OBJECTIVETo introduce different surgical treatment for gyncomastia at different grades.

METHODS37 cases with gynecomastia were divided into three grades as: grade I with fat as main tissue, grade II with proliferated fibro-gland as main tissue, grade III with big and ptosis breasts and sagging skin. Different surgical methods were chosen according to the different grades of gyncomastia. These include liposuction, subareolar fibroglandular tissue removing, combined technique of the two methods, and breasts resection with free transplantation of nipple-areola complex.

RESULTSAll patients were satisfied for the appearance of post-operative flat male chest. Complications, such as scar, numbness of nipple and areola were acceptable for them.

CONCLUSIONSDifferent surgical methods should be chosen for the gynecomastia at different grades. It can improve both the physical and psychological problems for patients.

Adolescent ; Gynecomastia ; classification ; surgery ; Humans ; Lipectomy ; Male ; Mammaplasty ; methods ; Nipples ; transplantation ; Retrospective Studies

To explore therapeutic efficacy of androgens and low dose all-trans retinoic acid (ATRA) for myelodysplastic syndrome (MDS) patients, 55 patients of MDS were observed, including 41 cases of refractory anemia (RA), 11 cases of refractory anemia with excess of blasts (RAEB), 2 cases of refractory anemia with excess of blasts in transformation (RAEB-t) and 1 case of chronic myeloic-monocytic leukemia (CMML). These patients received danazol (600 mg/day) or stanazol (6 mg/day) and ATRA (10 mg/day) for at least 3 months. The results showed that according to MDS international working group response criteria, at the end of three months,complete remission (CR) was seen in 1 patient, partial remission (PR) was found in 2 patients. Hematologic improvement: major response (MaR) were seen in 15 patients, minor response (MiR) were seen in 4 patients. The total response rate was 35.8%. In conclusion, danazol or stanazol in combination with low dose ATRA are partialy effective in therapy for patients with low-risk myelodysplastic syndrome.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Androgens ; adverse effects ; therapeutic use ; Anemia, Refractory ; drug therapy ; Anemia, Refractory, with Excess of Blasts ; drug therapy ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Chemical and Drug Induced Liver Injury ; Drug Therapy, Combination ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; drug therapy ; Treatment Outcome ; Tretinoin ; administration & dosage ; adverse effects ; therapeutic use

OBJECTIVEThe goals of this work was to analyse the cost of Shenqi Fuzheng injection-an extraction of a Chinese traditional herbs on reducing adverse effects in lung cancer patients during chemotherapy.

METHODSIn a randomized cross-over trial, each patient completed two identical cisplatin-based chemotherapy cycles, one with Shenqi Fuzheng injection, another without Shenqi Fuzheng injection. Adverse effects and change scores of quality of life (QOL) during chemotherapy were compared in tow cycles. The direct cost dealing with adverse effect and cost-effectiveness analysis were taken.

RESULTSOne hundred and thirty were enrolled with 123 of whom were evaluable. The patient characteristics were well balanced between the two groups. The chemotherapy cycles with Shenqi Fuzheng injection spent 220.5 more Chinese yuan, but the adverse effect of leukopenia, thrombocytopenia and vomiting were slight different and the change of score of several QOL domains showed significant better as compared to those in another cycle.

CONCLUSIONShenqi Fuzheng injection could reduce the severity of toxicity related to chemotherapy and improve the QOL of patients and had some benefits in terms of cost-effectiveness.

