An Aersol-OT (AOT) included microemulsion containing fluorouracil was prepared by using appropriate proportion of oil, co-surfactant and water for increasing the drug transdermal delivery ability. According to the area of microemulsion basing on the pseudo-tertiary phase diagrams, the optimum formulation was screened initially. And the permeation flux of fluorouracil across excised mice skin was determined in vitro using Franz diffusion cell to optimize the formulation further. The effect of the kind of co-surfactant, the content of water, the content of mixed surfactant, the mass ratio of surfactant/cosurfactant (Km) and the drug load on skin permeation of fluorouracil were evaluated. The optimum formulation was composed of 0.5% (w/v) fluorouracil, 30% water, 20% mix-surfactant (AOT/Tween 85, Km = 2) and 49.5% oil (IPM). The cumulative amount permeated of fluorouracil in 12 hour was 1 355.5 microg x cm(-2), 19.1 folds and 7 folds more than 0.5% fluorouracil aqueous solution and 2.5% (w/w) fluorouracil cream, respectively. The permeation of this microemulsion accorded with first-order model. The water/AOT/Tween 85/IPM microemulsion system promoted the permeation of fluorouracil greatly, which may be a promising vehicle for the transdermal delivery of fluorouracil and other hydrophilic drug.
Administration, Cutaneous ; Animals ; Antimetabolites, Antineoplastic ; administration & dosage ; pharmacokinetics ; Drug Carriers ; Drug Delivery Systems ; methods ; Emulsions ; Fluorouracil ; administration & dosage ; pharmacokinetics ; Male ; Mice ; Myristates ; chemistry ; Oils ; chemistry ; Polysorbates ; chemistry ; Skin Absorption ; Succinates ; chemistry ; Surface-Active Agents ; chemistry ; Water ; chemistry

OBJECTIVETo compare the clinical efficacy of SS syrup, a Chinese medicine, and pilocarpine in treating patients with xerostomia.

METHODSThirty-eight patients conformed to the inclusive criteria were randomly divided into two groups, they were treated by SS syrup (SS group) and pilocarpine (control group) respectively. Three indexes, i.e. questionnaire of dryness in mouth, total static salivary flow and dynamic salivary flow, before treatment, 1, 2 and 4 weeks after treatment were recorded and statistically analyzed.

RESULTSSignificant difference was shown in the 3 indexes in the SS group between before treatment and 1, 2 and 4 weeks after treatment (P < 0.05), while in the control group significant difference was shown between before treatment and 1, 2, and 4 weeks after treatment except for total dynamic salivary flow after I weck treatment (P < 0.05).

CONCLUSIONSS syrup, which has no adverse reaction, no contraindication, could be taken chronically, and shows good efficacy in improving the symptoms of xerostomia.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Xerostomia ; drug therapy

OBJECTIVETo compare the nutritional status between pancreaticojejunostomy(PJ) and pancreaticogastrostomy(PG) following pancreaticoduodenectomy.

METHODSA retrospective clinical analysis was performed on 37 patients undergoing pancreaticoduodenectomy(PD) for duodenal carcinoma and pancreatic non-epithelial tumor with PG(n=19) and PJ(n=18) in the First Hospital of Sun Yat-sen University from April 2006 to December 2010. All the patients had a needle catheter jejunostomy inserted at the conclusion of laparotomy. Postoperative early enteral nutrition and parenteral nutrition was performed for all the patients. Nutritional status of two groups was compared in body mass index (BMI), serum nutritional parameters such as albumin, transferrin and prealbumin before surgery and on 1, 3, and 6 months postoperatively.

RESULTSThere were no significant differences between PG and PJ groups in operative time, blood loss, pancreatic fistula, perioperative death, or postoperative length of hospital stay. One month after surgery, there were no significant differences in BMI [(17.1±7.0) vs. (19.0±4.8) kg/m(2), P>0.05], albumin [(30.1±0.5) vs. (32.1±1.3) g/L, P>0.05], transferrin [(1.89±0.57) vs. (2.01±0.61) g/L, P>0.05] and prealbumin[(0.18±0.05) vs. (0.18±0.09) g/L, P>0.05]. These parameters were decreased at 1 month after surgery, and gradually recovered to baseline or higher than the preoperative levels at 6 months after surgery. However, the differences were still not statistically significant between two groups.

