Hamartoma ; Humans ; Laryngeal Diseases ; Male ; Middle Aged

Objective To study the tolerance to 188Re-1-hydroxy-1 ,1-ethylidene disodium phosphonate(HEDP) in patients with bone pain caused by osseous metastases. Methods Thirty-one patients(10with prostate cancer, 9 with breast cancer, 3 with lung cancer, 5 with liver cancer, 2 with rectal cancer, 1with esophageal cancer and 1 with renal cancer) received a single injection dose of 188Re-HEDP. The patients were divided into four groups according to the injection dose: 20 MBq/kg (6 patients), 30 MBq/kg(6 patients), 40 MBq/kg (9 patients), and 50 MBq/kg (10 patients). Haematological toxicity (WHO grading) of grade Ⅲ- Ⅳ was considered unacceptable. Vital signs and adverse effects after injection were recorded for 8 weeks. Blood counts were measured weekly during a period of 8 weeks. Biochemical parameters and electrocardiogram were assayed at week 4 and 8. Statistical analysis was performed for per-protocol (pp) population (t-test). Results Twenty-seven patients belonged to PP population with 5 in the group of 20 MBq/kg, 5 in the group of 30 MBq/kg, 8 in the group of 40 MBq/kg and 9 in the group of 50 MBq/kg.No obvious adverse effects and no significant change of vital signs, electrocardiogram, liver and renal function were found after injection. Alkaline phosphatase was slightly higher than baseline at week 4 and 8 after therapy, but the difference was not statistically significant. In the 20 MBq/kg group, reversible grade Ⅰ leucopenia was noted in 1 patient. In the 30 MBq/kg group, 2 patients showed reversible grade Ⅰ leucopenia including 1 alone with reversible grade Ⅲ thrombopenia. In the 40 MBq/kg group, reversible grade Ⅰ leucopenia and thrombopenia was observed in 1 patient and reversible grade Ⅱ leucopenia and thrombopenia in another patient. In the .50 MBq/kg group, 3 patients showed reversible grade Ⅱ leucopenia. The lowest level of thrombopenia was at week 4(143.5 × 109/L), leucopenia at week 6 (5.4 × 109/L) and anaemia at week 8(t = 3.1325, 3.3156, 3.4917, all P ＜ 0. 05 compared with baseline). At week 8, the mean level of platelet and leucocyte recovered to baseline. "Bounce pain" was found in 2 of 27 patients (7.41%).Conclusions The dose of 20 MBq/kg, 30 MBq/kg, 40 MBq/kg or 50 MBq/kg of 188Re-HEDP do not cause significant side effects on cancer patients with bone metastases, though there is a tendency that the haematological toxicity may increase as the dose of 188Re-HEDP increases.

ObjectiveTo explore the effect of metalloproteinases (MMPs) inhibitor on expression of MMP-3 in degenerated lumbar intervertebral disc.MethodsThe animal model of degenerated lumbar intervertebral disc was established with rats. The 32 rats were randomly divided into the experimental group and control group with 16 animals in each group. From the fourth week after operation, the animals of the experimental group were injected with tetracycline 25 mg per day, those of the control group with saline. Two weeks late, the tissue of degenerated lumbar intervertebral disc was taken and the expression of MMP-3 was tested by immumohistochemistry and Western-bloting.ResultsThe expression of MMP-3 in the experimental group decreased and significantly different from the control group ( P<0.05).ConclusionMMPs inhibitor can decrease expression of MMP-3 in degenerated lumbar intervertebral disc.

Objective To analyze the clinical speciality of invasive fungal infection(IFI)and provide doctors with clinical evidence for early anti-fungal therapy.Method One hundred and thirty-seven patients with 91 male and 46 female,who suffered from invasive fungal infection in ICU from January.1,2000 to June 30, 2006,were enrolled in this study.The age ranged from 17 to 82 years old.Out of 137 patients with IFI,the percentage of albicans candida,glabirate candida,tropicalis candida and parapsilosis candida were 47.4%, 26.3%,20.4% and 3.6%,reseparately.The sputum,urine,blood and other drainages were collected to perform the fungal examination after three days of admission every three days.Results Of 137 patients,42 of them were complicated with hemorrhage,53 patients with IFI developed candida anthema in the chest,abdomen and extremity.,49 patients suffering from IFI had organ dysfunction.The chest image revealed that infiltration caused by IFI especially occurred in apex of lung in some patients.The pathogen analysis displayed that albicans candidiasis easily developed candida anthema,glabirate candidiasis frequently resulted in organ dysfunction,and tropicalis candida led to hemorrhage in some organs.Conclusions The clinical specialty,of IFI caused by candida included hemorrhage,candida anthema,organ dysfunction,and infiltration in apex of lung.

