Hepatitis B-related acute-on-chronic liver failure (ACLF) is a severe clinical syndrome characterized by jaundice, coagulopathy, ascites and hepatic encephalopathy and with a high mortality rate of 65% to 93%. It involves significant ethical issues when a randomized, double-blinded, placebo-controlled clinical study is conducted to such a serious disease. Therefore, a prospective cohort study design was utilized to explore a new treatment modality of applying integrated traditional Chinese and Western medicine.

Objective To explore the clinical effect of blood purification combined with fasudil in elderly cardiac surgery patients with postoperative acute kidney injury.Methods Fifty elderly cardiac surgery patients with postoperative acute kidney injury were divided into control group and study group by random digit table method with 25 cases each.The 2 groups were treated with routine drug and blood purification,the study group was additionally given fasudil injection 30 mg + 0.9％ sodium chloride injection 50 ml vein pumping,1 time/12 h,for 7 d.The urine volume,urine N-acetyl-β-D-glucosaminidase (NAG),urine γ-glutamyl transpeptidase (γ-GTP),urine α 1-microglobulin (α 1-MG),serum creatinine (SCr),blood urea nitrogen (BUN) and creatinine clearance rate (CCr) were observed,and the acute physiology and chronic health evaluation (APACHE) Ⅱ score was computed.Results There were no statistical differences in the indexes before treatment between the 2 groups (P＞ 0.05).The urine volume after treatment 3,5,7 d in study group was more than that in control group [(38.72 ± 2.68) ml/h vs.(31.68 ± 2.52) ml/h,(47.24 ±3.73) ml/h vs.(40.24 ± 2.52) ml/h、(63.80 ± 2.50) ml/h vs.(56.60 ± 3.30) ml/h],urine NAG,urine α 1-MG,urine γ-GTP,SCr and BUN were lower than those in control group [NAG:(25.05 ±5.44) U/L vs.(28.04 ± 5.21) U/L,(24.06 ± 3.43) U/L vs.(27.23 ± 6.43) U/L,(22.08 ± 3.25) U/L vs.(26.23 ± 4.41) U/L; α 1-MG:(24.05 ± 3.65) mg/L vs.(26.74 ± 6.74) mg/L,(22.98 ± 3.58) mg/L vs.(25.57 ± 3.58) mg/L,(20.95 ± 3.78) mg/L vs.(25.48 ± 3.45) mg/L; γ-GTP:(8.2 ± 0.4) U/L vs.(10.8 ± 3.8) U/L,(7.3 ± 0.2)U/L vs.(10.5 ± 2.5) U/L,(6.5 ± 1.4) U/L vs.(9.7 ± 2.6) U/L; SCr:(206.52 ± 6.72) μ mol/L vs.(255.16 ±6.75) μmol/L,(182.98 ±6.26) μmol/L vs.(252.23 ±9.53) μmol/L,(33.25 ±7.95) μmol/L vs.(170.75 ± 7.94) μ mol/L; BU N:(19.61 ± 3.23) mmol/L vs.(20.25 ± 3.25) mmol/L,(16.76 ± 2.06) mmol/L vs.(18.32 ± 4.84) mmol/L,(12.28 ± 2.26) mmol/L vs.(14.27 ± 4.54) mmol/L],CCr was higher than that in control group [(18.66 ± 3.89) ml/min vs.(13.28 ± 3.25) ml/min,(27.76 ± 4.36) ml/min vs.(16.23 ± 4.18)ml/min,(33.79 ± 5.58) ml/min vs.(22.12 ± 4.65) ml/min],there were statistical differences (P ＜ 0.05).The APACHE Ⅱ score before treatment and after treatment 5,7 d in control group were (32.20 ±4.51),(26.38 ±5.28) and (21.43 ±4.22) scores,in study group were (33.05 ±3.82),(22.15 ±3.42) and (13.25 ± 2.15) scores.There was no statistical difference in the APACHE Ⅱ score before treatment (P ＞ 0.05),the APACHE Ⅱ score after treatment was improved,furthermore APACHE Ⅱ score after treatment 5,7 d in study group were better than those in control group,there were statistical differences (P ＜ 0.05).Conclusions The treatment effect of blood purification combined with fasudil is remarkable in elderly cardiac surgery patients with postoperative acute kidney injury.At the same time,it has high security and very important clinical significance.

