Objective To probe into the treatment effect and the influencing factors of early goal directed therapy(ECDT)in patients with septic shock.Method One hundred and twenty-six patients with septic shock were assigned into the treatment group(n=62)and the control group(n=64).The treatment group was administrated with EGDT,while the control group used conventional therapy for cycle and capacity support.Then sequential organ failure assessment(SOFA)score,APACHE Ⅱ score before treatment and 28-dav-mortality were respectively recorded before the above-mentioned treatment and at 24 hours after the therapy in the two groups.The treatment group was again subdivided into two groups after 6 hours recovery according to the resuscitation results:the sufficiently resuscitated group(n=40)and insufficiently resuscitated group(n=22).Age,genders,correlated haemodynamic parameter,SOFA score,APACHE Ⅱ score and serum lactic acid concentration before resuscitation and 28 d mortality were compared between the two groups.Results There was no significant difference in SOFA score and APACHE Ⅱ score before resuscitation between the treatment group and the control group[SOFA:(12.26±4.37)vs.(12.54±5.21);APACHE Ⅱ:(21.26±6.03)vs.(21.64±6.80)].The two scores at 24 hours after resuscitation[SOFA:(9.18±3.63)vs.(10.62±4.27);APACHEⅡ:(14.92±3.81)vs.(18.21±4.25);P＜0.05]and 28-day-mortality rate(48.39%vs.76.56%,P＜0.05)of the treatment group were significantly lower than those in the control group.There was significant difference in the age,mean arterial pressure (MAP),APACHEⅡ score between the sufficiently restoring group and the insufficiental resuscitated group.The 28-day-mortality of the sufficiently restoring group was significantly lower than that in the insufficiently restoring group.Conclusions EGDT can improve the prognosis in patients with septic shock.Ages,MAP and APPCHE Ⅱ score before resuscitation can be the important factors of EGDT.

Epidermal growth factor receptor (EGFR) is a classic protein tyrosine kinase receptor, which plays an important role in cell proliferation, survival, adhesion, differentiation and apoptosis. Abnormality of EGFR and its signaling are closely associated with tumor initiation and development. Many environmental physical and chemical agents can interfere with EGFR and its signal transduction pathways via affecting its phosphorylation, conformation and function, or distribution on cell membrane, finally influencing gene expression and cell fate. This review focuses on the recent progress of above aspects for further understanding of epigenetic mechanisms of cellular stress and carcinogenesis related with environmental agents.
Carcinogens ; Environmental Exposure ; adverse effects ; Environmental Pollutants ; adverse effects ; Humans ; Phosphorylation ; Receptor, Epidermal Growth Factor ; drug effects ; metabolism ; Signal Transduction ; drug effects

Objective To compare three kinds of irradiation treatment plans for cervical and upper thoracic esophageal cancer,in order to arrived at proper decision for the patient.Methods From February 2001 to June 2004,43 such patients were studied with three different simulated treatment plans made including conformal plan,conventional four-field plan and conventional two-field plan for every one.All plans were evaluated with iso- dose curve and dose-volume histogram.Results GTV on 95% isodose curve was 99.5%,98.2% and 87.4% in conforaml plan,conventional four-field plan and conventional two-field plan,respectively;PTV_1 and PTV_2 on 95% isodose with 97.8%,97.2%,94.8% and 95.8%,86.6%,73.7%.The volume of＞20 Gy dose of left lung accepted was 18.6%,17.2% and 32.3%,in conformal plan,conventional four-field plan and conventional two-field plan,respectively;the right lung received 20.5%,19.9% and 35.5%.Conclusions Conformal plan is the best in radiotherapy,as it can provide ideal dose distribution of irradiated target with adequate protection of the normal tissues.Conventional four-field plan,being easy to carry out,can replace the conformal plan in most situations.Conventional two-field has the most uneven dose distribution and largest lung volume irradiated.

OBJECTIVETo compare the incidence of metabolic disorders (MS) in patients with primary aldosteronism (PA) and essential hypertension (EH).

METHODSMS prevalence was observed in 200 EH patients (male 104) and 220 PA patients (male 117) hospitalized to our hospital from August 2005 to March 2007.

RESULTS(1) The prevalence of MS in PA group was significantly higher than that of EH group (47.3% vs. 31.5%, P = 0.009). (2) Blood pressure was significantly higher in PA group than that of EH [SBP: (150.67 +/- 15.45) mm Hg vs. (145.69 +/- 17.13) mm Hg, P = 0.042; DBP: (93.03 +/- 10.51) mm Hg vs. (85.83 +/- 14.44) mm Hg, P = 0.037]. (3) Incidences of abdominal obesity (86.8% vs. 78.5%, P = 0.024) and insulin resistance (insulin sensitivity index: 42.42 +/- 16.11 vs. 49.58 +/- 22.43, P = 0.008) were significantly higher in PA group than in EH group.

