OBJECTIVETo perform a Meta-analysis on peginterferon with interferon in treatment of HIV patients coinfected with refractory genotype HCV.

METHODSA literature search of Medline was conducted to identify eligible randomized controlled trials. Meta analysis was conducted to evaluate peginterferon and interferon in treatment of coinfected HCV genotype 1 or 4 in HIV patients.

RESULTSix trials of 88 matched the selection criteria. Total 1,131 patients with coinfection of HCV genotype 1 or 4 and HIV were included. Sustain viral response was higher in patients treated with peginterferon plus ribavirin compared with that of interferon plus ribavirin (26 % compared with 8 %) or peginterferon alone (26 % compared with 13 %). Severe adverse effects and withdrawal rates were similar for patients treated with peginterferon and patients treated with interferon.

CONCLUSIONPeginterferon plus ribavirin in treatment of patients with coinfection of genotype 1 or 4 HCV and HIV can achieve higher sustain viral response and the likelihoods of serious adverse effects and withdrawal rates are similar to other therapies.

Adult ; Antiviral Agents ; administration & dosage ; Drug Therapy, Combination ; Female ; Genotype ; HIV Infections ; complications ; drug therapy ; immunology ; Hepacivirus ; classification ; genetics ; Hepatitis C, Chronic ; complications ; drug therapy ; virology ; Humans ; Interferon-alpha ; administration & dosage ; Male ; Polyethylene Glycols ; administration & dosage ; Randomized Controlled Trials as Topic ; Recombinant Proteins ; Ribavirin ; administration & dosage

In this article, the items from 1999 to 2003 of pharmaceutics of Chinese medicine accepted and supported by subject of traditional Chinese medicine, No.9 department of life science, national natural science foundation of China (NSFC) have been reported, in several aspects, such as extracting process, preparation, biopharmaceutics, pharmacokinetic, etc. The problems in these items have also been analyzed briefly.
Biopharmaceutics ; China ; Dosage Forms ; Drugs, Chinese Herbal ; Pharmacokinetics ; Research ; Research Support as Topic ; Technology, Pharmaceutical

OBJECTIVETo investigate the changes in the bacterial ecology and to analyze the bacterial resistance to antibiotics in a burn ward in Nanning district during the past 15 years, so as to provide reference to the clinical management of burn infection under subtropical climate.

METHODSFive thousand eight hundred and fifty-five strains of bacteria were isolated from the wounds and blood of 2269 burn patients admitted to our hospital from April of 1989 to March of 2004. Kiry-Bauer method was employed for the detection of antibiotic sensitivity test. The bacterial examination and bacterial resistance were analyzed in spans of every five years.

RESULTSBurn patients in our district were mainly infected by the gram negative bacilli (3559 strains, accounting for 60.79%), among which Pseudomonas aeruginosa, Enterobacter cloacae and Nitrate negative bacilli were major ones in every period. Gram positive cocci accounted for 33.99% (1990 strains), which ranked the second, among which Staphylococcus aureus, Staphylococcus epidermidis, and Coagulase negative staphylococci (MRCNS) were the most predominant ones. The bacterial resistance to multiple antibiotics, such as Gentamicin, third generation of Cephalosporin, and Norfloxacin showed a tendency of increase or maintained at high level while the incidence of resistance to Imipenem and Vancomycin was very low.

CONCLUSIONThe climate and the way of using antibiotics exerted direct effects on the status of the bacterial ecology and change in bacterial resistance to various antibiotics.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; pharmacology ; Burn Units ; Burns ; microbiology ; Child ; Child, Preschool ; Colony Count, Microbial ; Drug Resistance, Bacterial ; Gram-Negative Bacteria ; drug effects ; isolation & purification ; Gram-Positive Bacteria ; drug effects ; isolation & purification ; Humans ; Infant ; Microbial Sensitivity Tests ; Middle Aged ; Young Adult

OBJECTIVETo investigate the method and effect of axial pattern myocutaneous flap in reconstructing breast by using color doppler flow imaging (CDFI) technique.

METHODSSuitable axial myocutaneous flaps were selected according to the character of the focus in 26 cases of breast cancer after operation and radiotherapy. All the axial pattern myocutaneous flaps were designed on the basis of traditional design method before operation; then, CDFI with high resolution was used to examine the starting spot, exterior diameter, trail and length of the myocutaneous flaps' major artery. The myocutaneous flaps were redesigned according to the results of CDFI and transferred to reconstruct the breasts. The results of operation and examination were investigated.

RESULTSAccording to the CDFI, only one thoracodorsal artery's blood current was slow, its wall was rough and presented with arteriosclerosis. The blood flow was fluent and the vessel wall was smooth with other supplying arteries in the flaps. And no embolism, sclerosis or absence of blood vessel was found. The starting spots, exterior diameters, trails and anatomic layers of the major supplying arteries of the flaps were displayed clearly with CDFI, in accordance with the results of operation. Twenty-one cases of latissimus dorsi myocutaneous flap, 4 cases of the contralateral transverse abdominis myocutaneous flap and 1 cases of the bilateral transverse abdominis myocutaneous flap were used in this group. The flaps survived and healed well, the breasts were reconstructed well with perfect appearance, shape and sensation.

