Objective To explore the pathological changes by CT scan on localized thermochemotherapy dur- ing and after the operation of human gliomas.Methods Retrospective analysis was given to the CT scan of 37 pa- tients receiving thermochemotherapy during and after the operation,and the relation of the tumorous cells and mi- crovessels and CT density by EM were analyzed.Changes of tumorous cells and microvessels after localized ther- mochemotherapy on C_6 gliomas in rat were analyzed.Results When the tumor was low dense on CT pattern,less cellular number with increasing the amount of fluid between the cells was demonstrated pathologically.On EM,a lower cellular electron density was observed.The amount of fluid in cytoplasm was increased,the cytoplasm was porous,swelling denaturation was chiefly seen in organelle.If the tumor had mixed density on CT,cellular number was more,the amount of fluid was less.On EM,cellular electron density increased correspondingly,the fluid in cyto- plasm decreased,organdie was aggregated.After thermochemotherapy,the tumor reduced,liquefied,and vanished by CT scan.It could be observed that the tumorous cell become smaller,concentrated and cataclased,finally formed apoprotic bodies and separated from the cell in C_6 gliomas in EM.The tumorous vessels was less,smaller and thinker. Some vessels only could see the base membrane and no endothelioid cells.Conclusion The remaining tumors is van- ished by CT scan.The mechanisms of tumors disappearance proposes to explain that thermochemotherapy can dam- age C_6 glioma cells and microvessels,decrease microvessels density and induce tumor ceils apoptosis.That inhibits tu- morous angiogenesis and proliferation.

Colectomy ; Colorectal Neoplasms/surgery* ; Humans ; Laparoscopy ; Treatment Outcome

OBJECTIVETo analyze the efficiency of cervical lymph node metastasis dissection and postoperative morbidity after selective three-field lymph node dissection (3FLND) for thoracic esophageal squamous cell carcinoma, and explore the proper selection conditions.

METHODSAccording to the conditions as follows: systemic evaluation, tumor T staging, tumor location, cervical CT and ultrasonography and the number of lymph nodes metastases, 85 patients with thoracic esophageal squamous cell carcinoma were selected and received 3FLND.

RESULTSIn the same period 45.5% (85/187) of the patients received 3FLND selectively based on the conditions. The rate of the cervical lymph nodes metastasis was 40.0% (34/85). The rate of the cervical positive lymph nodes of the upper, middle and lower thoracic esophageal carcinomas with enlarged lymph nodes suggested by cervical CT and ultrasonography was 68.4% (13/19), 41.7% (20/48) and 16.7% (1/6), respectively. Twelve patients with upper thoracic esophageal carcinoma with enlarged lymph nodes unrevealed by cervical CT and ultrasonography showed no histopathological lymph node metastasis. In the same period 17.1% (32/187) of the patients were selectively not undergone three-field lymph node dissection. The cervical lymph node metastasis rates in patients with upper and middle mediastinal lymph node metastasis were 79.3% (23/29) and 58.6% (17/29), significantly higher than 8.9% (5/56) and 7.1% (4/56) in the patients without upper and middle mediastinal lymph node metastasis (P<0.05). There was no in-hospital mortality in the group. The incidence of pulmonary complications and over-all postoperative morbidity was 24.7% and 42.4%, respectively.

CONCLUSIONSSelective 3FLND based on certain conditions can reduce the risk of postoperative morbidity and improve the efficiency of metastatic cervical lymph node dissection in thoracic esophageal squamous cell carcinoma. The thoracic tracheoesophageal groove positve lymph node indicated by CT scans should be one of selective conditions for 3FLND. The upper thoracic esophageal carcinoma should selectively receive 3FLND. The selection standards should be more strict for the lower thoracic esophageal carcinoma.

