Objective To evaluate the efficacy of fascia iliaca compartment block with dexmedetomidine combined with ropivacaine for analgesia in the patients suffering from proximal femoral fractures.Methods Eighty emergency patients with proximal femoral fractures,aged 25-70yr,weighing 55-82 kg,of ASA physical status Ⅰ-[Ⅲ,were equally and randomly divided into 2 groups using a random number table:ropivacaine group (group R) and dexmedetomidine mixed with ropivacaine group (group DR).All the patients underwent fascia iliaca compartment block described by Dalens.0.4％ ropivacaine 30 ml was injected in group R,and 1 μg/kg dexmedetomidine 30 ml containing 0.4 ％ ropivacaine was injected in group DR.The severity of pain was assessed by VAS scores,and the level of sedation was assessed by Ramsay scores.At 30,60,90 and 120 min after injection (T1-4),VAS scores at rest and during activity were recorded,the effective analgesia (VAS scores at rest and during activity≤6) and satisfactory sedation (Ramsay scores 2-4) in group DR were also recorded,and the development of hemorrhage or hematoma at the puncture site,local anesthetic poisoning,adverse cardiovascular events and over-sedation was also recorded.Results Compared with group R,the rate of effective analgesia during activity was significantly increased at T2-4,and no significant change was found in the rate of effective analgesia at rest in group DR.In group DR,the rate of satisfactory sedation was 73 ％,88％,95％ and 95％ at T1-4,respectively,and no over-sedation occurred.No patients developed hemorrhage or hematoma at the puncture site,or local anesthetic poisoning in the two groups.Conclusion Fascia iliaca compartment block with 1 μg/kg dexmedetomidine combined with 4％ ropivacaine 30 ml can alleviate the early pain caused by passive activity without inducing obvious adverse reactions in the patients suffering from proximal femoral fractures.

OBJECTIVETo assess the expression of HER-2 and leptin in gastric cancer and evaluate their relationship with VEGF expression and clinicopathological features, and their prognostic value for gastric cancer patients.

METHODSOne hundred and ten gastric cancer specimens and the corresponding metastatic lymph nodes were detected for HER-2 by immunohistochemistry (IHC). All primary cancer tissues were detected for leptin, OB-Rb and VEGF. Ninty-six specimens of normal gastric mucosa served as the control.

RESULTSThe expression level of HER-2, leptin and OB-Rb in gastric cancer tissues were significantly higher than those in normal tissues (19.1% vs. 8.0%, 49.1% vs. 34.0%, and 60.9% vs. 46.0%, P < 0.05). HER-2 overexpression was moderately homogenous in primary gastric cancer and matastatic lymph nodes (P = 0.607, Kappa = 0.581). There was a correlation between the expression of HER-2 and leptin, both of which were significantly correlated with tumor invasion depth, metastatic lymph nodes ratio (NR), distal metastasis, TNM stage and VEGF expression. However, there was no significant correlation between OB-Rb expression and the clinicopathological features evaluated. Cox regression multivariate analysis showed that tumor size, histological grade, NR, stage, chemotherapy and HER-2 expression were independent prognostic factors.

CONCLUSIONSHER-2 is stably expressed in primary gastric cancer and metastatic lymph nodes. HER-2 and leptin play an important role in the progression and angiogenesis of gastric cancer. High expression of HER-2 is a prognostic factor for poor outcome.