It is proposed that gut-liver-lung axis plays an important role in the pathophysiologic development of the critical illness, and it induces excessive inflammatory response in vivo and multiple organ dysfunction syndrome. The mechanisms of therapeutic effects of rhubarb on critical patients are studied based on the theory of Chinese traditional medicine. Researches demonstrate that rhubarb can be used to protect gut barrier, maintain intestinal micro-ecological environment and prevent bacterial translocation. It also can be used to inhibit the release of inflammatory mediators by liver inflammatory-effector cells, reduce inflammatory reaction in the liver and protect hepatic cell functions. Furthermore, rhubarb can be used to reduce pulmonary vascular permeability and extenuate pulmonary edema, inhibit the release of neutrophil myeloperoxidase, and lower the level of inflammatory response and decrease inflammatory mediators in circulation. The above results indicate that rhubarb may interrupt or partly interrupt the gut-liver-lung axis after trauma and reduce the intensity of systemic inflammatory response syndrome. Therefore, rhubarb may obviously lower the incidence of multiple organ dysfunction syndrome and be used to prevent and treat systemic inflammatory response syndrome and multiple organ dysfunction syndrome after trauma.
Capillary Permeability ; drug effects ; Humans ; Intestines ; microbiology ; Liver ; immunology ; Multiple Organ Failure ; drug therapy ; Phytotherapy ; Rheum ; Sepsis ; drug therapy ; Systemic Inflammatory Response Syndrome ; drug therapy

Carotid Artery, Internal ; diagnostic imaging ; Cerebrovascular Disorders ; diagnostic imaging ; physiopathology ; Extremities ; physiopathology ; Humans ; Ischemic Attack, Transient ; complications ; diagnostic imaging ; drug therapy ; Male ; Middle Aged ; Middle Cerebral Artery ; diagnostic imaging ; Thromboembolism ; diagnostic imaging ; physiopathology ; Ultrasonography, Doppler, Transcranial

Gastrointestinal Microbiome ; physiology ; Gastrointestinal Tract ; microbiology ; Humans ; Intestinal Diseases ; microbiology

This paper analyses the defects of bubble oxygen inhalators currently used, and investigates into their solutions for improvement.
Oxygen Inhalation Therapy ; instrumentation ; methods ; Oxygenators ; standards

BACKGROUNDBoth procalcitonin (PCT) and plasma endotoxin levels cannot be solely used for a definite diagnosis of bacteremia or sepsis, and there has been few study comparing the values of the two biomarkers for the diagnosis of bacteremia. The aim of this study was to identify bacteria causing bacteremia and evaluate the role of the two biomarkers in the diagnosis of bacteremia in Intensive Care Unit (ICU).

METHODSThe medical records of 420 patients in ICU were retrospectively reviewed. Patients (n = 241) who met the inclusion criteria were subjected to blood culture (BC) for the analysis of the endotoxin or PCT levels. The exclusion criteria included the presence of infection with human immunodeficiency virus and/or AIDS, neutropenia without sepsis, pregnancy, treatment with immunosuppressive therapies, or blood diseases such as hematological tumors. Patients' BC episodes were divided into BC negative, Gram-negative (GN) bacteria, Gram-positive bacteria, and fungi groups. The PCT and plasma endotoxin levels were compared in the different groups.

RESULTSA total of 241 patients with 505 episodes of BC were analyzed. The GN bacteria group showed higher levels of PCT and endotoxin than the BC negative, Gram-positive bacteria, and fungi groups. GN bacteremia was more prevalent than Gram-positive bacteremia. The GN bacteremia caused by non-Enterobacteriaceae infection presented higher endotoxin level than that by Enterobacteriaceae, but no significant difference in PCT levels was observed between the two groups. The plasma endotoxin significantly differed among different groups and was bacterial species dependent.

CONCLUSIONSPlasma endotoxin was more related to GN than to Gram-positive bacteremia, and that endotoxin level was species dependent, but PCT level remained relatively more stable within the GN bacteria caused bacteremia. Both GN and positive bacteria caused bacteremia in the ICU patients in different regions of China. And PCT is a more valuable biomarker than endotoxin in the diagnosis of bacteremia.

Adult ; Aged ; Bacteremia ; blood ; diagnosis ; Calcitonin ; blood ; Endotoxins ; blood ; Female ; Gram-Negative Bacteria ; isolation & purification ; Humans ; Intensive Care Units ; Male ; Middle Aged