OBJECTIVE:To evaluation of the efficacy and safety of azithromycin in the treatment of acute infections METHODS:A randomized controlled multicenter clinical study was used to compare the clinical efficacy of azithromycin(200mg q d for 3～5 days) with erythromycin(500mg b i d for 5 days) RESULTS:The cure rate,effective rate,and bacterial clearance rate were 76 7%,95 0%,and 94 3% respectively for azithromycin group and were 48 3%,76 7%,and 77 4% respectively for erythromycin group with a side-effect incidence of 10 0% for azithromycin group and 39 3% for erythromycin group CONCLUSION:Azithromycin is superior to erythromycin in clinical efficacy,safety and side-effect incidence

Objective To prepare the mB7-1-GPI-anchored Lewis vaccine and investigate its antitumor effects. Methods mB7-1-GPI was incorporated on Lewis tumor cells and mB7-1-GPI-anchoring tumor vaccine was prepared. The anti-tumor immunity induced by the prepared mB7-1-GPI-anchored Lewis tumor cell vaccine in tumor-bearing mice was observed. Results Flow cytometric analysis showed that mB7-1-GPI were positively expressed on the surface of Lewis tumor cells. After Lewis tumor cells incubated with mB7-1-GPI, the positive rate (PR) of mB7-1 antigen was 95.8% (0h), 93.6% (4h), 91.1% (8h) and the fluorescence intensity (FI) was 11.2(0h), 10. 6(4h), 9. 8(8h). The IL-2 and IFN-γ production of splenic lymphocytes + lewis cells was (25.9 ± 1.4) pg/ml, (56. 0± 3. 5 ) pg/ml. The IL-2 and IFN-γ production of splenic lymphocytes + lewis/mB7-1-GPI was ( 871.3 ± 10. 4 ) pg/ml, ( 1329. 0 ± 11.9 ) pg/ml. In 25 days, the mean diameter of tumor of Lewis/mB7-1 -GPI was shorter than Lewis( 1.4 ± 0. 21 )cm & ( 2. 5 ± 0. 27 )cm , P ＜ 0. 05 ). Lewis tumor cell-bearing C57BL/6 mice treated with Lewis/mB7-1-GPI vaccine survived much longer than mice treated with Lewis vaccine ( 75.2 ± 2. 0 ) d & (40. 2 ± 2. 0 ) d ( P ＜ 0. 05 ). Conclusion The Lewis tumor vaccine prepared with mB7-1-GPI fusion protein significantly inhibited the tumor growth in Lewis bearing mice. It represented an useful new strategy for attaching immunological factor onto tumor cell surfaces without genetic manipulation.

Objective To investigate the reliability of the Three-Column classification for fracture of tibial plateau and compared with the conventional Schatzker classification.Methods From December 2004 to March 2007,304 patients with tibial plateau fracture were treated in our department.The CT scans and 3D reconstruction were performed in all patients before operation.All the patients were classified by the Three-Column classification and then treated with open reduction and internal fixation via the corresponding approaches based on the Three-Column classification.To validate the Three-Column classification,four doctors classified 50 patients which were chosen randomly from 323 consecutive fracture cases.Schatzker classification was also classified at the same time.Inter-observer reliabilities of the Three-Column classification and the Schatzker classification were figured out respectively in the form of Kappa value.Results According to the Three-Column classification,there were 4 pure compression fractures (1.2％),181 one-column fractures(56.0％),108 two-column fractures(33.4％) and 30 three-column fractures (9.3％) in all 323 cases.In one-column fracture cases,the numbers of lateral,medial,and posterior column fractures were 114 (63.0％),53 (29.3％),and 14 (7.7％),respectively.Among two-column fracture cases,the lateral-medial column fractures (33.3％) were 36.While the number of medial-posterior column fractures and lateral-posterior column fractures were 34 (31.5％) and 38 (35.2％),respectively.There was a moderate inter-observer reliability when using Schatzker classification (Kappa=0.567; range,0.513-0.589).There was a substantial interobserver reliability when using the Three-Column classification (Kappa=0.766; range,0.706-0.890).Conclusion The Three-Column classification based on CT and 3D reconstruction is simple and more reliable for fracture of tibial plateau.It is suggested that the new classification system,the Three-Column classification,can be used and popularized in the orthopaedic surgery.

