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

Leukemia inhibitory factor (LIF) plays important roles in varieties of biological processes. This factor is highly conserved in mammalian animals and only one heterozygous LIF mutation was reported to cause the infertility of women. A LIF mutation was generated and the evidences were provided that the mutation of mature LIF at the 29th amino acid totally abolished its functions, including stimulation of STAT activation assayed by Luciferase reporter gene expression and EMSA experiments. In addition, the mutated LIF failed to inhibit the proliferation of M1 cells. The data indicated that the mutation of LIF did not have a dominant negative effect but lost the biological functions, suggesting that the 29th amino acid is critical for maintaining the activities of LIF.

A rapid screening model for biosurfactant-producing strains is described in this paper, according as biosurfac-tant can make the blood-plate hemolysis and produce the blue cycles in blue-glue-plate. 12 microorganisms have been got from soil and water samples sampled from oil field and refinery using this model, and one of them can produce the glyco-lipid biosurfactant, which can depress the interfacial tension of water from 71. 3mN/m to 30. 5mN/m, and yield is 6.5 g/L.

The purpose of study was to evaluate the effect of stopping use of cyclosporine A (CsA) in reversion of donor chimeras of chronic myeloid leukemia (CML) patients relapsed after transplantation. Two CML patients were transplanted with allogeneic peripheral blood stem cells, and relapsed after transplantation, their bcr/abl gene and/or ph1 chromosome showed positive, donor chimeras decreased. For these two CML patients relapsed after transplantation, the use of CsA was stopped immediately, and the patient's body temperature, skin rash, blood picture, liver function and chimeras were planed to observe carefully. The results indicated that acute graft versus host disease (aGVHD) appeared in both patients. A hundred percent (100%) of donor chimeras were then found with bcr/abl gene and/or ph1 chromosome turning to negative in both patients. In conclusion, to stop using of CsA might be effective in the treatment of some CML patients relapsed after transplantation by reversing of donor chimeras and inducing graft-versus-leukemia (GVL) effect accompanied by GVHD.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclosporine ; therapeutic use ; Graft vs Leukemia Effect ; immunology ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; genetics ; therapy ; Male ; Neoplasm Recurrence, Local ; genetics ; Peripheral Blood Stem Cell Transplantation ; adverse effects ; Transplantation Chimera ; immunology

OBJECTIVETo investigate the relationship between microalbuminuria and arterial compliance in hypertensive and diabetes patients.

METHODSA total of 200 patients with essential hypertension and/or diabetes were studied. Albumin/creatinine ratio (ACR) was determined. Carotid to femoral Pulse Wave Velocity (PWV), C(1) and C(2) were measured by a Complier Colson device and DO-2020, respectively.

RESULT(1) C(1) and C(2) were lower and PWV higher in high ACR group than in normal ACR group (P < 0.01). (2) In patients younger than 60 years, C(1) was lower and PWV higher in high ACR group than that in normal ACR group (P < 0.01). In patients older than 60 years, C(1), C(2) were lower in high ACR group than in normal ACR group.

CONCLUSIONThe results indicated that compliance of large and small vessels in hypertensive and diabetic patients decreased with increasing ACR.

Adult ; Aged ; Albumins ; analysis ; Albuminuria ; Arteries ; physiopathology ; Creatinine ; urine ; Diabetes Mellitus ; physiopathology ; urine ; Elasticity ; Female ; Humans ; Hypertension ; physiopathology ; urine ; Male ; Middle Aged

BACKGROUNDThe extended spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) are the major pathogens causing pneumonia and have a significant impact on the clinical course. Limited data exist on molecular characterization of ESBL-producing E. coli and K. pneumoniae that cause pneumonia. The aim of this study was to investigate the comprehensive multilevel characteristics of E. coli and K. pneumoniae causing pneumonia in China for the first time.

METHODSE. coli (17) and K. pneumoniae (21) isolates responsible for pneumonia were isolated from 1270 specimens collected in a prospective multi-center study in eight teaching hospitals in China from June to December in 2007. The susceptibilities, ESBL confirmation, sequence typing, blaCTX-M and blaSHV genes, their genetic environment and plasmid Inc/rep types were determined.

