Objective:The recent therapeutic effects and safety profile of pemetrexed plus cisplatin as first-line chemotherapy in advanced lung adenocarcinoma were evaluated. Methods:A total of 41 chemotherapy-naive locally advanced or metastatic non-small cell lung cancer patients, who were diagnosed with adenocarcinoma by pathological examination, were included. All patients received 500 mg/m2 pemetrexed on day 1. A total dose of 75 mg/m2 cisplatin was divided into three daily doses administered over 3 d. Treat-ments were repeated every three weeks. The therapeutic efficiency and safety profile were evaluated every two treatment cycles. Re-sults:All 41 patients were eligible for the evaluation of therapeutic efficiency. Seventeen patients showed partial response, 20 patients showed stable disease, and four patients showed disease progression. The overall response rate (ORR) was 41.5%and the disease con-trol rate (DCR) was 90.3%. Subgroup analysis showed that the ORR in males was significantly higher than that in females (63.1%vs. 22.7%, P=0.009). The median progression-free survival of all patients was 11.0 months, whereas the median overall survival was 12.6 months. The intracranial lesions of six patients with brain metastases were well controlled after chemotherapy and palliative whole brain radiotherapy. The ORR and DCR for these patients were 83.3%and 100.0%, respectively. In terms of safety, only 4.8%of the pa-tients showed gradesⅢandⅣneutropenia, nausea, or vomiting. Conclusion:Pemetrexed plus cisplatin is an effective and well-tolerat-ed regimen as first-line therapy for patients with lung adenocarcinoma. According to subgroup analysis, efficacy in males was signifi-cantly better than that in females. Good efficacy was observed in patients with brain metastases treated with chemotherapy and pallia-tive whole brain radiotherapy. No additional adverse effects were observed.

Objectives To search for the relationship between HP and lesions of gastric mucosa of children.Methods Four hundred and fifty-eight bioptic specimens-from eastrie mueosa in children were strained with hematoxylin-eosin(HE)and Warthin-Starry for light microscopic study.Results HP was detected in 152 specimens. HP deteetable rate-in specimens with normal mucosa was 1. 1%, in compari-on with 42.3% in those with chronic superficial gastritis and 14. 3% in those with chronic atrophic gastrins .Specimens with chronic active gastritls, mostry manitesting local active lesions,had HP detectable rate of as high as 80.2%、69. 7% of the specimene with HP were found to have obvious lymph follicles reaction within lamina propria in their gastric mucosa.Conclusions There is a close relationship between HP infection and Pediatric chronic gastritis(especially chronic active gastritis). Histopathologically, HP-associated gastritis is characterized by chronic and local active inflamations, and tbe formation of lymph follicles within lamina propria.

Objective To investigate the effects of astragalus polysaccharides(APS)on the metabolism of collagen in hamsters with diabetes mellitus(DM) and explore the possible mechanism of APS on diabetic cardiomyopathy. Methods The levels of insulin,C-peptide,myocardial enzymes,glycosylated serum protein(GSP),plasma and myocardial angiotensin(AngⅡ) were tested in APS group(n=15) and DM control group(n=15).Immunohistochemistry was used to measure the expression levels of typeⅠand typeⅢ collagen,activities of matrix metalloproteinases(MMPs) were examined by using zymography,and TNF-? and TGF-? mRNA were detected by RT-PCR. Results Compared with DM control group,levels of GSP,myocardial enzymes and myocardial AngⅡ were much lower in APS group(P0.05).The level of expression of collagen Ⅰ,the ratio of collagen Ⅰ/collagen Ⅲ,and the activity of pro-MMP-2 and MMP-2 in APS group were significantly lower than those in the DM group(P

Antibodies, Antineutrophil Cytoplasmic ; blood ; Child ; Female ; Hematuria ; etiology ; Humans ; Kidney ; pathology ; physiopathology ; Kidney Function Tests ; Proteinuria ; etiology ; Renal Insufficiency ; etiology ; Vasculitis ; blood ; complications ; pathology

Objective To study the relationship between tyrosine phosphorylation(TP)and protein expression of insulin receptor substrate-1(IRS-1)and insulin resistance in patients with gestational diabetes mellitus(GDM).Methods IRS-1 expression and TP in skeleton muscle tissue were determined by Western blot and immunoprecipitation in women with GDM(GDM group,n=22),normal pregnant women(normal pregnancy group,n=22)and normal nonpregnant women(normal nonpregnant group,n=13).Fasting plasma glucose(FPG)and fasting insulin(FINS)were measured by oxidase assay and immunoradioassay. Results(1)The levels of FPG,FINS,and insulin resistance index were calculated according to homeostasis model assessment [ HOMA-IR;(5.6?0.8)mmol/L,(15.4?5.1)mU/L,and 1.2?0.5 ] in GDM group were significantly higher than those in normal pregnancy group [(4.4+0.5)mmol/L,(10.6 ?3.1)mU/L,and 0.8?0.3;P