Aged ; Antineoplastic Agents ; adverse effects ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Cross-Over Studies ; Drugs, Chinese Herbal ; economics ; therapeutic use ; Female ; Humans ; Injections ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged

To explore the role of regulatory peptides in the secretion of bronchial epithelial cells (BECs), we observed the effects of four peptides, i.e.vasoactive intestinal peptide (VIP), epidermal growth factor (EGF), endothelin-1 (ET-1), and calcitonin gene-related peptide (CGRP), on the secretion of ILs from unstimulated or O3-stressed BECs. The results of the experiments showed that VIP exerted an inhibitory effect on the secretion of IL-1 and IL-8 from unstimulated and O3-stressed BECs, VIP also decreased the secretion of IL-5 from O3-stressed BECs; EGF promoted secretion of IL-1 and IL-8 from unstimulated BECs, but decreased the secretion of ILs from O3-stressed BECs; ET-1 and CGRP enhanced the secretion of IL-1, IL-5, and IL-8 from unstimlated BECs, CGRP also increased the secretion of ILs from O3-stressed BECs. The results obtained demonstrate that intrapulmonary regulatory peptides modulate the secretion of ILs from BECs, and may play an important part in transduction of inflammatory signals.
Animals ; Bronchi ; cytology ; Calcitonin Gene-Related Peptide ; pharmacology ; Cells, Cultured ; Endothelin-1 ; pharmacology ; Epidermal Growth Factor ; pharmacology ; Epithelial Cells ; drug effects ; secretion ; Female ; Interleukins ; secretion ; Male ; Rabbits ; Vasoactive Intestinal Peptide ; pharmacology

OBJECTIVETo investigate the relationship between the distribution of mononucleotide polymorphism of five regulation regions of alpha-IFN among HLA-DRB1*11 gene episodes and the therapeutic effects of alpha-IFN treatment in chronic hepatitis B patients.

METHODSOne hundred seven chronic hepatitis patients from Nanjing Second Hospital who were treated by alpha-IFN for 12 months and then followed at least six months without the treatment were randomly selected for this regressive analysis. They were grouped into a continuous responsive group and a non-continuous responsive group. Hepatitis B virus X interacting protein gene locus was searched in NCBI. Single nucleotide polymorphism (SNP) gene locus was detected based on a pooling sequencing method. Primer and TaqMan-MGB probes referring to different mononucleotide loci were designed respectively to detect SNP in five regulation regions of alpha-IFN. Then gene sequencing differences between the two groups were analyzed.

RESULTSAmong the 107 cases there were 30 cases (28.0%) in the continuous responsive group and 77 cases (71.9%) in the non-continuous responsive group. CT occupation rate in five regulation regions of IFN reached 18.0% in the continuous responsive group and 23.8% in the non-continuous responsive group. AG occupation rate reached 10.8% in the former group and 15.8% in the latter group. The differences in CT and AG between the two groups were significant.

CONCLUSIONSThe distribution of mononucleotide polymorphism of five regulation regions of alpha-IFN among HLA-DRB1*11 gene episodes affects the IFN anti-virus treatment. Detecting the gene distribution of mononucleotide in five regulation regions of alpha-IFN helps in predicting the therapeutic effects of alpha-IFN.

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; DNA, Viral ; Genotype ; HLA-DR Antigens ; genetics ; HLA-DRB1 Chains ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; drug therapy ; genetics ; Humans ; Interferon-alpha ; therapeutic use ; Polymorphism, Single Nucleotide ; Regression Analysis ; Treatment Outcome ; Young Adult