CONCLUSIONSThe influence of PJ and PG on the postoperative nutritional status are comparable.

Adult ; Aged ; Female ; Gastrostomy ; Humans ; Male ; Middle Aged ; Nutritional Status ; Pancreas ; surgery ; Pancreaticoduodenectomy ; Pancreaticojejunostomy ; Postoperative Period ; Retrospective Studies

Objective:To observe the effects of electroacupuncture (EA) of three different frequencies (2 Hz,80 Hz and 2 Hz/80 Hz) on the free radicals in hippocampus of vascular dementia (VD) model mice.Methods:A total of 100 Kunming mice were randomly divided into a sham operation group,a model group,a 2 Hz EA group,an 80 Hz EA group and a 2 Hz/80 Hz EA group,with 20 mice in each group.The ischemia-reperfusion VD model was established by repeated blockade of bilateral common carotid arteries.Mice in EA groups began EA treatment on the 4th day after the operation.Baihui (GV 20),Dazhui (GV 14),Geshu (BL 17) and Zusanli (ST 36) were punctured and then connected to EA instrument,with different waves of 2 Hz,80 Hz or 2 Hz/80 Hz (10 min/time) applied accordingly,once a day.During the jumping stand experiment,the learning performance,memory performance and hippocampal calcitonin gene-related peptide (CGRP),nitric oxide synthase (NOS),malondialdehyde (MDA),changes in superoxide dismutase (SOD) and true choline esterase (TChE) were observed.In hippocampus,the CGRP level was determined by radioimmunoassay;the MDA level was determined by thiobarbituric acid colorimetric method;the activities of NOS and TChE were determined by spectrophotometry;the activity of SOD was determined by xanthine oxidase method.Results:Compared with the sham operation group,the performances of learning and memory decreased significantly in the model group (P＜0.01);in hippocampus,the CGRP level decreased,the MDA level increased,the activities of NOS and TChE increased,and the activity of SOD decreased in the model group.Compared with the model group,the learning and memory performances of the EA groups were significantly improved (P＜0.05 or P＜0.01);in hippocampus,the CGRP level increased,the MDA level decreased,the NOS and TChE activities decreased,and the SOD activity increased (P＜0.05 or P＜0.01).Among EA groups,the 2 Hz/80 Hz EA group was superior to the 2 Hz EA group and the 80 Hz EA group (P＜0.05 or P＜0.01).Conclusion:EA can improve the cognitive impairment of mice with ischemia-reperfusion VD.The mechanism may be related to the improvement of cerebral blood circulation,regulation of the central neurotransmitters,fighting lipid peroxidation and promoting nerve cell repair.The therapeutic effects of EA with different frequencies were different,and the intervention effect by EA at 2 Hz/80Hz is the most significant.

Purpose To investigate the expression characteristics and significance of P-selectin and HPA in benign and malignant hydatidform mole tissues. Methods By using immunohistochemical technique SP and RT-PCR, the expression of Pselectin and HPA was detected in 40 cases of benign hydatidiform mole tissues, and 12 malignant hydatidiform mole tissues.Meanwhile, 40 cases of normal placental villi tissues were observed. Results The protein positive rate and protein relative quantity expression and the mRNA relative quantity expression of P-selectin and HPA were gradually increasing in normal placenta villi tissues, benign hydatidiform mole tissues, and malignant hydatidiform mole tissues. The differences between groups were statistically significant (all P<0.05). The expression of P-selectin and HPA showed positive correlation (all P<0.05) in benign and malignant hydatidform mole tissues. Conclusion The over-expression of P-selectin and HPA promotes the occurrence and development of hydatidform mole. The detection of the expression levels of P-selectin and HPA is of great significance for the differential diagnosis and prognosis assessment of benign and malignant hydatidform mole. It could become a biological predictor of malignant development of hydatidform mole.

OBJECTIVETo investigate the related factors and prognosis of peritoneal dissemination and hepatic metastasis in gastric cancer, and the impact of palliative surgery on the prognosis.