Adenocarcinoma ; drug therapy ; metabolism ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Leptin ; metabolism ; Lymph Nodes ; metabolism ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Proportional Hazards Models ; Receptor, ErbB-2 ; metabolism ; Receptors, Leptin ; metabolism ; Stomach Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Survival Rate ; Tumor Burden ; Vascular Endothelial Growth Factor A ; metabolism

Objective:To investigate the inhibitory effect of in vivo non-targeting transfection of recombinant fibronectin polypeptide CH50 against tumors and to study the related mechanisms.Methods:After inoculated with tumor cells, BALB/c mice were injected with CH50 plasmids,control plasmids,and normal saline separately.The growth of the tumor was observed;the expression of genes (such as B7-1,B7-H1 etc.) in tumor tissues was detected by RT-PCR;and the count of T lymphocytes in local tumor tissues was analyzed by flow cytometry.Results:The tumor growth was obviously suppressed by in vivo CH50 expression.The expression of genes (B7-1 and B7-H1) was up-regulated along with the growth of tumor.CH50 increased the ratios of B7-1/B7-H1 and B7-1/B7-DC and suppressed the up-regulation of IL-10 and TGF-?genes.The direct action of CH50 on H22 cells resulted in the down-regulatoin of TGF-?gene.The count of T lymphoeytes in tumor tissues of CH50 treatment group was significantly higher than that in other groups.Conclusion:Ex- pression of CH50 by non-targeting transfection can effectively inhibit the growth of tumor;the regulation of the immuno- regulatory genes in tumor mieroenvironment is an important part of the treatment mechanism of CH50.

Adrenalectomy ; methods ; Adult ; Aged ; Female ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged

Objective To study phylogenies, epidemiology and genetic environment of CTX-M type of ESBLs produced by Escherichia coli and Klebsiella pneumoniae isolated from nine hospitals in Guangzhou. Methods The phylogenies of CTX-M type of ESBLs were analyzed by PCR Genetic environment of CTX-M-15 encoding gene (bla_(CTX-M-15)) were investigated by conjugation test and plasmid analysis. The clonal relationship of strains producing CTX-M-15 was determined by enterobacterial repetitive intergenic consensus PCR (ERIC-PCR). Results A total of 361 ESBLs-producing isolates of Escherichia coli and Klebsiella pneumoniae were collected. 67.3% of ESBLs strains were detected to produce CTX-M-type ESBLs, and the commonest genotypes in Escherichia coli and Klebsiella pneumoniae were CTX-M-14 (35.4% and 28.3%), CTX-M-15(21.5% and 26.1%) EBIC-PCR products of all CTX-M-15-producing strains show 39 strains of Escherichia coli were classified into 27 genotypes while 43 strains of Klebsiella pneumoniae were divided into 30 genotypes. Furthermore, the genotypes of CTX-M-55, CTX-M-19, CTX-M-27, with ceftazidime-hydrelyzing activity, were detected in this study. The great majority of bla_(CTX-M-15) genes were found to locate on a 65 000 bp-conjugative plasmid, and there was no blaTEM-1, bla_(OXA-1), blaDSA-1 or aac (6')-Ib-cr gene coexisted on the plasmid, ISEcp1-like insertion sequences, relative to mobilization of bla_(CTX-M-15) gene, were detected in all bla_(CTX-M-15) positive strains, and the distances between the end of ISEcp1-like insertion sequences and the start cedon of bla_(CTX-M-15) were equal, with 48 base pairs. Conclusion CTX-M-14 is still the most common genotype of ESBLs in Guangzhou, but high prevalence of CTX-M-15 ESBLs hydrolyzing ceftazidime already appears in south China.

ObjectiveTo search for a new method of anti-tumor immunity,using mutated tumor cells by spaceflight.MethodsTumor cells were carried in the Shenzhou 4 and the recoverable satellite No.18.After 7 days and 18 days spaceflight respectively,the effects of spaceflight were investigated primarily.Results2382 and 1 strains of mutated tumor cells from the airship No.4 and the recoverable satellite No.18 had been obtained respectively. Comparing with the control group, the growth rate of mutated cells decreased, moreover, the secretion of cytokines also changed.ConclusionSpaceflight may affect physiological characteristics of tumor cells, and that, there was a negative correlation between the ratio of surviving cells and carrying time.

OBJECTIVEThe study investigate the antioxidant probucol on endothelial function in patients with acute coronary syndrome (ACS).