Objective To evaluate the effects of beraprost sodium com-bined with losartan potassium on kidney function and microalbuminuria index of patients with early diabetic nephropathy .Methods A total of 68 cases of patients with early diabetic nephropathy were divided into the trial group ( n=34 ) and control group ( n=34 ) .The patients of control group were treated with conventional symptomatic treatment and beraprost sodium 40 μg, tid.On the basis of control group , the patients of trial group were treated with losartan potassium 50 mg, qd.The treatment for patients of two groups all lasted for 12 weeks.The changes in renal func-tion ( serum creatinine , blood urea nitrogen , homocysteine , cystatin C levels ) , and microalbuminuria index (β2 microglobulin , urine mi-croalbumin , urinary microalbumin /urine creatinine , 24 h urinary albu-min excretion rate ) and blood pressure , blood glucose and glycosylated hemoglobin of the two groups before and after the treatment were ob-served.Results In the terms of urea nitrogen , homocysteine , cystatin C,β2 microglobulin, urine microalbumin, urinary microalbumin /urine creatinine , 24 h urinary albumin excretion rate , the patients of twogroups all significantly decreased than before treatment (P <0.05), and in the terms of homocysteine , cystatin C, mi-croalbuminuria index , the patients of the trial group got more significant decline ( P <0.05 ) , but in the terms of serum creatinine, urea nitrogen, there was no significant difference between the two groups (P>0.05).The blood pressure of two groups significantly decreased after treatment , but blood glucose and glycosylated hemoglobin of two groups all got no significant difference than those of before treatment ( P>0.05 ) .There was no serious adverse drug reactions in the two groups, including coughing , elevated serum potassium and so on .Conclusion The beraprost sodium com-bined with losartan potassium can protect the kidney endothelial cells and improve kidney function of patients with early diabetic nephropathy , effectively reduce urinary protein and slow the progression of disease with high safety .

Objective To observe the efficacy and safety of the rat nerve growth factor combined with αlipoic acid in the treatment of diabetic periph-eral neuropathy (DPN).Methods Eighty -eight patients with DPN were randomly divided into two groups and they were given diabetes diet and insu -lin or oral hypoglycemic agents to control blood sugar.The control group (n =43) was given αlipoic acid 0.6 g,qd; the trial group (n =45) were given rat nerve growth factor injection 20 μg based on the control group,im, qd.Twenty -one days as a treatment cycle.Before and after treatment, the total symptom score(TSS) ,the nerve conduction velocity(NCV),microalbu-minuria and high sensitivity C -reactive protein were tested and recorded respectively before and after treatment in 2 groups.Results The NCV of the trial group was higher than those of the control group (P <0.01); after treatment,TSS was significantly lower in the trial group than in the control group (P <0.01); the microalbuminuria and high sensitivity C -reactive protein of the trial group descended more apparently than those of the control group (P <0.05).The total effective rate of the trial group was higher than that of the control group (P <0.05).Conclusion Rat nerve growth factor combined with αlipoic acid treatment is safe and effective for the treatment of diabetic peripheral neuropathy.

Objective The proto-oncogene c-Met was found to express on human laryngeal carcinoma Hep-2 cell line in previous research. In the present study, the author further examined whether inhibition of c-Met by RNA interference(RNAi) might inhibit biologic activity of Hep-2 cell line in vitro and proliferation using a murine laryngeal carcinoma model. Methods RNAi plasmid that can express small interfering RNA targeting c-Met or siRNA that did not match any known human coding mRNA( control siRNA plasmid) was designed,constructed,and transfected into Hep-2 cell line by using cationic liposome Lipofectamine2000 as transfecting agent. In vitro, the transfection efficacy was tested by RT-PCR and Western Blot method, then elected the most inhibitive c-Met-siRNA sequence. Cell proliferation, movement and invasion were studied using MTT, cell migration assay and cell invasion assay, respectively. The Hep-2 cells were transplanted into nude mice, then the time of tumor formation and growth were observed. After tumor formation, c-Met-siRNA was given as the anti-tumor therapy. Expression of c-Met, MMP-9 and VEGF were detected by Western Blot method. Results After the pSilencer2. 0/c-Met-shRNA recombinant plasmid transfeetion into laryngeal carcinoma Hep-2 cells, the expression of mRNA and proteinum of c-Met decreased significantly in Hep-2 cells. On the 35th day after tumor vaccination, the tumor volume was (138±27)mm~3 in c-Met-siRNA transfection group, Which was diminished significantly in contrast with control group( P<0. 01 ). The expression of c-Met, MMP-9 and VEGF in the tumor of experiment group was decreased significantly, respectively (P<0.05 ). Conclusions The results indicated that c-Met-siRNA can down-regulate the expression of c-Met and markedly inhibit laryngeal carcinoma Hep-2 cell proliferation, movement and invasion and the growth of transplantation tumor of nude mice. The siRNA expressing plasmid mediated gene therapy might be a new strategy in targeting molecular therapy of cancer of larynx.