CONCLUSIONThe prevalence of MS in hospitalized PA patients was significantly higher than that of EH patients characterized by prevalent abdominal obesity, insulin resistant and severe hypertension.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Hyperaldosteronism ; epidemiology ; metabolism ; Hypertension ; epidemiology ; metabolism ; Incidence ; Male ; Metabolic Syndrome ; epidemiology ; Middle Aged

Objective To evaluate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treating hepatocellular carcinoma (HCC) under liver capsular. Methods Forty three patients with 62 lesions of HCC under liver capsular received TACE followed by CT?guided percutaneous RFA after 1 to 2 weeks were analyzed retrospectively. The subjects were observed and follow?up imaging with enhanced MRI was performed to evaluate the therapeutic efficacy after combined treatment. The patients were followed up for 10 to 69 months. The patients with residual lesions received a second RFA, the patients with recurrence or new lesions received another TACE combined with RFA. The overall survival rates, median survival time and median time to progression were calculated by using Kaplan?Meier. Results A total of 55 TACE and 68 ablations were performed in 43 patients with 62 lesions. The procedure was successfully accomplished in all patients. The complete ablation rate after the first ablation was 90.3%(56/62). The 1, 3, 5?year overall survival rates were 95.3%, 78.1%and 43.9%, the median survival time was 58 months and the median time to progression was 32 months. Conclution For the treatment of hepatocellular carcinoma under liver capsular, TACE combined with RFA is safe and effective.

OBJECTIVETo explore the effects and the molecular mechanism of puerariae radix flavones (PRF) on acute myeloid leukemia cell line Kasumi-1 cells in vitro.

METHODSKasumi-1 cells treated by PRF for 48 hours were observed with Wright's and Hoechst 33258 dying. The apoptotic cells were analyzed by flow cytometry with AnnexinV/PI staining. The expression levels of bcl-2, Bim and Caspase-3/-8/-9 protein were assayed by Western blot and the AML1-ETO fusion gene was detected by real-time polymerase chain reaction.

RESULTSPRF could induce Kasumi-1 cells to apoptosis effectively. The proportion of apoptotic cells in 50, 200 and 500 µg/ml PRF treatment groups were (14.1 ± 0.8)%, (17.7 ± 1.3)% and (32.4 ± 1.4)%, respectively, and significantly higher than that of control \[(7.8 ± 0.7)%\]. The relative expression levels of the anti-apoptotic Bcl-2 protein were 0.85 ± 0.05, 0.62 ± 0.07 and 0.43 ± 0.05; the apoptotic Bim protein were 0.21 ± 0.06, 0.39 ± 0.04 and 0.75 ± 0.05; the caspase-3 and caspase-9 were 0.92 ± 0.04, 1.21 ± 0.07, 1.33 ± 0.04 and 0.35 ± 0.05, 0.53 ± 0.03, 0.69 ± 0.07, respectively. Compared to the blank control group, all these changes were significant (P < 0.01). Nevertheless, nearly no changes could be observed on the expression level of AML1-ETO fusion gene and caspase-8 protein.

CONCLUSIONApoptosis of Kasumi-1 cells induced by PRF might correlate to the down-regulation of Bcl-2 protein expression and the activation of caspase-3 and caspase-8 protein in the cells. It seemed that all these effects had no relationship with the AML1-ETO fusion gene.

Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Cell Line, Tumor ; Core Binding Factor Alpha 2 Subunit ; genetics ; metabolism ; Flavones ; pharmacology ; Humans ; Oncogene Proteins, Fusion ; genetics ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Pueraria ; RUNX1 Translocation Partner 1 Protein

This study was aimed to investigate the effects of flavonoids of puerarin (PR) on apoptosis of acute promyelocytic leukemia (APL) cell line NB4 cells and its mechanism. The NB4 were treated with PR in vitro, the MTT assay was used to detect the inhibitory effect of PR on cell proliferation. The apoptosis of NB4 cells were detected by flow cytometry labelled with Annexin V/PI. The expressions of pml/rar alpha, bcl-2 and survivin were detected by real time reverse transcription-polymerase chain reaction (real time RT-PCR), the expressions of JNK, p38 MAPK, FasL, caspase 3, caspase 8 were detected by Western blot. The results showed that with the increasing of PR concentrations, the apoptosis rates of NB4 cells were gradually elevated. Simultaneously, the mRNA expression of pml/rar alpha, bcl-2 and survivin decreased, while the protein expression of JNK, FasL, caspase 3 and caspase 8 increased, which presented the positive correlation to PR concentrations. When PR combined with arsenic trioxide (ATO), the expression levels of above mentioned mRNA and protein decreased or increased more significantly. It is concluded that PR can effectively induce the apoptosis of NB4 cells. PR combined with ATO displays synergistic effect. It may be triggered by the activation of JNK signal pathway.
Apoptosis ; drug effects ; Apoptosis Regulatory Proteins ; metabolism ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Humans ; Isoflavones ; pharmacology ; JNK Mitogen-Activated Protein Kinases ; metabolism ; Leukemia, Promyelocytic, Acute ; pathology