Carcinoma, Squamous Cell ; pathology ; surgery ; Esophageal Neoplasms ; pathology ; surgery ; Female ; Humans ; Lymph Node Excision ; methods ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Survival Rate ; Treatment Outcome

Objective To investigate the relationship between impaired glucose tolerance(IGT)and carotid atheromatous plague in patients with acute cerebral infarction and analyze the risk factors for plaque formation.Methods The 326 patients hospitalized in our department for acute cerebral infarction were divided into diabetes mellitus(DM)group,IGT group and normal glucose tolerance (NGT)group.The clinical features,biochemical indices and results of Doppler ultrasound examination of the carotid artery were compared between the 3 groups.Results The body mass index(BMI),total cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)of IGT group were markedly higher than those in NGT group(P＜0.05).Both the IGT and DM group showed significantly increased carotid intimal-medial thickness,plaque detection rate and the incidence of carotid scleratheroma in comparison with the NGT group(P＜0.05).Logistic regressive analysis identified age,TC,LDL-C and 2-h postprandial serum glucose as the independent risk factors for carotid scleratheroma.Conclusion In patients with acute cerebral infarction,those having impaired glucose often show obvious carotid scleratheroma with a severity similar to that in the DM patients.

OBJECTIVETo compare the effect of high frequency oscillatory ventilation (HFOV) and conventional mandatory ventilation (CMV) on the myocardial function of rabbits with inhalation injury.

METHODSSteam inhalation injury model was reproduced in 16 New Zealand albino rabbits. They were randomly divided into CMV group (n = 8) and HFOV group (n = 8) by drawing lots, and they received ventilation in metered volume and HFOV treatment respectively. Heart blood was drawn from rabbits before they were sacrificed 4 hours after treatment to determine the plasma activity of lactate dehydrogenase 1 (LDH1) and creatine phosphorylated kinase (CPK-MB). Myocardial tissue from left ventricle was harvested and homogenized to determine the concentration of TNF-α and IL-8, the activity of caspase-1, and the activity of myosin-light-chain kinase (MLCK) and the ATPase of myosin light chain (MLC-ATPase) by enzyme-linked immunosorbent assay, spectrophotometry, and the nuclide liquid scintillation technique respectively. Part of the myocardial tissue sample was examined pathologically. Data were processed with analysis of variance.

RESULTS(1) The activities of LDH1 and CPK-MB in plasma were obviously higher in CMV group than in HFOV group [(643 ± 108), (342 ± 48) U vs. (233 ± 92), (186 ± 36) U, with F value respectively 10.326 and 9.846, P values all below 0.01]. (2) The contents of TNF-α, IL-8 and the activity of caspase-1 in myocardial tissue homogenate were obviously higher in CMV group than in HFOV group [(181 ± 35), (89 ± 19) pg/g, and (0.56 ± 0.27) g/g protein vs. (94 ± 21), (43 ± 11) pg/g, and (0.24 ± 0.12) g/g protein, with F value respectively 8.239, 7.826, 5.716, P values all below 0.01]. (3) The activities of MLC-ATPase and MLCK were lower in CMV group than in HFOV group [(0.24 ± 0.12) µmol×mg(-1)×min(-1), (3.3 ± 1.1) mmol×mg(-1)×min(-1) vs. (0.48 ± 0.16) µmol×mg(-1)×min(-1), (7.7 ± 1.7) mmol×mg(-1)×min(-1), with F value respectively 4.125, 4.766, P values all below 0.01]. (4) No obvious necrosis, degeneration or inflammatory cell infiltration was observed in myocardial tissue of rabbits in 2 groups under light microscope; but the myocardial fiber was slightly swollen, and it was less marked in the HFOV group.

CONCLUSIONSThe influence of HFOV on myocardial myosin phosphorylation system of rabbits with inhalation injury is less than that of CMV.

Animals ; Burns, Inhalation ; metabolism ; physiopathology ; therapy ; High-Frequency Ventilation ; Myocardium ; metabolism ; Myosin-Light-Chain Kinase ; metabolism ; Rabbits ; Respiration, Artificial

OBJECTIVETo investigate the effects of high frequency oscillatory ventilation (HFOV) and its combination with administration of pulmonary surfactant (PS) on inflammatory response of lung tissue in rabbits with inhalation injury.

