Objective To explore the advantage of stepwise therapy of dehydration drugs on aged people with cerebral contusion for reduce the incidence of delayed traumatic intracranial hematoma and improve neurological function.Methods One hundred and twenty standard patients were divided into stepwise therapy group(n =60,group A) and regular therapy group(n =60,group B) by randomly.In group A,according to the developing regularity of cerebral edema,we use less dehydration drugs on early stage,and increase the dose step by step with the disease developed.In group B,we use dehydration drugs regularly,then compare the incidence rate of delayed traumatic intracranial hematoma and the cure rate of the disease between this two groups.Results The incidence of delayed traumatic intracranial hematoma was 8％ (5/60) in A group,and 30％ (18/60) in B group.Compared with B group,the stepwise therapy of dehydration drugs on cerebral contusion can reduce the incidence of delayed traumatic intracranial hematoma obviously,there was significant difference between two groups(x2 =6.21,P ＜0.05) ;The recovering rate was 70％ (42/60) in B group,and 30％ (28/60) in B group,there was significant difference between two groups (x2 =6.72,P ＜ 0.05).Conclusion The treatment of stepwise therapy is more reasonable on aged people with cerebral contusion,the incidence of delayed traumatic intracranial hematoma can be reduced obviously compared with regular therapy of dehydration drugs.

10.3969/j.issn.2095-4344.2013.25.009

BACKGROUND:High-dose antibiotics for bone infection have many adverse reactions, and its outcomes are not perfect. Thus, to explore a degradable material as a vector to prevent bone infection is valuable. OBJECTIVE:To study drug release characteristics of gatifloxa-poly sebacic anhydride local control ed release system in vivo. METHODS:A 3 mm × 6 mm bone window was made at right knee joint of New Zealand rabbits. The gatifloxacin-poly sebacic anhydride sustained release preparation was implanted. Heart blood, bone tissue and myeloid tissue specimens were obtained at 1, 2, 3, 6, 9, 12, 15, 18, 25 and 30 days after surgery. High-performance liquid chromatography was utilized to determine gatifloxacin concentration. Scanning electron microscope was employed to observe the structural changes before and after implantation of gatifloxacin-poly sebacic anhydride sustained release preparation. RESULTS AND CONCLUSION:After implantation of gatifloxacin-poly sebacic anhydride sustained release preparation, drug concentration gradual y decreased in the myeloid tissue, peaked at 1 day, stabilized at 3-15 days, gradual y reduced at 15-30 days. However, the drug concentration was stil higher than the minimal inhibitory concentration 0.1 mg/L against Staphylococcus aureus at 30 days. The peak of drug concentration in the bone tissue occurred at 3 days, and stabilized at other days, which was higher than 0.1 mg/L. At the same time point, drug concentration in the blood specimen was lower than that in the myeloid tissue and bone tissue. The degradation of gatifloxacin-poly sebacic anhydride sustained release preparation was surface erosion, and the shape of the degradation residue is smal globular. The change of the internal structure of gatifloxacin-poly sebacic anhydride sustained release preparation was not found. In the drug release procedure, gatifloxacin-poly sebacic anhydride sustained release preparation did not show disintegration or fragmentation. These results indicated that
gatifloxacin-poly sebacic anhydride local sustained release preparation has good abilities of drug load and drug release.

ObjectiveTo study the clinical feature, diagnosis, treatment and prognosis of hepatic angiomyolipoma.Methods The clinical materials of eight surgically treated patients with hepatic AML were retrospectively analyzed.ResultsThere were five females and three males, with age ranging from 25 to 59 years (mean 39 6 years). Tumors were located in the right lobe of the liver in 5 cases, and in the left lobe in 3 cases. Ultrasonography and computed tomography were performed in all cases. Magnetic resonance imaging and angiography were done in two each cases. The myoid cells in all tumors showed over expression of HMB 45. One patient died of postoperative heart failure, seven were followed up for 9 mos to 12 years without tumor recurrence. Conclusions Comprehensive imaging features can reveal the characteristic components of hepatic angiomyolipoma. HMB 45 immunostaining can be used to confirm the diagnosis. Surgical resection is an effective treatment of hepatic AML.

