Objective To assess the effectiveness of traditional Chinese Medicine (TCM ) syndrome differentiation treatment for diabetic nephropathy in elderly patients. Methods A total of 96 elderly patients with diabetic nephropathy admitted to our hospital from January 2015 to December 2017 were recruited and divided into a regular care group (n= 48)and a TCM group(n= 48).Both groups received conventional treatment ,with TCM syndrome differentiation treatment added to the TCM group. The effectiveness of the treatment modalities was compared. Results In the regular care group ,significant effectiveness was observed in 12 patients ,effectiveness in 24 patients ,and ineffectiveness in 12 patients ,with a total effectiveness rate of 75％ .In the TCM group ,significant effectiveness was seen in 18 patients ,effectiveness in 27 ,and ineffectiveness 3 ,with a total effectiveness rate of 93％. The total effectiveness rate of the TCM group was higher than that of the regular care group(χ2 =6.400 ,P=0.011).After treatment ,fasting blood glucose ,2 h postprandial blood glucose , urea nitrogen ,creatinine ,and 24 h urine protein in the TCM group were significantly lower than in the regular care group and than pre-treatment levels(P<0.05). Conclusions TCM differentiation can not only significantly improve the treatment effectiveness in elderly patients with diabetic nephropathy ,but also relieve the clinical symptoms.

OBJECTIVETo study in vivo mercury absorption and accumulation through repeated transdermal administration of Yuhong ointment containing calomel, in order to provide scientific evidences for clinical safe medication.

METHODA total of 100 SD rats were randomly classified into five groups: the control group, the Yuhong ointment group, the double-concentration Yuhong Ointment group, the quadruple-concentration Yuhong ointment group and the 1.6% calomel group. The rats were treated with the dosage of 0.04 g . cm-2 by repeated transdermal administration for 2, 4 weeks. After the drug discontinuance for 4 weeks, the levels of mercury in blood, urine, and tissues of heart, liver, brain and kidney were determined, respectively.

RESULTCompared with the control group, the blood mercury level of the Yuhong ointment group show no obvious change after treatment for 4 weeks. However, the levels of mercury in blood and urine of other experimental groups increased significantly with time and the increase in dosage, and so did the level of mercury in major organ. At 4 weeks, all experimental groups showed increase in the content of mercury, and kidneys displayed the highest level, whereas brain displayed the lowest level After the drug discontinuance for 4 weeks, the mercury level in blood and urine of every dose group recovered to normal, with significant decline in the content of mercury in each organ.

CONCLUSIONAfter transdermal administration in rats for 4 weeks, there was no obvious absorption of mercury in blood. Mercury was mainly accumulated in kidneys and excreted through urine. The results suggest that the patients' mercury content and kidney function indexes need to be monitored in long-term clinical use of Yuhong ointment.

Absorption ; drug effects ; Animals ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Male ; Mercury ; analysis ; blood ; pharmacokinetics ; urine ; Ointments ; Rats ; Rats, Sprague-Dawley ; Safety ; Time Factors

OBJECTIVEto map out the frequency and types of K-ras gene mutations present in colorectal and lung cancer patients; to evaluate the clinical applicability of a novel real-time double-loop probe PCR using the ADx-K-ras kit, and to compare its performance with the result by using traditional Sanger DNA sequencing in detection of somatic mutations of the tumor genes.

METHODSa total of 827 formalin-fixed paraffin-embedded (FFPE) blocks including 583 from the colorectal and 244 from the lung cancer patients were assayed. Genomic DNA of the sample tissues was extracted, purified and subjected to PCR amplification of K-ras gene codon 12 and 13 and DNA sequencing was carried on using both the traditional Sanger sequencing method and the ADx's K-ras mutation detection kit, respectively. The mutation rates for K-ras gene at codon 12 and 13, and the mutation frequencies detected by using both methods were analyzed.

RESULTS533 out of 583 (91.4%) colorectal cancer samples and 144 out of 244 lung cancer samples (59.0%) were detected using the traditional Sanger DNA sequencing technique, and 583 out of 583 (100.0%) colorectal plus 244 out of 244(100.0%) lung cancers were detected, respectively by using the ADx-K-ras kit. Of the 583 colorectal cancer samples, 192 (32.9%) showed mutations by using the ADx-K-ras kit in comparing with a result of 160 samples (27.4%) with K-ras gene mutation by using the traditional Sanger DNA sequencing technique. Of the 244 lung cancer samples, 26 (10.7%) showed K-ras gene mutations by using ADx-K-ras kit, while in 144 samples detected by using the traditional Sanger DNA sequencing technique, only 12 samples (8.3%) showed K-ras gene mutations. In colorectal cancer analyzed, GGT→GAT at codon 12 was the most common event with 35.1% (66/188) mutations, followed by GGC→GAC at codon 13 with 26.6% (50/188) and GGT→GTT at codon 12 with 18.6% (35/188), while GGT→GCT at codon12 was the most rare with only 1.6% (3/188) of the total mutation cases. In patients with lung cancer analyzed, GGT→GTT at codon 12 was the most common mutation, accounting for 40.9% (9/22), and GGT→GCT at codon 12 the most rare with only about 4.5% (1/22) of the total mutation cases.

CONCLUSIONSK-ras gene mutations were present in colorectal cases, and significantly more frequent than that in lung cancer. There were significant statistical differences between the two methods. ADx-K-ras real-time PCR showed much higher successful detection rates and mutation ratios compared to Sanger sequencing. As a result, the real-time PCR with ADx-K-ras kit proves to have a good clinical applicability and a strong advantage over the traditional Sanger DNA sequencing. It is a effective and reliable tool for clinical screening of somatic gene mutations in tumors.