0.05).The expression of NF-?Bp65 protein in epithelial ovarian cancer was significantly correlated with FIGO stage(P0.05).There was obviously negative correlation between KISS- 1 and MMP-9 expression in ovarian cancer(rs=-0.547,P

Objective：This study was designed to investigate the effect of brain irradiation on blood-brain barrier (BBB) quantitatively by measuring cis-diamminedichloroplatinum (DDP) concentration in cerebrospinal fluid (CSF). Methods：Twenty-two patients with brain metastases from non-small cell lung cancer (NSCLC) received brain irradiation (BI). During BI, DDP (20mg/m2) was given before radiotherapy and after cumulative doses of 10gray, 20gray, 30gray， and 40gray separately 3h prior to CSF collection and blood collection. Ten NSCLC patients without brain metastases were given the same dose DDP and the CSF and blood samples were collected. Samples were assayed for DDP levels by using flameless atomic absorption spectrophotometry. Results：There were 20 patients with and 10 without brain metastases assessable. The average DDP level in CSF was 1.02mg/L for patients with brain metastases before BI, which was significantly higher than the average level of 0.33mg/L for patients without brain metastases. The DDP level in CSF increased with the dose of BI and reached the highest level after 30gray irradiation(2.36mg/L). Conclusion：The BBB of patients with brain metastases is impaired in a certain degree and DDP could reach its therapeutic level in the CSF. The BBB would gradually open following BI, and DDP would reach the highest level after a dose of 30gray whole brain irradiation. In the CSF of patients with normal BBB, the DDP concentration is much lower than the therapeutic level.

【Objective】 To study the differentiate expression genes and regulation signaling pathways related to the occurrence and development of dilated cardiomyopathy with heart failure, we used bioinformatics methods to explore gene chip in gene expression omnibus(GEO) and genes related to dilated cardiomyopathy in online mendelian inheritance in man(OMIM) . 【Methods】 GSE21610 and GSE29919 chip gene sets sequenced by Herz- &Diabeteszentrum NRW laboratory of the University of Bochum, Germany with myocardial biopsy specimens from clinical cases under the platform GPL570 and uploaded to GEO public database were selected to perform our study. Myocardial biopsy specimens from dilated cardiomyopathy with heart failure and normal cardiac function were regarded as the experimental group(14 and 21 cases, respectively) and the control group(12 and 8 cases, respectively). Up-regulated expression genes with the criteria: P < 0.05, were screened in GEO2R with the selected samples of two chips, which were then used to perform kyoto encyclopedia of genes and genomes(KEGG) pathways analysis, gene ontology(GO) function analysis, and protein-protein interaction(PPI) analysis, and the results were displayed through Volcano map, Venn map, Heat map, and Bubble charts with enrichment pathways drawn by R language packages. Meanwhile, KEGG pathways with the criteria: NOM. P < 0.05, and core genes relating to dilated cardiomyopathy with heart failure were performed through gene set enrichment analysis (GSEA). All candidate genes were then intersected with the reported genes in the OMIM, respectively, and clinical significance of these candidate genes was explored in relevant literatures. 【Results】 A total of 173 up-regulated expression genes with P < 0.05, were obtained by GEO2R, which are mainly related to inflammatory signals, cell proliferation and differentiation regulating, and classical apoptotic signaling pathways. These genes were intersected with the 754 reported genes in OMIM, and three reported up-regulated expression genes were obtained: NPPA for diagnosis of heart failure, APOA1 that associates with cytokine action, and COL6A1 that regulates lateral tubular remodeling. 158 and 46 core genes from KEGG pathways with NOM. P < 0.05 were obtained by GSEA, respectively, which were then intersected with the 754 reported genes in OMIM, and two core genes were obtained: PRKCA, enhancing myocardial contractility, and BMP2, promoting the development of heart failure. 【Conclusions】 Based on bioinformatics analysis, we found that the candidate genes PRKCA, BMP2, NPPA, and COL6A1 are likely to be closely related to the occurrence and development of dilated cardiomyopathy with heart failure, which can be used to reveal meaningful therapeutic clues and directions for the clinical treatment of dilated cardiomyopathy with advanced cardiac dysfunction.

OBJECTIVETo evaluate antifungal combination strategy in children with hematologic diseases and invasive fungal disease( IFD).

METHODSA retrospective clinical study was performed based on 67 childhood patients with hematologic diseases and IFD who firstly accepted combination antifungal therapy for ≥ 7 days during January 2012 and December 2014. Of them, 11 cases received combination of echinocandin with azole, 10 cases received combination of echinocandin with amphotericin B, and 46 cases received combination of azole with amphotericin B.

RESULTSOverall response rate was 79.1%. Univariate analysis revealed that granulocyte recovery (P=0.031), status of underling disease (P=0.023) and the duration of the therapy (P=0.046) were significantly associated with efficacy. Multivariate analysis showed that the independent prognostic factor was the duration of combination antifungal therapy (OR=0.229, 95% CI 0.061- 0.863, P=0.029). The response rates of echinocandin combined with azole, echinocandin combined with amphotericin B and azole combined with amphotericin B were 81.8%, 60.0% and 82.6%, respectively (P>0.05), and 12-week survival rates were 81.8%, 80.0% and 86.5%, respectively (P>0.05). The drug- related adverse reactions occurred 59 times in 34 patients. BUN increasing, hypokalemia and abnormal liver functions were considered the main side effects.

CONCLUSIONFor IFD in children with hematologic disease, to extend the duration of treatment (≥ 14 days) could significantly improve the curative effect. Combinations of echinocandin with azole, echinocandin with amphotericin B and azole with amphotericin B can be used as a combination treatment options. Combination of Azole with amphotericin B is efficacious, safe and economic treatment option considering efficacy, survival rate, cost and dosage form.

Amphotericin B ; administration & dosage ; therapeutic use ; Antifungal Agents ; administration & dosage ; therapeutic use ; Child ; Drug Therapy, Combination ; Echinocandins ; administration & dosage ; therapeutic use ; Hematologic Diseases ; microbiology ; Humans ; Mycoses ; drug therapy ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVETo characterize the immune response induced by SAG1 encoding plasmid combined with IL-2 gene adjuvant in mice and to assess the protective effect of this vaccination against toxoplasmosis.

METHODSMice were co-injected intramuscularly with plasmid encoding Toxoplasma gondii SAG1 plus murine IL-2 expression vector at a dose of 100 microg. Booster immunizations were employed 2 more times at 3-week interval. As controls, mice were inoculated with PBS or empty plasmid pcDNA3. Humoral and cellular responses were assayed using ELISA for the determination of Ab, Ab isotype and IFN-gamma, as well as IL-4. To detect the integration and dissemination of DNA in the injected mice, PCR and in situ hybridization were performed. All mice were then infected with highly virulent RH tachyzoites of Toxoplasma gondii intraperitoneally.

RESULTSSignificant increases in specific IgG levels were observed in mice after immunization three times with SAG1 expression plasmid. With respect to the IgG isotype, co-inoculation of IL-2 expression plasmid enhanced the level of IgG2a and the production of IFN-gamma. Challenging mice by vaccinating with combined plasmids with RH tachyzoites resulted in prolonged survival.

CONCLUSIONHumoral and cytokine responses elicited by SAG1 DNA immunization can be modulated by co-inoculation with IL-2 expression plasmid. The use of DNA vaccine in combination with an appropriate cytokine gene to prevent T. gondii infection warrants further investigation.

Animals ; Antibodies, Protozoan ; blood ; Antigens, Protozoan ; Cytokines ; biosynthesis ; Female ; Immunization ; Immunoglobulin G ; blood ; classification ; Interleukin-2 ; genetics ; Mice ; Protozoan Proteins ; genetics ; Protozoan Vaccines ; immunology ; Toxoplasma ; immunology ; Toxoplasmosis, Animal ; prevention & control ; Vaccines, DNA ; immunology

0.05).Conclusions ATP-TCA could be used to individualize chemotherapy by selecting agents for particular patients of cervical cancer.The expression of GST-? and TS protein might be useful biomarkers to predict the resistance to DDP and 5-FU in patients with cervical cancer.

OBJECTIVETo establish the method of high-performance liquid chromatography HPLC for the determination of N-acetyl-S-(2-carbamoylethyl)-cysteine (AAMA) in urine.

METHODSAfter acid hydrolysis, AAMA in urine was converted into S-2-carboxyethyl cysteine (CEC). CEC reacted with the derivative reagent ophthalaldehyde and formed the derivative with strong fluorescence absorption. The HPLC-fluorescence detector was applied, with an excitation wavelength of 340 nm and an emission wavelength of 450 nm.

RESULTSUrinary AAMA demonstrated an excellent linearity in the range of 5.3~123.5 μmol/L, with a correlation coefficient of 0.9994. The minimum detectable concentration was 0.1 μmol/L (the volume of urine sample was 1.0 ml), the recovery of standard addition was 97.4%~104.2%, and the between-run precision was 2.3%~4.3%. The sample could be stored in the refrigerator for at least 7 days at a temperature of 4℃.

CONCLUSIONThe method is simple, with a low cost, a high sensitivity, and good precision and accuracy, and the instrument and equipment commonly seen in laboratories are applied. Therefore, this method is worthy of wide application.

Acetylcysteine ; analogs & derivatives ; urine ; Chromatography, High Pressure Liquid ; Humans

OBJECTIVETo establish the method of graphite furnace atomic absorption spectrometry for the measurement of stannum in urine with calcium nitrate as the matrix modifier.

METHODSGraphite tube was pretreated with calcium nitrate as the matrix modifier, the urine sample was diluted with 1% nitric acid and then direct injection was performed for these samples, and graphite furnace atomic absorption spectrometry was applied for measurement.

RESULTSThe concentration of stannum in urine showed a good linear relationship within the range of 8.0~40.0 μg/L, with a correlation coefficient of 0.9981. The minimum detectable concentration was 0.72 μg/L, the degree of precision was 1.54%~6.69%, and the recovery rate was 99.23%~107.63%.

CONCLUSIONThis method can determine the content of stannum in urine accurately and rapidly, with a high sensitivity and a low cost.

Graphite ; Humans ; Spectrophotometry, Atomic ; Tin ; urine