CONCLUSIONSCDFI is a simple, visualized and noninvasive method for designing the axial pattern myocutaneous flap in breast reconstruction, it can provide more scientific and accurate evidence for preoperative determination of myocutaneous flap transplantation.

Adult ; Breast Neoplasms ; radiotherapy ; surgery ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; methods ; Mastectomy ; Middle Aged ; Surgical Flaps ; Treatment Outcome ; Ultrasonography, Doppler, Color ; Ultrasonography, Mammary ; methods

Objective To introduce an optimized practical method of making and detecting pipettes for microinjection.Methods Transfer pipette was made from hard glass capillary. We softened the hard glass capillary by rotating it in a spirit-lamp flame,then moved out from the flame and quickly pulled it into two transfer pipettes.After broken by a grinding wheel,the tip of the pipette was fire-polished by quickly touching the flame to make a fine opening.A hard glass capillary (1.0 mm,ouside diametre)was pulled into two holding pipettes by pipette Puller.The pipette shoulder was broken at desired position with a grinding wheel,then the fine pipette tip opening was heated by a microforge and shrinked into a diameter -15 μm.Injection pipette could be made directly from a capillary with filament by Puller.The solution loaded injection pipette and holding pipette were assembled into the micromanipulator and could be checked before use.We transfered both pipettes into the zygotes media drop,touched the holding pipette with the tip of the injection pipette to make a "suitable"opening.Then we switched injection pipette to the mineral oil and applied injection pressure through the injector to check whether the solution could come out of the tip smoothly and at a proper speed.It could be further verified by pronucleus microinjection of zygotes.Results The results showed that the method introduced in this paper could produce suitable pipettes for zygote microinjection.In particular,the method of detecting the opening of the injection pipette was helpful for achieving high efficiency of zygote microinjection.Conclusion The method introduced here to make and detect pipettes for microinjection is very helpful for establishing a standard microinjection manipulation procedure and improving the efficiency of zygote microinjection.

OBJECTIVETo study the effect of hirudin on the function of human hyperplastic scar fibroblasts (HSFBs).

METHODSHSFBs were cultured in vitro. Hirudin solution in the concentration of 1, 10, and 50 kU/L was respectively added into DMEM culture medium to form 1, 10, and 50 kU/L hirudin groups, with 9 wells in each group. HSFBs cultured without hirudin were set up as control group. Cell inhibition rate, secretion level of TGF-beta1 from cells, and expression levels of mRNA of type I and III precollagen were determined at 24, 48, and 72 h after culture.

RESULTSInhibition rates of HSFBs growth was respectively (29.3 +/- 0.9)%, (30.1 +/- 0.3)%, and (45.2 +/- 1.9)% when cultured with 10 kU/L hirudin for 24, 48, and 72 hs, which were higher than those in control group [(0.0 +/- 0.0)%, P < 0.05]. There was statistically significant difference between control group and 1 and 50 kU/L hirudin groups in the inhibition rates of HSFBs at some time points (P < 0.05). Secretion level of TGF-beta1 of HSFBs in 1, 10, 50 kU/L hirudin groups was respectively (228.5 +/- 1.8), (210.5 +/- 11.1), and (168.5 +/- 14.1) pg/mL when cultured for 48 hs, of which the last 2 figures were significantly lower than that of control group [(265.0 +/- 1.5) pg/mL, P < 0.05]. Hirudin in the concentration of 10 and 50 kU/L could inhibit the expression of mRNA of type I and III precollagen in HSFBs.

CONCLUSIONSHirudin solution in the concentration of 10 and 50 kU/L can inhibit the proliferation of HSFBs and secretion of TGF-beta1 and collagen in certain degree.

Cells, Cultured ; Cicatrix, Hypertrophic ; pathology ; Fibroblasts ; cytology ; drug effects ; secretion ; Hirudins ; pharmacology ; Humans ; Transforming Growth Factor beta1 ; metabolism

OBJECTIVETo demonstrate the association of tumor budding with clinicopathological features and prognosis in T2 rectal cancer.

METHODSClinicopathological data of 123 patients who underwent potentially curative resection for T2 rectal carcinoma between 2001 and 2005 at the Changhai Hospital were collected. All pathology slides were stained with hematoxylin and eosin for microscopic examinations. The maximum value of tumor buds(MV) and average value of tumor buds(AV) were calculated, which were classified as low value (≤5), median value (5 < bud value < 10), and high value (≥10).

