infant, Newborn ; Infectious Disease Transmission, Vertical ; Mother-Child Relations ; Mutation ; Pregnancy ; Pregnancy Complications, Infectious ; Pregnancy Trimester, First ; Thymidine ; analogs & derivatives ; Vaccines, Combined

Objective To survey the distribution and amibiotie resistance of bacterium isolated from hospitalized patients with hematolegical diseases.Methods Bacterial strains were isolated from patients with hematological disease.Antimicrobial susceptibility testing was done by the method of minimum inhibitory concentration.Results A total of 56 bacterial strains were isolated from all kinds of specimens,including blood,phlegm and urine.14.3% were gram-positive and 85.7% were gram-negative bacterium.Escheriehia coli and pseudomonas aeruginosa account for 21.4% of gram-negative bacterium,respectively.Detection rates of ESBLs in E.coli and K.pneumoniae were 75.0%(8/12)and 33.3%(2/6),respectively.Conclusion Our data may have great significance for the empirical use of antimicrobial agents in the treatment of infections in patients with hematological disease.

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Dactinomycin/adverse effects* ; Female ; Gestational Trophoblastic Disease/drug therapy* ; Humans ; Methotrexate/therapeutic use* ; Pregnancy ; Retrospective Studies