OBJECTIVETo evaluate the early and midterm outcomes of carotid endarterectomy (CEA) compared with carotid stenting (CAS) in patients with carotid artery stenosis.

METHODSA prospective randomized single-center clinical trail to compare with endarterectomy and stenting in patients with symptomatic carotid stenosis of at least 50% and asymptomatic stenosis of at least 70%. From May 2004 to December 2006, there were 40 patients who agreed with the treatment were randomly assigned to undergo either CEA or CAS. The primary end point was any stroke or death within 30 d after treatment and the secondary end point was any stroke, myocardial infarction and any complications of the treatment, or death or ipsilateral stroke and carotid restenosis between 1 month and 18 months, and the cost-effectiveness of both groups were analyzed retrospectively as well.

RESULTSThere were no significant differences of the characteristics in the two groups. Twenty cases in CEA group underwent 23 endarterectomies (3 cases had bilateral CEA, respectively), in which 9 carotid shunt (39.1%) and 12 patching (52.2%) were used. Twenty cases in CAS group underwent 23 stents (3 cases had bilateral CSA, respectively), in which 21 emboli-protection devices (91.3%) were used. There was no significant difference in 30 d neurological complications (4.3% vs. 8.7%), acute myocardial infarction (4.3% vs. 0), and wound hematoma (8.7% vs. 0) between CEA and CAS, respectively. There was no ipsilateral transient ischemic attack or carotid restenosis at 18 months in each group. The average cost of hospitalization was (16 450.95 +/- 6188.76) vs. (70 130.15 +/- 11 999.02) RMB in CEA and CAS, respectively, with significant difference (P < 0.01).

CONCLUSIONThe early and midterm outcomes are no significant difference between CEA and CAS, but in China, the cost of hospitalization in CAS is much higher than that of CEA.

Aged ; Carotid Stenosis ; therapy ; Endarterectomy, Carotid ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stents ; Treatment Outcome

OBJECTIVETo investigate the effects of inspiratory muscle training followed by non-invasive positive pressure ventilation in patients with severe chronic obstructive pulmonary disease (COPD).

METHODSThis investigator-initiated randomized, controlled trial recruited 88 patients with stable GOLD stage IV COPD, who were randomized into 4 equal groups to continue oxygen therapy (control group) or to receive inspiratory muscle training followed by non-invasive positive pressure ventilation (IMT-NPPV group), inspiratory muscle training only (IMT group), or noninvasive positive pressure ventilation only (NPPV group) for at least 8 weeks. The outcomes of the patients were assessed including the quality of life (SRI scores), maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), dyspnea (MRC scores), 6-min walking distance (6MWD) and lung function.

RESULTSs Compared to baseline values, SRI scores, 6MWT and MRC scores increased significantly after 8 weeks in IMT-NPPV, IMT and NPPV groups, and the improvements were significantly greater in IMT-NPPV group than in IMT and NPPV groups (P<0.05 for all). In IMT-NPPV and IMT groups, MIP and MEP increased significantly after the training (P<0.05), and the improvement was more prominent in IMT-NPPV group (P<0.05). No significant changes were found in pulmonary functions in the groups after 8 weeks of treatment (P>0.05).

CONCLUSIONInspiratory muscle training followed by non-invasive positive pressure ventilation, compared with inspiratory muscle training or non-invasive positive pressure ventilation alone, can better enhance the quality of life, strengthen the respiratory muscles, improve exercise tolerance and relieve the dyspnea in patients with COPD.

Dyspnea ; therapy ; Exercise Tolerance ; Humans ; Lung ; physiopathology ; Noninvasive Ventilation ; Physical Conditioning, Human ; Positive-Pressure Respiration ; Pulmonary Disease, Chronic Obstructive ; therapy ; Quality of Life ; Respiratory Muscles ; physiopathology