Objective To obserre antiviral effect, immune rebuilding efficacy and side effects of didonosine, stavudine and nevirapine combination therapy for human immunodeficiency virus (HIV) type 1 infection. Methods Three medicines were administered for 8 HIV-1 infected cases. Plasma HIV RNA load, and the levels of CD 4 + T cell and CD 8 + T cell were detected before starting treatment and 4,12 and 24 weeks after starting treatment. Side effects and changes in laboratory's examinations were observed during the trial. Results After 12 and 24 week treatment, the plasma HIV-1 level reduced 2 28 logs and 2 63 logs, from a mean baseline of (283,125?187,217) copies/ml to (1,501?930) copies/ml and (669?477) copies/ml, the CD 4 + T cell counts increased from a mean baseline of (337?221) cells/ml to (393?301) cells/ml and (414?284) cells/ml, and CD 8 + T cell counts decreased from a mean baseline of (918?371) cells/ml to (823?315) cells/ml (812?305) cells/ml, respectively. Part of cases occurred mild or medium rash, nausea, headache, fatique, abdomina1 pain and diarrhea, and had blood transaminase increased, and leucocyte and hemoglobin decreased. Conclusions Didonosine, stavudine and nevirapine showed high anti-HIV and immune rebuilding effects in highly active antiretroviral therapy (HAART). The medicine regimen was well tolerated in a six-month clinical trial.

Objective To analyze the clinico-pathological characteristics, prognostic factors and the rational therapy for the uterine papillary serous carcinoma(UPSC). Methods Thirty-three cases of UPSC were treated in our hospital between January 1996 and December 2005. The clinico-pathologic characteristics, treatment and prognosis were retrospectively analyzed. Results The three-year overall survival for patients with stage Ⅰ, Ⅲ and Ⅳ was 77.4%,53.3% and 12.1%, respectively. Patients with late stages and deep myometrial invasion were associated with a worse prognosis by univariate analysis(P

Lobaplatin is the third generation platinum anticancer drug,and has been listed for the clinical treatment of advanced breast cancer,small cell lung cancer and chronic myeloid leukemia.Studies have shown that lobaplatin as the latest third generation platinum anticancer drug,has good water solubility,broadspectrum anti-tumor,strong anti-tumor activity,no cross-resistance with other platinum drugs,low toxicity and many other features.Lobaplatin has shown a clear advantage.

Objective To discuss wound edge characteristics at different clinical periods and in-tervention of traumatic perforation of tympanic membrane. Methods A total of 494 patients wth trau-matic perforation of tympanic membrane were treated and grouped based on treatment time and size of per-foration. Group A (n = 154, within 12 hours after injury) were treated by residual tympanic membrane repair and gelfoam. Group B (n =149, 12 hours after injury) were treated by simple gelfoam. Group C (n = 116) and Group D (n =75) were treated by conventional therapy. The wound healing of peroration was observed after one month. Results Of all, there were 419 patients with maximum perforation diameter > 2.5 mm within five hours after injury, of which 349 patients (83.3%) were with residual tympanic membrane valgus of perforation rim, 29 (6.9%) with involution of perforation rim and 41 (9.8%) with complete loss of tympanic membrane. Of 75 patients with maximum perforation diameter <2.5 ram, residual valgus of perforation rim was found in 18 (24.0%) and tympanic membrane wrinkle near wound edge in the other patients. Under endoscopic repair of crimp tympanic membrane, maximum perforation diameter was reduced for (6.5±2.5)mm in 143 patients at 6th hour, (6.0±1.5)mm in 11at 7-11 hours, (2.0±1.5) mm in 27 at 13-24 hours, (1.5±1.0) mm in 59 at 25.5-48 hours, (1.0±0.5) mm in 49 at 51-73 hours and 0 mm in 14 at 75-192 hours. The follow up lasted for one month, which showed that healing rate of perforation in groups A, B, C and D were 85.3%, 71.2%, 59.2% and 81.4%, respectively. Healing time span was (10±4) days, (19±4) days, (25±2) days and (16±2) days, respectively. Conclusions Traumatic perforation of tympanic membrane is not com-plete tympanal deletion but residual tympanic membrane valgus of perforation rim,involution and tympanicmembrane crushing, which shows insignificant change with time. In time repair of residual tympanic membrane 12 hours(especially 6 hours) after injury may reduce the largest diameter of perforation and re-markably shorten the healing time of perforation.