METHODSSevere steam inhalation injury models were reproduced in 24 New Zealand albino rabbits. They were divided into control group (n = 8), HFOV group (n = 8), and HFOV + PS group (n = 8) according to the random number table, and they received ventilation in metered volume, HFOV, and HFOV + PS treatment respectively. Lung tissue samples of rabbits were collected at 3.5 h after treatment for pathological inspection and pulmonary injury score, assay of the activity of myeloperoxidase (MPO) and cysteinyl aspartate-specific protease 1 (caspase-1), and the determination of the contents of TNF-alpha, IL-18, IL-10, IL-13 and their mRNA expression.

RESULTSPathological change in different degree of rabbit lung tissue in each group were observed, and they were most obvious in the control group, and least in the HFOV + PS group. The lung tissue injury scores of control group, HFOV group, and HFOV + PS group was 3.71 +/- 0.43, 2.87 +/- 0.26, and 2.08 +/- 0.28 respectively. The difference between either two of them were statistically significant (P < 0.01). The MPO content and caspase-1 activity of rabbits in HFOV and HFOV + PS groups were obviously lower than those in control group (P < 0.01), and MPO content and caspase-1 activity of rabbits in HFOV + PS group were obviously lower than those in HFOV group (P < 0.05). In HFOV group and HFOV + PS group, the contents of TNF-alpha, IL-18 and their mRNA expression in lung tissue homogenates were obviously lower than those in control group (P < 0.01); while the contents of IL-10, IL-13 and their mRNA expression were obviously higher than those in control group (P < 0.01). Changes in these contents and expression in HFOV + PS group were more obvious than those in HFOV group (P < 0.05).

CONCLUSIONSHFOV can alleviate inflammatory response in rabbit lung tissue and pulmonary injury induced by inhalation injury, and the effect is more obvious when combined with PS.

Animals ; Burns, Inhalation ; complications ; therapy ; Disease Models, Animal ; High-Frequency Ventilation ; Inflammation ; Lung Injury ; etiology ; therapy ; Pulmonary Surfactants ; therapeutic use ; Rabbits

The aim of this paper is to develop and validate a rapid and sensitive LC-APCI/MS method for the determination of triptolide (TP) in plasma and to study the pharmacokinetic properties of TP in Beagle dogs. Sample preparation consisted of liquid-liquid extraction of interests. with ethyl acetate from dog plasma. The analytes and internal standard prednisolone were well separated on a Zorbax Extend-C18 analytical column. Plasma TP was detected by selected-ion monitoring (SIM) of LC-APCI/MS as its deprotonated molecular ions [M - H] - at m/z 358.9. Pharmacokinetic studies were undertaken in dogs following an iv dose of 0.05 mg x kg(-1) of TP or an ig dose of 0.05, 0.08, 0.1 mg x kg(-1), separately. The pharmacokinetic parameters were calculated by DAS software. Calibration curves were linear over the concentration range of 1 - 200 ng x mL(-1) of TP with the within- and between-batch precisions less than 10%. The within and between-batch accuracy was 95.0% to 105.0%. Recovery of LC-MS method for TP in plasma was over 75%. The T1/2beta was (2.5 +/- 0.8) h after intravenous administration of TP at the dose of 0.05 mg x kg(-1). There were no significant differences in T(max), T1/2 alpha and T1/2 beta among the three ig dosage groups. AUC and C(max) increased proportionally with doses. The absolute bioavailability of TP after ig administration of 0.05 mg x kg(-1) was (75 +/- 17)%. The LC-MS method for determination of triptolide in dog plasma was sensitive and rapid. It was showed that the elimination of triptolide was rapid. The absolute bioavailability of triptolide given orally was high.
Administration, Oral ; Animals ; Area Under Curve ; Biological Availability ; Chromatography, High Pressure Liquid ; Diterpenes ; administration & dosage ; blood ; pharmacokinetics ; Dogs ; Dose-Response Relationship, Drug ; Epoxy Compounds ; administration & dosage ; blood ; pharmacokinetics ; Female ; Injections, Intravenous ; Male ; Mass Spectrometry ; Phenanthrenes ; administration & dosage ; blood ; pharmacokinetics ; Plants, Medicinal ; chemistry ; Random Allocation ; Tripterygium ; chemistry

OBJECTIVETo investigate the factors affecting the prognosis of invasive pulmonary fungal infection (IPFI) in patients after kidney transplantation.