This study was aimed to investigate the inhibitory effect of flavonoids of puerarin (PR) in different concentrations on proliferation of 4 kinds of acute myeloid leukemia (AML) cell lines (Kasumi-1, HL-60, NB4 and U937), and to explore its possible mechanism. The MTT method was used to detected the inhibitory effect of PR on proliferation of AML cell lines. The flow cytometry was adopted to determine the change of cell cycle in vitro. The results showed that a certain concentration of PR could inhibit the proliferation of these 4 cell lines effectively in time-and dose-dependent manners, and the intensity of inhibition on 4 kinds of AML cell lines was from high to low as follows: NB4>Kasumi-1>U937>HL-60. Meanwhile, PR could also change cycle process, cell proportion in G1/G0 phase decreased, cells in S phase increased and Sub-diploid peak also appeared. It is concluded that PR can selectively inhibit the proliferation of 4 AML cell lines and block cell cycle process, especially for NB4 cells.
Apoptosis ; drug effects ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; HL-60 Cells ; Humans ; Isoflavones ; pharmacology ; Leukemia, Myeloid, Acute ; classification ; pathology ; U937 Cells

Objective To investigate the distribution of water fluoride and the present status of water- improving delluoridation projects in the endemic fluorosis areas in Gansu Province. Methods According to "The National Technical Scheme for Endemic Disease Control in 2004" for the water improving projects, water fluoride content was determined from fluorosis villages in 34 counties of 11 cities in Gansu Province. The fluoride content in drinking water was assessed by F-ion selective electrode. Results Water fluoride content was determined in 1576 fluorosis villages of 34 counties. Water fluoride content of 7829 water samples was determined, and the fluoride content of 1891 samples was over standard. Water fluoride content was ≤ 1.00 mg/L(accounting for 75.19%) in 1185 villages and 1.00 mg/L(accounting for 24.81%) in 391 villages; the highest water fluoride content was 6.78 mg/L Nine hundred and ninety three water-improving and defluoridation projects were determined. Water fluoride content of 867 water-improving and defluoridation projects was determined; 768 projects had water fluoride content ≤1.00 mg/L(accounting for 87.67%) and water fluoride content of 108 projects was 1.00 mg/L(accounting for 12.33%),with the highest water fluoride content being 5.27 mg/L. Water-improving and delluoridation projects mostly relied on drilling a well to obtain under-grand water. Abandoned projects accounted for 30%. Conclusions In 34 counties of 11 cites(prefecture), nearly 30% of the villages had water fluoride content exceeding the standard. The situation of endemic fluorosis control is still serious in Gausu Province, countermeasures for endemic fluorosis must be carried out as soon as possible and surveillance of water-improving and defluoridation projects must be strengthened.

Objective To analyse the preliminary clinical results of intensity modulated radiation therapy (IMRT) for 122 untreated nasopharyngeal carcinoma (NPC)pafients.Methods 122 NPC pa- tients received IMRT alone from Feb.2001 to Jun.2004,with 31 females and 91 males,and a median age of 45 years(range 25-66).According to the Fuzhou Stage Classification,there were StageⅠ11 patients, StageⅡ34,StageⅢ62,and StageⅣa 15.IMRT was carried out using an inverse planning system (COR- VUS 5.0,Peacock plan) developed by the NOMOS Corp.The treatment was given with the Multi-leaf Inten- sity Modulating Collimator (MIMIC) using a slice-by-slice arc rotation approach.The prescription dose was 68 Gy/30f to the nasopharynx gross tumor volume (GTV_(nx)),60-66 Gy/30f to positive neck lymph nodes (GTV_(nd)),60 Gy/30f to the first clinical target volume (CTV_1) and 54 Gy/30f to the second clinical target volume (CTV_2).Kaplan-Meier method was used to calculate the overall survival rate (OS),distant metas- tasis-free survival rates (DMFS),and local-regional control rates from the last date of therapy.Log-rank test was used to detect the difference between groups.Results The median follow-up time was 20 months ( range 6 to46 months).The 1-,2-,and 3-year OS was 95.2%,91.4%,85.1%,DMFS was 91.9%, 88.6%,85.6%,and the local-regional control rates was 96.5%,93.2%,93.2%,respectively.Statistics of the local control rate was insignificant either for advanced T(T3+T4) stage or early T(T1+T2) stage diseases(P=0.148).The 2-year regional control rate was insignificant either for patients with N(+) or N (-),but the 2-year DMFS was significant both for patients with N(+) and N(-)lesions(P=0.004).For 17 patients who failed,there were two with residual disease and one with recurrence at the primary site (17.6%),three patients in the neck (17.6%),twelve patients (70.6%) in distant metastases.Conclu- sions Intensity modulated radiation therapy does provide excellent local-regional control for untreated NPC, especially in patients with advanced T stage or N(+) lesion.Distant metastasis is the main cause of failure. N (+) is significantly correlated with distant metastasis.