RESULTSSixteen E. coli (94.1%) and eleven K. pneumoniae (52.4%) isolates were ESBL producers. About 77.8% and 66.7% of them were resistance to ciprofloxacin and levofloxacin, and 100% were susceptible to imipenem. The most prevalent ESBL gene was CTX-M-14, followed by SHV-2, CTX-M-15, CTX-M-3, CTX-M-65, SHV-12, SHV-26 and SHV-28. SHV-1 and SHV-11 were also detected and coexisted with blaCTX-Ms in five strains, and three strains contained only SHV-1. All CTX-M-14 were detected ISEcp1 upstream and nine were found IS903 downstream and the majority of them (64.3%) were carried by IncF plasmids. All blaSHV were flanked by recF and deoR, located on IncF, IncN, IncX and IncH plasmids. Two SHV-2, one SHV-1 and the only SHV-28 were further preceded by IS26. Genes lacY and lacZ were detected at further upstream of two blaSHV-1. The K. pneumoniae carrying SHV-28 was susceptible to β-lactams, and no mutations or deletions in gene or promoter sequences were identified to account for susceptibility. Multilocus sequence typing experiments showed the ESBL-producing strains were genetically diverse.

CONCLUSIONSThe rate of occurrence of blaESBL in E. coli and K. pneumoniae causing pneumonia was high, and blaCTX-M-14 was dominant and probably mobilized by ISEcp1 mainly on IncF plasmids. Importantly, unexpressed blaESBL genes may occur in susceptible isolates and hence may have clinical implications.

Blotting, Southern ; Escherichia coli ; enzymology ; genetics ; Klebsiella pneumoniae ; enzymology ; genetics ; Plasmids ; genetics ; Pneumonia ; microbiology ; Promoter Regions, Genetic ; genetics ; Prospective Studies ; beta-Lactams ; metabolism

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

With the promoting of medicine and health system reform,it provided new requirement for the price management of medical consumbles.Based on the current statns of medical consumbles price management in China,it studied the mechanism of pricing and reimbursement of Japan and Australia.To implement the price management mode of Chinese medical consumables through optimizing China medical service item package charging,playing the function of evidence-based evaluation and economic evaluation and establishing the supervision system of medical consumable prices.

OBJECTIVETo explore the epidemiological characteristics of inhalation injury and to summarize the clinical application experience of diagnostic standard of burn of larynx.

METHODSMedical records of 443 patients with inhalation injury admitted to our burn unit from January 1999 to June 2013 were analyzed, including gender, age, severity of inhalation injury, complications and diseases before injury; total area and that of full-thickness burn injury, admission time after burn, and burn condition of larynx of patients with different degrees of inhalation injury; treatment and outcome including rate, time, and complication of tracheotomy, mortality, and cause of death. Data were processed with nonparametric Kruskal-Wallis test and chi-square test. The relationship between severity of inhalation injury and total burn area, degree of burn of larynx, tracheotomy rate, and mortality was assessed by Spearman correlation analysis.