METHODSThe clinicopathologic and follow-up data of the patients with gastric carcinoma treated in our hospital from Aug. 1994 to Jul. 2005 were analyzed retrospectively.

RESULTSThe clinicopathologic factors correlated with peritoneal dissemination included serosal penetration, whole stomach cancer, undifferentiated type, female and hepatic metastasis, while those correlated with hepatic metastasis included Borrmann IV, lymph node metastasis and peritoneal dissemination (P< 0.05). The postoperative one-year survival rate of the patients with hepatic metastasis (H group) were lower than that of the patients with peritoneal dissemination (P group)(P< 0.05). The one- year survival rate of the patients with peritoneal dissemination undergoing palliative resection was significantly higher than that of the patients undergoing by-pass operation or feeding neostomy, and exploratory laparotomy (P< 0.05), while there was no significant difference among the three groups of the patients with hepatic metastasis.

CONCLUSIONSThe short-term prognosis of the patients with hepatic metastasis is poorer than that of the patients with peritoneal dissemination. Palliative resection could improve the short-term survival rate of the patients with peritoneal dissemination, while it had no significant impact on the survival rate of the patients with hepatic metastasis.

Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; mortality ; secondary ; Male ; Middle Aged ; Neoplasm Metastasis ; Peritoneal Neoplasms ; mortality ; secondary ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; mortality ; pathology ; Survival Rate

OBJECTIVETo summarize the clinicopathological characteristics and analyze the prognostic factors of young patients with gastric cancer.

METHODSA total of 99 patients with the age less than or equal to 40 were admitted in The First Affiliated Hospital of Sun Yat-sen University from August 2001 to December 2009. Their clinicopathological and follow-up data were compared with middle-aged and elderly patients with the age more than 40.

RESULTSThere were statistically significant differences in gender, tumor location, Borrmann type, histological type, differentiated histology, depth of invasion, peritoneal metastasis between young patients and elder ones. The 5-year survival rates of young and elder patients were 49.1% and 44.4% respectively, and the difference was not statistically significant (P>0.05). Univariate and multivariate analyses showed that TNM stage (P=0.014) and surgical methods (P=0.012) were independent predictive factors of survival for young patients. For the young patients, the 5-year survival rate was 56.7% after curative resection, 11.1% after palliative resection. Those who underwent palliative surgery or biopsy alone died within 1 year after surgery. The difference between difference surgical procedures in survival were statistically significant (P<0.05).

CONCLUSIONSAs compared to elder patients, young patients with gastric cancer have special clinicopathological features. However, no significant difference of survival rate is found between the young and the elder patients. TNM stage and surgical methods are independent prognostic factors of young patients with gastric cancer. Radical resection appears to confer the only chance of prolonged survival.

Adult ; Age Factors ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Male ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; epidemiology ; pathology ; surgery ; Survival Rate

OBJECTIVETo evaluate the diagnostic value of 3.0 T diffusion-weighted imaging with background suppression (DWIBS) magnetic resonance (MR) for lymph node metastasis in rectal cancer.

METHODSThirty-five patients with rectal cancer who underwent preoperative routine MRI+DWI examination were enrolled in the study and were treated by rectal cancer resection plus lymph node dissection. Metastatic and non-metastatic lymph nodes were confirmed by postoperative pathology. Apparent diffusion coefficient (ADC) values, long-axis and short-axis diameters of lymph nodes were measured. Receiver operating characteristic (ROC) curve was used to assess the diagnostic efficacy of ADC, long-axis and short-axis diameters for differentiating metastatic lymph nodes from non-metastatic lymph nodes.