METHODSThis retrospective study involved 80 concurrent patients with IPFI after receiving kidney transplantation in Zhujiang Hospital from January 1, 2000 to April 1, 2010. Fourteen factors including age, gender, pathogens, body temperature on day 5, renal insufficiency, mechanical ventilation, and clinical pulmonary infection score (CPIS) on day 5 were analyzed by univariate analysis and multivariate Logistic regression analysis to identify the factors related to the prognosis.

RESULTSUnivariate analysis showed that a normal body temperature on day 5 of antifungal treatment (P=0.024), fasting high blood glucose (P=0.001), renal insufficiency (P=0.002), malnutrition (P=0.018), time of infection after transplantation (P=0.046), low CPIS on day 5 (P=0.000) and mechanical ventilation (P=0.000) all affected the prognosis of the patients. Logistic regression analysis showed that renal insufficiency (OR=18.096), mechanical ventilation (OR=130.7) and low CPIS on day 5 (OR=0.011) were independent prognostic factors, among which the low CPIS on day 5 was a protective factor.

CONCLUSIONTimely and adequate empirical therapy and renal replacement therapy, along with adjusted anti-fungal therapy protocol according to the CPIS score on day 5, may improve the prognosis of IPFI after kidney transplantation.

Adult ; Female ; Humans ; Kidney Transplantation ; adverse effects ; Logistic Models ; Lung Diseases, Fungal ; diagnosis ; etiology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors

OBJECTIVETo investigate the influence of recombinant human growth hormone (rhGH) on body fluid compartments and water-sodium retention in severe burn patients.

METHODSThirty adult patients with severe burn were divided into treatment (T) and control (C) groups by block randomized design. Patients in both groups were subcutaneously injected with same amount of rhGH (12 IU/d) or isotonic saline during 7 - 21 post burn day (PBD). The total body water (TBW), intracellular water (ICW), extracellular water (ECW) were measured by bioelectrical impedance analysis (BIA) on 7, 14, 21 PBD. The 24 h urinary output of Na+ was determined by ion selective electrode method (ISE).

RESULTSThere were no significant difference in levels of TBW, ICW, ECW and 24 h urinary output of Na+ between two groups on 7, 14, 21 PBD (P > 0.05). No difference in results was found between groups at different time points (P > 0.05). After the data were analyzed, the level of TBW (36 +/- 6 L), ICW (21 +/- 4 L) on 21 PBD were evidently lower than those on 7 PBD (38 +/- 6 L, 23 +/- 7 L, P < 0.01).

CONCLUSIONThe level of ICW and TBW in severe burn patients decreased along with the time. Proper dosage of rhGH has no significant effect on body fluid compartments and water-sodium retention.

Adolescent ; Adult ; Aged ; Body Fluid Compartments ; Body Water ; Burns ; metabolism ; physiopathology ; therapy ; Edema ; etiology ; Electric Impedance ; Extracellular Space ; Female ; Human Growth Hormone ; therapeutic use ; Humans ; Male ; Middle Aged ; Sodium ; metabolism ; Young Adult

Objective To study the method of emergency blood collection during a long-distance voyage to ensure blood transfusion treatment.Methods Ten voluntary blood donors were recruited, a base unit of blood was collected and preserved.Reactions of the blood donors were observed, and the blood quality was tested.Results The success rate of blood collection was 90% and the qualification rate was 100%.Conclusion Emergency blood collection during a long-distance voyage is feasible,which can help ensure blood supply in peace time or war time.