Objective:To identify the polymorphisms of cytochrome P450 3A5 gene (CYP3A5) and multidrug resistance gene 1 (MDR-1) and their distributions in Hans renal transplant recipients in Hunan province, we analyzed the difference of the gene polymorphisms and distributions between Hunan province and 11 other provinces of China.
Methods:We collected 598 Hans renal transplant recipients who had operation or follow-up examination in 3rd Xiangya Hospital from Hunan province. We examined the gene polymorphisms of CYP3A5 and MDR-1 and compared their distributions with the data from 11 other provinces of China by chi-square test.
Results:hTere were CYP3A5*1/*1 genotype in 58 cases (9.7%), CYP3A5*1/*3 genotype in 251 cases (42.0%), CYP3A5*3/*3 genotype in 289 cases (48.3%);MDR-1 3435CC genotype in 238 cases (39.8%), MDR-1 3435CT genotype in 263 cases (44.0%), MDR-1 3435TT genotype in 97 cases (16.2%). Frequency of CYP3A5*1/*1 and*1/*3 genotypes of Hunan province was higher than the that from the 11 other provinces of China and the frequency of mutator*3 was lower. Frequency of MDR-1 3435CC and 3435CT genotypes of Hunan province was higher and the frequency of mutator T was lower than that from the 11 other provinces of China.
Conclusions:There were significant difference in gene polymorphisms and distributions of CYP3A5 and MDR-1 between Hunan province and the 11 other provinces of China. It may be a guideline for us to use calcineurin inhibitor drugs in the early stage atfer renal transplantation.

BACKGROUND: Liver cells are regulated by proliferation and apoptosis following ischemia/reperfusion injury, and the liver regeneration is obvious inhabited after ischemia/reperfusion injury, which can be relieved by ischemic preconditioning. However, the mechanism is still poorly understood.OBJECTIVE: To explore the effects of ischemic preconditioning on remained liver cell apoptosis and proliferation following autologous liver transplantation.DESIGN, TIME AND SETTING: The randomized controlled animal experiment was performed at the experimental animal center of Xiangya Medical College of Central South University from September 2006 to July 2007.MATERIALS: Totally 144 male Sprague Daweley rats were randomly divided into hepatic resection, auto-transplantation, ischemic preconditioning groups, with 48 animals in each group.METHODS: Rats in the hepatic resection group were underwent left hepatic lobe and median lobe resection without blocking blood current at the right hepatic lobe and caudal lobe. In the auto-transplantation group Venous traffic branches of rats were broke, with liberating caudate lobe, first porta hepatis, and inferior vena cava, followed by blocking and continuous hypothermical perfusion preservative fluid via porta hepatic, simultaneously, anemia hepatectomy was performed (left hepatic lobe and median lobe was resected). The liver was washed and preserved in cold preservation solution for 15 minutes. At the end, portal triad clamping was removed and underwent abdominal closure. The procedure of rats in the ischemic preconditioning group was identical to auto-transplantation group except 10 minutes blocking and 10 minutes recover the blood flow at right hepatic lobe and caudal lobe prior to portal vein perfusion. Liver tissues were harvested at hours 0, 1, 3, 6, 12, 24, 48 and 72 after hepatic resection in 3 groups. MAIN OUTCOME MEASURES: Contents of aspartate aminotransferase and alanine aminotransferase were calculated by biochemical analyzer. The index of cell apoptosis was detected by flow cytometry. In addition, proliferation of liver cells was measured by Ki-67 expression. RESULTS: Compared to the auto-transplantation group, the levels of alanine aminotransferase and aspartate aminotransferase were dramatically decreased in hepatic resection and ischemic preconditioning groups at each time point exception with 0 hour after operation (P < 0.05). Few apoptosis cells existed in each group at 0 hour after operation. The index of cell apoptosis increased slightly after resection in the hepatic resection group, which was sharp increased in the auto-transplantation group after reperfusion, reached a peak at 12 hour, and then gradually decreased. Compared auto-transplantation group, the index of cell apoptosis in ischemic preconditioning group was significantly decreased (P < 0.05). The expression of Ki-67 in 3 groups increased after hepatic resection, peaked at 24 hour after hepatic resection, then decreased lower and lower. Compared to the hepatic resection group, the expression of Ki-67 in auto-transplantation group was significantly lower after hepatic resection (P < 0.05). Compared to the auto-transplantation group, the expression of Ki-67 in ischemic preconditioning group was significantly increased after hepatic resection (P < 0.05).CONCLUSION: Ischemic preconditioning can decrease cell apoptosis and promote cell proliferation after rat's liver auto-transplantation, which may be one mechanisms of ischemic preconditioning in promoting liver regeneration.