RESULTSA total of 151 lymph nodes were confirmed with exact location in 35 patients. Sixty-five metastatic lymph nodes and 86 non-metastatic lymph nodes were identified. The ADC values of metastatic lymph nodes and non-metastatic lymph nodes were(0.86±0.14)×10(-3) and (0.94±0.16)×10(-3) mm(2)/s respectively. The long-axis diameter were(9.78±3.13) and (7.90±1.77) mm, respectively. The short-axis diameter were (7.65±2.00) and (6.45±1.19) mm, respectively. There were statistically significant differences between metastatic and non-metastatic lymph nodes in ADC values, long-axis diameter, and short-axis diameter(all P<0.01). The areas under the ROC curve of ADC value, long-axis diameter, and short-axis diameter were 0.648, 0.706, and 0.692, respectively. Optimal cutoff values for these parameters were 1.05×10(-3) mm(2)/s, 7.95 mm, and 5.90 mm, respectively, and the corresponding sensitivities and specificities were 93.8% and 30.2%, 75.4% and 61.6%, 90.8% and 38.4%.

CONCLUSIONSQuantitative measurement of ADC value may reflect the degree of diffusion restriction of metastatic lymph nodes by DWIBS at 3.0 T MR. Accurate diagnosis of metastatic lymph nodes in rectal cancer demands comprehensive evaluation combining ADC value with diameter measurement.

Diffusion Magnetic Resonance Imaging ; methods ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Rectal Neoplasms ; diagnosis ; pathology

OBJECTIVETo investigate the effect of spleen preservation on the outcome of radical resection for cardia cancer.

METHODSData of 108 cardia cancer patients(Siewert types II and III ), undergone radical resection with D(2) or D(3) lymphadenectomy between July 1994 and December 2003 in our department, were analyzed retrospectively. Survival status was ascertained on December 2004. Of these 108 patients, 38 underwent splenectomy and 70 splenic preservation. Clinicopathological features and outcomes of the splenectomy and non-splenectomy groups were compared.

RESULTSSeventy-four patients (68.5%) had lymph node involvement; 18 patients (16.7%) had involvement of lymph nodes in the splenic hilus. Postoperative morbidity in two groups was similar. Overall 5-year survival rate in the non-splenectomy group was significantly higher than that of the splenectomy group (38.7% vs 16.9%, P=0.008). Multivariate regression analysis indicated that tumor invasion (P=0.009) and lymph node metastasis (P=0.001) were independent prognostic factors rather than splenectomy. Although splenectomy was associated with survival, it was not an independent prognostic factor (P= 0.085).

CONCLUSIONSSplenectomy does not improve survival of patients undergone curative resection for gastric cardia cancer. Thus, the spleen should be preserved in patients without direct cancer invasion of the spleen.

Adult ; Aged ; Aged, 80 and over ; Cardia ; pathology ; surgery ; Female ; Heart Neoplasms ; surgery ; Humans ; Lymph Node Excision ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Spleen ; surgery ; Splenectomy ; Stomach Neoplasms ; surgery ; Survival Rate ; Treatment Outcome

OBJECTIVETo evaluate the efficacy and influencing factors of imatinib in patients with advanced gastrointestinal stromal tumor(GIST).

METHODSFrom April 2004 to January 2010, clinicopathological data of 73 adult patients with advanced GIST treated with imatinib at the First Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The treatment outcomes and associated factors were investigated.

RESULTSTreatment outcomes included complete response in 1(1.4%) patients, partial response in 53(72.6%), stable disease in 14(19.2%), and primary resistant in 5(6.8%). All the patients had routine followed up, the length of which ranged from 12 to 76 (median 32) months. The median progression-free survival was 45.0 months(95% confidence interval, 34.2-55.8). The progression-free survival(PFS) rate was 87.7% in 1 year, 63.6% in 3 year, and 39.6% in 5 years. On multivariate analysis, both mutation status and patient performance were independent factors influencing the efficacy of imatinib treatment(both P<0.01). PFS was significantly better in patients with c-kit exon 11 mutations than those with exon 9 mutations, and better in lower ECOG scales than in higher ones.

CONCLUSIONImatinib is effective in treating patients with advanced GIST, c-kit exon 9 mutations and poor performance status predict an adverse survival benefit of imatinib therapy.

Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Benzamides ; therapeutic use ; Exons ; Female ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; drug therapy ; genetics ; Humans ; Imatinib Mesylate ; Male ; Middle Aged ; Mutation ; Piperazines ; therapeutic use ; Proto-Oncogene Proteins c-kit ; genetics ; Pyrimidines ; therapeutic use ; Retrospective Studies ; Treatment Outcome ; Young Adult