METHODSA total of 49 ACS patients randomly received standard therapy plus probucol (P, n = 24) or standard therapy (C, n = 25). Plasma oxidized low-density lipoprotein (ox-LDL), nitric oxide (NO) and circulating endothelial cells (CEC) were measured. The brachial arterial hyperemia-induced flow mediated dilation (FMD) and sublingual nitroglycerin (NTG) mediated vasodilatations were measured by high resolution ultrasound. These variables were analyzed before and after 3 months therapy.

RESULTSPlasma NO and FMD was significantly increased after 3 months therapy than before therapy [(80.46 +/- 10.24) micromol/Lvs (48.46 +/- 12.24) micromol/L, P < 0.01; (13.46 +/- 1.20)% vs (7.45 +/- 1.02)%, P < 0.05, respectively], while the number of CEC and ox-LDL were significantly decreased (P < 0.01) in P group. These values were similar before and after 3 months in C group. The linear correlation analysis showed that plasma ox-LDL negatively correlated with NO (r = -0.574, P < 0.01) and FMD (r = -0.517, P < 0.01) and positively correlated with CEC (r = 0.385, P < 0.01) in patients received 3 months probucol therapy.

CONCLUSIONSChronic antioxidant probucol therapy could improve endothelial function in patients with ACS.

Adult ; Aged ; Angina, Unstable ; blood ; drug therapy ; Anticholesteremic Agents ; therapeutic use ; Endothelial Cells ; drug effects ; physiology ; Endothelium, Vascular ; drug effects ; physiopathology ; Female ; Humans ; Lipoproteins, LDL ; blood ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; physiopathology ; Nitric Oxide ; blood ; Probucol ; therapeutic use

OBJECTIVETo investigate the expressions of RhoC and osteopontin (OPN) protein in esophageal squamous carcinoma (ESC) and their association with the biological behavior of ESC.

METHODSThe expressions of RhoC and OPN protein were detected in 80 ESC cases by immunohistochemistry.

RESULTSThe positive expression rate of RhoC was 66.25% in these ESC cases. The rate was significantly higher in cases with lymph node metastasis than in those without (r(s)=-2.115, P<0.05), but RhoC expression was not associated with the tumor diameter, differentiation or TNM grade (P>0.05). The RhoC-positive patients had significantly shorter survival time than the negative patients (P<0.001). All the 80 ESC patients were positive for OPN expression, and OPN expression levels were correlated with the differentiation (chi(2)=10.766, P<0.05) and lymph node metastasis of the tumor (r(s)=-2.289, P<0.05), but not with the tumor diameter or TNM grade (P>0.05). Higher expression level of OPN was closely related to shorter survival time of the patients (P<0.05). A positive correlation was found between RhoC protein and OPN expressions (r(s)= 0.408, P<0.001) in these cases.

CONCLUSIONThe expressions of RhoC and OPN protein are closely related to lymph node metastasis of ESC and the patients survival time, and therefore may serve the purpose of prognostic evaluation of ESC.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; biosynthesis ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Esophageal Neoplasms ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Osteopontin ; biosynthesis ; Prognosis ; Survival Analysis ; rho GTP-Binding Proteins ; biosynthesis ; rhoC GTP-Binding Protein

OBJECTIVETo evaluate the feasibility and efficacy of intraperitoneal chemotherapy for malignant ascites caused by different types of abdominal cancers guided by chemo-sensitivity methyl tetrojolium coloremetric (MTT) assay in vitro.

METHODSCancer cells in the malignant ascites were collected for MTT assay to determine the chemo-sensitivity. The drug producing the highest or the second highest inhibition rate was selected for intraperitoneal chemotherapy. The correlation between the results of MTT assay and the response of malignant ascites, the clinical features, Karnofsky performance score (KPS) and prognosis were analyzed.