OBJECTIVE: To evaluate the risk factors of delayed graft function (DGF) and its impact on renal transplantation from donation after cardiac death (DCD). METHODS: We conducted a retrospective study consisting of 48 subjects who underwent a DCD kidney transplantation from February 2010 to March 2012. We classified the recipients into two groups: an IGF (immediate graft function) group (n=30) and a DGF group (n=18), and analyzed the risk factors of DGF and its impact on transplantation. RESULTS: DGF occurred in 18 of the 48 (37.5%) kidneys from DCD donors, and the occurrence of DGF did not adversely influence the survival of patients (P=0.098) and graft (P=0.447). In the univariate analysis, the preoperative dialysis time of recipients (P<0.001), HLA mismatch site (P<0.001), the cause of brain death (P=0.011), BMI (P<0.001), preoperative serum creatinine of donors (P=0.0001), norepinephrine used in donors (P<0.001), warm ischema time (WIT) (P<0.001), cold ischema time (CIT) (P<0.001) showed significant differences. In the multivariate analysis, cerebral hemorrhage as the cause of brain death (P=0.022, OR=39.652), preoperative serum creatinine of donors≥177 μmol/L (P=0.008, OR=57.148) and the preoperative dialysis time of recipients≥12 months (P=0.060, OR=15.060) were independent risk factors for DGF development. CONCLUSION The independent risk factors for DGF are the cause of brain death, the terminal creatinine level, and the preoperative dialysis time.
Brain Death ; Creatinine ; blood ; Delayed Graft Function ; Graft Survival ; Humans ; Kidney ; physiopathology ; Kidney Transplantation ; Multivariate Analysis ; Renal Dialysis ; Retrospective Studies ; Risk Factors ; Time Factors ; Tissue Donors

ObjectiveTo explore the appropriate teaching methods for medical international students.MethodsTotally 84 students in grade 2005 and 63 students in grade 2006 took part in clinical skills training in 2010 and 2011.The traditional method was employed in grade 2005 and interactive teaching and imagery training was applied in grade 2006 combined with the traditional methods.ResultsThe scores of clinical skill tests ( posterior thorax puncture test,abdomen puncture test,bone puncture,catheterization test) were significantly higher in grade 2006 than in grade 2005 with statistical differences,P ＜ 0.01.The clinical skill test scores were not statistically different between grade 2005 and 2006 before training,P ＞ 0.05,but the scores were statistically different between grade 2005and 2006 after training,P ＜ 0.05.Conclusion Using polynary teaching methods synthetically is helpful to improve the clinical skill training effect for medical international students.

Objective To evaluate the efficacy and safety of a novel mutated recombinant tissue-type plas-minogen activator (rt-Pam) in a rat model of acute cerebral thrombosis. Method Eighty-seven adult Wister rats were randomly divided into control group, recombinant tissue-type plasminogen activator (rt-PA) group, low dose of rt-Pam group and routine dose of rt-Pam group. The rats of different groups were treated for 3 hours after thrombosis of middle cerebral artery. The size of infarction, neurological scores and severity of hemorrhage were observed 24 hours after treatment. The protective role of rt-Pam in the brain tissue was evaluated as per the infiltration of neutrophils and the concentration of plasminogen activator receptor-1 (PAR-1). Results Compared with control group, the sizes of infarction in the low dose of rt-Pam group and routine dose of rt-Pam group were significantly smaller [(108.5 ±27.3) mm3 and (68.3 ±17.2) mm3 vs. (323.4 ±42.3) mm3]. The neurological scores were evidently correlated with the size of infarction (r = 0.613, P<0.001), while the liability of cerebral hemorrhage in low dose of rt-Pam group was not significantly increased. The rt-Pam also reduced the production of myeloperox-idase, as well as the production of PAR-1 in comparison with rt-PA group [(13.8 ± 3.1) vs. (28.3±4.5), P <0.00l]. Conclusions The novel rt-Pam could be a better thrombolytic agent than rt-PA in treating acute stroke.