RESULTSUnivariate analysis and multivariate analysis revealed that MV(P=0.000), AV(P=0.001), and lymphatic invasion (P=0.006) were independent predictors for lymph node metastasis in T2 rectal cancer. Neural invasion and poorly differentiation were significantly associated with MV(P<0.05). Neural invasion, vascular invasion and poorly differentiation were were significantly associated to AV (P<0.01). Disease-free survival (DFS) of patients with low AV, median AV and high AV was 110.5 months, 95.8 months, and 60.0 months respectively. There were significance differences in DFS of low AV with median and high AV(P<0.05). DFS of patients with low MV, median MV and high MV was 115.1 months, 98.5 months, and 86.0 months respectively. There were significance differences in DFS between low and high AV, and median and high MV(P<0.01 and P<0.05), while no significant difference existed between low and median MV.

CONCLUSIONTumor budding is a useful marker to indicate high invasiveness of rectal cancer and a valuable prognostic predictor.

Female ; Humans ; Lymphatic Metastasis ; Male ; Prognosis ; Rectal Neoplasms ; pathology ; surgery

OBJECTIVETo evaluate the efficacy and safety of colonoscopy-guided placement of self-expandable metallic stent without fluoroscopic monitoring in the emergence management for acute malignant colorectal obstruction.

METHODSClinical data of 42 patients (24 males and 18 females with a mean age of 64.3 years) undergoing colonoscopy-guided placement of self-expandable metallic stents without fluoroscopic monitoring for acute malignant colorectal obstruction between January 2010 and June 2012 were reviewed retrospectively.

RESULTSThe obstruction was located in the rectum (n=19), sigmoid (n=9), descending colon (n=8), splenic flexure (n=1), hepatic flexure (n=3), and ascending colon (n=2). Technical success was achieved in all the 42 patients (100%). The mean time of operation was (11.8±10.4) min (range 1.1-51.0 min). No serious procedure-related complication occurred. Minor bleeding occurred in 3 cases (7.1%). One patient died on the second day after surgery because of heart failure.

CONCLUSIONSColonoscopy-guided placement of self-expandable metallic stents without fluoroscopic monitoring in emergence management for acute malignant colorectal obstruction is effective and safe with shorter operative time.

Adult ; Aged ; Aged, 80 and over ; Colonoscopy ; Colorectal Neoplasms ; complications ; Female ; Humans ; Intestinal Obstruction ; etiology ; therapy ; Male ; Middle Aged ; Retrospective Studies ; Stents

OBJECTIVETo investigate the emergency therapeutic strategy for sigmoid vovulus in the elderly.

METHODSClinical data of 14 elderly patients with sigmoid vovulus were analyzed retrospectively.

RESULTSThe mean age was(79.1±7.2) years(range, 70-93), and 11 patients (78.6%) were male. Emergency decompression and restoration with colonoscopy was performed in all the patients with a success rate of 100%. No patient required emergent surgery. Four patients(28.6%) recurred and they were managed well by repeat colonoscopic restoration.

CONCLUSIONEmergency colonoscopic restoration is the first treatment of choice for sigmoid vovulus in the elderly because it is safe and effective, and can be performed repeatedly.

Aged ; Aged, 80 and over ; Colon, Sigmoid ; surgery ; Colonoscopy ; Decompression, Surgical ; Emergencies ; Female ; Humans ; Intestinal Volvulus ; surgery ; Male ; Recurrence ; Retrospective Studies

OBJECTIVETo evaluate the safety and efficacy of surgical treatment for recurrent colorectal carcinoma in the elderly.

METHODSThe clinical and follow up data of 24 elderly patients with recurrent colorectal carcinoma who were treated between January 2000 and June 2009 at the Changhai hospital of the Second Military Medical University were analyzed retrospectively.

RESULTSAmong the 24 patients there were 14 men and 10 women. The mean age of the patients was 76.9 ± 5.3 years. The local recurrence was found in 15 patients. In 9 patients, both distant metastases and local recurrence were found. A total of 24 patients received operation, including radical resection in 15 patients and palliative resection in 8 patients. One patient had laparotomy only because of diffuse metastases in the abdomen and involvement of the duodenum and common bile duct.The patient received stent placement in the common bile duct and chemotherapy after the surgery. Postoperative complication occurred in 7(29.2%) patients, which included ileus(n=1), pulmonary infection(n=1), urinary infection(n=1), wound infection(n=2), wound dehiscence(n=1), and wound fat liquefaction(n=1). There were no perioperative deaths. The median survival time was 6 months in the entire cohort. The median survival time was 33 months in patients undergoing radical resection, and the 1-, 3-, and 5-year survival rate was 71.4%, 28.6%, and 14.3%. The median survival time was 3 months in patients who underwent palliative resection, and the 1-year survival rate was 0. The difference between the two groups was statistically significant(P<0.01).

CONCLUSIONOutcomes are acceptable after radical resection for elderly patients with recurrent colorectal cancer if careful preoperative evaluation and perioperative management are performed.

Aged ; Aged, 80 and over ; Colorectal Neoplasms ; pathology ; surgery ; Female ; Humans ; Male ; Neoplasm Recurrence, Local ; surgery ; Prognosis ; Retrospective Studies ; Survival Rate