10.3969/j.issn.1007-3969.2013.05.009

Background and purpose:Primary malignant melanomas of the uterine cervix and vagina are rare neoplasms with very poor prognosis. This article aimed at investigating the clinicopathologic characteristics, treatment and prognosis of primary malignant melanomas of the cervix and vagina. Methods:The clinical data of 51 patients with primary malignant melanomas of the cervix and vagina treated at Fudan University Shanghai Cancer Center from Dec.1998 to Jul. 2011 were reviewed. Results:The 2-and 4-year progression-free survival (PFS) rates were 32.8%and 13.1%, respectively. The 2-and 4-year overall survival (OS) rates were 67.2%and 39.8%, respectively. Three patients survived more than 5 years. Twenty-nine (56.9%) patients had a recurrence. The common sites were vaginal stump/pelvis (10 patients, 34.5%), liver (4 patients, 13.9%), lung (3 patients, 10.3%), bone (3 patients, 10.3%) and vulva (3 patients, 10.3%). Larger tumor size and lymphovascular space invasion were the independent predictors of poor OS (P<0.05). Pelvic lymph nodes metastases were associated with shorter PFS (P=0.05). Among them, those who received combined immunotherapy and chemoradiotherapy achieved longer median time to progression (TTP) (17 months) compared with patients who had chemotherapy alone (9 months) or immunotherapy alone (11 months). Conclusion:Primary melanomas of cervix and vagina have a very poor prognosis. The multidisciplinary treatment of combining surgery, chemoradiotherapy, and immunotherapy can improve the patients’ prognosis.

Objective To investigate the effects of TNF-?,IL-12,IL-15 and underglycosylation IgA_1 in mesangial deposition in the clinicopathological study of IgA nephropathy(IgAN).Methods Seventy-four patients with IgAN were enrolled in the study,with 10 patients randomly selected after remission,10 MCD and 10 healthy volunteers as control groups.The levels of TNF-? in serum and urine were examined by radioimmunoassay,and the levels of IL-12 and IL-15 were examined by ELISA.Immunohistochemistry was used to detect the expression of TNF-? in renal tissue,and the directed immunofluorescence was used to detect the underglycosylation of IgA_1(UGIgA_1)in mesangial deposition.Results The levels of TNF-?,IL-12 and IL-15 in serum of patients with IgAN were higher than those of MCD group,healthy control group and remission group.Compared with the negative group,33 patients with UGIgA_1 positive in renal tissues had lower levels of TNF-? in serum,longer course and less class of renal tissue injury.The positive areas of TNF-? in renal tissue and levels of TNF-? in serum were positively correlated with urinary protein(r=0.249,0.702,P=0.000).There was negative correlation between the levels of TNF-? in serum and Ccr(r=-0.231,P=0.048).The levels of IL-15 was positively correlated with the course of disease(r=0.266,P=0.022) and negatively with Scr(r=-0.320,P=0.005).Conclusions The TNF-?,IL-12 and IL-15 are all involved in the onset of proteinuria in IgAN patients,and IL-15 acts as a factor against renal injury.The patients with UGIgA_1 positive in mesangial have longer course and less pathological changes damaged than those of the UGIgA_1 negative patients.The TNF-? may serve as an important factor in the aggravation of IgAN.