Objective To explore clinical effect of double-tube continuous negative pressure drainage in the treatment of Morel-Lavallée leision.Methods We retrospectively analyzed the clinical data of 13 patients with Morel-Lavallée leision,which were diagnosed and treated in our hospital from May 2009 to July 2010.They were 11 women and 2 men,aged from 19 to 57 years (average,32.5 years).All patients underwent operations within 3 days after injury,except for 2 patients whose diagnosis was postponed.The operation was performed with small incision and double-tubes were placed for continuous negative pressure drainage.Double-tubes were not removed until effusion was less than 30 ml/24 hours.The heal was defined as no skin necrosis and subcutaneous hydrops at lesion site,no skin floating and sliding at palpation.Results Double-tubes were removed 4 to 12 days postoperatively (average,6.3 day).All of 13 patients were followed up for an average of 13.7 months (range,10 to 18 months).Skin necrosis occurred in 1 patient.Lesions were healed 4 to 10 weeks postoperatively(average,7.2 weeks).No deep infection or delayed hematogenous infection was found.There were no general systematic complications.Superficial infection at wound site occurred in one patient and healed after wound management.Conclusion Application of double-tube continuous negative pressure drainage is a safe,less invasive,low-cost and effective treatment for Morel-Lavallée leision.

Child, Preschool ; Coronary Aneurysm ; etiology ; pathology ; Coronary Vessels ; pathology ; Female ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; complications ; pathology

OBJECTIVETo clarify the role of RhoC in the growth of hepatocellular carcinoma cells and its molecular mechanism, so as to explore the molecular target of tumor cell growth.

METHODSsiRNA-RhoC plasmid was constructed and RhoC gene silencing the cell-line of hepatocellular carcinoma was setup. Cell growth was assessed by MTT assay. AgNORs staining was applied to determine cell proliferation. Plate cell clone test was conducted to examine the capacity of cell clone formation. FACS was adopted to measure the course of cell cycle and semi-quantitative RT-PCR was used to determine the expression of cell cycle proteins. In order to further determine the effect of RhoC expression on cell growth, a RhoC over-expression human hepatocellular cell line was setup by PcDNA3-RhoC plasmid transfection.

RESULTSThe inhibition rate of RhoC was 82.3%. From the fourth day of cell culture, the growth of cells in RNAi group was significantly slower than that in parental Bel7402 and negative control groups (0.41 ± 0.10 vs. 0.73 ± 0.11 and 0.71 ± 0.07 respectively, P < 0.05). AgNORs staining showed that average cell stained particles in RNAi group was significantly lower than that in parental Bel7402 and negative control(1.23 ± 0.35 vs. 3.47 ± 0.93 and 3.17 ± 0.78, P < 0.01). Plate clone formation test showed that clone formation efficiency in the RNAi group was notably lower than that in the control group [(20.33 ± 5.42)% vs. (70.58 ± 10.10)% and (69.83 ± 14.77)%, respectively, P < 0.01]. Cell cycle analysis by FACS showed that G(0)/G(1) cell percentage in the RNAi group was significantly higher than that in the control group [(73.14 ± 5.93)% vs. (57.05 ± 5.97)% and (52.99 ± 4.80)%, P < 0.05]. Compared with Bel7402 and negative control groups, the expression of following growth associated genes was significantly decreased: cyclin D1(0.45 ± 0.21 vs. 1.25 ± 0.24 and 1.12 ± 0.15, respectively, P < 0.05)and CDK4 (0.55 ± 0.08 vs. 1.18 ± 0.32 and 1.10 ± 0.29, respectively, P < 0.05); the following genes were notably increased: p16(1.07 ± 0.23 vs. 0.36 ± 0.12 and 0.35 ± 0.13, respectively, P < 0.01)and p21(0.42 ± 0.12 vs. 0.17 ± 0.06 and 0.19 ± 0.08, respectively, P < 0.05). RhoC was highly expressed in PcDNA3-RhoC transfected hepatocellular cell line. From the third day on of the cell culture, cell growth in PcDNA3-RhoC group was remarkably higher than that in the HL7702 and PcDNA3 groups (0.83 ± 0.10 vs. 0.54 ± 0.11 and 0.58 ± 0.55, respectively, P < 0.05).

CONCLUSIONSRhoC is the key molecule in promoting hepatocellular cell growth, and is a promising target for tumor cell growth controlling.

Carcinoma, Hepatocellular ; genetics ; metabolism ; pathology ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; Cyclin D1 ; metabolism ; Cyclin-Dependent Kinase 4 ; metabolism ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Cyclin-Dependent Kinase Inhibitor p21 ; metabolism ; Humans ; Liver Neoplasms ; genetics ; metabolism ; pathology ; Plasmids ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection ; rho GTP-Binding Proteins ; genetics ; metabolism ; rhoC GTP-Binding Protein

OBJECTIVETo compare the effect of transurethral resection of the prostate combined with endocrine therapy (TURP + ET) with that of αlA-blockers combined with ET ((αlA-b + ET) in the treatment of bladder outlet obstruction (BOO) in patients with advanced prostate cancer (PCa), and to investigate the safety of the TURP + ET for the treatment of PCa with BOO.