AIM:To asses the presence and clinical significance of metallothionein,(MT) in primary invasive ductal carcinoma of the breast. METHOD: 96 cases of routinely fixed and paraffin-embedded primary breast carcinomas were investigated with the labelled avidin biotin immunohistochemical method. RESULTS: The positive staining for MT observed was 52.1% (50/96). In most cases both nuclear and cytoplasmic staining was seen. A statistically association was found between MT positive staining and nuclear grade( P

Objective To investigate the impact of squamous cell carcinoma antigen(SCCAg)in patients with recurrent squamous cell carcinoma of the uterine cervix.Methods Totally 72 patients with recurrent squamous cell carcinoma of the uterine cervix treated at the Cancer Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,between 1999 and 2005 were retrospectively analyzed to investigate the impact of SCCAg on diagnosis and prognosis by univariate and multivariate analysis.Results This study included 30 patients with recurrent disease after primary radical surgery and 42 patients with recurrent cervical cancer after radio-chemotherapy.Sixty one patients(85%)had serum SCCAg elevated (≥1.5 pg/L),and 20 of these(28%)had an increase of SCCAg before clinical manifestation of relapse.The median leading time was 3 months(range:1-13 months).Forty five patients had no symptoms with only SCCAg elevation,and 15 patients experienced leg edema and(or)sciatic pain,7 patients suffered from irregular bleeding and 5 patients had symptoms resulting from distant metastasis.Thirty three patients were diagnosed by histology biopsy and (or) cytology,39 patients were diagnosed with SCCAg elevation and clinical and radiological examinations,29 of these patients were diagnosed only by SCCAg elevation and CT or MRI.Fourteen patients recurred limited to the cervix or to the cervix and adjacent tissues(central recurrence),31 cases recurred at pelvis,and 20 patients with distant metastasis and 7 patients suffered from Pelvic recurrence and distant metastasis.Twenty three cases received salvage therapy including surgery for patients recurring after definitive radiotherapy and radiotherapy and or conform radiotherapy for patients after primary radical surgery,46 patients were given palliative chemotherapy and or radiotherapy,and 3 patients refused any treatment.The median and mean survival time were 11 months and 23 months respectively(2-62 months).The 3-year,5-year overall survival rate were 25%and 19%respectively.Univariate analysis showed SCCAg elevation before primary treatment,grade,recurrent site,treatment method,SCCAg≥10pg/L,SCCAg elevation during treatment,and SCCAg not within normal after treatment were correlated with 3-year survival rate.Twenty patients had an increase of SCCAg before clinical manifestation of relapse compared with other patients who did not,and the 3-year survival rate was not significantly different (22% vs 27%). Multivariate analysis revealed that only grade and treatment methods were independent risk factors. Conclusion The impact of the SCCAg in recurrent squamous cell carcinoma of the uterine cervix needs further study.

Objective To observe the survival of myoblasts carrying hIGF-1 gene transplanted into the mice, and the expression of hIGF-1 in the transplanted mice. Methods Eighty four male C3H mice(20～30g,7～11w)were divided into four groups: group A, B, C and D (20 mice each group), and the remaining four mice were used as normal control. At the middle of the right gastrocnemius muscle, the mice in group A and B were injected with 1?10~6 myoblasts either carried with or without hIGF-1 gene. Muscle contusion at the middle of the right gastrocnemius muscle of the mice in group C and D was produced. At day 3 following injury, they were injected with 1?10~6 myoblasts either carried with hIGF-1 gene (group C) or without hIGF-1 gene (group D). At the day 2, 5, 10, 20, 30 after injection, four mice of each group were sacrificed randomly. BrdU staining in all mice were performed to evaluate cells surviving, and the expression level of hIGF-1 in group A and C was assessed by immunohistochemical staining and real-time-PCR. Results The BrdU staining in both normal and injured mice transplanted with myoblast carried with or without hIGF-1 were positive. hIGF-1 was expressed and secreted in both group A and C. Conclusion The myoblast carrying hIGF-1 gene transplanted into normal or injured mice can survive for a certain period of time, and can secrete hIGF-1.