Objective To investigate the effects of dilute concentration and acting time of pronase on quality of gastroscopy.Methods A total of 448 patients were randomly divided into two groups : sodium bicarbonate group and pronase with sodium bicarbonate group.Pronase was diluted into 50 ml (400 U/ml)and 100 ml (200 U/ml) using sodium bicarbonate.The patients were pretreated by pronase of different concentrations 10 min, 20 min, 30 min, 60 min and 120 min before gastroscopy.Diluent of same quantity were taken by the control group.Visibility of gastroscopy, procedure times and positive rates of lesions were compared.Results Pretreatment of pronase significantly improved visibility of gastroscopy, raised positive rates of lesions, and reduced procedure times of gastroscopy, compared with the control group (each P ＜ 0.05).The visibility of gastroscopy were over 80％ 20,30, and 60 minutes before the examination with no significant difference(P ＞ 0.05).The visibility of gastroscopy decreased sharply 30 minutes after taking pronase, especially after 60 minutes.There was no significant difference in the quality of gastroscopy between the 200 U/ml and 400 U/ml group 20-60 minutes before gastroscopy (P =0.640).Conclusion Pronase (200 U/ml-400 U/ml) significantly improves visibility of gastroscopy, raises positive detection rates of lesions, and reduces procedure time of gastroscopy 20-60 minutes before pretreatment.

Objective The purpose of this study was to evaluate gene amplification by chromogenic in situ hybridization (CISH) and the protein expression of Her-2/neu gene in patients with uterine papillary serous carcinoma ( UPSC) and to determine its prognostic value.Methods Thirty-six patients with confirmed pathologic diagnosis of UPSC in Cancer Hospital of Fudan University from Jan.1996 to Jan.2006,were analysed retrospectively.CISH was performed to assess Her-2/neu gene amplification,and protein expression was evaluated by immunohistochemistry (IHC).The prognostic factors were analyzed by log-rank test or Cox proportional hazard model.Results Among 36 cases with UPSC,13 patients (36.1% ) showed moderate staining (++) to strong staining (+++) for Her-2/neu protein,while amplification of the Her-2/neu gene by CISH was observed in 4 of the 36 (11.1% ) cases.Her-2/neu protein over-expression was significantly associated with advanced surgical stage and worse prognosis by univariate analysis ( P = 0.030 and P = 0.002,respectively),while the multivariate analysis shown that only Her-2/neu protein over-expression and deep myometrial invasion were associated with a poor prognosis ( P < 0.05 ).In 13patients with Her-2/neu protein over-expression,the mean survival period with chemotherapy was shorter than those without chemotherapy (20 vs.42 months,P = 0.370 ).Conclusion Her-2/neu protein over-expression is significantly associated with advanced surgical stage UPSC and poor survival outcome,and might reduce the chemotherapy sensitivity.

Objective To investigate the effects of pioglitazone on atrial ionic channel remodeling in alloxan-induced diabetic rabbit models.Methods A total of 32 rabbits were randomly (random number) divided into control (CN) group,diabetes mellitus (DM) group,diabetes mellitus + pioglitazone 4 mg/ (d · kg) (DPG) group and diabetes mellitus + double pioglitazone 8 mg/ (d · kg) (DPI) group.The diabetic state was examined by quantitative determination of blood glucose levels of ≥ 14 mmol/L.Langendorff-perfused rabbit hearts were used to isolate single atrial myocyte,and whole-cell patch-clamp technique was used to record action potential duration (APD) and atrial ionic channel currents (ICa,L and INa).Variables with normal distribution were compared with One-way ANOVA and LSD-t test.Results Compared with controls,APD90 and APDS0 of left atrial myocytes were significantly prolonged in DM group (P ＜0.05 vs.CN),and there was no significant difference in APD90 frequency adaptation between them (P ＞0.05 vs.CN).The densities of INa were reduced and the densities of ICa,L were increased in DM group (P ＜ 0.01 vs.CN).The above variables were markedly attenuated in DPG and DPI group.Conclusions Pioglitazone may inhibits atrial ionic channel remodeling in diabetic rabbit models.