No abstract available.
Mycobacterium avium Complex* ; Mycobacterium avium* ; Mycobacterium*

Background and purpose: Brain metastases are common occurrences in patients with non-small cell lung cancer (NSCLC). Gefitinib is a specific inhibitor of epidermal growth factor receptor-associated tyrosine kinase, which has been commonly used in the treatment for advanced NSCLC. The aim of this study was to evaluate the antitumor efficacy of gefitinib in NSCLC patients with brain metastases. Methods: Fifty NSCLC patients with brain metastases were reviewed retrospectively. All of them were treated with gefitinib, given orally at a daily dose of 250 mg. These patients discontinued administration of gefitinib when disease progression, death or intolerable side effects appeared. X~2 test was applied in response analysis. Survival analysis was compared with Kaplan-Meier method and Log-rank test respectively. The multivariate analysis was perfonned with Cox's proportion risk model. Statistical significance was defined as P<0.05. Results: In terms of intracranial lesions, partial response (PR) was observed in 5 patients (10%), stable disease (SD) in 37 patients (74%) and progressive disease (PD) in 8 patients (16%), objective response rate (ORR) and disease control rate (DCR) were 10% and 84%, respectively. As for systemic disease, PR was observed in 5 patients (10%), SD in 30 patients (60%) and PD in 15 patients (30%), overall ORR and DCR were 10% and 70%, respectively. Overall DCR was related to the patients' PS score and the number of brain metastases (P=0.004, P=0.022), but there was no statistical difference in overall DCR among different subtypes of age, gender, smoking history, histology, the onset of brain metastases, chemotherapy, brain radiotherapy and side effects (P>0.05). The median time to disease progression (MTTP) was 7.0 months, which was related to the patients' PS score and smoking history (P=0.000, P=0.045). The median survival time (MST) was 10.8 months, and 1-and 2-year survival rates were 44% and 6% respectively. The univariate analysis showed that the survival time was related to the patients' PS score. smoking history and the number of brain metastases (P=0.011, P=0.028, P=0.044). The multivariate analysis indicated that both the patients' PS score and smoking history were two independent prognostic factors (P=0.005, P=0.006) and the relationship of the survival time and the number of brain metastases was near to statistical significance (P=0.075). Conclusion: The patients with non-smoking history and favorable performance status(PS 0-1) may have better survival benefit and those with single brain metastasis have a trend to survive longer. Gefitinib may be effective on brain metastases in NSCLC patients and appears to be a possible new treatment option.

OBJECTIVE:To improve the method for the determination of content and related substances of Molsidomine tablet. METHODS:HPLC was adopted to determine the content and related substances,HPLC-MS was adopted for the qualitative degra-dation impurities in destruction test. The column was Waters Symmetry-C18 with mobile phase of 0.05% formic acid- methanol (gradient elution) at a flow rate 1.0 ml/min and 0.2 ml/min (respectively for content and related substances determination,mass spectrometry),the detection wavelength was 210 nm,column temperature was 30℃,the injection volume was 20μl and 5μl(re-spectively for content and related substances determination,mass spectrometry). RESULTS:Each component was well separated un-der chromatographic conditions;degradation impurities were confirmed;the linear range of molsidomine was 4. 0-28.0 μg/ml(r=0.9997);RSDs of precision,stability and reproducibility tests were lower than 1%;recovery was 97.74%-100.70%(RSD=0.49%,n=9). CONCLUSIONS:The method is simple,accurate with good specific and high precision,and can improve the quali-ty control of Molsidomine tablet.