Objective To observe the effect of the injection of myoblast carrying human insulin-like growth factor-1(hIGF-1) on the expression of endogenous IGF-1 mRNA and IGF-1 level in mice skeletal muscle following injury.Methods Seventy two male C3H mice(20~30g,7~11w)were randomly divided into three groups(24 mice in each group) with four mice normal controls.Applied a falling hit from certain height at the medial calf of right lower limbs in three groups,the injured skeletal muscle model was successfully simulated.Three days following injury,the mice in group A and B were injected with 1?106 myoblasts either carried with or without hIGF-1 gene respectively and the mice in group C were injected with 100?l saline at the injured muscle.Three mice in each group were sacrificed randomly at day 2,5,10,15,20,30 after contusion.The expression level of mIGF-1 was assessed by immunohistochemical staining and real time PCR.Results mIGF-1 mRNA expression and mIGF-1 factor secretion were observed in all three groups;the amount of mIGF-1 mRNA expression and mIGF-1 secretion in group A were significant higher than that in group B and C.Conclusion Myoblast carrying hIGF-1 transplantation could promote endogenous IGF-1 secretion in injured skeletal muscle.

Objective To study the clinical, histopathological and immunohistochemistric features of different types of primary cutaneous lymphomas.Methods 17 cases of primary cutaneous lymphomas were ret-rospectively reviewed.All cases were classified according to the WHO-EORTC(World Health Organization-Eu-ropean Organization for Research and Treatment of Cancer) classification system combined with morphology and immunobistochemistry.The clinicopathological features of each type were observed and summarized.Results Among the 17 cases, male were 10, female were 7.The average age was 51 years old (from 16 to 78).All pa-tients visited the doctor for skin diseases 14 cases were T-cell lymphoma including 5 cases of primary cutaneous anaplastic large cell lymphuma, 2 cases of mycosis fungoides, 4 cases of subcutaneous panniculitis-like T-cell lymphoma, and 3 cases of primary cutaneous peripheral T- cell lymphomas (including 1 primary cutaneous ag-gressive epidermotropic CD8+ cytotoxic T-cell lymphoma).3 cases were B-cell lymphoma including 2 diffuse large B-cell lymphoma, leg-type and 1 primary cutaneous follicle center lymphoma.Conclusion The clinical behaviors and pathological characteristics of primary cutaneous lymphomas were complicated and variant.Nei-ther of them could be neglected in the diagnosis.

Objective To probe into the advantages and disadvantages of intravenous chemotherapy and intraperitoneal chemotherapy for advanced epithelial ovarian cancer.Methods All of the 226 patients with advanced epithelial ovarian cancer were treated by maximum cytoreductive surgery or non-effective cytoreductive surgery and received 6-8 courses of postoperative regular chemotherapy(chemotherapy regimens,TP:taxol and cis-platinum or carboplatinum;PC:cis-platinum and cyclophosphamide;PAC:cis platinum and adriamycin and cyclophosphamide)during Jan 1998-Jan 2006.We systematically compared the characteristics of patients in intraperitoneal chemotherapy(IPC)group and intravenous chemotherapy(IVC)group.We measured the incidence rate of the response,side-effects,the recurrence time of intraperitoneal tumor and survival time of the two groups respectively.ResultsFor the first phase after operation(three courses of treatment),the response rate of two groups were 75.8％and 52.8％respectively.For the response rate of IPC was higher than that of IVC(P＜0.01).The second phase after operation(all courses finished),the response rate of two groups were 93.9％and 87.7％,respectively(P＞0.05).After maximum cytoreductive surgery,the recurrence rate of IPC and IVC were 47.0％and 59.4％,respectively(P＞0.05).After non-effective cytoreductive surgery of IPC and IVC groups,the recurrence rates were 84.8％and 86.2％,respectively(P＞0.05).The recurrence time of intraperitoneal tumor of IPC and IVC groups were 24 and 18 months,respectively(P=0.001).The overall survival time ofgroups IPC and IVC were 32 and 30 months(P=0.188).There were some differences in the side-effect between IPC and IVC.The rates of chemotherapeutic phlebitis of IPC and IVC were 34.0％and 10.8％ respectively(P＜0.01).The rates of serious gastrointestinal reaction of IPC and IVC were 33.8％and 25.8％,respectively(P=0.236).There was no significant difference in bone marrow depression,intestinal adhesion and intestinal obstruction.ConclusionsIPC can extend the disease progression free survival than IVC,without increasing overall survival period.IPC can also reduce the side-effect of chemotherapeutic phlebitis.However,IPC is used limitedly,and can not substitute for IVC.Combination of IPC with IVC may enhance their effectiveness and reduce the side-effects.