RESULTSMTT assay indicated that Taxotere (TXT) and Hydroxycamptothecin (HCPT) were the most effective to cancer cells in malignant ascites, and HCPT was mostly frequently used for intraperitoneal chemotherapy (56.9%). Twenty-four patients showed response by intraperitoneal chemotherapy (complete response: 7; partial response: 17) with a slightly significant correlation between the results of MTT assay and response of malignant ascites (P = 0. 014). The KPS of the responders was improved significantly (P < 0.001), and the response of malignant ascites to intraperitoneal chemotherapy was demostrated as an independent prognostic factor by multi-variate analysis in this series.

CONCLUSIONIn vitro chemo-sensitivity MTT assay guided intraperitoneal chemotherapy for malignant ascites is simple, effective and safe, which can improve the KPS and prognosis of the responders.

Adenocarcinoma ; drug therapy ; pathology ; Adult ; Aged ; Antineoplastic Agents ; administration & dosage ; pharmacology ; therapeutic use ; Antineoplastic Agents, Phytogenic ; administration & dosage ; pharmacology ; therapeutic use ; Ascites ; drug therapy ; pathology ; Camptothecin ; administration & dosage ; analogs & derivatives ; pharmacology ; therapeutic use ; Cell Survival ; drug effects ; Colorectal Neoplasms ; drug therapy ; pathology ; Female ; Humans ; Injections, Intraperitoneal ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pancreatic Neoplasms ; drug therapy ; pathology ; Stomach Neoplasms ; drug therapy ; pathology ; Taxoids ; administration & dosage ; pharmacology ; therapeutic use ; Tumor Cells, Cultured

BACKGROUNDAngioplasty in the unprotected left main coronary artery (LMCA) has been controversial. This study aims to evaluate the safety and clinical effectiveness of stenting, including bare metal stent and drug eluting stent (DES), for treatment of unprotected LMCA disease.

METHODSBetween September 1997 and December 2005, a total of 297 consecutive patients underwent percutanous coronary intervention (PCI) on LMCA lesions in our hospital. Their in-hospital data and clinical follow-up outcomes were analyzed and those in pre-DES "era" (group I, from September 1997 to December 2002) were compared with those in DES "era" (group II, from January 2003 to December 2004. Patients in 2005 for the time of follow-up less than one year were not included in this group).

RESULTSAltogether 368 coronary stents were successfully deployed in 295 patients. Stents failed to be implanted after balloon predilation in two patients, who received coronary artery bypass graft (CABG) successfully. Bifurcation techniques for distal LMCA executed in 206 patients (69.4%, 206/297), included crossover stenting in 156 (75.7%), T stenting in 4 (1.9%), provisional T stenting in 28 (13.6%), kissing stenting in 5 (2.4%) and stent crushing in 13 (6.3%) patients. During their hospital stay, 5 (1.7%) patients died after PCI procedure, of which 4 died from cardiac origin and one of renal failure. The total in-hospital major adverse cardiac events (MACE) were 2.0% (6/297). In the follow-up period, 19 patients (6.5%) died [15 (5.1%) of cardiac death and 4 of non-fatal myocardial infarction (MI)]. Besides, 2 (0.7%) developed subacute thrombosis (SAT) and 16 (5.4%) performed target lesion revascularization (TLR). The total follow-up MACE was 14.5% (43/297). Further analysis also showed that, compared with patients in group I, those in group II apparently had more multi-vessel involvement (14.7% vs 81.9%, P < 0.001), and more bifurcation lesions (32.4% vs 72.2%, P < 0.001). After PCI, in-hospital MACE of group II was significantly lower than that in group I (1.1% vs 9.4%, P < 0.05). And the incidences of MACE, TLR and angiographic restenosis in group II were all significantly lower than those in group I (all P < 0.05) after one year follow-up.

CONCLUSIONSAs new PCI strategies and intervention devices such as DES are developed, coronary stenting, which might have brought better in-hospital and long-term outcomes than CABG, are proved to be technically successful and can be safely applied for the treatment of LMCA lesions in the experienced center for coronary intervention.

Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; Coronary Angiography ; Coronary Disease ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents