Objective To investigate the optimal timing of surgical treatment for multi-drug resistance patients,discuss the clinical effect of surgery with chemotherapy treatment for muhi-drug resistant tuberculosis,and obtain more evidence for further optimizing surgical treatment strategy for such patients.Methods 100 cases who were multi-drug resistant and who received treatment in our hospital from July 2003 to June 2010 were included in this retrospective study.Among them,50 (observation group) received pulmonary lobectomy followed by anti-tuberculosis chemotherapy for 12 to 24 months,and the others (control group) only received anti-tuberculosis regimens although they had indications for pulmonary lobectomy.All patients in both groups were followed up for 12 to 24 months.Therapeutic effects and post-operational events were compared statistically in the observation group patients according to their duration of disease.Results Results At the end of follow-up,the cure rate,illness exacerbation rate and mortality were 36.0％ (18/50),16.0％ (8/50) and 26.0％ (13/50) respectively in the control group,whereas those in the observation group were 80.0％ (40/50),2.0％ (1/50) and 4.0％ (2/50) respectively.Resistanee to new anti-tuberculosis drugs appeared in 3 cases (6％) in the control group,while there was no new resistance in the observation group.The cure rate and complication rate were 96.30％ and 3.70％ respectively for patients whose duration of illness was less than 2 years,whereas those were 47.8％ and 43.5％ respectively for cases whose duration of illness was more than 2 years.Bronchopleural fistula,hemorrhage,pyothorax and pulmonary atelectasis were main postoperative complications,from which 11 cases recovered and 2 died,the death caused by choking of big haemoptysisand and multiple organs failure.Conclusion The therapeutic effects of surgical treatment plus anti-tuberculosis chemotherapy were better than chemotherapy alone.Pulmonary lobectomy could result in better response if done at the earlier stages of illness.Complications of operations were acceptable.

Sulfur , a major component of gunpowder , has been widely used in the engineering and military in-dustries since ancient times . In fact , the application of sulfur in traditional Chinese medicine ( TCM ) has a long history , which indicated the uniqueness of TCM theory and practice . Besides , sulfur has played an impor-tant role for the development of TCM in the history . In order to scientifically analyze the role of sulfur in TCM , this paper focused on the application and evolution of sulfur in the development process of TCM , which aimed to provide a reference for the study of the value and role of sulfur in TCM .

Objective:To study the effect and underlying mechanism of sulfur-fumigation and water-soaking on total ash of Di-oscoreae Rhizoma, find the key factor( s) affecting the total ash of Dioscoreae Rhizoma, and explore the rationality of ash limits of Di-oscoreae Rhizoma described in Chinese Pharmacopoeia. Methods:Dioscoreae Rhizoma was respectively dealt with sulfur-fumigation and water-soaking. The changes in total ash content of Dioscoreae Rhizoma was detected by the ash determination methods for total ash and SO2 described in the pharmacopoeia, and then the ash content change of inorganic salts was used to study the mechanism. Results:Sulfur-fumigation could slightly reduce the total ash content of Dioscoreae Rhizoma, while significantly reduce the ash content of calcium oxalate and calcium sulfate with the reduction degree of 7. 20% and 9. 90%, respectively. Calcium phosphate and calcium chloride were slightly affected by sulfur-fumigation, and the results indicated that the effect of sulfur-fumigation on ash content was mainly real-ized by increasing the decomposition rate of calcium oxalate and calcium sulfate. Water-soaking could decline the ash content of Di-oscoreae Rhizoma, and the phenomenon was common in the rhizome medicinal materials. The influence of water-soaking on total ash was more significant than that of sulfur fumigation. Conclusion:Sulfur-fumigation can reduce the total ash content of Dioscoreae Rhizo-ma by increasing the decomposition rate of calcium oxalate and calcium sulfate, however, the effect is mild and the process isn't the key influencing factor in the total ash content of Dioscoreae Rhizoma. During the preparation of Dioscoreae Rhizoma medicinal slices, water-soaking can cause the great loss of water-soluble mineral salts, such as Cl-, C2 O4 2-, NO3 - and SO4 2-, which leads to the reduction of total ash content, therefore, water-soaking is the key influencing factor in the total ash content of Dioscoreae Rhizoma.

To study the changes of metabolites in rat urine after treatment of Aristolochia fangchi decoction by metabonomic method.

OBJECTIVECombined the blood biochemical markers, the renal histopathological changes and the metabonomics profile were investigated to study the toxicity differences between Aristolochia fangchi and Stephania tetrandra.

METHODTen rats were randomly selected from 70 male Wistar rats as blank control group. The remaining 60 rats were divided into three groups. The two treated groups were orally administrated by 8.1 g x kg(-1) of A. fangchi and S. tetrandra respectively and the control group by equal volume of distilled water for 4weeks. Before the administrated and every 2 weeks, urine and plasma were collected and their 1H-NMR spectra were acquired, and then subjected to data process and PCA. Blood biochemical analysis and histopathological examination were carried out.

RESULTOn the 2nd weekend, the BUN of the two treated groups, the AST of A. fangchi group were all markedly higher than that of the control group (P < 0.05). Compared with the A. fangchi group, the SCr higher in the S. tetrandra group (P < 0.05). The kidney pathological changes were apparently in the two treated groups and the pathological changes in the liver apparently in the S. tetrandra group. Along with the lasting of administration to the 4th week, the BUN, ALT and AST of the two treated groups, the SCr of A. fangchi group were all significantly higher than that of the control group (P < 0.01). The renal and liver injuries in the two treated groups were all become more seriously. Comparing the A. fangchi group, the BUN, SCr and AST were all higher in the S. tetrandra group (P < 0.05). Compared with control group, the urinary concentrations of citrate, 2-oxo-glutarate, taurine, hippurate, TMAO, creatine and the plasma concentrations of 3-D-hydroxybutyrate, acetone, NAC, OAC, creatinine were all changed.

CONCLUSIONThe A. fangchi and S. tetrandra all can induce the renal and liver lesion and its seriousness is correspondent to the lasting of administration. The liver and kidney toxicity of S. tetrandra are all more serious than the A. fangchi.

Animals ; Aristolochia ; chemistry ; Blood Chemical Analysis ; Drug-Related Side Effects and Adverse Reactions ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; metabolism ; Kidney ; chemistry ; drug effects ; metabolism ; pathology ; Liver ; chemistry ; drug effects ; metabolism ; pathology ; Male ; Metabolomics ; Random Allocation ; Rats ; Rats, Wistar ; Stephania tetrandra ; chemistry ; Urine ; chemistry

BACKGROUND: The blocking of the programmed cell death protein (PD-1)/programmed death-ligand 1 (PD-L1) axis has been found to have an anticancer activity against various types of cancer by enhancing T cell immunity, while there are no studies linking the PD-1/PD-L1 axis to chemotherapy drugs in osteosarcoma (OS). The present study aimed to investigate the effects of blocking PD-1/PD-L1 axis on the cisplatin chemotherapy in OS in vitro and in vivo. METHODS: Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was applied to detect PD-L1 mRNA in OS tissues. Cell proliferation and apoptosis were measured by Cell Counting Kit-8 (CCK-8) and flow cytometry assays, respectively. In vivo, the syngeneic mice were treated with cisplatin and anti-PD-1 antibody alone or jointly. RESULTS: In this study, it revealed that PD-L1 mRNA was highly expressed in OS tissues. Further inhibitory evaluation showed that the K7M2-LV cells (PD-L1 overexpression) co-cultured with PD-1 lymphocytes could promote K7M2 cell proliferation. Meanwhile, the combination of anti-PD-1 antibody and cisplatin significantly decreased the proliferation and increased the apoptosis of K7M2 cells in a co-culture system. In vivo, the combination of anti-PD-1 antibody and cisplatin significantly inhibited tumor growth, while the mechanisms did not involve regulatory T cells. CONCLUSION The present data suggested that the blocking of PD-1/PD-L1 axis had a positive prognostic value, which can enhance the chemotherapeutic effect of cisplatin in OS. These findings provide a rationale for utilizing PD1/PD-L1 blocking antibodies as a single agent to cure refractory OS in patients receiving cisplatin treatment.

Humans ; Tranexamic Acid/therapeutic use* ; Arthroplasty, Replacement, Knee ; Antifibrinolytic Agents/therapeutic use* ; Blood Loss, Surgical ; Postoperative Hemorrhage