METHODSWe retrospectively analyzed 63 cases of PCa with BOO, 28 treated by αlA-b + ET and the other 35 by TURP + ET. We obtained the residual urine volume (RV), maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), and quality of life score (QoL) before and after treatment along with the overall survival rate of the patients, followed by comparison of the parameters between the two methods.

RESULTSAt 3 months after treatment, RV, IPSS, and QoL in the TURP + ET group were significantly decreased from (137.8 ± 27.6) ml, (22.3 ± 3.6), and (4.2 ± 0.8) to (29 ± 13.6) ml, (7.8 ± 2.1), and (1.6 ± 0.5) respectively (P < 0.05), while Qmax increased from (5.6 ± 2.1) ml/s to (17.6 ± 2.7) ml/s (P < 0.05); the former three parameters in the αlA-b + ET group decreased from (133.6 ± 24.9) ml, (21.5 ± 3.2), and (4.7 ± 1.1) to (42 ± 18.3) ml, (12.8 ± 2.6), and (2.5 ± 0.7) respectively (P < 0.05), while the latter one increased from (6.3 ± 2.4) ml/s to (11.7 ± 2.3) ml/s (P < 0.05), all with statistically significant differences between the two groups (P < 0.05). The overall survival rate of the TURP + ET group was not significantly different from that of the αlA-b + ET group (51.4% vs 46.4% , P > 0.05).

CONCLUSIONTURP + ET is preferable to αlA-b + ET for its advantage of relieving BOO symptoms in advanced PCa without affecting the overall survival rate of the patients.

Adrenergic alpha-1 Receptor Antagonists ; therapeutic use ; Antineoplastic Agents, Hormonal ; therapeutic use ; Combined Modality Therapy ; methods ; Humans ; Male ; Prostatic Neoplasms ; complications ; drug therapy ; pathology ; surgery ; Quality of Life ; Retrospective Studies ; Transurethral Resection of Prostate ; Treatment Outcome ; Urinary Bladder Neck Obstruction ; drug therapy ; etiology ; surgery

Adolescent ; Adult ; Aged ; China ; DNA Mutational Analysis ; Female ; Genotype ; Hepatitis B ; virology ; Hepatitis B virus ; genetics ; Humans ; Male ; Middle Aged ; Mutation

Objective: To investigate the alterations of bcl-2 gene family in the rat brain and the molecular mechanism of neuronal apoptosis follow ing traumatic brain injury (TBI). Methods: Male Sprague-Dawley rats were subjected to lateral fluid percussion brain injury(FPBI) of moderate severity. bax and bcl-xL mRNA and protein expression was detected by RT-PCR an d immunohistochemistry. In addition to morphological evidence of apoptosis, TUNE L histochemistry was used to identify DNA fragmentation in situ under both l ight and electron microscope, whereas characteristic internucleosomal DN A fragm entation of apoptosis was demonstrated by DNA gel electrophoresis. Resul ts: bcl-xL mRNA and protein decreased in the ipsilateral hemisphere t o the impact site as early as 6 h post-injury［(67.42±7.54)% and (85.85±5.72)% r espectively］. The decrease in bcl-xL mRNA and protein preceded apoptosis was observed 12 h post-injury. And this was the main cause of up-regulation of the ratio of bax to bcl-xL in the acute period(minutes-hours) followin g FPBI. bax mRNA and protein were observed to rise slowly, doubled 3 d post- injury, returned to sham level slowly. The delayed cell death (days-weeks) migh t associated with the up-regulation of pro-apoptotic gene bax. Conclusio n: The expression of bcl-xL and bax coincide with apoptosis following TBI. The reg ulation of bax and bcl-xL by TBI occur before transcription. The balance of bax/bcl-xL ratio determines the neurocytes to survive or die following FPBI.

Severe tracheal stenosis can not only cause critical medical problems such as severe shortness of breath, hypoxia, and even orthopnea, but also impose overwhelming challenges on the physicians, particularly the anesthesiologist. Life-threatening airway obstruction can make the patient's gas exchange extremely difficult.Though several options could be offered regarding the treatment of tracheal stenosis, normally, tracheal resection and following reconstruction is the first choice for severe airway stenosis. Successful surgical intervention relies on the close communication and cooperation between surgeons and anesthesiologists. In these cases, airway management is the top issue for the anesthesiologist, and the level of difficulty varies with stenosis location, severity of stenosis, and surgical technique. Extracorporeal membrane oxygenation (ECMO), or cardiopulmonary bypass (CPB), is rarely utilized for the surgery, but for those impossible airways due to nearly complete tracheal obstruction, ECMO or CPB could be the final choice for anesthesiologists. Here we report a case of successful urgent airway management for tracheal resection and reconstruction assisted by temporary CPB.
Cardiopulmonary Bypass ; Emergencies ; Female ; Humans ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Trachea ; surgery