Colorectal Neoplasms ; genetics ; Genes, ras ; genetics ; Humans ; Lung Neoplasms ; genetics ; Mutation ; Polymerase Chain Reaction ; methods ; Sequence Analysis, DNA ; methods

OBJECTIVETo evaluate the techniques and clinical applications of 16 multislice helical CT in colonic lesions.

METHODSEighty-one patients including 54 colorectal carcinomas, 5 adenomas, 1 non-Hodgkin's lymphoma, 6 inflammatory bowel diseases, and other 15 cases underwent volume scanning using 16 multislice helical CT. Four types of reconstruction included multiple planar reconstruction, shaded surface display, raysum, and CT virtual colonoscopy.

RESULTSComplete colon could be shown in all patients. The lesions' morphology, number, size, location, intestinal cavity, pericolonic changes, and other abdominal organs were satisfactorily shown by CT.

CONCLUSIONSSixteen multislice helical CT colonography is a valuable imaging technique for detecting colonic diseases. It is effective in diagnosis and treatment planning. It can display the portions of colon that is inaccessible at colonoscopy.

Adenocarcinoma ; diagnostic imaging ; Adenoma ; diagnostic imaging ; Adult ; Aged ; Aged, 80 and over ; Colonography, Computed Tomographic ; methods ; Colonoscopy ; Colorectal Neoplasms ; diagnostic imaging ; Female ; Humans ; Inflammatory Bowel Diseases ; diagnostic imaging ; Male ; Middle Aged ; Tomography, Spiral Computed ; methods

BACKGROUND: Cerebrospinal fluid (CSF) has been demonstrated as a better source of circulating tumor DNA (ctDNA) than plasma for brain tumors. However, it is unclear whether whole exome sequencing (WES) is qualified for detection of ctDNA in CSF. The aim of this study was to determine if assessment of ctDNA in CSF by WES is a feasible approach to detect genomic alterations of glioblastoma. METHODS: CSFs of ten glioblastoma patients were collected pre-operatively at the Department of Neurosurgery, Sun Yat-sen University Cancer Center. ctDNA in CSF and genome DNA in the resected tumor were extracted and subjected to WES. The identified glioblastoma-associated mutations from ctDNA in CSF and genome DNA in the resected tumor were compared. RESULTS: Due to the ctDNA in CSF was unqualified for exome sequencing for one patient, nine patients were included into the final analysis. More glioblastoma-associated mutations tended to be detected in CSF compared with the corresponding tumor tissue samples (3.56 ± 0.75 vs. 2.22 ± 0.32, P = 0.097), while the statistical significance was limited by the small sample size. The average mutation frequencies were similar in CSF and tumor tissue samples (74.1% ± 6.0% vs. 73.8% ± 6.0%, P = 0.924). The R132H mutation of isocitrate dehydrogenase 1 and the G34V mutation of H3 histone, family 3A (H3F3A) which had been reported in the pathological diagnoses were also detected from ctDNA in CSF by WES. Patients who received temozolomide chemotherapy previously or those whose tumor involved subventricular zone tended to harbor more mutations in their CSF. CONCLUSION Assessment of ctDNA in CSF by WES is a feasible approach to detect genomic alterations of glioblastoma, which may provide useful information for the decision of treatment strategy.

OBJECTIVE: To derive the Chinese medicine (CM) syndrome classification and subgroup syndrome characteristics of ischemic stroke patients. METHODS: By extracting the CM clinical electronic medical records (EMRs) of 7,170 hospitalized patients with ischemic stroke from 2016 to 2018 at Weifang Hospital of Traditional Chinese Medicine, Shandong Province, China, a patient similarity network (PSN) was constructed based on the symptomatic phenotype of the patients. Thereafter the efficient community detection method BGLL was used to identify subgroups of patients. Finally, subgroups with a large number of cases were selected to analyze the specific manifestations of clinical symptoms and CM syndromes in each subgroup. RESULTS: Seven main subgroups of patients with specific symptom characteristics were identified, including M3, M2, M1, M5, M0, M29 and M4. M3 and M0 subgroups had prominent posterior circulatory symptoms, while M3 was associated with autonomic disorders, and M4 manifested as anxiety; M2 and M4 had motor and motor coordination disorders; M1 had sensory disorders; M5 had more obvious lung infections; M29 had a disorder of consciousness. The specificity of CM syndromes of each subgroup was as follows. M3, M2, M1, M0, M29 and M4 all had the same syndrome as wind phlegm pattern; M3 and M0 both showed hyperactivity of Gan (Liver) yang pattern; M2 and M29 had similar syndromes, which corresponded to intertwined phlegm and blood stasis pattern and phlegm-stasis obstructing meridians pattern, respectively. The manifestations of CM syndromes often appeared in a combination of 2 or more syndrome elements. The most common combination of these 7 subgroups was wind-phlegm. The 7 subgroups of CM syndrome elements were specifically manifested as pathogenic wind, pathogenic phlegm, and deficiency pathogens. CONCLUSIONS There were 7 main symptom similarity-based subgroups in ischemic stroke patients, and their specific characteristics were obvious. The main syndromes were wind phlegm pattern and hyperactivity of Gan yang pattern.
Humans ; Syndrome ; Ischemic Stroke ; Medicine, Chinese Traditional ; Liver ; Phenotype