Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Cardiotonic Agents ; therapeutic use ; Child ; Diuretics ; therapeutic use ; Heart Failure ; drug therapy ; etiology ; surgery ; therapy ; Heart Transplantation ; methods ; Heart-Assist Devices ; Humans ; Pediatrics ; Treatment Outcome

Objective To determine relative risk factors for positive surgical margins in extraperitoneal laparoscopic radical prostatectomy(LRP). Methods From February 2004 to September 2007,33 patients(mean age 70 years old)with prostate cancers underwent extraperitoneal LRP.All patients were diagnosed by pathology preoperatively.Gleason score:3+3 14 cases(43%),3+4 11 cases(33%),4+3 6 cases(18%),4+4 2 cases(6%).Clinical stage:T1a-T1b 4 cases(12%),T1c 14 cases(43%),T2a-T2b 5 cases(15%),T2c10 cases(30%).Logistic regression analyses were performed. Results LRP was successfully performed on 31 cases.There were 2 cases converted to open surgery.Nine cases(27%)had PSMs.There were 6 cases(67%)and 4 cases(17%)of clinical stage T2c in PSM and negative surgical margin(NSM)groups respectively(P=0.010).There were 3 cases(33%)and 0(0)with high Gleason score(higher than 7)in PSM and NSM cases(P=0.015).There were 4 cases(44%)and 5 cases(21%)with t-PSA higher than 20dg/ml in PSM and NSM cases respectively(P=0.178).In these 9 cases,there were 4 cases(44%)positive with DRE.However there were 9 in the 24 NSM cases(38%)(P=0.509).Clinical stage T2c was independently positively correlated with PSM(OR=24.69).High Gleason score(higher than 7)and t-PSA higher than 20 ng/ml were positively correlated with PSM. Conclusions Clinical stage is positively correlated with PSM.It is an independent factor.High Gleason score(higher than 7)and t-PSA higher than 20 ng/ml mignt be the risk factors in predicting PSM and should be used together with clinical stage.Positive DRE findings may be also useful to predict PSM.

Crohn Disease ; pathology ; Humans ; Infant ; Male

Objective To evaluate the efficacy of 10-day compound allantoin containing quadruple regimen in the treatment of chronic gastritis with Helicobacter pylori (H.pylori) infection,and to compare with the bismuth-containing quadruple therapy.Methods Altogether 173 patients with H.pylori positive chronic gastritis confirmed by gastric endoscope were divided into 10-day compound allantoin containing quadruple regimen group (n =43),24-day compound allantoin containing quadruple regimen group (n =46),10-day bismuth-containing quadruple regimen group (n =42) and 24-day bismuth-containing quadruple regimen group (n =42).After the treatment,the eradication rate of H.pylori,the rate of gastrointestinal symptoms (epigastric pain,bloating and belching) relief and the adverse effects of each group were observed.Intention-to-treat (ITT),per-protocol (PP) statistical analysis and chi-square analysis were performed for statistical analysis.Results H.pylori eradication rates of 10-day compound allantoin containing quadruple regimen group,24-day compound allantoin containing quadruple regimen group,10-day bismuth-containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group analyzed by ITT were 90.7％ (39/43),91.3％ (42/46),90.5％ (38/42) and 88.1％ (37/42),respectively; while analyzed by PP were 90.7％ (39/43),93.3％ (42/45),90.5％ (38/42) and 90.2％ (37/41),respectively.And there were no statistical differences between groups (all P＞0.05).Ten days after the treatment,the rates of epigastric pain relief of 24-day compound allantoin containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group were 81.1％ (30/37) and 78.8％ (26/33),respectively,the rates of bloating relief were 82.4％ (28/34) and 71.0％ (22/31),respectively,and the rates of belching relief were 76.9％ (20/26) and 75.0％ (21/28),respectively.There were no statistical differences between the two groups (all P＞ 0.05).However after 24-day treatment,the rates of epigastric pain relief of 24-day compound allantoin containing quadruple regimen group and 24-day bismuth-containing quadruple regimen group were 91.9 ％ (34/37) and 87.9％ (29/33),respectively,the rates of bloating relief were 94.1％ (32/34) and 87.1％ (27/31),respectively,and the rates of belching relief were 96.2％ (25/26) and 85.7％ (24/28),respectively.There were no statistical differences between the two groups (all P＞0.05).And the rates of epigastric pain and bloating relief increased after 24-day treatment compared with those of 10-day treatment,however the differences were not statistically significant between the two groups (all P＞ 0.05).In 24-day compound allantoin containing quadruple regimen group,the rate of belching relief was higher after 24-day treatment compared with that of 10-day treatment,and the difference was statistically significant (x2=4.127,P=0.042).No severe adverse effects were observed in each group,and there were no adverse effects such as oral metal odor,tongue black and melena in compound allantoin containing quadruple therapy.Conclusions Ten-day compound allantoin containing quadruple therapy as first-line approach in the treatment of chronic gastritis with H.pylori infection can get better H.pylori eradication and the efficacy is similar to bismuth quadruple therapy.Meanwhile the symptom relief rate is high and no obvious adverse effects were found.

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous group of immunosuppressive cells derived from bone marrow stem cells.MDSCs can not only strongly inhibit the anti-tumor immune reactions mediated by T cells,but also directly accelerate angiogenesis,tumor progression and metastasis.Nonresolving inflammation (NRI),a major driving factor in the occurrence and development of tumor,and MDSCs are present in tumor microenvironment and become hot topics in recent years.However,the relationships between MDSCs and NRI,especially in the relevant molecular regulatory networks,have not been fully elucidated.The relationships between MDSCs and NRI,the molecular regulatory networks,the key regulatory points and the strategies for targeted treatment are reviewed in this paper based on the current literatures and the work achieved by our research team.

Objective To investigate the therapeutic effect and mechanism of ribavirin to mice viral myocarditis. Methods Onehundred and twenty mice were randomly divided into 3 groups. Group 1 was normal control group 1 .group 2 CVB3 control group, group 3 ribavirintherapy group. In the latter two groups, 0.2 mL CVB3(10-7.5Tcid5o/mL)was infected into abdominal cavity. Ten mice of each group were killed at the 7 th, 14 th,21 st,28 th day. Mice motality,light and electron microscape, myocardial viral tiler, myocardial pathological score,serum cTnI,malonytdialdehyde(MDA) and cardiac myocyte apoptosis rate(CMAR) were examined.Re-sults The motality,myocardial viral titer,myocardial pathological score,cTnI were lower in group 3(ribavirin therapy group) than in group 2(CVB3 control), and MDA and CMAR were no significant differences between ribavirin group and simple CVB3 group. Conclusion Ribavirin has good treatment effect to mice viral myocardilis,and its mechanism is due to decrease viral titer.

Gastric adenocarcinoma (GC) is one of the most common malignancies in the world and one of the most frequent causes of cancer-related death.Autophagy is a highly regulated catabolic pathway responsible for the degradation of long-lived proteins and damaged intracellular organelles.However,the mechanism and guiding significance of autophagy in the development and progression of GC have remained to be elucidated.This study aimed to explore the clinicopathological significances and prognostic values of autophagy-related proteins AMBRA1 and Beclin-1 in GC.Quantum dots based immunofluorescence histochemistry (QDs-IHC) was performed to observe the expression of AMBRA1 and Beclin-1 proteins in the tissue rmicroarrays including 163 specimens of GC and 20 noncancerous gastric tissues.Simultaneously,AMBRA1 and Beclin-1 proteins were detected by Western blotting in the 10 fresh GC and corresponding normal gastric tissues.The results showed that the expression levels of both AMBRA1 and Beclin-1 proteins were higher in GC tissues than in noncancerous gastric tissues by QDs-IHC and Western blotting (P＜0.05).High AMBRA1 expression was detected in 90 of 163 (55.2％) GCs and high Beclin-1 expression was detected in 83 of 163 (50.9％) GCs.High AMBRA1 expression was closely related to depth of invasion,and lymph nodes metastasis (P＜0.05).High expression of Beclin-1 protein was correlated with tumor grade (P＜0.05).Positive correlation was observed between AMBRA1 and Beclin-1.Survival analysis indicated the high expression of AMBRA1 and Beclin-1 was an independent factor in predicting poor overall survival (OS) of GC patients.These findings suggest the high expression of AMBRA1 and Beclin-1 proteins is significantly correlated with GC progression.High AMBRA1 and Beclin-1 expression heralds worse outcome of GC patients,suggesting a novel candidate prognostic marker and a therapeutic target for GC.

Objective To investigate the prevalence of CKD in patients underging coronary angiography with suspected coronary heart disease(CHD). Methods A total of 1031patients with suspected CHD undergoing coronary angiography in Zhongda Hospital from December 2008 to October 2009 were enrolled in the study.The prevalence of CKD and associated risk factors were analyzed.GFR Wag estimated with MDRD equation.CKD was deftned as eGFR<60branches of coronary artery was considered as CHD. Results The mean age of patients were (64.37±11.02)years.There were 543 males and 488 females,including 551 patients with CHD and 134 patients with CKD(13%).Patients with CHD had a significantly higher prevalence of CKD compared with patients without CHD(18.33%vs 6.88%,P<0.01).With the increasing number of stenosis coronary vessels(n=0,1,2,3),eGFR was declined[(84.25±19.00),(81.61±23.92),increased(0.42%,0.82%,1.96%,3.25%,P=0.006),and the prevalence of CKD increased (6.88%,13.11%,21.57%,23.38%,P<0.01).Logistic regression analysis indicated that increasing age(OR 1.094,95%C/1.068 to 1.120),increasing number of stenosis coronary vessels(OR 1.288,95%CI 1.074 to 1.543).hypertension(OR 1.974,95%CI 1.082 to 3.603),cardiac systolic insufficiency(OR 3.183,95%CI 1.696 to 5.972),and hyperuricemia(OR 5.366,95%CI 3.224 to 8.9311 were risk factors for CKD. Conclusions The prevalence of CKD in patients with CHD diagnosed by coronary angiography is quite high.Aging,elevated number of stenosis coronary vessels,hypertension,cardiac systolic insufficiency and hyperuricemia are important risk factors for angiographic patients with CKD.

Objective To evaluate the skill and outcome of arthroscopic reconstruction of posterior cruciate ligament (PCL) with retention of PCL remnant. Methods From April 2004 to June 2006, 38 patients (38 knees) with PCL deficiency were verified by clinical and arthroscopic examinations. Of them, there were 9 knees combined with disruption of the posterolateral comer, 6 with rupture of the posteromedial corner, 8 with lateral meniscus tear and 4 with medial meniscus tear. With reservation of PCL remnant and synovium, all the impaired PCLs were reconstructed with single bundle of autogenous quadrupled hamstring tendons under arthroscopy. Interference screws were used for direct anatomic fixation of the reconstructed ligament. Results No severe comphcations occurred at early stage after operation in all 38 patients who were followed up for 12-37 months (average 20.79 months). Lysholm score was improved significandy from 40-70 points (mean 51.32 pints) before operation to 70-100 pints (mean 92.37 points) at the latest follow up (t=-30.14, P<0.01). According to International Knee Documentation Committee (IKDC) score, there was a remarkable improvement from 16 abnormal knees (grade C) and 22 severely abnormal knees (grade D) preoperatively to 18 normal knees ( grade A), 18 nearly normal knees (grade B) and 2 abnormal knees at the latest follow up (Z=-6.00, P <0.01). Of 38 patients, 36 returned to normal sports level but 2 degraded level of sports. Conclusions Arthroscopic PCL reconstruction with retention of PCL remnants is a feasible technique, with satisfactory outcome. Preservation of PCL remnants and synovium may be beneficial to biological incorporation and reinnervation of the reconstructed ligament.

Objective To investigate the relationship between coagulation function and the tumor size, clinical stage and metastasis status in renal cell carcinoma (RCC) patients. Methods A total of 290 RCC patients from 2004 to 2009 were included in present study. There were 181 male patients and 109 female patients. The average ages was (56.3± 13. 5) years. There were 252 cases of clear cell carcinoma, 19 cases of papillary carcinoma, 5 cases of chromophobe cell carcinoma, 3 cases of cystic RCC, and 11 cases of other types. TNM classification: stage Ⅰ 202 patients, stage Ⅱ32 patients , stage Ⅲ 32 cases, stage Ⅳ 24 cases. There were N0 264 patients, N1 11 patients and N2 15 cases. There were M0 273 cases, M1 17 cases. One hundred and eighty-six cases of benign renal tumors were set as the control group. Fibrinogen (Fib), prothrombin time (PT), activated partial thromboplastin time (APTT) and international normalized ratio (INR) were detected. Results The preoperative serum Fib of RCC patients was (39. 6±15.6) g/L, the control group was (32. 8±8. 2)g/L. There was significant difference between them (P<0. 05). The values of preoperative APTT,INR, and PT were (31.7±5.2)s, (1.0±0. 1), (11.2±1.3)s in RCC group and (32. 4±4.2)s,(1.0±0. 1), (11.1±1.3)s in the control group. There were no significant differences between them (P＜0.05). The values of Fib in stage Ⅰa, Ⅰb, Ⅱ, Ⅲ, Ⅳ groups were (32. 6±6. 6), (36. 1±8. 7),(48.8±21.6), (49.9± 17.8) and (59.7± 19.2)g/L, respectively. There was no significant difference between stage Ⅰ, and the control group. But the other stages showed significant difference with the control group (P<0.01). Hyperfibrinogenemia (Fib>44.0 g/L) in the RCC group accounted for 74 cases (25.5%). If the value of Fib ≤44. 0 g/L, 92.1% of patients can be excluded from the probability of metastasis. Conclusions Preoperative plasma Fib levels could be elevated in RCC patients with distant metastasis or lymph node metastasis. Increased preoperative plasma Fib levels, especially hyperfibrinogenemia may be a predictor of metastasis.