RESULTS(1) Among the patients, there were 353 (79.7% ) male and 90 (20.3% ) female, with the ratio of male to female 4:1. There were 64 (14.4%) patients younger than or equal to 20 years, 203 (45.8%) patients older than 20 years and younger than or equal to 40 years, 144 (32.5%) patients older than 40 years and younger than or equal to 60 years, and 32 (7.2%) patients older than 60 years. The numbers of patients with mild, moderate, and severe inhalation injury were respectively 297, 108, and 38. Seven patients suffered from complications, and 21 patients had diseases before injury. There were statistically significant differences among the patients with different degree of inhalation injury in regard to total burn area and full-thickness burn area (with H values respectively 73.752 and 142.830, P values below 0.01), while no statistically significant difference was observed in admission time after burn ( H = 1.528, P > 0.05). Correlation analysis showed that severity of inhalation injury was positively correlated with total burn area (r = 0.399, P < 0.001). Among the patients with mild inhalation injury, incidences of patients with mild, moderate, and severe burn of larynx were respectively 68.0% (202/297), 32.0% (95/297), and 0, and those among the patients with moderate inhalation injury were respectively 0,53.7% (58/108), and 46.3% (50/108). There were statistically significant differences in degree of burn of larynx of patients with different degree of inhalation injury (χ2 = 336.703, P < 0.001). Correlation analysis showed that severity of burn of larynx was positively correlated with severity of inhalation injury (r = 0.700, P < 0.001). (2) The rate of tracheotomy was 37.02% (164/443). The rates of tracheotomy in patients with mild, moderate, and severe inhalation injury were respectively 10.44% (31/297), 87.96% (95/108), and 100.00% (38/38), χ2 = 271.654, P < 0.001. Correlation analysis showed that the rate of tracheotomy was positively correlated with severity of inhalation injury (r = 0.784, P < 0.001). Tracheotomy was done mainly within 6 h post burn (63.4%, 104/164). The incidence rate of complication of tracheotomy was 5.5% (9/164). (3) Thirty-one patients died, with a mortality rate of 7.00%. The mortality rates of patients with mild, moderate, and severe inhalation injury were respectively 1.01% (3/297), 12.96% (14/108), and 36.84% (14/38), H = 74.273, P < 0.001. It was found that the mortality was positively correlated with severity of inhalation injury (r = 0.371, P < 0.001). The causes of death of the patients were respectively sepsis (14, 45.2%), respiratory failure (7, 22.6%), airway obstruction (2, 6.5%), airway hemorrhage (2, 6.5%), cerebral hemorrhage (2, 6.5%), cardiac accident (2, 6.5%), and diabetes insipidus (1, 3.2%), and 1 (3.2%) patient quit treatment and discharged from hospital for economic reason.

CONCLUSIONSAmong the patients with inhalation injury, male is dominated in number, and the young adults formed the highest constituent ratio. The severity of inhalation injury was correlated with total burn area, severity of burn of larynx, tracheotomy rate, and mortality. With the guidance of diagnostic criteria of burn of larynx and indication of tracheotomy, the risk of laryngeal obstruction can be eliminated. The early preventive tracheotomy can decrease the difficulty and risk of the operation.

Adolescent ; Adult ; Age Distribution ; Aged ; Airway Obstruction ; etiology ; surgery ; Burn Units ; Burns ; Burns, Inhalation ; complications ; mortality ; surgery ; China ; epidemiology ; Female ; Humans ; Incidence ; Injury Severity Score ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Sepsis ; epidemiology ; Severity of Illness Index ; Sex Distribution ; Tracheotomy ; methods ; Young Adult

OBJECTIVETo investigate the role of surgery in the treatment of giant mass lung cancer and to analyze prognostic factors affecting surgical result.

METHODSFrom August 1992 to August 2005, the clinical data of 137 patients with giant mass lung cancer ( > or =8 cm in diameter) were retrospectively reviewed. 122 cases had radical resection with 63 lobectomies, 48 pneumonectomy and 11 other resection modes, the remaining 15 patients underwent palliative resection. The prognostic factors including sex, tumor size, p-TNM stage, T stage, N stage, histological types and operation extent were analyzed with SPSS 13.0 software. The survival rate was calculated by Kaplan-Meier method and logrank was used for comparing survival difference. Univariate and multivariate prognostic factors for survival were analyzed by Cox proportional hazard regression model.

RESULTSThe overall 1-, 3- and 5-year survival rate was 76.0%, 49.2% and 40.1%, respectively. Sex (P = 0.001), p-TNM stage (P = 0.001), N stage (P = 0.042), surgical approach (P = 0.026) and T stage (P = 0.006) were found to be prognostic factors in Cox univariate analysis. p-TNM stage (P = 0.001) were identified as an independent prognostic factor in Cox multivariate analysis.

CONCLUSIONp-TNM stage is the crucial prognostic factor in surgical treatment for giant mass lung cancer. Strict selection of candidate for resection and complete resection may be helpful in improving survival in patient with giant mass lung cancer.

Adenocarcinoma ; pathology ; surgery ; Carcinoma, Squamous Cell ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; pathology ; surgery ; Male ; Neoplasm Staging ; Pneumonectomy ; methods ; Proportional Hazards Models ; Retrospective Studies ; Sex Factors ; Survival Rate ; Tumor Burden