Objective To analyze the treatment and prognosis of lung cancer patients with brain metastases.Methods The clinical data of 352 lung cancer patients with brain metastases were retrospectively reviewed.According to the treatment modalities,patients were divided into palliative therapy group(n=28),simple whole brain radiotherapy(WBRT)or chemotherapy group(n=49)and comprehensive treatment group(n=275).Comprehensive treatment group was subdivided into WBRT plus chemotherapy group(n=192),stereotactic radiosurgery(?knife)plus chemotherapy/WBRT group(n=72,n=16 for?knife plus chemotherapy and n=56 for?knife plus WBRT and chemotherapy)and neurosurgical resection plus chemotherapy/WBRT group(n=11).In comprehensive treatment group,111 patients received chemotherapy≤3 cycles,and the other 164≥4 cycles.Survival curves of each group were drawn respectively,and both survival time and survival rates were compared among groups.Results The median survival time of palliative therapy group,simple WBRT or chemotherapy group,WBRT plus chemotherapy group,?knife plus chemotherapy/WBRT group and neurosurgical resection plus chemotherapy/WBRT group was 1.7,3.2,9.0,11.6 and 17.1 months,respectively.It was revealed by survival analysis that WBRT plus chemotherapy group was better than simple WBRT or chemotherapy group (P=0.0000),?knife plus chemotherapy/WBRT group was better than simple WBRT or chemotherapy group(P=0.0000),and neurosurgical resection plus chemotherapy/WBRT group was better than simple WBRT or chemotherapy group and WBRT plus chemotherapy group(P=0.0001,P=0.0229).There was no significant difference in survival rates between neurosurgical resection plus chemotherapy/WBRT group and?knife plus chemotherapy/WBRT group(P=0.2543),and there was no significant difference in survival rates between those with?knife plus chemotherapy and those with?knife plus WBRT and chemotherapy(P=0.3804).In comprehensive treatment group,the survival rates of those with chemotherapy≥4 cycles was significantly higher than that of those with chemotherapy≤3 cycles(P=0.0000). Conclusion Both WBRT plus chemotherapy and?knife plus chemotherapy and WBRT are effective modalities for the treatment of lung cancer patients with brain metastases,and the latter has the tendency to gain more survival benefit.There is no significant difference in the survival time between patients receiving?knife with WBRT and those without.It is proper for the patients to have no less than 4 cycles of chemotherapy.

AIM:The objective of the study was to explore whether intestinal endotoxemia participate in the development of Alzheimer disease.METHODS:Adult Wistar rats were subjected to 90 days intraperitoneal injection with D-galactose and aluminum trichloride(AlCl3) to establish the model of Alzheimer disease.After the administration,the study and memory ability in the rats were observed by Morris water maze.The level of lipopolysaccharide(LPS) in the sera of Alzheimer disease's rats was determined by tachypleus amebocyte lysate method.The level of tumor necrosis factor-?(TNF-?) and interleukin-1(IL-1) in the sera were determined by radioimmunoassay.The expressions of amyloid ?-protein precursor(APP),presenilin 1(PS1) and ?-site APP-cleaving enzyme(BACE) in hippocampus were detected by RT-PCR.RESULTS:Compared with the normal control,the level of LPS in the sera and the expressions of APP,PSI,BACE mRNA in the hippocampus were markedly increased(P

Objective To compare the safety and efficacy of whole stage and first stage of labor analgesia on puerperas with pregnancy-induced hypertension syndrome.Methods From March, 201 5 to November,201 5,1 96 single fetus,aged 22-35 years,term pregnancy,primipara,ASA physical status Ⅰ or Ⅱ, diagnosed pregnancy-induced hypertension syndrome, were randomly divided into the whole stage of labor analgesia group (group T)and the first stage of labor analgesia group (group F).Patients in group T received labor analgesia after uterine contractions regularly,and continued the labor analgesia to the end of the delivery;patients in group F received labor analgesia after uterine contractions regularly and the uterus cervix was 3 cm,in the end of the first stage of la-bor,using the normal saline instead of the medicine.The MAP and VAS score were recorded before analgesia and 10 minutes,60 minutes after the beginning of analgesia,when the uterine cervix dilated absolutely,the second stage of labor and when the fetal is delivered.The Bromage scores were recor-ded at the second stage of labor.The time for the first stage of labor,the second stage of labor and the third stage of labor were recorded.The mode of delivery,the incidence of eclampsia,postpartum hemorrhage,the use of oxytocin and antihypertensive in the delivery progress were recorded.The ne-onate weight,Apgar score and the cord blood gas analysis were recorded.Results At the uterine cer-vix dilated absolutely and the second stage of labor,the MAP [(106.0±7.0)mm Hg vs.(1 1 5.4± 7.3)mm Hg,(106.2 ± 7.2 )mm Hg vs.(1 1 6.0 ± 7.6 )mm Hg]and VAS score [(2.0 ± 1.1 ) scores vs.(5.1±1.2)scores,(1.9±1.2)scores vs.(5.2±1.3)scores]in group T were lower than those in group F (P <0.05).The patients who received oxytocin in group T were more than that in group F [50(5 1%)vs.35(35%),P <0.05].Conclusion The whole stage labor epidural analgesia is safe and effective for puerperas with pregnancy-induced hypertension syndrome.

Objective To investigate the MRI features of urethral sphincter in female with stress urinary incontinence(SUI) by the study of the indexes of the thickness of middle urethral sphincter, the function urethral length and bladder neck funnel . Methods Forty patients of female patients diagnosed as SUI by clinical were retrospectively as SUI group, and 40 asymptomatic female volunteers were recruited as reference group. All of the subjects were tested by pelvic MRI scanning both in static status and in the condition of Valsalva. The thickness of middle urinary sphincter was measured in the horizontal axis plane. In the midsagittal plane, the function urethral length was measured from the internal orifice to perineal fascia. The bladder neck funnel whether exist was observed from the midsagittal plane. For the comparison of the urinary sphincter thickness and urethral length of the two groups, independent sample t test was adopted. For urethral length in static status and under the condition of Valsalva, paired t test was done. For comparison of positive rate of the bladder neck funnel, Chi?squared test has been done. Results The value of the middle urinary sphincter thickness in the groups of SUI and reference were (2.23±0.68) mm and (2.69± 0.75) mm, respectively. Thus the differences of the two groups had statistical significance (t=-2.839, P<0.01 ). In the static status, the urethral length in SUI and reference group were (2.72±0.51) cm and (2.94± 0.34) cm respectively, wheras in Valsalva condition, the value were (2.33 ± 0.49) cm and (2.43 ± 0.43) cm respectively. The differences of the two groups had statistical significance in static status (t=-2.322, P=0.023), wheras there had no statistical significance in the two groups in Valsalva condition (t=-1.049,P=0.297). For SUI and reference group, both in static status and Valsalva condition, the difference of function urethral length had statistical significance (P< 0.01). The positive rate of bladder neck funnel for SUI was 72.5% (29/40), and for reference was 22.5% (9/40), the difference of the two groups had statistical significance(χ2=20.050, P<0.01). Conclusion For female SUI patients, urinary sphincter muscle is much thinner, function urethral length is much shorter and has higher positive rate of bladder neck funnel.

Objective To investigate the dynamic changes in each radical line of pelvic floor levator hiatus in female with stress urinary incontinence(SUI). Methods A retrospective analysis of MR images was performed in 30 female patients with clinically diagnosed SUI and 30 asymptomatic female volunteers recruited as reference group. All of the subjects underwent pelvic MRI scanning both in static statusand Valsalva maneuver, respectively, Valsalva was performed by attempt to forcibly urinate while holding her breath, respectively. Area of pelvic diaphragm hiatus (LHA), ntero-posterior length (LHL) and tmixmum width (LHW) were measured in horizontal axis plane of the obtained images.H line distance was measured in the midsagittal plane. Independent sample t test was performed to compare the difference in LHA, LHL and LHW between two groups. Paired t test was used to compare difference in LHA, LHL and LHW between two groups in static status and Valsalva maneuver, respectively. Results In static status, the values in LHA, LHL, LHW and H line distance for SUI groups were(28.7±19.3) cm2, (7.1±2.2) cm, (4.7± 1.6 ) cm and (5.7±1.1) cm, respectively. The parameters for the reference group were(13.1±3.7)cm2, (5.3± 0.8) cm, (3.4 ± 0.5) cm and (5.7 ± 0.9) cm, respectively. The difference in LHA, LHL, LHW between two groups was statistically significant (t=4.33, 4.36, 4.23, and P<0.01 for all indexes), whereas the difference in H line distance between two groups was no statistically significanct because of P> 0.05. In Valsalva
maneuver, LHA, LHL, LHW and H line distance were (40.0±26.0) cm2, (8.0±2.3) cm, (6.0±2.5) cm and (6.1± 1.5)cm for SUI group, and were (16.2±6.2) cm2,(5.5±1.0) cm, (3.6±0.8) cm and (6.0±1.0) cm for the reference group, respectively. The difference in LHA, LHL and LHW between two groups was statistically significant, (t=4.88, 5.36, 4.91 respectively, and P<0.01), whereas the differencein H value between two groups was no statistically significant (P< 0.05). For SUI group , the difference of LHA, LHL and LHW between static status and Valsalva maneuver had statistically significant with P<0.01. For reference group, the difference of LHA and LHL between static status and Valsalva maneuver had statistically significant(P<0.05). Conclusion Dynamic and static pelvic MRI can evaluate the morphology and variation of pelvic floor levator hiatus much intuitively and accurately. pelvic floor levator hiatus becomes enlarged in female with SUI.

Objective To develop a method for the determination of Hesperidin,magnolol from "He-Wei-Yin" Mixture,and for its quality control,high-performance liquid chromatography (HPLC) is used.Method After plenty of study about the condition,the final result choosed was as following:an analytical column of HypersiC18(200mm?4.6mm,5?m ) maked by HP was utilized. The column number was 13164421196.The mobile phase was adapted gradient with methanol-1% acetum solution,according to the following profile:0～30min,methanol concentration from 30% to 70%;30～40min,from 70% to 80%;40～50min,from 80% to 30%. The flow rate was 1.0ml/min with the column kept at ambient temperature. All the components had come out in 45 min with the detection wavelength at 294nm. It followed the order of Heperidin,Magnolol according to the retention times in the chromatography.Results In the result,the regression equations were as following:Hesperidin was Y=139.718X+4.511 with a good linearity (r=0.99994). Magnolol was Y=1456.342X+106.506 with a good linearity (r=0.99957) between the peak area and the mass of the standard.The recoveries of the method were as following:in the "He-Wei-Yin" Mixture,for hesperidin,precision of the method RSD=1.87%(n=5),recovery of the method 96.53%(RSD=3.36%,n=3);for Magnolol,precision of the method RSD = 0.34% (n=5); recovery of themethod 93.17%(RSD=4.69%,n=3).At the same condition as above,the determination of content was carried out for six different dose and batch No.Conclusion The method is simple and reliable,easy to operate,suitable for the quality control of Hesperidin and Magnolol in "He-Wei-Yin" Mixture.

Objective To study the association between renal dysfunction and platelet parameters in elderly patients with early heart failure (HF).Methods 637 patients (350 old-aged and 287 middle-aged) with hypertension,CHD,T2DM admitted to our hospital from January 2013 to December 2014 served as a disease group and 464 subjects (229 old-aged and 235 middle-aged) selected from the 973 Aging Project in September 2007-June 2008 served as a healthy group.Their eGFR and platelets (PLT) were calculated,their plateletcrit (PCT) and mean platelet volume (MPV) were measured.Association between platelet parameters and renal dysfunction was analyzed by binary logistic regression analysis.Results The MPV and PCT were significantly lower in the old-aged disease group than in the old aged healthy group (9.78± 1.45 vs 10.66±0.78,P＜0.01;19.79 ± 6.21 vs 21.82 ± 6.04,P＜0.01).The PLT and PCT were closely associated with the eGFR in two groups (P＜0.05,P＜0.01).Binary logistic regression analysis indicated that the median and high PLT in disease group and the median PLT in healthy group were independently associated with renal dysfunction (OR=0.560,95％CI:0.315-0.996;OR=0.480,95％CI:0.262-0.879;OR=0.483,95％CI:0.249-0.936,P＜0.05).Conclusion Attention should be paid to the effect of PLT and their functional activity on renal function in treatment of early HF patients because aging-induced change of PLT and their functional activity are associated with renal dysfunction.